Study shows political affiliation drove use of ivermectin, hydroxychloroquine

The use of two unproven COVID-19 treatments was higher in counties with a larger share of Republican voters in late 2020, according to a study released Friday, suggesting stark political differences in medical decisionmaking.

Hydroxychloroquine prescribing volume from June through December 2020 was roughly double what it had been the previous year, and prescriptions were 150 percent higher in the most Republican counties than in the least, according to the study published Friday in the JAMA Internal Medicine journal.

Hydroxychloroquine is an antimalarial drug that is also used to treat lupus and rheumatoid arthritis. Early in the pandemic, former President Trump called it a miracle drug for COVID-19, and it has been heavily promoted as a treatment for the virus by Trump allies despite almost no evidence.

The Food and Drug Administration issued an emergency use authorization for the drug in late March 2020, but then revoked it less than three months later. After FDA revoked the authorization, prescribing volume was more than twice as high in counties with the largest share of Republican voters.

Ivermectin is an anti-parasitic drug used most often in veterinary medicine, though it is authorized in humans for use in curing head lice, roundworm infections and other parasitic conditions.

The drug is not authorized for treating COVID-19, and there is no evidence that it can. But it’s gained a following among anti-vaccine groups and right-wing politicians, and in December 2020 prescribing volume was more than 950 percent higher in the most Republican counties compared to the least.

The study noted the spike aligned with several key events, such as a mid-November 2020 release of a now-retracted manuscript claiming that the drug was highly effective against COVID-19, and a widely publicized U.S. Senate hearing in early December that included testimony from a doctor promoting ivermectin as a COVID-19 treatment.

“This is the first evidence, to our knowledge, of such a political divide for a basic clinical decision like infection treatment or prevention,” Michael Barnett, assistant professor of health policy and management at Harvard T.H. Chan School of Public Health and lead author of the study, said in a statement.

“We’d all like to think of the health care system as basically non-partisan, but the COVID-19 pandemic may have started to chip away at this assumption,” Barnett added.

The study compared prescriptions for the two drugs with rates for two similar medications, methotrexate sodium and albendazole, that have not been proposed as COVID-19 treatments. Those drugs did not see similar spikes.