A bill, HB146, that would make it easier for Alabamians to purchase the drug Ivermectin faced significant pushback during a meeting of the House Health Committee on Wednesday.
If passed and signed into law, the bill would allow pharmacists to issue Ivermectin to adults without a specific prescription under a “standing order” signed by a care provider. The bill specifies that any such standing order will need to include a risk assessment profile and a standardized information sheet.
Approved by the FDA for treatment of parasitic infections, ivermectin became the subject of national discussion during the COVID-19 pandemic, when it was briefly considered as a possible treatment for the novel coronavirus.
However, one webpage on the drug hosted by the FDA now states that the agency “has determined that currently available clinical trial data do not demonstrate that Ivermectin is effective against COVID 19 in humans.” Clinical evidence that the drug is effective against other ailments besides parasitic infections is also lacking or nonexistent.
Matt Hart, a lawyer with the Alabama Board of Medical Examiners, and Niko Corley, director of legislative and public affairs for the Medical Association of the State of Alabama, both said past legislation is adequate to address the concerns of the bill’s sponsor and that HB146 is unnecessary.
“Let’s not build a highway when we can fill in potholes and take care of those issues,” Corley quipped.
Becky Gerritson, executive director of Eagle Forum for Alabama, also spoke in favor of the bill during the public hearing, calling Ivermectin a “Nobel Prize winning medication.” (The inventors of the compound later developed into ivermectin were one of the recipients of the 2015 Nobel Prize in Physiology or Medicine “for their discoveries concerning a novel therapy against infections caused by roundworm parasites.”)
“Before I get into what this bill does, let me tell you what this bill does not do,” Rep. Phillip Rigsby, R-Huntsville, said at the start of Wednesday’s meeting. “This bill does not make Ivermectin over-the-counter. There’s been a lot of confusion about bills like this in other states, specifically in Tennessee which is what this bill mimics, that that medication is over-the-counter. It is not.”
“It does exactly what this bill does. This bill is a mechanism bill, it is an access bill. What it does is it allows a physician or a prescriber—in this bill, a physician, a PA, or a nurse practitioner—to write a standing order,” he continued. “And if you don’t know what a standing order is, a standing order defines a therapy, in this case the use of Ivermectin, and it tells how this person would qualify, how that person would be evaluated, and the dose that would be given.”
“Typically standing orders are reserved for things with strong evidence of benefits, a narrow risk profile, and clear eligibility criteria, like vaccines,” Rep. Mark Shirey, R-Mobile, asked Rep. Rigsby after the public comment period. “Also, Ivermectin is not risk free. It depends on body weight, liver disease, neurological conditions, current medications, and pregnancy.”
“I understand that there’s a questionnaire or something that you guys would go through,” he said. “Isn’t that best done by the physician?”
Shirey also stated that there would be an “increased risk of off-label and non evidence-based use.”
“Personally, I think it’s better for a physician to prescribe this,” he continued. “If my patient wanted this, we’d have a conversation. We would decide if it was appropriate or not. And if I did prescribe it, I would follow up with my patient to make sure I’m not causing harm.” Shirey is a practicing optometrist in Mobile.
“I’ve had the question, ‘why ivermectin?’” Rigsby had stated earlier. “‘What’s the big deal with ivermectin, why would you bring this?’ Well we all know this drug was politicized during the COVID outbreak. A lot of patients wanted this therapy, but had no access.”
“The main reason I’m bringing this bill is safety,” Rigsby stated. “I do not want patients to go out to the vet’s office and get Ivermectin specifically designed for animals and use it on themselves.”
During an interview with APR earlier this month, the sponsor of another bill that would make it easier for Alabamians to procure Ivermectin, Rep. Chip Brown, also noted that making the drug easier to purchase would be safer than “the paste or the liquid forms that aren’t necessarily intended for human consumption.”
