Dear Members and Friends

There has been growing concern among members of the community who may be anticipating or having trouble obtaining their prescription drugs, particularly hydroxychloroquine (Plaquenil, HCQS, Apo-hydroxy), following recent reports of the drug's possible use for treating Covid19 infection.  It should be noted studies are still underway of this drug and several other medications being tried to ameliorate the effects of severe covid19 infection and are still not conclusive.

What is hydroxychloroquine and why its use for lupus?

1. Hydroxychloroquine was originally a developed for the prevention and treatment of malaria but now is most widely used for the control of a variety of inflammatory/autoimmune diseases such as rheumatoid arthritis and lupus.  
2. For persons with lupus, hydroxychloroquine is considered an essential drug recommended for all lupus patients, due to its important role in stabilizing disease and preventing flares.  Flares in lupus are periods of increased disease activity associated with uncontrolled inflammation that can lead to increased symptoms, risk of organ damage or sometimes life-threatening complications.  
3. Hydroxychloroquine also lowers the risk of cardiovascular events such as stroke, heart attack and uncontrolled clotting problems that are particularly common in lupus patients.  
4. Used alone or in combination with other drugs, it has a unique and essential role in in lupus treatment. 

Managing Your medications during the Covid19 outbreak

1. We recognise that lupus patients are considered to be among the vulnerable group for severe Covid19 infection both as a result of the disease itself and the immunosuppressive drugs often required for controlling the disease.  
2. It is not advised, however, that patients with lupus stop their medication due to fear of contracting Covid19 disease, because stopping your treatment can lead to a flare of the lupus.  Should a flare occur, in addition to the risk of organ damage, the risk of infection may become even higher. Remaining on your medications including hydroxychloroquine helps prevent such flares.  
3. In the case of Covid19 or other infection, steroids and some immunosuppressive medications may need to be adjusted as instructed by your doctor; however, hydroxychloroquine is not considered immunosuppressive and can usually be continued in the presence of infection.  

Ensuring Your Supply of Medication

In the presence of the outbreak, the Foundation has advised its members to take maximum precautions to avoid infection and also to ensure that they maintain a continuous supply of all their medications, including hydroxychoroquine.  

There are, fortunately, several measures now in place to assist you with maintaining a steady supply of your medication during the covid19 outbreak.:

1)    Lupus patients along with other vulnerable patients can secure up to three (3) months’ supply of your medications on a single visit to the pharmacy.  This applies to public patients (using Government hospitals and clinics) using the DrugServ pharmacies and also to private patients using private sector pharmacies

a)    Private sector patients can purchase 3 months' supply drugs at reduced cost due to the following:

i)       National Health Fund subsidy has been extended to up to 3 months:  

(1)  lupus is covered on the individual benefits programme - systemic lupus since April 2019 and other forms of lupus including discoid lupus since February 2020 - Lupus patients should ensure they have signed up for this programme

(2)  the subsidy available under the NHF has been extended to up three months (instead of the usual 30 days) due to the covid outbreak until July 2020

ii)     several insurance companies have extended the allowable supply of drugs to be covered in one refill by an extra month, up to three months in the case of Sagicor and two months in the case of Medicus.

b)    For Public Sector users (who utilise government hospitals and Clinics) utilising NHF's DrugServ Pharmacies

i)       up to 3 month's supply of medications can now be dispensed, subject to availability, for all patients with chronic conditions, instead of the usual 30-day supply

ii)     additional supplies have been ordered in anticipation of increase demand and supply chain disruptions

iii)    prescriptions remain available free of cost as usual

2)    To minimise risk of exposure while filling prescriptions, patients are being encouraged to use the drop off and pick up service offered by their pharmacy 

a)    For Public Sector users of DrugservPharmacies convenience measures include

i)       scheduled refill service

ii)     priority service

iii)    Quick Prescript app via your smart phone or kiosk

3)    If you do not have sufficient prescription refills to tide you over, we suggest you:

a)    Keep your scheduled doctor's appointment - once you are satisfied that proper measures are in place at your doctor's office to prevent contact spread and allow for appropriate social distancing.

b)    Get in touch with your doctor and request prescription refill.  Be prepared to update your lab work or to go in for an appointment if you have not been seen recently and the doctor requires this.

c)     Take along an NHF Registration Form (yellow) or Update form (blue) if you are not yet registered with the NHF or your records have not yet been updated to reflect your lupus diagnosis

We remain in close communication with Government agents and professional bodies to see what can be done to give priority to lupus patients in securing their medications in the context of a possible shift in demand or supply.

We are thankful for the spirit of corporation being exhibited and join you in praying for our community and other vulnerable persons, our front-line workers, leaders and the nation for God's continued protection and guidance during this challenging time.

LUPUS FOUNDATION OF JAMAICA

You are not alone!