Our pharmacists speak out on the use of hydroxychloroquine as an emerging treatment option and appropriate clinical guidance during the coronavirus (COVID-19) outbreak

During the past several weeks, our pharmacy program team has been working to ensure that our clients’ injured and ill workers continue to receive the necessary and appropriate medications during this time of crisis. One area that we have been monitoring is the increased interest in the medications chloroquine (Aralen) and hydroxychloroquine (Plaquenil) for the treatment of COVID-19. These two older medications are typically used to treat malaria or autoimmune conditions like lupus and are rarely utilized within the scope of workers’ compensation.

Effectiveness

Regarding the effectiveness of these medications in treating COVID-19, the current clinical picture is not clear and anecdotal at best. More studies are needed with more participants to better determine true effectiveness.

Safety concerns and side effects

Safety concerns remain the biggest reason for pause when considering chloroquine and hydroxychloroquine for the treatment of COVID-19. These medications have been shown to interact with a large number of other medications, which can lead to serious and life-threatening side effects. They are known to cause serious heart rhythm issues, as well as pose risks by causing low blood sugar that can lead to loss of consciousness. Both medications have also been shown to cause severe and irreversible visual impairment, even when prescribed for a short period of time. Overall, these medications are not typically prescribed without very close monitoring by a physician.

Regulatory groups in multiple states have received allegations of providers inappropriately prescribing hydroxychloroquine or chloroquine to themselves, family, friends and/or coworkers without a legitimate medical purpose. The departments of licensing further require that prescribing any kind of prescription must also be associated with medical documentation showing proof of the medical necessity and medical condition for which the patient is being treated. 

Next steps

As we see claims for COVID-19 at Sedgwick, we are working carefully to navigate the treatment options. Our pharmacy utilization review team is giving these cases specialized consideration and reviewing all requests for hydroxychloroquine or chloroquine as a matter of safety. As further studies are performed across the globe, we will continue to monitor the science and clinical literature for these medications and any other potential drug treatment options and update our process as needed.

While finding the right treatment for this virus is critical, we’re also steadfast in our determination to ensure the safety of injured workers is at the forefront of all decisions. If you have questions, please share them in the comments section here. Continue to watch our coronavirus news feed for additional guidance – and stay well.