World Hepatitis Awareness Day: ‘Find the Missing Millions’

Every year, World Hepatitis Day (WHD) stands as an opportunity for communities of the world to come together under a single theme to raise awareness on viral hepatitis. This year, the theme is ‘Find the Missing Millions.’

Abarca calls on the healthcare community to take action and raise awareness to find the “missing millions” of people living with undiagnosed hepatitis so that they may seek the treatment and support they need. Through awareness, we can save lives through education on hepatitis’ prevention, diagnosis, and treatment options.

What is Hepatitis?

Hepatitis is inflammation of the liver, in most cases, the cause is a virus. The most common types of this virus are Hepatitis A, Hepatitis B, and Hepatitis C.

At the links above, the U.S. Centers for Disease Control and Prevention (CDC) provides comprehensive information about the differences between each type, how they are spread, as well as details on prevention and treatment.

Today, it is believed that 290 million people are living with viral hepatitis and are unaware that they have it. In America alone, nearly 2.4 million Americans are living with the hepatitis C virus, it being the country’s deadliest infectious disease. Despite this reality, many state Medicaid programs still have several discriminatory restrictions in place that keep Americans from accessing hepatitis C treatment and in turn, are preventing the country from ending the epidemic.

The National Viral Hepatitis Roundtable (NVHR), a national coalition working to eliminate viral hepatitis, and the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI), have recently acclaimed Puerto Rico for removing discriminatory restrictions on access to hepatitis C treatment that were limiting more than one million Puerto Ricans who are covered by the Medicaid program from accessing life-saving medications.

In collaborative efforts made by ASES (Puerto Rico’s Health Insurance Administration), Abbvie (a research-driven biopharmaceutical company), and Abarca Health, these discriminatory barriers have been significantly reduced, increasing Puerto Rico’s rating to a “B” and formally including hepatitis C treatment in its managed care program that covers all beneficiaries. Increasing access to such treatment will help people of the island eliminate hepatitis C and improve treatment options. 

As part of Abarca’s unstoppable commitment to delivering better care to underserved populations, this step forward is an excellent milestone for Puerto Rico’s healthcare system.

Abarca is proud to be able to aid in this great achievement and is committed to the work ahead. We will continue to work with ASES to call attention to viral hepatitis in our communities and support access to the treatment programs needed.

This blog was written by Lillian Colón López, MPH, Pharm. D., Clinical Client Advisor at Abarca Health.

An introduction to biosimilars

Biologic therapies provide life-saving treatments to patients with chronic conditions. However, they are also among the country’s most expensive medications. While just 2% of the US patient population uses biologics, they account for 26% percent of the nation’s total prescription drug spending, according to a recent study from the Biosimilars Council.

Here’s the good news: Biosimilars are increasingly being developed to combat rising costs, and improve access to these medications. Here’s a quick introduction to these game-changing treatments:

  • What is a biosimilar?
    A biosimilar is a biological medication that is similar to an FDA-approved biologic, also known as the reference product. However, these medications are not generic versions of the reference product. Rather, a biosimilar is a drug that has no clinically meaningful differences in safety, purity, and potency from its reference product.The first biosimilar was approved in the US in 2015 and, as of January of this year, there are now more than 25 FDA approved biosimilars, with more than 50 in development.
  • What conditions do biosimilars treat?
    Biosimilars are most commonly used to treat chronic conditions, including rheumatoid arthritis, anemia, leukopenia, inflammatory bowel disease, psoriasis, and various forms of cancer.
  • What benefits do biologics provide for members?
    These drugs are also expected to cost 10-40% less than their reference products, which will significantly lower out of pocket costs. As a result, more patients will have access to these medications–which helps to boost adherence and improve health outcomes for the members who need it most.
  • How do biosimilars lower medication costs?
    Biosimilars could shift utilization towards more financially accessible therapies. They may also drive competition in the biologic market place–which forces companies to adjust their pricing in order to attract and maintain consumers. In fact, it has been estimated that FDA-approved biosimilars could save patients and the healthcare system up to $250 billion in their first 10 years on the market.
  • Why does it take so long for biosimilars to come to market?
    Developing these medications is expensive, with an estimated cost between $100 and $300 million per product–which could limit the number of manufacturers who are capable of making them or are willing to invest in these therapies. Once a product has been created, it must go through a lengthy FDA approval process, which is often followed by patent litigations that must be settled before it can be made available to consumers.

While adoption of these drugs are growing slowly, at Abarca, we think biosimilars are a critical part of providing a better way in healthcare, and we will continue to monitor and evaluate these treatments as they become available.

This blog was written by Ana M. Rivera, PharmD, Clinical Programs Manager at Abarca.

Help Abarca spread awareness on PTSD

June 27th is PTSD Awareness Day, and Abarca goes all in to bring to light some of the symptoms, signs, and treatment options for this mental health disorder. Although PTSD has been most commonly known to affect war veterans, anyone can develop this disorder.

Today, people suffer from PTSD for varying reasons, including the after trauma inflicted after natural disasters such as earthquakes and hurricanes, as well as pandemics like the one the world is currently facing due to the COVID-19 outbreak.

Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, frightening, or dangerous event.

When a person undergoes a situation that invokes fear, many split-second changes in the body are triggered to help defend or avoid danger – this is called a “fight-or-flight” response.
Most people will experience a scope of reactions after trauma, yet most people recover from initial symptoms naturally. If a person continues to experience problems, they may be diagnosed with PTSD and may feel stressed or frightened, even when they are not in danger.

Possible signs and symptoms that usually last for more than one month:

* Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic event
* Repeated upsetting dreams where the content of the dreams is related to the traumatic event
* Avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event
* Loss of interest in activities that you used to enjoy
* Persistent and elevated negative evaluations about yourself, others, or the world (for example, “I am unlovable,” or “The world is an evil place”)
* Irritability or aggressive behavior
* Feeling constantly “on guard” or like danger is lurking around every corner (or hypervigilance)
Possible Factors that can increase the risk for PTSD include:
* Living through a dangerous event and/or traumas
* Getting hurt
* Seeing another person hurt, or seeing a dead body
* Childhood trauma
* Feeling horror, helplessness, or extreme fear
* Having little or no social support after the event
* Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
* Having a history of mental illness or substance abuse

Treatments & Therapies

As with all conditions, PTSD affects people differently, so a treatment that may work for one person may not have the same effect on another. The main treatments are medications, psychotherapy, or both. If you or someone you know is suffering from PTSD, it is important to seek help from an experienced mental health provider.

Most people with PTSD don’t feel comfortable to get the help they need. Join Abarca in spreading the word that effective treatments are available  —whether the person suffering is a veteran or survivor of sexual assault, a serious accident, natural disasters, or other traumatic events, treatments are available and can lead to a better quality of life.

Other Resources:

* The National Center for PTSD, part of the U.S. Department of Veterans Affairs, has a website with targeted information for anyone interested in PTSD (including veterans, family, and friends) and for professional researchers and health care providers. The site also offers videos and information about an online app called PTSD Coach.
* Clinician’s Guide to Medications for PTSD: This material was developed for researchers, providers, and helpers by the U.S. Department for Veterans Affairs.
* Information for health care professionals: The National Center for PTSD offers a page of general information about the effects of events such as natural disasters and terrorist acts, reviews of disaster research, and useful resources for care providers.
* Information for the general public: The National Center for PTSD offers resources about the effects of PTSD and trauma on families, children, and relationships. Materials include resources for families and veterans and suggestions for helping caregivers respond to children.

This blog was written by Lillian Colón López, MPH, Pharm. D., Clinical Client Advisor at Abarca Health.

Maintaining medication adherence as COVID-19 restrictions are lifted

After approximately three months of quarantine, the US is beginning to reopen from the COVID-19 lockdowns. While there are many unknowns about our new normal, it is still critical that we stay vigilant about our health and safety.

As such, it has never been more important that members remain adherent to their treatment plans. Here are a few ways that health plans and PBMs can help:

  • Ensure access to 90-day supplies. Despite phased openings, some members may still be weary of making too many trips to public places. By ensuring access to 90-day supplies of medication, plans and PBMs can help members significantly reduce how often they need to go to the pharmacy, without impacting their medication access.
  • Medication synchronization. By allowing pharmacies to synchronize a member’s maintenance refills with other medications, members can obtain all of their medications in one pharmacy visit.
  • Early intervention. There are several indicators that show plans and PBMs if a member is at risk of discontinuing his or her treatment plan. By establishing guidelines within your organization that encourage early intervention, members can receive the support they need before their health has been compromised.
  • Engage pharmacists. Members interact with their pharmacist more regularly than any other healthcare provider. With this level of access, pharmacists play an essential role in improving medication adherence. Through RxTarget™, for example, Abarca enables pharmacists to track member behaviors in real-time and flags those in need of an intervention to improve their adherence.
  • Home delivery. Public health officials are still encouraging residents in many localities to stay home when possible. Home delivery programs, like Triple-S en Casa, allow members to manage, order, and receive their prescriptions while maintaining social distancing.

Though we are all still working to navigate the new post-COVID-19 world, Abarca’s dedication to our members and clients has never been stronger. By working together, and being willing to go off road, we can help ensure the ongoing health and safety of our members.

This blog was written by Ana M. Rivera PharmD, Clinical Programs Manager at Abarca.

Let’s work together in spreading awareness of Rheumatoid Arthritis

It’s Rheumatoid Arthritis [RA] Awareness Week (June 17-23) and Abarca goes all in to bring awareness to the 1.5 million Americans, most of which are women, who suffer from this condition by sharing information on its signs, symptoms, and treatments.

What is rheumatoid arthritis (RA)?

RA is an autoimmune and inflammatory disease, which means that your immune system is attacking healthy cells in your body by mistake, causing inflammation (painful swelling) in the affected parts of the body. RA typically attacks a person’s joints, usually many joints at once, and most commonly the small joints in the hands, wrists, and knees. RA is the most common cause of inflammatory arthritis.

Rheumatoid_Arthitis_Abarca_Inforgraphic

Though we know how RA works, the causes of this condition are unknown. However, through much research on genetic and environmental factors, certain risk factors have been indicated such as:

Age: Despite popular belief that it is a condition of the old, RA can begin at any age, but it has been shown to be more prevalent in people of older age, especially in adults in their sixties.

Sex: Typically, women RA cases are 2 to 3 times more likely than men cases.

Genetics/inherited traits: People born with HLA (human leukocyte antigen) class II genotypes are more likely to develop RA. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or obesity.

Smoking: Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can even worsen the disease.

History of live births: Women who have never given birth may be at greater risk of developing RA.

Early Life Exposures: Some early life exposures may increase the risk of developing RA in adulthood.  For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Also, it has been found that children of lower-income families are at increased risk of developing the condition as adults.

Obesity: Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.

How can I manage RA and improve my quality of life?

RA affects many aspects of daily living including work, leisure, and social activities.  Fortunately, there are multiple low-cost strategies available that are proven to increase a person’s quality of life.

Get physically active. Experts recommend that ideally, adults be moderately physically active for 150 minutes per week, through activities like walking, swimming, or biking 30 minutes a day for five days a week. Of course, you can divide these 30-minute into three intervals of ten-minute sessions throughout the day. Learn more about physical activity for arthritis.

Join a self-management education class. People with inflammatory arthritis (including RA) gain confidence when they learn how to control their symptoms. Learn more about the proven self-management education programs that the CDC recommends.

Stop Smoking. Cigarette smoking makes RA worse and can cause other medical problems. Smoking can also make it more difficult to stay physically active, which is an important part of managing RA.

Maintain a Healthy Weight.  Being overweight can cause increased pain and mobility problems for people with RA, so it’s important to maintain a healthy weight.

In addition to medications, people who suffer from RA can manage the condition through self-management strategies proven to reduce pain and disability, which in the long run can improve their quality of life and relieve daily pains so that they may live as normal as possible. Also, people with RA can improve joint function by learning to use five simple and effective arthritis management strategies.

For more information about the treatment of RA, review the Clinical Practice Guidelines for the Treatment of Rheumatoid Arthritis from the American College of Rheumatology (ACR) or the ACR’s Rheumatoid Arthritis Patient page.

Rheumatoid Arthritis Awareness Weekto the RA community and sharing the message that it can affect anyone of any age. Join us in our mission for better care and help us spread information on healthier living habits, and ensure that the best possible, innovative treatments reach the patients who need them.

This blog was written by Lillian Colón López, MPH, Pharm. D., Clinical Client Advisor at Abarca Health.

Abarca goes all-in to promote National Men’s Health Week

On the 15th-21st of June, the world celebrates Men’s Health Week. During this week, communities around the globe bring awareness to health issues that especially affect men, focusing on getting them to become more aware of problems they may have or could develop and do something about them now.  Abarca goes all in to support the cause for the better care of the men in our communities and uses this week as a reminder for men to take steps to be healthier, and let them know that they don’t have to do it alone!

Last year the health observance week focused on Diabetes in men. This is a disease that becomes present in men much more than women and can develop complications in male bodies at a higher rate than in females. This means men are more likely to have amputations due to the disease and in the worst cases, die in higher numbers than women. While much work has been done in the diagnosis and fight against Diabetes, awareness is the most important key to fighting the rise of this disease. The more people become aware of it, the more likely they are to make healthy changes and stop or delay the onset of diabetes.

Let’s remember that along with a healthy diet and medications, regular physical exercise is an essential part of managing diabetes or dealing with prediabetes. It has been proven that when the body is active, the body’s cells become more sensitive to insulin, and thus, the treatment will work more effectively.

Each year the health community uses Men’s Health Week to let men know that it’s okay to talk about their health issues and not just ignore them and push them to the side. Knowledge is power, after all!

So, how can you help? Set an Example with Healthy Habits:

According to the CDC, you can support the men in your life by having healthy habits yourself and by making healthy choices.

  • Eat healthily and include a variety of fruits and vegetables every day in your diet. Fruits and vegetables have many vitamins and minerals that may help protect you from chronic diseases. Limit foods and drinks high in calories, sugar, salt, fat, and alcohol.
  • Regular physical activity has many benefits. It can help control your weight, manage diabetes, reduce your risk of heart disease and some cancers, and can improve your mental health and mood. Find fun ways to be active together. Adults need 2½ hours of physical activity each week.
  • Set an example by choosing not to smoke and encourage the men in your life to quit smoking.
  • Help the men in your life recognize and reduce stress.

Remind Men to Get Regular Checkups

Encourage men to see a doctor or health professional for regular checkups and to learn about their family health history.

It comes with no surprise that this year’s Men’s Health Week theme is ‘Take Action on Covid-19′.

 For men

  • take action to avoid spreading the virus
  • take action to get the best out of lockdown and the ‘new normal’
  • take action to beat ‘underlying conditions’.

Abarca is committed to finding better ways to encourage the men in our lives to take care of their health, whether it’s your husband, partner, dad, brother, son, or friend you can help support their health and safety. This week let’s promote healthy bodies, physical exercise, good diets, and regular visits to the doctor so that we may help prevent and catch diseases early on.

More Information:

This blog was written by Lillian Colón López, MPH, Pharm. D., Clinical Client Advisor at Abarca Health.

Tackling Pharmacy & Doctor Shopping While Combatting the Opioid Epidemic

In recent years, the opioid epidemic has made a significant impact on healthcare in the United States.

One of the consequences of this crisis is the rise of pharmacy and doctor shopping–the practice of a patient seeking out multiple doctors and pharmacies to write and fill additional prescriptions without the knowledge of other pharmacies or providers. This problem has become so widespread that one out of every 143 patients who were prescribed an opioid painkiller obtained their prescriptions from multiple physicians, according to a recent study.

This practice presents a significant risk to the safety of patients and can create substantial financial costs. To combat doctor and pharmacy shopping, and protect the health of our members, Abarca takes a multi-pronged approach:

  • Using advanced analytics. Abarca’s team runs daily audits to identify patients who may be attempting to obtain the same prescription from multiple sources.
  • Deploying modern technology. With Darwin, our team is able to identify and respond to suspicious transactions in real-time, implement edits to restrict certain behaviors at point of sale, and conduct analyses after claims have been submitted.
  • Analyzing member behavior. Our investigations track specific member behaviors that may indicate pharmacy or doctor shopping. This includes how often or how many physicians or pharmacies a member is visiting, the distance the beneficiary travels to visit the different doctors or pharmacies, if he or she is paying cash for prescriptions, and how many pharmacies he or she is using. This analysis can also consider if a patient is using other drug categories that can potentiate the opioid effect and represent a potential safety risk.
  • Looking at the pharmacy. When pharmacy shopping is detected, investigators reach out to providers and gather information about why multiple prescriptions are being written and filled at more than one drug store. We also leverage the Prescription Drug Monitoring Program (PDMP) tool to gather information on opioid claims that are dispensed at the pharmacy but not billed through insurance.
  • Identifying potential trends. Connecting individual member behaviors can be the key to unlocking broader trends of fraud, waste, and abuse. For example, we saw a rise in suspicious claims at pharmacies closely located to pain clinics. With that information, we can now designate resources that are focused explicitly on better addressing over-prescribing in these areas.
  • Coordinating closely. We work closely with pharmacies, health plans, providers, and regulatory agencies to identify and respond to potential cases of pharmacy and doctor shopping.

In response to an emergency, including the COVID-19 pandemic, government agencies require PBMs and health plans to be more flexible in drug authorization requirements to expand medication access. However, to prevent an increase in fraud and doctor shopping during these relaxed periods, Abarca’s Pharmacy Integrity Team and our Fraud Investigators work closely with local government agencies to ensure that cases are quickly identified and addressed.

Through the combined efforts of the Abarca team and our partners across the industry, critical steps are being taken to address pharmacy and doctor shopping head-on and mitigate the risks for our members and clients.

This blog was written by Ana M. Rivera PharmD, Clinical Programs Manager, and Juan L. Nieves, Pharmacy Integrity Team Leader, at Abarca.

Abarcans are Raising Awareness for Multiple Sclerosis

Abarcans stand with the nearly 2.3 million people worldwide living with Multiple Sclerosis (MS) every day, almost one million of which live right here in the United States. We strongly believe that bringing awareness to MS is necessary for providing the steps toward a better way of managing the condition and improving the patients’ quality of life.

What is Multiple Sclerosis?

Nerves are the body’s best friend. We rely on them to send vital messages between the brain and the rest of the body as tiny electrical signals, but in a person with MS, those messages don’t get where they need to go. 

According to the National MS Society, MS is an autoimmune disease that damages the protective lining of nerves, ‘disrupting the flow of information within the brain, and between the brain and body.’ Symptoms vary from person to person and in many cases, may appear to be invisible, though are often disabling. People with MS may have trouble walking, and may experience numbness or tingling in their hands or feet. They may also have trouble seeing and can experience memory loss.

What causes MS?

The cause of the condition is still unknown, though scientists believe that a combination of environmental and genetic factors contribute to the risk of developing MS. Most people are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. There is no cure for MS, though there are several medications that can help control the varying symptoms.

World MS Day:

May 30th marks the World Multiple Sclerosis Awareness Day, coordinated by the MS International Federation and its associated members around the globe. The 2020-2022 World MS Day theme is ‘connections’. MS Connections is all about building community connection, self-connection, and connections to quality care. We are challenging social barriers that leave people affected by MS feeling lonely and socially isolated. Together, we advocate for better services, celebrate support networks, and champion self-care. Change the future, find your #MSConnections.

Abarca’s participation in the MS Connections campaign is part of our Better Care Community Program, an initiative aimed at making healthcare awesome, while at the same time, supporting community organizations that make health services more accessible, and also bringing awareness to conditions affecting our communities.

Get involved:

Find out more about World MS Awareness Day, including virtual events happening in your area, the latest news posted from around the world, and tools available to aid in your World MS Awareness Day campaigns. Join Abarca in spreading awareness and advocacy for more research funding so that one day we may live in a world free of MS.

 

This blog was written by Suzette Velez, Director Of Clinical Services at Abarca Health.

Strengthening Abarca’s internal structure

We’re making good on our promise to provide a smarter platform, a better experience, and a higher standard. PBMs and plans across the country are now experiencing what we call “PBM Awesome,” and demand for our solutions is on the rise.

To continue to enhance and evolve our strategic vision, while maintaining the high levels of client service that Abarca is known for, we are making the following organizational changes.

Effective immediately, Javier Gonzalez, Pharm.D., will serve as the company’s Chief Growth Officer. In this role, Gonzalez will direct our go-to-market and customer value creation strategies, including pharmacy and rebate trend management strategies, and data analytics. He will also be responsible for deepening our relationships with customers and partners, leading the company’s business development efforts. An accomplished managed care executive and  20-year veteran of the PBM industry, Javier has been Abarca’s Chief Operating Officer since 2016.

“Javier not only understands Abarca’s unique and powerful culture, but he also has an innate sense of where the healthcare and PBM industries are going,” said Jason Borschow, President & CEO at Abarca. “We are all very excited about his leadership and vision for the future.”

As part of this reorganization, Adriana Ramirez, Esq. will assume the role of Chief Operating Officer, overseeing the various business units responsible for developing and delivering PBM products and services to Abarca’s clients. Ramirez has been with the company since 2013 and has served numerous roles, the most recent, Chief Legal & Compliance Officer and VP of Client Services.

PBMs and the Run on Hydroxychloroquine

Leading pharmacy benefit managers (PBMs) say the initial flood of demand for the antimalarial drug hydroxychloroquine, sparked by suggestions from the White House that it was an effective treatment for COVID-19, finally is showing some signs of easing. This has lessened pressures on supplies of the drug for FDA-approved indications, such as lupus and rheumatoid arthritis.

Prime Therapeutics’ ongoing monitoring of utilization trends for hydroxychloroquine showed a rapid spike between March 17 and 25, which caused many community pharmacies to scramble to maintain adequate supplies for the FDA-approved uses, as noted above.

“During this time, we did receive a few escalated member inquiries regarding drug supply issues. This was primarily due to local/regional supply chain inventory adjustments,” said David Lassen, MD, Prime’s chief clinical officer. “We assisted these members by redirecting to pharmacies with known inventory. We also took measures to limit quantities of prescriptions for new COVID-19 users to prevent further drug shortage concerns and/or potential stockpiling.”

Between late April and early May, after new reports suggested that the drug did not help hospitalized COVID-19 patients and the FDA warned against the use of hydroxychloroquine outside of the hospital setting or a clinical trial due to risk for heart rhythm problems (bit.ly/2WFOEog), Prime saw its utilization of the drug return to pre-baseline levels. This suggests that there is no longer a high demand for the product as a COVID-19 treatment in the outpatient setting, “which is consistent with the evolving clinical trial data suggesting that the risks (cardiovascular) may outweigh any benefits for this drug in the treatment of COVID-19,” Dr. Lassen said.

The Florida and Puerto Rico–based PBM Abarca also observed intermittent shortages of hydroxychloroquine during the mid-March utilization spike. “During that time, we continually monitored shortages and recommended strategies to our payors to prevent and address drug shortages to protect high-risk patients who depend on hydroxychloroquine for the treatment of their rheumatoid arthritis and lupus erythematosus disease states,” said VP of PBM Operations, Lissette Lorenzo, PharmD, adding that the company also has seen a return to pre-pandemic demand in the past few weeks. “Despite the sharp drop-off in utilization, our clinicians continue to monitor access to hydroxychloroquine. At this point, we have not received any complaints of patients who cannot obtain their medication supplies due to shortages caused the pandemic,” she said.

CVS Health reports that its retail, mail service and specialty pharmacies have adequate supply of hydroxychloroquine and are taking all necessary steps to maintain supply. “Very early on, we implemented quantity limits (with client consent) to help meet the needs of patients with conditions such as lupus,” said spokesperson Trey Hollern. “We continue to balance the growing interest in off-label use of certain prescription medications to treat COVID-19 pneumonia (like hydroxychloroquine) with the ongoing needs of patients and members who are prescribed these drugs to help manage chronic conditions, such as lupus.”

Increased demand for other medications being prescribed to treat COVID-19 and its complications has led to some temporary shortages, Mr. Hollern added. Besides hydroxychloroquine, these medications include azithromycin, which often is given in combination with hydroxychloroquine in COVID-19 patients, as well as albuterol inhalers, which are approved for treatment of lupus, bacterial infections, HIV, rheumatoid arthritis and asthma but often are used adjunctively in COVID-19. “In addition to standard processes at the pharmacy level,” he said, “CVS Health implemented new measures across our enterprise for these medications, such as adhering to state-level dispensing guidelines in our retail pharmacies and, as a PBM, setting coverage limits on quantity for pharmacies in our network.”

On May 7, an observational Columbia University study of more than 1,400 hospitalized patients—the largest study of hydroxychloroquine to date in COVID-19—found that the drug was not associated with either a greatly lowered or an increased risk for the composite end point of intubation or death (N Engl J Med, 2020 May 7. [Epub ahead of print]. doi: 10.1056/NEJMoa2012410).

ASHP Site Shows a Mixed Bag
Underscoring the moving target of hydroxychloroquine and azithromycin shortages, both drugs were still listed as being in short supply by the ASHP’s drug shortages website in early May. But a slightly deeper dive into the listings shows that the drugs can be obtained, albeit in a limited range of formulations and strengths.

According to ASHP’s “Current Drug Shortages” list, Concordia and Milan both had hydroxychloroquine available in 100-count/200-mg dosages, while several other suppliers had the drug on allocation to current customers and contracted wholesalers for approved indications. As for azithromycin, three suppliers—Athenex, Fresenius Kabi and Slate Run Pharmaceuticals—were listed as having IV lyophilized -powder for injection available in 10-count packages of 500-mg vials.

This article was written by Gina Shaw and originally published in Specialty Pharmacy Continuum.