Disputed drug took detour
Hydroxychloroquine initially shipped to Pryor pharmacy
It’s been a long, strange trip for Oklahoma’s $2.6 million shipment of hydroxychloroquine, bought a year ago as a once-promising treatment for COVID-19.
The 1.2 million doses of the drug normally used to treat lupus and rheumatoid arthritis and prevent malaria were shipped from a California distributor to a small pharmacy in Pryor, with the state paying for the hydroxychloroquine from money borrowed from fees generated by medical marijuana licenses.
The hydroxychloroquine now sits in a warehouse at an undisclosed location, with the Oklahoma State Department of Health reluctant to answer questions about what it will do with the drug or why it went to Pryor.
Records obtained by Oklahoma Watch show the drug has an expiration date in December. Meanwhile, lupus and rheumatoid arthritis patients had to navigate a temporary shortage related to a spike in demand related to the drug’s supposed COVID-19 usage.
In the early weeks of the pandemic, former Secretary of Health Jerome Loughridge authorized the purchase of up to $3 million of hydroxychloroquine from California-based FFF
Enterprises Inc., according to an April 3, 2020, memo.
At the time, the state was scrambling to secure coronavirus tests, ventilators and personal protective equipment, with the federal government largely leaving states to do their own purchasing of the scarce supplies.
At the end of April, Loughridge approved another $3 million to purchase supplies in a memo sent to Gino Demarco, a deputy director at the Tourism Department and a logistics expert who served as the state’s PPE supply chain leader. Loughridge and Demarco have since returned to the private sector.
At the time, the state had not yet received money under the federal CARES Act, so it had a problem: How to pay quickly for protective equipment and hydroxychloroquine at a time when nobody knew the pandemic’s effect on the state budget. The medical marijuana fund from patient and business licenses was among the few state financial accounts with a surplus at the time.
In normal times, the state can’t use fee revenue for other government purchases. But the Legislature had granted Stitt additional powers under the Catastrophic Health Emergency Powers Act, a law passed in the wake of the 9/11 attacks but never used in Oklahoma until the COVID-19 pandemic.
At a late April 2020 news conference, Gov. Kevin Stitt described how he directed Demarco to procure gowns, gloves, N-95 masks and build up the state’s stockpile of equipment.
“We knew we were getting reimbursed for that,” Stitt said at the time. “Also, in early March, hydroxychloroquine was also shown to be a treatment. So we went out and procured that as well. Now there’s some other evidence that it may not be as effective. But I was being proactive and trying to protect Oklahomans.”
Shipped to Pryor
The hydroxychloroquine shipment was sent to Beggs Pharmacy in Pryor. The health department couldn’t provide any explanation as to why the drug was sent there. The pharmacy’s owner, Derek Sien, referred all questions to the Governor’s Solution Task Force.
Clayton Bullard, who was part of Stitt’s coronavirus task force, said the pharmacy’s owner also ran a distributing company that was going to dispense the drug for $1.05 per prescription. That deal never came to fruition. Just weeks later, the U.S. Food and Drug Administration revoked its emergency use authorization of hydroxychloroquine to treat COVID-19.
“The pharmacy lost money on that deal. They didn’t make any money,” Bullard said. “They were going to make money on their distribution fee, but because within four months of that product being acquired, the FDA retracted hydroxychloroquine to be used for COVID issues. So the pharmacy actually sat on it and stored it for close to nine months at their own cost and then never made a dime on it because there was no distribution of it.”
The health department said it had no records of any contracts involving Sien’s A&K Distributors LLC and hydroxychloroquine. Sien and the pharmacy were included in emails related to the hydroxychloroquine purchase last April, including several confirming details of the shipment to Beggs Pharmacy by FFF Enterprises.
Bullard said the hydroxychloroquine shipment is now in Oklahoma City. The health department declined to confirm that, saying the location was secret because of “security concerns.” It did not detail those security concerns.
“Every pill was accounted for, and that inventory has been transferred to Oklahoma City and is sitting in Oklahoma City warehouses,” Bullard said.
Bullard said the state could easily find a buyer for the hydroxychloroquine and suggested that Veterans Administration would be able to use that size of shipment fairly quickly.
Higher demand leads to drug shortage
Even as COVID-19 vaccines were quickly put into clinical trials in the spring and summer of 2020, nobody really knew what existing drugs might be helpful to treat the virus spreading rapidly across the country and around the world. The possibilities included hydroxychloroquine, common steroids, certain antibiotics and even zinc.
Among Medicare patients, use of hydroxychloroquine grew rapidly in spring and summer last year, according to a preliminary analysis by the inspector general for the U.S. Department of Health and Human Services. “Investigators found Medicare prescription payments for the drug rose 28% from March to July 2020, compared to the same period a year earlier.”
Much of the increase was from its use in nursing homes.
“Prescribers may have followed hope more than evidence, and patients may have taken unproven drugs without knowing why,” the investigators wrote in a March column.
Former President Donald Trump was among the biggest cheerleaders touting the use of hydroxychloroquine to treat COVID-19. His public comments weren’t backed by the science, which showed limited or no benefits of using the drug for COVID-19. The FDA’S short-lived authorization was limited to dispensing the drug for COVID-19 patients in hospital settings with strict medical oversight.
Still, several governors, including Stitt, put limits on the dispensing of hydroxychloroquine in the first few months of the pandemic. Under an executive order, patients in Oklahoma were limited to a 14-day and then a 30-day supply for each prescription from March to May last year.
A poll by the Lupus Foundation of America found more than half of lupus patients surveyed had issues securing adequate supplies of hydroxychloroquine last summer. The drug appeared on the FDA’S drug shortage list for several months, although it has since been removed. Meanwhile, one pharmaceutical company, Teva, said in December it will no longer manufacture the drug.