The Lupus Foundation of America is working with medical professionals to actively pursue all avenues to ensure people with lupus have access to the medications and medical care they need, including hydroxychloroquine (Plaquenil) and chloroquine. These drugs are commonly used in the treatment of lupus and are currently under investigation as potential treatments for coronavirus (COVID-19). We support efforts to fast track study of these drugs for COVID-19, but at the same time urge all stakeholders – patients, health care providers, industry, and government — to work together so that those with lupus and other conditions who rely on these drugs continue to have access to them while their potential use in COVID-19 is studied.

For many people with lupus there are no alternatives to these medications. For them, hydroxychloroquine or chloroquine are the only methods of preventing inflammation and disease activity that can lead to pain, disability, organ damage, and other serious illness. An increase in lupus-related disease activity not only significantly impairs the health and quality of life of people with lupus but will also place further strain on health care providers and systems in a time of crisis.

Unfortunately, there are already verified reports across the country of pharmacies having major shortages of these vital drugs. The Foundation applauds the commitment of pharmaceutical companies that have pledged to increase production and supply of these medications. We call on all manufacturers of hydroxychloroquine and chloroquine to do the same.  However, increased production must not solely be done for the purpose of responding to COVID-19, but also to meet the existing needs of people with lupus. The efficacy and safety of these drugs for lupus are established, and the drugs routinely are prescribed for lupus. While we support investigating their use for COVID-19, it is important that the nation not forget the people who already rely on these medications in their daily lives.

The Lupus Foundation of America is actively communicating with the lupus community about this issue and working with medical experts to provide guidance to health care professionals and people living with lupus. Additionally, we have collaborated with national patient organizations to submit a letter to the Congressional Leadership and the Administration calling for the implementation of needed patient protections. Highlights of the letter urge Congress to:

• Remove burdensome barriers to obtaining medications, including limits on refills or other efforts to ensure supply of these medications. This is a particular concern to maintain a consistent supply for people who take an approved medication that is being studied for use in COVID-19, such as hydroxychloroquine, which is used to treat lupus and rheumatoid arthritis
• Require all payers to allow for provision of an emergency supply of medications and supplies by relaxing restrictions on timing of refills and amounts, to at least the CDC-recommended extra 30-day supply and up to a 90-day supply to reduce returns to the pharmacy
• Require all payers to waive prior authorization and utilization management requirements
• Require payers to relax requirements for in-person visits for refills, including allowing visits through telehealth
• Require all payers to establish policies to assist patients with cost-sharing related to their emergency supply or allow for delayed payment of out-of-pocket costs for emergency supplies.