Marked Growth in Ivermectin, Zinc & Dexamethasone Retail Dispensing in United States During Pandemic

Marked Growth in Ivermectin, Zinc & Dexamethasone Retail Dispensing in United States During Pandemic

Researchers from what is known as the United States Centers for Disease Control and Prevention (CDC) COVID-19 Response Team based in Atlanta, Georgia, sought out to answer the question whether outpatient retail dispensing frequency of various treatments for COVID-19 grew in volume since the onset of the pandemic denoted by the declaration of a national emergency on March 13, 2020. Using the IQVIA National Prescription Audit Weekly nationally prescription data taken from U.S. retail pharmacies covering 17 potential COVID-19 treatments as identified by the National institutes of Health COVID-19 Treatment Guidelines, as well as the American Society of Health-System Pharmacists Assessment of Evidence for COVID-19 Related Treatments, the authors found some interesting trends. For example, coinciding with what many perceived as hype around hydroxychloroquine dispensing of that drug peaked during March 20, 2020. While few correlated ivermectin with COVID-19 after the University of Monash lab findings in April, various small studies commenced primarily in low to middle income countries (LMICs), which led to growing demand in the U.S. peaking initially during the week of July 24 and again spiking during the second cold season wave through December 18, the cut-off point of this study. Zinc-based dispensing peaked both at the end of April 10 and August 7, rising again during the second cold season wave by December 11th. Dexamethasone increased 50% over the baseline pre-pandemic amounts through December 18. The net takeaway here is that while physicians stopped prescribing hydroxychloroquine, the use of ivermectin, zinc and dexamethasone has increased.

The results of this interesting study, funded by the CDC, are found in JAMA Internal Medicine.

Ivermectin Prescription Growth

Of interest, while the National Institutes of Health COVID-19 Treatment Guidelines Panel didn’t recommend ivermectin for COVID-19 clinical care, (only for research), they changed their position after learning of a number of clinical trials associated with that drug used to treat parasitic-based conditions to not recommend for nor against till further data materializes.  The growth of ivermectin dispensing, along with zinc and dexamethasone for the treatment of SARS-CoV-2 infection, the virus behind COVID-19 coincided with the increase in actual coronavirus cases starting in July and again in the fall continuing into December.

Lead Research/Investigator

Andrew I. Geller, MD, Medical Officer

Maribeth C. Lovegrove, MPH

Jennifer N Lind, PharmD, MPH

S. Deblina Datta, MD

Daniel S. Budnitz, MD, MPH

Responses

  1. Interesting study, but not a good indicator of Ivermectin use by individuals looking to their own health. Ivermectin, like hydroxychloroquine, is available in pill form only by prescription and therefore incurs an unwarranted price increase over the cost of the medications available in other forms. The expense of a doctor visit as well as the delay in starting the treatment and the inflated cost of prescription medications are to some degree dodged by folks with a livestock raising background. Ivermectin is a widely used anti-parasite medication sold for livestock and pet treatment. A widely used form of Ivermectin sold under several brand names formulated at 1% Ivermectin, 40% glycerol and the balance propylene glycol and intended as an injection for cattle and pigs has long been used as an oral treatment by dog owners to prevent heart worms and other parasites. The formulation delivers 200 mcg per kg when used according the directions. That is one ml of the formulation per 110 lbs. body weight for cattle. That makes calculating a dose for men or dogs a simple procedure. All the ingredients in this medication are approved for human use. A single oral dose at 200 mcg per kg for a 180 pound man can cost as little as 35 cents.
    With this knowledge many people with livestock experience self medicate and share their knowledge with friends. In my limited experience, I know of five senior people who tested positive for Covid-19 and manifested symptoms and who had all symptoms disappear within a day or two of taking a single dose. Soon after a follow-up virus test showed them to be clear of the virus. Many more than that take it as a prophylactic. In order to discover a close estimate of Ivermectin use among the public, one would need to find the increase in agricultural sales of Ivermectin. That, however would not yield a close estimate of the number of people using it since there is no way of knowing how many people share a bottle of the product. The number of people who have benefited and continue to benefit from the availability of the medication intended for livestock cannot be known. Nor can it be known to what degree this off label use has impacted the number of infections. Governing agencies have tried to limit our access to this life saving medication and citizens who follow the news of successful trials of Ivermectin take their health into their own hands.
    It is past time to make Ivermectin available as an over-the-counter medication in the way aspirin, acetaminophen, Ibuprofen, and a host of other useful medications are sold. One should ponder the relationship between the manifest international and national race toward consolidation of political power and the widespread denial of the usefulness of inexpensive prevention and treatment of Covid-19 and very likely a host of other viral diseases.