Utah has already ordered $800K of malaria drugs, could spend millions more on unproven COVID-19 treatment

[Update: Utah governor says the state will not make planned purchase of malaria drugs for COVID-19 patients]

Utah officials have already committed $800,000 on an initial order of 20,000 doses of malaria medication promoted as a possible treatment for COVID-19, according to records that surfaced Thursday as state lawmakers looked at carving out $8 million that could be for a second and much larger purchase of the unproven drug.

If approved by the Legislature, the $8 million set-aside could fund the massive hydroxychloroquine order that state health officials have been pondering in recent weeks. Officials say their idea is to procure the medicine for 200,000 coronavirus patients and distribute it to drug stores across the state, where it would be available at no cost to people with a prescription certifying their COVID-19 diagnosis.

Health experts consulted by the state discouraged the purchase, saying that “there is no rationale for the state to expend precious resources” without any solid evidence that the medication helps coronavirus patients.

The state’s objective was to prevent any shortages of the drug, which are often prescribed to people with lupus and rheumatoid arthritis. But on Thursday, health officials released a statement that suggested this threat might be subsiding.

“The most consistent element of COVID-19 has been that things are constantly changing,” said Jeff Burton, acting executive director of the Utah Department of Health. “We wanted to put ourselves in a position that if there were to be a shortage in the supply chain of hydroxychloroquine we were well-positioned to be able to provide medication to Utah residents who need it. The good news is, the supply chain has recently shown signs of stabilization.”

Health officials said they are still researching federal requirements about the compounding and distribution of hydroxychloroquine and have not yet signed a contract for the 200,000 courses of treatment.

But records show the state has already ordered $800,000-worth of hydroxychloroquine and chloroquine from Meds in Motion, a Utah pharmacy chain that amassed the drugs touted by President Donald Trump as a potentially promising coronavirus treatment. Health officials have said they did not supervise this transaction and that it was not part of the larger deal they’ve been negotiating with Meds in Motion.

A purchase order obtained by The Salt Lake Tribune shows the state’s purchasing division requested 20,000 doses of the malaria drugs from Meds in Motion on March 31 — about 10 days after state leaders and business representatives held a news conference where one doctor declared the medicine had pulled some coronavirus patients back from the brink of death like Lazarus of the Bible.

It’s not clear what the state has done with this stash of medication, how the purchase was arranged or what the source of funding was.

The order happened a couple weeks before the Legislature passed SB3001, a spending bill that set aside $2 million for a drug stockpile. Lawmakers on Thursday were considering another proposal to reserve an additional $6 million in federal funds for medication. Specific expenditures for the drugs were not spelled out in the language of either bill.

Rep. Brad Last, House chairman of the Legislature’s main budget committee and sponsor of the proposal considered Thursday, HB4001, said the money could go toward hydroxychloroquine or any other treatment that ends up showing promise.

“These funds are going to be set aside for potential treatments, and we might not even know what they are at this time,” said Last, R-Hurricane.

Last told his colleagues that the state bought the initial 20,000 doses of hydroxychloroquine and chloroquine after the federal government warned of potential drug scarcities. He also argued that the $6 million appropriation was a “fairly small amount” of the roughly $1.3 billion in federal funds expected to flow to Utah.

Rep. Ray Ward, a physician, attempted to tweak the bill so the $6 million could only go toward medications for their FDA-approved uses. At this point, that would exclude purchases of hydroxychloroquine as an off-label treatment for coronavirus. Ward, R-Bountiful, argued that the state should not be expending funds on unproven therapies that “might in the end turn out to be damaging.”

His colleague, Rep. Suzanne Harrison, agreed and said the state’s drug acquisition efforts so far have troubled her.

“I have concerns that this lack of transparency is just enriching certain companies, potentially, and I just urge caution and fiscal responsibility," said Harrison, D-Draper, a physician anesthesiologist.

However, Last resisted the change, saying it could hamper the state’s ability to adapt to a situation in flux, and House lawmakers narrowly rejected Ward’s amendment before passing the overall bill. The Senate later signed off on the proposal, sending it to the governor’s desk.

Alliance for a Better Utah, a government accountability and progressive advocacy group, condemned the $6 million appropriation in a Thursday evening statement.

“At a time when Utah hospitals are depending on volunteers to sew medical masks for health care workers on the front lines, it is unconscionable that state leaders are choosing to blow public money in this way," Chase Thomas, the alliance’s executive director, said in the statement. “Public funds should not be used to bail out a private business gamble, nor should public funds be used to purchase an unproven drug against the advice of medical professionals.”

The owner of Meds in Motion, Dan Richards, has established a relationship with Senate President Stuart Adams. Both of them are part of an informal group of officials and businesspeople that formed to discuss testing and treatment options during the pandemic.

Adams, R-Layton, has supported stocking up on the medicine and participated in talks about buying it from Richards’ company.

“If it does work and we don’t have any of it and it will save people’s lives, what a travesty," Adams told reporters Thursday. "And if it doesn’t work and we’ve expended a few dollars, well, it might be a travesty but I don’t think the dollars will equate to the lives, perhaps, that may have been lost.”

However, health experts in Utah have warned that the drug has no proven benefit to coronavirus patients and could be dangerous to some.

On Tuesday, news broke about a study of 368 Veterans Affairs (V.A.) patients with coronavirus found that those who took the medicine, hydroxychloroquine, had higher rates of death than those who did not. There was no apparent benefit from the drug.

It was not a rigorous experiment and hasn’t been peer-reviewed. However, according to the Associated Press, the study is larger than others that have attempted to explore the drug’s potential for treating COVID-19.

In an interview about the V.A. study, Burton said he was reviewing the information but didn’t expect it would derail the deal with Meds in Motion.

“At this point, there would have to be a lot more information to come in that would cause us to not want to proceed,” Burton said Wednesday.

Infectious disease experts in Utah and elsewhere have argued that coronavirus patients should only use hydroxychloroquine — which has been approved by the FDA but not for COVID-19 — inside of a clinical trial so researchers can gather data about its effectiveness. In rare cases, the drug can cause dangerous heart rhythm problems, and physicians studying it in Utah say they are carefully monitoring patients using the medication.

Several clinical trials in Utah are already offering access to the medication, including two launched by Intermountain Healthcare and the University of Utah Health.

Taylor Stevens contributed to this report.