With the death toll from COVID-19 now surpassing 14,000 in the U.S., President Donald Trump and some of his advisers have repeatedly touted the promise of certain anti-malarial drugs to combat the disease caused by the novel coronavirus. That enthusiasm has sparked increasing concern that the surge in demand for such drugs, hydroxychloroquine and chloroquine, is imperiling access for patients who take them to treat autoimmune conditions such as lupus and rheumatoid arthritis. To help alleviate the issue, some major PBMs tell AIS Health that they’re placing utilization management controls on off-label use of hydroxychloroquine, chloroquine and other drugs with the potential to treat COVID-19.
OptumRx, one of the country’s largest PBMs and part of UnitedHealth Group, as of March 31 is limiting prescriptions for hydroxychloroquine and chloroquine to 30 tablets within a 90-day time period, “with an automatic bypass for members utilizing for chronic conditions such as rheumatoid arthritis or systemic lupus,” Chief Medical Officer Sumit Dutta, M.D., says in comments emailed to AIS Health. Members who are newly starting on hydroxychloroquine for rheumatoid arthritis or systemic lupus will be able to request quantities beyond 30 tablets.