How did we miss this? Hydroxychloroquine is not the killer the fauch said it was. In many cases it actually works. Below we have Resolution 509 from the AMA, also we a link to a joint statement from
the American Medical Association, American Pharmacists Association and American Society of Health-System Pharmacists
Resolution: 509 (November 2020) Page 3 of 6
1 Whereas, The COVID-19 pandemic is a serious medical issue, people are dying, and
2 physicians must be able to perform as sagacious prescribers; therefore be it
3
4 RESOLVED, That our American Medical Association rescind its statement calling for physicians
5 to stop prescribing hydroxychloroquine and chloroquine until sufficient evidence becomes
6 available to conclusively illustrate that the harm associated with use outweighs benefit early in
7 the disease course. Implying that such treatment is inappropriate contradicts AMA Policy
8 H-120.988, “Patient Access to Treatments Prescribed by Their Physicians,” that addresses off
9 label prescriptions as appropriate in the judgement of the prescribing physician (Directive to
10 Take Action); and be it further
11
12 RESOLVED, That our AMA rescind its joint statement with the American Pharmacists
13 Association and American Society of Health System Pharmacists, and update it with a joint
14 statement notifying patients that further studies are ongoing to clarify any potential benefit of
15 hydroxychloroquine and combination therapies for the treatment of COVID-19 (Directive to Take
16 Action); and be it further
17
18 RESOLVED, That our AMA reassure the patients whose physicians are prescribing
19 hydroxychloroquine and combination therapies for their early-stage COVID-19 diagnosis by
20 issuing an updated statement clarifying our support for a physician’s ability to prescribe an FDA
21 approved medication for off label use, if it is in her/his best clinical judgement, with specific
22 reference to the use of hydroxychloroquine and combination therapies for the treatment of the
23 earliest stage of COVID-
19 (Directive to Take Action); and be it further
24
25 RESOLVED, That our AMA take the actions necessary to require local pharmacies to fill valid
26 prescriptions that are issued by physicians and consistent with AMA principles articulated in
27 AMA Policy H-120.988, “Patient Access to Treatments Prescribed by Their Physicians,”
28 including working with the American Pharmacists Association and American Society of Health
29 System Pharmacists. (Directive to Take Action) Fiscal Note: Modest - between $1,000 - $5,000
Received: 10/23/20
We are issuing this joint statement to highlight the important role that physicians, pharmacists and health systems play in being just stewards of health care resources during times of emergency and national disaster. We are aware that some physicians and others are prescribing or dispensing medications currently identified as potential treatments or prophylaxis for COVID-19 (e.g., chloroquine or hydroxychloroquine, azithromycin) for themselves, their families, or their colleagues. In addition, some entities have been purchasing excessive amounts of these medications through commercial distribution channels in anticipation of potentially using them for COVID-19 prevention and treatment. We strongly oppose these actions that can lead to supply disruptions for patients who need these medicines for chronic conditions.
We collectively support state and federal requirements that direct a
prescription must be written only for a legitimate medical purpose.
Novel off-label use of FDA-approved medications is a matter for the
physician’s or other prescriber’s professional judgment. We also
strongly support a pharmacist’s professional responsibility to make
reasonable inquiries to a prescriber to resolve any questions about a
prescription. If a prescription is not for a legitimate medical purpose,
it should not be written, and it should not be dispensed. We encourage patient-centered
care decisions, made on an individualized basis with patients’ informed
consent about the risks and benefits associated with any treatment
regimen. However, evidence-based science and practice must guide
these determinations. Physicians, pharmacists and other members of the
healthcare team are more than capable of working together and resolving
questions.
At the same time, we caution hospitals, health systems, other entities, and individual practitioners that no medication has been FDA-approved for use in COVID-19 patients. Definitive evidence for the role of these drugs in treating COVID-19 patients has not been determined through robust clinical trials; decisions to use these medications off-label must be made with extreme caution and careful monitoring. Physicians, pharmacists, patients and policymakers must understand that these medications have dangerous side effects, that may lead to patient harm, including fatal cardiac arrhythmias. In the event that an adverse drug event is suspected or observed from any medication used to prevent or treat COVID-19, we urge healthcare providers to submit a report to FDA MedWatch. Stockpiling these medications—or depleting supplies with excessive, anticipatory orders— and price gouging in the midst of a pandemic, have grave consequences for patients with conditions such as lupus or rheumatoid arthritis if the drugs are not available in the community. The health care community must collectively balance the needs of patients taking medications on a regular basis for an existing condition with new prescriptions that may be needed for patients diagnosed with COVID-19. Being just stewards of limited resources is essential.
We are further concerned by the confusion that may result from various state government agencies and boards issuing emergency rules limiting or restricting access to chloroquine, hydroxychloroquine or other emerging therapies or requiring new procedures for physicians and other healthcare professionals and patients. If these bodies promulgate new rules, we urge that they emphasize professional responsibility and leave room for professional judgment. We further urge that patients already on these medications for chronic conditions should not be negatively impacted by new laws, rules or other guidance. In a time of national pandemic, now is not the time for states to issue conflicting guidance, however well-intentioned, that could lead to unintended consequences.
We applaud the ongoing efforts to conduct clinical trials and generate evidence related to these and other medications during a time of pandemic. We are also encouraged that some pharmaceutical manufacturers are increasing production of high-demand medications as well as supplying them for use in clinical trials.
The nation’s physicians and pharmacists continue to demonstrate remarkable leadership on a daily basis. We are confident in physicians’ and pharmacists’ judgment to make the right decisions for their patients, communities and the health care system overall.
Editor's note
The updated joint statement provides further detail and clarification
about key areas that have evolved in recent weeks, including in-patient
use of certain medications compared to prophylaxis, the
distribution/supply chain, safety considerations and the need for
adverse-event reporting, and further supports the need for
evidence/science to guide discussions and decisions.
