FDA NOTICE

On March 28, 2020, the FDA issued an Emergency Use Authorization for hydroxychloroquine and chloroquine for the treatment of COVID-19. They retracted this authorization on June 15, 2020. Based on a review of the latest research, the FDA determined that these drugs are not likely to be an effective treatment for COVID-19 and that the risks of using them for this purpose might outweigh any benefits.

  • Hydroxychloroquine is a prescription drug that’s used to treat malaria, lupus, and rheumatoid arthritis.
  • While hydroxychloroquine has been proposed as a treatment for COVID-19, there is not enough evidence to approve the drug for this use.
  • Hydroxychloroquine is covered under Medicare prescription drug plans for its approved uses only.

If you’ve been keeping up on the discussions around the COVID-19 pandemic, you’ve likely heard of a drug called hydroxychloroquine. Hydroxychloroquine is commonly used to treat malaria and several other autoimmune conditions.

Although it has recently come into focus as a potential treatment for infection with the novel coronavirus, the Food and Drug Administration (FDA) has not yet approved this drug as a COVID-19 treatment or cure. Because of this, Medicare generally only covers hydroxychloroquine when it’s prescribed for its approved uses, with a few exceptions.

In this article, we’ll explore the different uses of hydroxychloroquine, as well as the coverage that Medicare offers for this prescription drug.

Medicare Part A (hospital insurance) covers services related to inpatient hospital visits, home health aides, limited stays at a skilled nursing facility, and end-of-life (hospice) care. If you’re admitted to the hospital for COVID-19 and hydroxychloroquine is recommended for your treatment, this medication would be included in your Part A coverage.

Medicare Part B (medical insurance) covers services related to the prevention, diagnosis, and outpatient treatment of health conditions. If you’re being treated at your doctor’s office and are given the drug in this setting, this will likely be covered under Part B.

Hydroxychloroquine is currently FDA approved to treat malaria, lupus, and rheumatoid arthritis, and it’s covered under some Medicare prescription drug formularies for these conditions. However, it has not been approved to treat COVID-19, so it will not be covered by Medicare Part C or Medicare Part D for this use.

Hydroxychloroquine, also known by the brand name Plaquenil, is a prescription drug that is used in the treatment of malaria, lupus erythematosus, and rheumatoid arthritis.

Hydroxychloroquine was originally used during World War II as an antimalarial to prevent and treat malarial infections in soldiers. During this time, it was noted that hydroxychloroquine also helped with inflammatory arthritis. Eventually, the drug was further researched and found to be useful for patients with systemic lupus erythematosus, as well.

Possible side effects

If you’ve been prescribed hydroxychloroquine, your doctor has determined that the benefits of the drug outweigh its risks. However, you may have certain side effects when taking hydroxychloroquine, including:

  • diarrhea
  • stomach cramps
  • vomiting
  • headache
  • dizziness

Some of the more severe side effects that have been reported with the use of hydroxychloroquine include:

Drug interactions

Whenever you begin a new medication, it’s important to be aware of any drug interactions that may occur. Drugs that may react with hydroxychloroquine include:

  • digoxin (Lanoxin)
  • drugs to lower blood sugar
  • drugs that alter heart rhythm
  • other malaria drugs
  • antiseizure drugs
  • immunosuppressant drugs

Effectiveness

Both the brand-name and generic versions of this drug are equally effective in the treatment of malaria, lupus, and rheumatoid arthritis. However, there are some cost differences between the two, which we’ll discuss later in this article.

Hydroxychloroquine has been touted by some as a “cure” for COVID-19, but where does this drug really stand as a treatment option for infection with the novel coronavirus? So far, the results are mixed.

Initially, a clinical trial using hydroxychloroquine and azithromycin for COVID-19 treatment was spread among media outlets as evidence of the effectiveness of the drug. However, a review of the study published shortly after found that there were many limitations to the study that could not be overlooked, including the small sample size and lack of randomization.

Since then, newer research has suggested that there is not enough evidence to safely suggest using hydroxychloroquine as a treatment for COVID-19. In fact, one recently published review states that a similar study performed in China using hydroxychloroquine found no evidence of effectiveness against COVID-19.

The importance of testing drugs for the treatment of new diseases can’t be overstated. Until there’s strong evidence to suggest that hydroxychloroquine can treat COVID-19, it should only be used under close supervision by a doctor.

Possible Medicare coverage in the future

If you’re a Medicare beneficiary, you may be wondering what would happen if hydroxychloroquine, or another drug, were approved to treat COVID-19.

Medicare provides coverage for the medically necessary diagnosis, treatment, and prevention of diseases. Any drugs that are approved to treat an illness, such as COVID-19, are generally covered under Medicare.

Because hydroxychloroquine is currently not covered under Medicare Part C or Part D plans for COVID-19, you may be wondering just how much it will cost you out of pocket without coverage.

The chart below highlights the average cost of a 30-day supply of 200-milligram hydroxychloroquine at various pharmacies around the United States without insurance coverage:

PharmacyGenericBrand name
Kroger$96$376
Meijer$77$378
CVS$54$373
Walgreens$77$381
Costco$91$360

Costs with Medicare coverage for approved uses will vary from plan to plan, based on the formulary’s tier system. You can contact your plan or pharmacy or look up your plan’s formulary for more specific cost information.

Getting help with prescription drug costs

Even if hydroxychloroquine is not covered under your Medicare prescription drug plan, there are still ways to pay less for prescription drugs.

  • One way to do this is through a company that provides free prescription drug coupons, such as GoodRx or WellRx. In some cases, these coupons can help you save a significant amount on the retail cost of the drug.
  • Medicare offers programs to help cover your healthcare costs. You may qualify for Medicare’s Extra Help program, which is designed to help with your out-of-pocket prescription drug costs.

Hydroxychloroquine has not yet been approved to treat COVID-19, so Medicare coverage for this drug to treat infection with the novel coronavirus is limited to in-hospital use under rare circumstances.

If you need this drug for an approved use, like malaria, lupus, or rheumatoid arthritis, you will be covered by your Medicare prescription drug plan.

There’s hope going forward that vaccines and treatments for COVID-19 will become available.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

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