Hydroxychloroquine Chloroquine and Azithromycin Use During the COVID-19 Public Health Emergency

March 26, 2020

The Tennessee Medical Association and Tennessee Pharmacists Association have received anecdotal information regarding the inappropriate ordering, prescribing, and dispensing of prescriptions for hydroxychloroquine, chloroquine, and azithromycin, after public announcements that the drugs may be effective to prevent the contraction of, reduce symptoms of, or to treat, the COVID-19 virus. TMA and TPA are concerned that many members of the public are requesting the prescriptions from primary care prescribers without a proper diagnosis.   

Not only does the inappropriate ordering, prescribing, and dispensing of these drugs  deplete the supply of medications accessible to our hospitals to treat COVID-19 patients, but it also places our patients that have been diagnosed with auto-immune conditions such as rheumatoid arthritis and lupus at increased risk for condition-related morbidity and mortality. TMA and TPA are opposed to these actions. Further, the inappropriate ordering, prescribing, and dispensing of these medications creates wide-spread shortages of these medications and causes prices for these drugs to sharply increase. Even though several manufacturers are ramping up production to meet the increased demand, patients need these medications right now for management of their non-coronavirus-related conditions and hospitals need these medications to treat known COVID-19 patients. This problem is not limited to Tennessee and state health officials are taking action to prevent it. 

Like public health officials, TMA and TPA are hopeful that further clinical studies will validate the efficacy of these drugs as well as other treatments, but at this time, there are no FDA-approved therapeutics to treat, cure, or prevent COVID-19. 

TMA and TPA recognize the essential role that physicians, pharmacists and health systems play a critical role in caring for patients, especially during times of emergency and national disaster. Physicians and pharmacists are urged to continue to order, prescribe, and dispense these medications for their patients diagnosed with auto-immune conditions but refrain from issuing prescriptions for family, friends, or other patients for non-coronavirus-related conditions so that adequate supplies remain for COVID-19 hospitalized patients and those with diagnosed auto-immune conditions such as rheumatoid arthritis and lupus. Please heed these guidelines and impart them on the APRNs and PAs with whom you collaborate. 

Read more in a joint statement from AMA, APhA, and ASHP and read a letter from Tennessee Department of Health Commissioner, Dr. Lisa Piercey