Commercial and Medicare Advantage insurers are spending an estimated $129.7 million annually on ivermectin prescriptions for COVID-19, even though the antiparasitic drug has not been shown to be effective against the virus, according to a new JAMA study.
The researchers analyzed a sample of a prescription drug database covering the period from December 1, 2020, through March 31, 2021. Ivermectin prescriptions for COVID-19 surged in the United States at the end of 2020, according to the paper.
The investigators identified oral ivermectin prescriptions dispensed during the study period, excluding those for patients who lacked continuous enrollment or who had a diagnosis code for a parasitic infection during the week before the prescription. The researchers assumed the remaining prescriptions were for COVID-19.
Of the 5939 ivermectin prescriptions written in this sample, 348 (5.9%) were excluded. Of the remaining 5591 prescriptions, 4700 (84.1%) were for privately insured patients. The mean age of those patients was 51.8 years.
Mean out-of-pocket spending on the ivermectin prescriptions was $22.48 for privately insured patients and $13.78 for Medicare Advantage patients. Mean insurer reimbursement was $35.75 and $39.13, respectively. Aggregate total spending was $273,681 for privately insured patients and $47,143 for Medicare Advantage patients, of which insurer reimbursement represented 61.4% and 74%, respectively.
To assess the potential magnitude of US insurer spending on ivermectin prescriptions for COVID-19, the authors estimated private and Medicare plan spending on these prescriptions during the week of August 13, 2021, the most recent week for which dispensing data were available. They used their analysis of the earlier sample to inform those estimates.
The researchers assumed that all 88,000 ivermectin prescriptions dispensed in that week were for COVID-19, except for 3600, the average weekly dispensing total in the 12 months before the pandemic.
They also assumed that 52% (43,888) and 28% (23,632) of the remaining 84,400 prescriptions were paid by private and Medicare plans, reflecting the overall distribution of payer type for US prescriptions.
In the week of August 13, 2021, private and Medicare plans paid an estimated $1,568,996 and $924,720, respectively, for ivermectin prescriptions for COVID-19, the study shows. Multiplying those amounts by 52 weeks yielded an estimated total annual payment of $129,673,240.
The authors noted that this wasteful spending exceeds the estimated annual Medicare spending on unnecessary imaging for low back pain. The amount of waste, they said, is even higher because their estimates don’t include Medicaid spending.
And, by encouraging some people not to get vaccinated, they maintained, the unwarranted ivermectin prescriptions probably resulted in additional COVID-19 cases that would have increased insurance costs.
The researchers suggest that insurance companies restrict ivermectin coverage by requiring prior authorization of the drug. These restrictions could reduce wasteful spending, they noted, while impacting only a small number of patients who had conditions for which the drug is indicated.