A study led by a group of researchers from the University of Michigan Medical School and the University of Boston investigated insurance claims in the United States during the COVID-19 pandemic, discovering that $2.5 million in ivermectin prescriptions for one week were covered for SARS-CoV-2 despite not approved by the U.S. Food and Drug Administration (FDA) for that indication. Extrapolated over a 12 month period, just under $130 million was paid out to treat COVID-19. While the authors declare this a “waste,” hundreds of knowledgeable physicians in the U.S. have actively prescribed the repurposed generic drug approved for antiparasitic uses. The drug is extensively used to combat COVID-19 in at least a dozen if not more low-and middle-income countries (LMICs) but the U.S. medical establishment has fiercely resisted off-label use. The National Institutes of Health did invite physicians to present their meta-analysis findings and shortly thereafter adjusted their national guidance to a more neutral position. However, with the drug’s popularity during the pandemic has come an associated backlash by a confluence of groups called, by some industry observers, as the medical establishment. What becomes clear in this study is the magnitude of the ivermectin-based economy during the pandemic. This study’s results are showcased in JAMA.
TrialSite was the first media platform to systematically track and write about ivermectin studies since the University of Monash preclinical lab study demonstrated that ivermectin obliterated SARS-CoV-2 in cell culture. From there, many studies proliferated across predominantly low-and middle-income countries (LMICs) from Bangladesh and India to Brazil, Mexico, Nigeria, and Iraq. Some European nations such as Slovakia approved the drug on an emergency basis.
For a comprehensive view into ivermectin-based research search TrialSite for a review of dozens of studies. A controversial situation, as the momentum to use ivermectin off-label intensified, a counter-effort involving regulatory agencies, health organizations such as the World Health Organization, industry, and medical societies emerged.
Lawsuits across America have proliferated as hospital protocols when failing often triggers the families of patients to suggest ivermectin to the hospital’s staff and administration. Nearly always denied, law firms such as Ralph Lorigo developed busy practices representing patients and their families in the right to secure prescriptions in the hospital.
TrialSite chronicled numerous times the drug has saved lives, including the ICON study in Broward County, Florida led by Jean-Jacques Rajter and his physician wife Juliana Ceplowicz-Rajter. Demonstrating in this case series that ivermectin appeared to lower the COVID-19 mortality rate, the study results were published in the peer-review journal Chest.
TrialSite chronicled the incredible public health story in Uttar Pradesh where not only did the Indian national government approve ivermectin on an emergency basis for a period of time but that public health officials in India’s most populous state employed extensive outbound public health teams with ivermectin-based home medicine kits and aggressive testing which appeared to help turn around a severe Delta variant-based surge in 2020. This effort was even touted by the World Health Organization (WHO) although they omitted the term ivermectin.
By 2021, a confluence of industry, government, and academic elites backed by the media went into attack mode to vilify the drug based on staggering increases in prescriptions. TrialSite reported that ivermectin prescriptions went from 3,000 prescriptions per week around the start of the pandemic to nearly 90,000 prescriptions per week during 2021. Thereafter, TrialSite reported on a number of efforts to purge the use of the drug in America and elsewhere. This media platform shared that some representatives in government confided that they feared publishing that they were allowing the use of the drug for fear of reprisals from the WHO.
Now, some more hard data surfaces thanks to this recent insurance-focused study. Given $2.1 million was authorized in one week, the estimated actual coverage of $130 million.
The Study
This recent study tracked reimbursement from private and Medicare plans during the week of August 13, 2021. 88,000 prescriptions were dispensed that week, less the average of 3600 that marked pre-COVID numbers. About 52% (43,888) and 28% (23632) of the remaining 84,400 prescriptions were covered by private and Medicare plans.
The study team reports the following data points:
Category of ivermectinAmount Private PayerMedicareMean out of pocket spend on IVM$22.48 ($24.78)$13.78 ($26.24)Mean insurer reimbursement$35.75 ($50.63)$39.13 ($40.18)Mean total spending$58.23 ($51.47)$52.91 ($42.47)Aggregate spend$273,681$47,142.81Insurer coverage61.4%74%
Moreover, for the week of August 13, 2021, both private and Medicare plans paid out an estimated $1,568,996 (43888 x $35.75) and $924,729.16 (23,632 x $39.13) for ivermectin prescriptions for COVID-19. The authors report a total weekly amount of $2,493,716.16 extrapolated to $129,673,240.30 per annum.
Study limitations can be reviewed at the source.
Lead Research/Investigator
Kao-Ping Chua, MD, Ph.D., Susan B. Meister Child Health Evaluation and Research Center, University of Michigan Medical School
Rena M. Conti, Ph.D., Department of Markets, Public Policy, and Law, Questrom School of Business, Boston University, Boston, Massachusetts
Nora V. Becker, MD, Ph.D., Division of General Medicine, University of Michigan Medical School, Ann Arb