Ivermectin use has increased 24 times and insurers have covered the costs

Insurers are covering the cost of the antiparasitic drug ivermectin to treat COVID-19 despite a lack of evidence for its safety and effectiveness, according to a new study.

The Food and Drug Administration did not authorize or approve ivermectin for the treatment of COVID-19, and in fact, published several statements recommending against it. Clinical trials of ivermectin tablets for the prevention and treatment of COVID-19 are ongoing. But a study published in JAMA by a group at the University of Michigan and Boston found that oral ivermectin use rose 24-fold between December 2020 and March 2021, with insurers paying between 61% and 74% of total costs.

In evaluating claims data, the authors estimated that of the 88,000 ivermectin prescriptions filled in a single week in August 2021, approximately 4% were for an approved prescription. Before the pandemic, the Centers for Disease Control and Prevention reported that only 3,600 prescriptions for ivermectin were filled each week.

That week, insurers paid almost $2.4 million for prescriptions, according to the report. Looking at the claims data for the full year, the total would be approximately $130 million.

“Insurers usually don’t cover ineffective treatments, or at least force patients to pay most of the cost,” said Khao-Ping Chua, co-author of the study. “Our study shows that they treat ivermectin prescriptions for COVID-19 differently. In doing so, they lower barriers to an ineffective drug that some are using as a substitute for COVID-19 vaccinations or evidence-based therapies.”

Chua, a pediatrician at Children’s Hospital of Michigan Medicine, and co-author Nora Becker of Boston University have proposed requiring physicians to fill out a prior authorization form to justify prescribing an antiparasitic drug. The authors acknowledge that this would create barriers for patients who require ivermectin for FDA-approved use for the treatment of helminths, head lice and certain skin conditions, but the impact will be much less than for those receiving the drug for COVID-19.

“Our view is that insurers should not cover these prescriptions unless ivermectin has been proven effective in treating COVID-19,” Chua said.

Eric Musser, director of federal affairs for the National Committee for Quality Assurance, a nonprofit that provides accreditation and performance measures for physicians, health insurance plans and medical groups, said they “take FDA recommendations very seriously.”

“Whatever we can include in our standard of care for COVID or other conditions will be evidence-based,” he said.