Insurance Often Covers Ivermectin for COVID-19, Even Though Drug Doesn't Work

Both the U.S. Food and Drug Administration and the World Health Organization say ivermectin pills — typically used to treat parasitic infections like worms — should not be used for COVID-19, except in clinical studies.

However, some doctors continue to prescribe the drug — and many insurers are paying for it, researchers found.

"Insurers usually don't cover ineffective treatments, or at least make patients pay for most of the cost," said study leader Dr. Kao-Ping Chua, a health care researcher at the University of Michigan in Ann Arbor.

"Our study suggests that they are treating ivermectin prescriptions for COVID-19 differently," Chua said in a university news release. "In doing so, they are reducing barriers to an ineffective drug that some are using as a substitute for COVID-19 vaccination or evidence-based treatments."

Interest in the drug surged in December 2020, the authors noted. But instead of protecting against the virus, the use of a medicine typically reserved for horses and cattle prompted a spike in calls to poison control centers across the country, according to prior research.

In this new study, an analysis of private insurance and Medicare Advantage claims from December 2020 through March 2021 revealed 5,600 prescriptions for oral ivermectin that weren't written for a parasitic infection.

The total cost per ivermectin prescription for COVID-19 was $58 for private plans, which paid 61% of this amount, or about $36. The total cost per prescription was $52 for Medicare Advantage plans, which paid 74% of this amount, or about $39. Patients paid the rest of the cost.

Based on these findings, the researchers calculated that private and Medicare plans may have paid $2.4 million for COVID-19-related ivermectin prescriptions in the week of Aug. 13, 2021 alone.

At that rate, insurers would spend nearly $130 million a year on ivermectin prescriptions for COVID-19, according to the study. The results were published online Jan. 13 in the Journal of the American Medical Association.

Insurers should match their coverage of ivermectin with the level of medical evidence surrounding it — just as they do for other medications, tests and procedures, the authors advised. They should also require doctors to justify prescribing ivermectin during the pandemic by filling out a prior authorization form, they added.

"To be clear, clinicians may still prescribe ivermectin for COVID-19, and patients can choose to pay for these prescriptions themselves. Our point is simply that insurers shouldn't cover these prescriptions unless ivermectin proves to be an effective COVID-19 treatment," said Chua, a pediatrician and member of the university's Institute for Healthcare Policy and Innovation.