NAPPSA Condemns Stockpiling of Hydroxychloroquine by Healthcare Professionals

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The Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) has expressed complete disapproval for the hoarding of hydroxychloroquine and chloroquine, as reportedly done by some health practitioners, saying it is unethical in every sense.

The association maintained that the first and foremost ethical responsibility of all healthcare professionals in situations like the COVID-19 pandemic is to provide urgent medical care and ensure availability of approved medications for appropriate use, as anything contrary to this will be unprofessional.

It stated that the increased demand for chloroquine and hydroxychloroquine for the treatment of COVID-19 has exacerbated their already limited availability for patients who rely on them to meet their medical needs, as they are experiencing difficulty in accessing the medicines for their conditions.

NAPPSA in a press release expressed worries for this set of patients who depend on chloroquine and hydroxychloroquine for their conditions as their symptoms do not respond to other treatments and there are no alternatives. “Many of these patients are not able to fill their prescriptions today, due to major shortages of hydroxychloroquine in the wake of nationwide confirmed reports of pharmacies having depleted their supplies and all drug manufacturers reporting back-orders”.

The statement signed by the NAPPSA President, Dr Anthony Ikeme and the Secretary,  Dr Aloysius Ibe  stated that NAPPSA joins the American Medical Association (AMA), American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP) in condemning this unethical act.

Acknowledging ongoing clinical studies all over the world to determine the efficacy in using hydroxychloroquine and chloroquine to treat COVID-19, the association noted efforts by the FDA in collaboration with innovators to expedite action on these activities, including leveraging scientific information about the virus and ongoing clinical trials in the US and other countries such as China, Japan, South Korea and Italy.

It cited the example of the US National Institutes of Health (NIH) as it has begun a randomised controlled trial for the treatment of COVID-19 patients with the investigational antiviral drug, remdesivir, while the FDA has been working with the drug sponsor to find multiple pathways to both study the drug under the FDA’s investigational new drug (IND) requirements, and thus collect helpful data about the efficacy of the drug, as well as provide the drug to patients under emergency use.

It explained that the FDA is committed to continuing to make use of its expanded access programme to allow the emergency use of remdesivir for eligible patients. To date, the agency has already granted over 250 patients access to this product. The data collected from the expanded access programme may contribute to the agency’s understanding of the drug, but controlled clinical trials are needed to determine if it is safe and effective for the treatment of COVID-19 infection.

The association therefore called on the medical community to ensure these products are effective; otherwise they risk treating patients with a product that might not work when they could have pursued other, more effective, treatments.”If clinical data proves the effectiveness of this product for treating COVID-19, NAPPSA anticipates an increased demand for hydroxychloroquine and chloroquine.  It is thus very important for drug regulatory agencies to engage domestic manufacturers to ramp up production of these drug products to mitigate any potential supply chain pressures.

The release further reads in part:

Illegally marketed COVID-19 products

“Despite the joint global efforts to facilitate prevention and treatment options, it is extremely important for everyone to know that some people and companies are trying to profit from this pandemic by selling unproven and illegally marketed products that make false claims, such as being effective against the coronavirus.  Fraudulent COVID-19 products can come in many varieties, including dietary supplements and other foods, as well as products claiming to be tests, drugs, medical devices, or vaccines.  NAPPSA urges the international regulatory agencies to closely monitor the market to combat these products with fraudulent claims.

Ongoing clinical trials

“Innovators are looking at products in a variety of areas, including the assessment of antiviral drugs that might treat the specific virus, as well as host targets, such as interleukin-6 (IL-6) receptor inhibitors that may be helpful in reducing lung inflammation and improving lung function in COVID-19 patients, thereby potentially slowing the progression of severe respiratory symptoms. Regeneron Pharmaceuticals Inc. has announced the initiation of a randomized controlled clinical trial of sarilumab, an antibody to the IL-6 receptor, to assess whether the modification of the inflammatory response by this treatment provides benefit to COVID-19 patients.

“There is also global interest in evaluating whether therapies, such as convalescent plasma and hyperimmune globulin, antibody-rich blood products that are taken from blood donated by people who have recovered from the virus, could shorten the length, or lessen the severity, of the illness. Facilitating the ultimate widespread use and availability of safe and effective medical countermeasures is critical for several reasons. In addition to reducing the severity and duration of respiratory or other symptoms through medical treatments, it could also help lessen the burden on medical personnel, equipment, and facilities”.

Founded in 2006 and representing over 7000 pharmacists, pharmaceutical scientists, pharmaceutical educators, NAPPSA works to support global health by enabling the advancement of pharmaceutical practice, sciences and education.    Many NAPPSA members are in the frontline providing pharmaceutical care to patients in COVID-19 pandemic and as members of the global health community we share responsibility of sharing our professional knowledge and experience with other healthcare professionals, organizations, policy makers and the general public.