@article{uninipr7509,
           title = {Excessive Sales of Pharmaceutical Drugs in a Low and Middle-Income Country During the COVID-19 Pandemic: The Case of Ecuador},
         journal = {SSRN Electronic Journal},
            year = {2022},
          author = {Esteban Ortiz-Prado and Juan Sebastian Izquierdo Condoy and Carla Mora and Jorge V{\'a}sconez-Gonz{\'a}lez and Ra{\'u}l Fern{\'a}ndez},
        keywords = {Self-medication, misinformation, medicines, COVID-19, Ivermectin, Hydroxychloroquine},
             url = {http://repositorio.unib.org/id/eprint/7509/},
        abstract = {Background: The rapid spread of the SARS-CoV-2 virus, especially during the first year of the COVID-19 pandemic, has caused an unprecedented health crisis worldwide. Fear of getting infected, and the high mortality rates in some places, prompted the general population to engage in self-medication practices.

Methods: We conducted a cross-sectional analysis of Ecuador's prescription and self-medication consumption trends during the first two years COVID-19 pandemic. Data came from an integrated countrywide database of the physician prescribing trends, the use of over-the-counter medicines, (OTC) and the medicine-related spending levels through the COVID-19 pandemic in Ecuador. We compared the absolute difference in monthly and yearly demand and calculated excessive expenditure from previous years.

Findings: We found that in Ecuador, the pre-pandemic (2017-2019) yearly expenditure among these ATC groups was, on average, \$150?646,206 while during 2020 and 2021, the same groups represented \$228.327.210, a significant 52\% increase. Of this amount, 13\% were OTC Medicines, and 87\% required a formal prescription. The most remarkable growth in drug sales came from ivermectin with 2,057\%, followed by hydroxychloroquine with 171\%.

Interpretation: Our study shows that people consumed large quantities of medicines during the first two years of the pandemic in Ecuador, including drugs with no proven benefit to treat or reduce the risk of progression due to COVID-19. We suggest that the lack of local prescription guidelines and prescription control, as well as generalized fear and misinformation led doctors and patients to prescribe and consume vast amounts of unnecessary medicines.}
}