With 5 million boxes, Prevent Senior and Hapvida continue to prescribe covid kit

Since the beginning of the pandemic, two networks of private hospitals have purchased more than 5 million cases of drugs proven to be ineffective against covid-19, such as chloroquine, ivermectin and hydroxychloroquine. This is shown by an unprecedented compilation made by Repórter Brasil from internal documents of the health plans that own hospitals: Prevent Senior and Hapvida.

The data make it clear that the prescription continued to occur even after Chloroquine manufacturers have released notes not recommending the drug for covid., and six months after the WHO has declared hydroxychloroquine ineffective. Stories
of patients show that medications from the so-called covid kit are still being prescribed.

One of the purchases that most caught the attention of specialists heard by the report was made by Hapvida in March this year, when more than 1 million boxes of chloroquine were acquired — 15 times more than the total purchased a year earlier, when the pandemic was in the beginning and the effectiveness of the drug was still being studied.

In the case of ivermectin, the same operator purchased between March and April this year more than 800,000 cases of the drug, whose use for covid was mocked by the FDA, the US drug regulatory agency.

Adding up the purchases, it would be possible to distribute practically a box of one of the medicines in the kit to each of the nearly 5 million beneficiaries of the operators, since Prevent currently has 540,000 patients and Hapvida, which dominates the market in the Northeast, has 4 .8 million.

Behind this mass distribution by operators, there was pressure from the leadership of both for their doctors to prescribe these drugs. There are also complaints from doctors who report punishments for refusing to prescribe the kit being shelved, inaction of advice and slowness of the responsible public bodies.

‘It’s not a discussion about medical autonomy’

According to medical standards, doctors can prescribe chloroquine and hydroxychloroquine (indicated for rheumatoid arthritis and lupus) and ivermectin (for the treatment of worms) for covid. It is the fact that operators buy millions of pills for patients – hospitalized in their hospitals or who have undergone consultations in call center – and pressure their doctors to prescribe this covid kit that made them the target of investigations.

“Contrary to what companies say, it’s not a discussion about medical autonomy or off-label prescription [uso de um remédio sem seguir as indicações originais]. These operators included in their protocols medications that were proven to be ineffective, putting the health of users at risk”, says Ana Carolina Navarrete, coordinator of the Health Program at Idec (Brazilian Institute for Consumer Protection).

In the case of Hapvida, 3.6 million boxes of medicines that make up the kit were purchased between March 2020 and May 2021, with 2.3 million boxes of chloroquine and hydroxychloroquine, and 1.3 million boxes of ivermectin. The data are contained in an internal document sent by the operator to the CPI to Covid.

Prevent Senior would have purchased the kit only in 2020, according to data obtained exclusively by the report. In total, between March and June 2020 alone, at least 1.5 million boxes of medicines in the kit were purchased, which is equivalent to almost three times the number of the company’s customers. In March last year, 240,000 boxes of chloroquine and hydroxychloroquine were purchased; in April, another 469 thousand; and in May and June, there were at least 400,000 per month.

At Prevent Senior, the kits were distributed in the operator’s hospital pharmacies, in the case of face-to-face consultations, or sent to patients’ homes, when care was provided by telemedicine.

pressure - Reproduction - Reproduction

Prevent Senior doctors were pressing for WhatsApp to prescribe the kit-covid

Image: Reproduction

Repórter Brasil found that the two companies continued to pressure doctors for mass and indiscriminate distribution of kits. And medications continue to be prescribed, according to reports from patients heard by the report and records on the website Reclame Aqui.

“A doctor from Prevent called offering the covid kit with chloroquine and hydroxychloroquine […] and revealed that they are required by the company to offer the kit,” said a client on the 13th.

More than a year of complaints

Among the first complaints relating the covid kit to operators is that of a doctor from Ceará who, in May of last year, denounced Hapvida to Cremec (Regional Council of Medicine of Ceará) after being fired for refusing to prescribe the kit properly. indiscriminate. To date, the board has not completed the investigation. Questioned, the agency said that the investigation takes place in secrecy. The case reached the Public Ministry of Ceará, which imposed a fine of R$ 468 thousand on Hapvida. The operator appealed.

A few months after the first complaint against Hapvida, it was Prevent’s turn, when the newspaper “O Estado de S.Paulo” reported that the company was distributing the kits by mail. In April, Globo News showed that Prevent was distributing chloroquine and putting pressure on doctors.

After the allegations, Hapvida and Prevent Senior were included in Covid’s CPI investigations. “The information we have is that this was an agreement between the hospital management and the government. And the so-called parallel office would be behind this one. He was the link between Prevent Senior and the federal government,” said senator Humberto Costa (PT).

It was through the WhatsApp groups that the pressure came for the operators’ doctors to prescribe the medication and also not to inform patients and families about the treatment. Repórter Brasil had access to screenshots of conversations and, in one of them, Pedro Benedito Batista Junior, executive director of Prevent, who is due to testify soon at the CPI, asks that doctors “don’t miss the opportunity to test patients”.

Pedro Benedito Batista Junior, executive director of Prevent, asks in a message that the doctors "don't miss the opportunity to test patients".  - Reproduction - Reproduction

Pedro Benedito Batista Junior, executive director of Prevent, asks in a message that doctors “don’t miss the opportunity to test patients”

Image: Reproduction

A doctor who worked at Hospital Antônio Prudente [administrado pela Hapvida, em Fortaleza] he said he was under the same pressure, including threats of dismissal for those who did not prescribe the kit.

Archived investigations

The case of the doctor from Ceará is not isolated in terms of investigations filed on the pressure to prescribe ivermectin and chloroquine. There are other complaints that went to the drawer, without punishment to the operators, which also end up benefiting from the slowness of other responsible bodies.

In São Paulo, Prevent Senior is also being investigated by the Public Prosecutor’s Office, but the Consumer Defense Prosecutor’s Office asked, in June, for the case to be closed due to lack of evidence. The case, however, remains open at the Public Health Prosecutor’s Office.

Cremesp (São Paulo Regional Council of Medicine) has also been investigating the case since April, but the process remains unfinished. Questioned, he said that the investigation is confidential. ANS, on the other hand, investigates other complaints against two operators, which remain confidential.

Idec sent a complaint to the ANS, the Public Ministry and the CPI against the two operators. “We concluded that companies did not comply with important obligations that they have with their consumers and should be sanctioned for this, including to reverse and repair the generalized lack of information, as well as any damage suffered by users”, says Navarrete, from Idec.

Prevent did not comment on the data or the complaints, only saying that “it acted within the ethical and legal parameters and, above all, with respect to the beneficiaries”. Hapvida already said that “it respects medical sovereignty and that all treatments are entirely autonomous by the professional, decided in common agreement with the patients”. (Read the full notes).

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