Researchers at Boston Children's Hospital in the U.S. have reported that the recent shortage of medicines used to treat coronavirus disease 2019 (COVID-19) could be due to extensive news media coverage that results in individual hoarding or institutional stockpiling of medicines. The study is currently available on the medRxiv* preprint server.
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
As of October 16, 2020, highly infectious and deadly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 38.8 million people and claimed more than 1 million lives globally. Rigorous testing, together with strict implementation of non-pharmaceutical control measures (masking, hand washing/sanitizing, movement restriction, etc.), is believed to be the most effective way to contain the viral spread.
Regarding pharmaceutical interventions to manage COVID-19 patients, several medicines have been proposed for repurposing as COVID-19 treatment. However, the US Food and Drug Administration (FDA) has reported that there is a nation-wide shortage of many of these medicines.
In the current study, the scientists investigated if this shortage is caused by the hoarding of drugs by individuals or stockpiling of drugs by institutions. They also investigated whether media news coverage has any influence on drug hoarding/stockpiling.
Current study design
The scientists analyzed US news media coverage and internet search related to eight repurposed medicines reported to be in shortage by the FDA between January 1, 2020, and June 30, 2020. These medicines include azithromycin, famotidine, hydroxychloroquine, cisatracurium, dexmedetomidine, continuous renal replacement therapy (CRRT), midazolam, and propofol.
A pharmacist associated with federal COVID-19 response selected and categorized eight repurposed medicines based on the data collected from the American Society of Hospital Pharmacists and national and international workgroups.
Of eight medicines, three were categorized as “able to be hoarded by individuals or stockpiled by institutions,” as people can directly purchase these medicines from pharmacies. These medicines include azithromycin, famotidine, and hydroxychloroquine.
Five repurposed medicines, including cisatracurium, dexmedetomidine, continuous renal replacement therapy (CRRT), midazolam, and propofol, were categorized as “able to be stockpiled by institutions only,” as people generally do not purchase these medicines on their own.
For each medicine, the scientists analyzed news media coverage by Media Cloud’s National Corpus. They separately analyzed the media coverage about medicines, excluding the word “shortage” and medicines, including the word “shortage.” Regarding internet search volume for each repurposed medicine, the scientists collected the data from Google Health Trends.
Important observations
For all three medicines that can be individually hoarded or institutionally stockpiled, news about medicines either including or excluding the word “shortage” sharply increased before the FDA-announced shortage. Moreover, internet searches related to these medicines also increased significantly before the shortage announcement.
A similar trend was observed for five medicines that are most likely to be stockpiled by institutions only. Media news about these medicines, either including or excluding the word “shortage,” also sharply increased before the FDA-announced shortage. However, no variation in internet search related to these medicines was observed before the shortage announcement.
Study significance
The study findings indicate that extensive news media coverage about essential COVID-19 treatment medicines can influence the hoarding/stockpiling behaviors of both individuals and institutions prior to the shortage. This, in turn, can deprive COVID-19 patients who are in the actual need of these medicines for off-label usage.
The increase in internet search patterns observed in the study indicates that people who are influenced by news actually try to look for medicines they can directly purchase and hoard for future use.
Because institutions are less likely to search drug-related information on the internet before purchasing, no variation in internet search pattern was observed in the case of medicines that can only be purchased by institutions. Thus, internet search trends seem to differentiate between individual hoarding and institutional stockpiling correctly.
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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