The Department of Veterans Affairs (VA) managed to dodge a clinical mistake that cost health insurance plans an estimated $130 million in the first years of the COVID-19 pandemic.
Just how the VA pulled this off remains somewhat of a mystery, according to a research letter published Wednesday in JAMA Network Open.
Researchers at the University of Michigan compared prescribing patterns for ivermectin by the VA and at retail pharmacies across the U.S., finding a wide gap both in the number of prescriptions filled and the cost to fill them. From June 2019 until February 2022, data collected from the VA’s Corporate Data Warehouse indicate that VA pharmacies approved 7,434 prescriptions for the medication, while retail pharmacies across the U.S. filled 2,362,572 ivermectin prescriptions.
Some considered ivermectin a miracle drug that could cure COVID-19, but, thanks to experts’ warnings, the public was eventually disabused of that notion.
What did the VA do that commercial payers didn’t?
That’s what the study’s authors want to know, as well, saying that perhaps the VA formulary oversight worked better or that “inappropriate demand for ivermectin increased less among veterans compared with nonveterans. Distinguishing between these possibilities could inform the design of interventions to decrease future provision of low-value care for COVID-19 and other conditions.”
Nora Becker, M.D., is a professor in the Department of Internal Medicine at the University of Michigan and the study’s corresponding author. She told Fierce Healthcare that the “big question here, of course, is why, and the answer is we don’t know yet. Perhaps VA physicians prescribed much less of it? Perhaps VA patients asked for it less? An important note here is also that VA patients can see other providers, so it’s also possible that VA patients did get ivermectin prescriptions, just not at the VA.”
Fierce Healthcare reached out to the VA but had not heard back at the time of publication.
For its part, the FDA never wavered during the ivermectin fad, spelling out that some formulations of ivermectin “are approved in the U.S. to treat or prevent parasites in animals. For humans, ivermectin tablets are approved at very specific doses to treat some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea.”
Medication watchdogs in other countries apparently let their guard down and recommended ivermectin for humans to fight COVID-19 thanks to about two dozen studies, which were later proven to be flawed.
Nonetheless, many countries jumped on the “ivermectin is a miracle drug" bandwagon, including most of Latin America.
Becker said that she and co-authors did find a slight uptick in ivermectin prescriptions at VA pharmacies, but that ended when the VA slapped a formulary restriction on the medication.
“We decided to do the study because in our prior study, we’d seen the rise in ivermectin prescriptions nationwide, and we knew that in September 2021 the VA had instituted a policy where pharmacists reviewed ivermectin prescriptions to ensure they were not being prescribed for COVID-19,” Becker told Fierce Healthcare. “We were interested in seeing the outcome of that policy and whether it reduced rates of ivermectin prescriptions.”