Drug for autoimmune disorders in short supply because of diversion to COVID-19 cases, where it’s unproven to help
Had Amy Cooper been first in line at the Safeway pharmacy that day, she might have avoided an alarming eight-day struggle to find the medicine she needs to suppress the disabling symptoms of her autoimmune disorder.
Instead, someone else got the last of the hydroxychloroquine at the Fort Bragg store, sending Cooper, who is in home isolation on the North Coast, on a desperate search for the drug she relies upon to function day to day.
Like others who suffer from lupus, rheumatoid arthritis and related autoimmune, inflammatory conditions, the 45-year-old Santa Rosa woman finds herself confronting a shortage of the vital medication, brought on by its unproven benefits for patients infected by the coronavirus.
President Donald Trump has helped fuel that rush, touting the drug as a potential breakthrough in the pandemic - “one of the biggest game changers,” he said recently - despite the caution heaped on by his administration’s top medical advisers.
Those who have depended for years on the drug, known commonly by the brand name Plaquenil, are now facing panic, as one pharmacy after another runs through its stocks with nothing left on the market for resupply.
“It’s not available,” pharmacist Mike McCaskill said from the Hoen Avenue Tuttle’s Pharmacy in Santa Rosa.
The drug’s scarcity has created an unexpected and harsh reality for an untold number of people across the country who need hydroxychloroquine, which, along with a related drug called chloroquine, are being studied for use in COVID-19 patients.
Originally used to treat malaria, it’s been touted heavily by Trump in recent weeks as a potential silver bullet in the battle against the deadly coronavirus, though its track record is limited to a few small, uncontrolled observational experiments and anecdotal reports.
But with the nation’s coronavirus cases at more than 457,000, and deaths surpassing 16,000, many medical providers and patients are desperate for an antidote.
Local pharmacists have watched their supplies of the drug dwindle as they fill prescriptions from physicians treating coronavirus cases. Another major factor in the shrinking supply: a March 25 ban on its export from India, where the United States obtains nearly half its stock. India implemented the ban to keep more of the product for its use in-country.
In addition, the U.S. government has scooped up 30 million ?doses of the drug for the Strategic National Stockpile to use in treating COVID-19 patients or in clinical trials. Some doctors are even prescribing it for themselves and their families as preventive medicine.
As a consequence, people like Windsor nurse Chelsea Ridgway, 32, had to scramble last month to fill her prescription for Plaquenil, spurred on by friends who anticipated a spike in demand once the president started advocating its use for coronavirus.
“I called seven or eight places,” Ridgeway said. “They were all out.”
She was eventually able to get a 90-day supply through Tuttle’s Doyle Park pharmacy, though their provisions were running low this week, pharmacist and owner Robert Pellegrini said.
“It’s definitely going to be a shortage coming up here,” he said.
Santa Rosa rheumatologist Jack Waxman said it’s a problem for “every one” of his patients, who have been calling with increasing frequency as they run into obstacles trying to refill prescriptions.
Some may have to taper their dosage to try to stretch out their supplies, he said, because alternative drugs often suppress immunity, a bad idea in the midst of a pandemic.
Cooper, who is staying in a family cottage in Fort Bragg to limit her exposure to Sonoma County’s higher coronavirus prevalence, said she went to the Safeway there last week to fill her prescription, calling ahead and learning they had 280 doses.
But she was in line when she realized the person in front of her was cleaning out the inventory, buying about six months’ worth through insurance and cash payments to stock up.
“I was furious,” she said.
She had three days of her medication left, and found a small stash of expired pills she has continued to take while she and her sister in Santa Rosa have frantically called around trying to refill her prescription. She’s also been in daily contact with Safeway, where the pharmacy staff called Thursday to say that their Sonoma County stores had been restocked with Plaquenil.
On Wednesday, they had said they would not be getting any more, Cooper said.
Ridgway said she’s uncomfortable with the idea that the drug’s scarcity leaves patients with autoimmune disorders and COVID-19 in competition, as if trying to determine who “deserves” it most.