Industry Trend Report Shows COVID-19 Impact on Pharmacy Claims, Community Pharmacy Access

Pharmacy utilization, patterns of utilization among hypothesized treatments for COVID-19, and medication utilization patterns were all impacted by the pandemic.

The 2021 Industry Trend Report in Pharmacy Quality sponsored by Pharmacy Quality Solutions (PQS) focuses on COVID-19’s impact on pharmacy claims and community pharmacy access during 2020. This report tracks prescription trends from the announcement of the COVID-19 public health emergency (PHE) through the remainder of the year and highlights associated mitigation approaches that may have impacted pharmacy and medication utilization patterns.

The 3-section report covers changes in pharmacy utilization, patterns of utilization among hypothesized treatments for COVID-19, and medication utilization patterns impacted by COVID-19.

“2020 was a unique year and we needed to approach this year’s trend report differently as it’s based on 2020 measurement data,” said PQS COO Nancy Chung. “Rather than directly comparing year to year data, this analysis evaluates the change in weekly prescription claims volume, from baseline, based on date of service and number of claims for 2020. We’ve included the same trend analysis for 2019 for comparison. We hope that this report serves as a reference for how the pandemic impacted medication utilization.”

One notable chart from the Industry Trend Report highlights the change in all claims for pharmacy utilization. The graph below shows an increased pharmacy utilization for all prescription claims, starting at week 9 and reaching a peak at week 12, when the public health emergency was declared.

There is a significant decrease after week 12, with utilization dropping precipitously to levels well below the prior year of 2019. Pharmacy utilization was also low in fall 2020, which may have been due to the resurgence of COVID-19.

An excellent example of abnormal utilization of hypothesized treatments for COVID-19 is the dramatic increase in claims for hydroxychloroquine (HCQ) in March 2020. The chart below tracks an overall increase in prescription claims for HCQ with 14 days or fewer supply for those with prior use of HCQ and those without.

The only FDA-approved indication for short courses of HCQ is to treat acute attacks of malaria, typically a very rare instance in the United States. HCQ is also used as a chronic medication for the treatment of lupus and rheumatoid arthritis.

The dramatically sharp increase in utilization of this medication with a supply of 14 days or fewer suggests that it was being pursued for a non-FDA approved indication of COVID-19 therapy. Utilization takes a sharp dip after HCQ fell out of the spotlight as a COVID-19 therapy into May 2020. But prescription claims volume for HCQ, well above normal levels, indicates ongoing use in the setting of COVID-19 despite lack of evidence and recommendations against its use for COVID-19 therapy.

Looking at medication utilization patterns impacted by COVID-19, another graph from the 2021 trend report charts the change in overall antibiotic prescription utilization.

The chart above shows that overall antibiotic prescription claims decreased near the declaration of the COVID-19 PHE and continued to remain below normal levels throughout 2020 after the declaration of the public health emergency, as compared to 2019.

This may be due to the following factors:

  • Decreased exposure to pathogens, because more Americans were spending more time at home where exposure risk is low.
  • Decreased health care utilization due to anxiety around exposure to COVID and increased recommendations.

Utilization approached normal levels to some extent during summer 2020 compared to 2019, but again was suppressed into the fall of 2020, likely corresponding with the renewed wave of COVID infections in fall of 2020.

2021 Trend Report Data: We analyzed prescription claims and other data from a subset of health plans and pharmacy benefit managers, representing total patient counts of approximately 25.4M and 27.1M, from 2019 and 2020 respectively. Prescription claims were associated with Medicare Advantage Prescription Drug Plans (MAPD) and standalone Prescription Drug Plans (PDP) lines of business.

For more pharmacy quality insights, please download the full report, the Industry Trend Report in Pharmacy Quality 2021, from the PQS website. tinyurl.com/2p868mkf

We at PQS are always looking for new ideas to analyze and explore! We value your feedback and contributions for future reports. If you’d like to share your comments with us, please send us a note at trendreport@pharmacyquality.com.

About Pharmacy Quality Solutions, Inc (PQS)

PQS is a healthcare quality improvement company, connecting healthcare payers and providers who value measurement as the pathway to better patient outcomes. Partners of PQS represent nearly 90% of all Medicare Part D lives and 95% of community pharmacies. PQS delivers the quality insights and guidance necessary to support their customers’ efforts to optimize the quality of medication management for their Medicare, Medicaid, and commercial populations. PQS’ industry-leading platform, EQUIPP®, provides standardized measurement and reporting on key medication use quality measures and value-based reimbursement programs focused on medication adherence, treatment outcomes and patient safety. For more information on how PQS can support you, please visit www.pharmacyquality.com.

For further information contact David Simoneaux at 919.767.9544 or dsimoneaux@pharmacyquality.com.