US hospitals are panic-buying drugs as they prepare for an influx of coronavirus patients, risking shortages in antimalarials and inhalers.
Wholesale distributors have begun rationing the treatments after sales of chloroquine, an antimalarial that some hope will work against the virus, have spiked by 3,000 per cent so far this month, compared to the same period last year. Hospitals have also increased purchases of a related drug with fewer side effects, hydroxychloroquine, by 260 per cent, according to data from Premier, a group representing 4,000 US hospitals.
With no drug available to treat the coronavirus, hospitals are searching for signs in small studies of what might work, and stocking up. Chloroquine showed some promising results in studies in France and China, but it is nowhere near the normal standard of evidence required. President Trump announced this week that it had been approved by the Food and Drug Administration to treat Covid-19 — but this turned out not to be true.
Soumi Saha, Premier’s senior director of advocacy, said the problem was that there is “no source of truth”. She said hospitals need treatment guidelines or protocols from the Centers for Disease Control and Prevention, or they will rush to buy every time small studies are released.
“We will be in a situation where we will continue to see panic buying any new information is released by other countries,” she said.
Hospitals are also rushing to buy more inhalers — such as those used by asthmatics — with orders up 112 per cent year-on-year. Drugmakers GSK and Boehringer Ingelheim are now rationing inhalers, according to Premier.
“We are actively working to ensure replenishment of wholesaler warehouses to meet the demand of hospitals across the country,” a spokesperson for Boehringer Ingelheim said. “We have also authorised overnight orders to distribution centres that have had inventories wiped out by hospital demand.”
GSK did not respond to requests for comment.
Normally, hospitals would put people suffering from respiratory illnesses on to nebulisers, a device that turns medication into mist to be inhaled, but they may fear that could spread the virus to other patients or staff. Instead, some seem to be relying on inhalers, which do not carry the risk of putting the virus in the air.
To boost supplies of antimalarials, generics manufacturers Teva and Novartis’ Sandoz have pledged to donate millions of doses to US hospitals. Israeli drugmaker Teva said on Friday that it would donate 10m doses of hydroxychloroquine to hospitals through wholesalers in the next month, while Sandoz said it would donate 50m by the end of May. Bayer, the German pharmaceutical group, also said it would donate 3m of its malaria tablets, but as they are not approved in the US, they need an emergency authorisation from the FDA.
Mylan, a US-based generics maker, has restarted production of hydroxychloroquine at its West Virginia plant and is looking to increase manufacturing outside of the US too.
But there may not be enough supply of ingredients for a drug that is normally used to treat malaria. Teva said it was “urgently” taking steps to acquire more active ingredients. About 80 per cent of all active ingredients are made outside of the US. Ms Saha said Premier believes the active ingredient for chloroquine is made in India, where the government has already banned the export of 26 key ingredients and medicines made from them.
Dan Kistner, group senior vice-president, pharmacy solutions, at Vizient, a group that works with more than half of the US acute care providers, is pushing for more transparency in the pharmaceutical supply chain so hospitals can predict shortages.
“You don’t have the transparency data for the most critical drugs that you and I need in a hospital to survive. You don’t know where they come from, you don’t know if there’s going to be a shortage,” he said.