JointHealth™ express   April 2, 2020

COVID-19 and hydroxychloroquine supply: What patients need to know

Patients living with types of inflammatory arthritis (e.g. rheumatoid arthritis, lupus and Sjogren’s disease) in Canada and across the world who take hydroxychloroquine (HCQ) are facing medication shortages. Providers such as rheumatologists and pharmacists who care for these patients are trying to make sense of varying policy recommendations for prescribing and allocation of HCQ.

The problem: Shortages of hydroxychloroquine

Inflammatory arthritis patients have concerns around the 30-day supply issue. Many patients are used to receiving a 90-day supply of their medications for their disease.

However, these are not ordinary times. Many inflammatory arthritis patients have been unable to fill their prescriptions for hydroxychloroquine. Professionals around the world are working day and night in an attempt to ensure an adequate supply of hydroxychloroquine for all patients, including those with rheumatologic conditions. Companies that supply hydroxychloroquine have indicated that they are ramping up production of this drug to help mitigate shortages.

Why the shortage?

Experiments (in cultured cells, not in humans) suggest that hydroxychloroquine has activity against the virus that causes COVID-19. The widely publicized paper describing the use of hydroxychloroquine in COVID-19 patients was very small and had serious design flaws, and so it is impossible to draw any conclusions from that study about the effectiveness of hydroxychloroquine in people. We are waiting for better studies in COVID-19 patients to be completed. In light of the tremendous and urgent need for treatment for COVID-19, it is important to test hydroxychloroquine in COVID-19 patients, particularly in the context of controlled clinical trials run by experts.

What the experts in Canada are saying

The Canadian Rheumatologist Association (CRA) has prepared a position statement on COVID-19 and the HCQ supply and is regularly updating a frequently asked questions document that provides additional context and addresses various nuances. Click here to read the COVID-19 and HCQ Supply FAQ document.

What should patients do?

If you have any questions, you should monitor the updates on Provincial Health Ministry as well as the CRA and ACE websites. If you have experienced difficulties filling your prescription, you should contact your rheumatologist.