(This story is from our new Health Tech newsletter. If you’d like to sign up, just click here.)
Stimulants prescribed during telehealth visits rose dramatically during the Covid-19 pandemic, when relaxed US regulations made it easier for patients to get the controlled substances online, a new study found.
Between 2019 and 2022, total stimulant prescriptions grew 37.5%, and the share that came from a telehealth visit rose from 1.4% in 2019 to 38.1% in 2022, according to a research letter published Friday in JAMA Network Open.
There’s a big caveat to the study — and it suggests that the sharp rise might actually be an undercount. Researchers from UCLA and analytics company Trilliant Health analyzed nationwide pharmacy fills associated with a medical visit filed through insurance. But any prescriptions written by direct-to-consumer companies or those paid out of pocket weren’t represented, and those businesses boomed during that period.
The data suggest that online prescriptions were a huge part of the increase. Prescriptions dispensed over the internet made up more than half — about 52% — of all stimulant prescriptions in the second quarter of 2020. Stimulants such as Adderall are commonly used to treat ADHD.
Previous studies have also shown that stimulant prescriptions increased during the pandemic. Federal law typically requires that patients have an initial in-person evaluation before they’re prescribed a controlled substance online, but that rule was temporarily suspended during the public health emergency, opening the door for more telehealth prescriptions.
Some startups like Cerebral and Done Global capitalized on that flexibility to prescribe stimulants online. The DOJ in June said it had charged Done executives peddling easy access to stimulants, at times when they weren’t medically necessary. Done did not immediately respond to a request for comment.
Those prescribing flexibilities are set to expire at the end of 2024, and hundreds of organizations have urged the federal government to extend them, arguing that millions of patients are poised to lose access to critical treatments.
The study in JAMA also looked at other types of drugs. It found that prescriptions for antidepressants grew 20.9% during the study period. The share from a telehealth visit grew from 1.5% in 2019 to 31.4% in 2022.
Total opioid prescriptions decreased 17.2% during the period, with the proportion from a telehealth visit rising from 0% in 2019 to 24.1% in the second quarter of 2020, and then dropping to 8.4% in 2022.
For each category of drugs, nearly all telehealth prescriptions were for individuals in non-rural areas.