To examine recent trends in leucovorin prescribing for children with Autism Spectrum Disorder (ASD) from January 1, 2023, to January 31, 2026, following public announcements regarding its potential benefits.
Key Findings:
Leucovorin prescription rates increased from a monthly mean of 34.1 per 100,000 encounters to 835.4 per 100,000 encounters by November 2025, with a notable rise beginning in February 2025.
The increase began months before the September 2025 White House announcement, indicating a pre-existing trend.
Mainstream media coverage may have influenced the rise in prescriptions.
Interpretation:
The sharp increase in leucovorin prescriptions for children with ASD appears linked to public announcements and media coverage, despite the lack of large-scale clinical trials confirming its efficacy for this indication, raising concerns about the implications of such prescribing practices.
Limitations:
Reliance on prescription-level data without confirmation of medical indication, which may not reflect actual clinical use.
Inability to assess patient-level clinical outcomes, limiting understanding of treatment effectiveness.
Lack of adjustment for site-level variation in Epic Cosmos participation, which may affect generalizability.
Conclusion:
The rapid increase in leucovorin use for ASD warrants ongoing surveillance, especially given the FDA's non-approval for this indication.
