Ivermectin Rx for COVID-19: Insurance Coverage Does Not Match Evidence

New study results suggest that doctors continue to prescribe ivermectin and health insurers are heavily subsidizing the cost of those prescriptions, even though clinical trials have not shown that the drug effectively treats COVID-19.

The study’s authors are calling for insurers to align their coverage of the drug with the level of medical evidence surrounding it, just like they do for other medications, procedures, and tests.

The study, results of which were published in JAMA by a team from Boston University and the University of Michigan, use insurance data to study how much health plans paid for oral ivermectin in late 2020 and early 2021. They found that plans paid 61% to 74% of the cost, or approximately $36 to $39 per prescription.

As a result of this coverage, the investigators estimate that US Medicare and private plans may have paid $2.4 million for ivermectin prescriptions for COVID-19 in the week of August 13, 2021, alone.

If prescribing and insurance reimbursement were at that level for an entire year, insurers would spend nearly $130 million in a year on the drug, despite a lack of evidence that it works, investigators said.

“Insurers usually don’t cover ineffective treatments, or at least make patients pay for most of the cost,” Kao-Ping Chua, MD, PhD, the health care investigator from the University of Michigan who led the study, said in a statement. “Our study suggests that they are treating ivermectin prescriptions for COVID-19 differently. In doing so, they are reducing barriers to an ineffective drug that some are using as a substitute for COVID-19 vaccination or evidence-based treatments.”.

Unless strong new evidence comes to light, insurers should require doctors to justify prescribing ivermectin during the pandemic by filling out prior authorization forms, investigators said.

Although they acknowledge that this could make it harder for individuals to get ivermectin for its FDA-approved indication, they think that the number of these individuals would be low, pointing to the results of a CDC study showing that only approximately 3600 ivermectin prescriptions were filled each week in the United States prior to the pandemic.

“To be clear, clinicians may still prescribe ivermectin for COVID-19 and patients can choose to pay for these prescriptions themselves. Our point is simply that insurers shouldn’t cover these prescriptions unless ivermectin proves to be an effective COVID-19 treatment,” Chua, a pediatrician at Michigan Medicine’s C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center, said in the statement.

The FDA and World Health Organization have both said that oral ivermectin should not be used for COVID-19 purposes, except in clinical studies.

Using Medicare Advantage and private insurance claims from December 2020 through the end of March 2021, investigators identified and examined 5600 prescriptions for oral ivermectin that were not written for a parasitic infection, the main reason that the drug is prescribed other than COVID-19.

The total cost per prescription was $52 for Medicare Advantage plans, which paid approximately 74% of this amount, or about $39. The total cost per prescription was approximately $58 for private plans, where the plan paid for approximately 61%, or $36.

The rest of the cost was paid by the individual.

The investigators then estimated that all but 3600 of the 88,000 ivermectin prescriptions filled in the week of August 13, 2021, were for COVID-19. Assuming that the study’s results generalized to these prescriptions, they estimated that Medicare and private plans paid $2.4 million for the prescriptions during that week alone.

Reference

Ivermectin Rx for COVID-19: Insurance coverage doesn’t match evidence. EurekAlert. News release. January 14, 2022. Accessed January 17, 2022. https://www.eurekalert.org/news-releases/940273