Prescriptions from doctors who had never written one before, up eightyfold

Hydroxychloroquine and chloroquine treat autoimmune disease and malaria.
Before 2020, **primary care providers and the specialists who routinely
prescribe them — rheumatologists, dermatologists — wrote about 97% of new
prescriptions.**

Then, in early March 2020, they received national attention as a possible
COVID-19 treatment.

In one month, from a rounding error to seventy-five thousand.

What the rest of that month looked like

The prescribing surge preceded the authorisation and outlasted the withdrawal.

Why this is a supply problem as well as a safety one

The people who take hydroxychloroquine continuously are people with **lupus and
rheumatoid arthritis**, for whom it is not optional. Every prescription written
outside its indication competes for the same manufactured supply.

So the recommendation has two halves, and the second is the one usually left
out:

**Continued adherence to current clinical guidelines for the indicated use of
these medications will ensure their availability and benefit to patients for
whom their use is indicated** — because **the potential benefits of these
drugs do not appear to outweigh their risks** for COVID-19.

**Attention to updated clinical guidance, especially by non-routine
prescribers**, is where the report puts the emphasis. A rheumatologist follows
the evidence on a drug they use every week. A specialist writing their first
prescription for it, during a news cycle, has no such habit.

Dispensing trends were returning to pre-pandemic levels by the time this was
published.

*(Data: IQVIA National Prescription Audit, covering about 92% of US outpatient
retail prescriptions. Hydroxychloroquine was roughly 99% of the prescriptions
in the study period.)*

Source: Centers for Disease Control and Prevention, MMWR.