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States push to ease access to ivermectin, other COVID treatments that establishment blocked

Oklahoma attorney general also says he'll leave alone doctors prescribing FDA-approved drugs for off-label COVID treatment.

Published: February 11, 2022 5:27pm

Updated: February 12, 2022 3:19pm

Elected officials are pushing back against medical licensing boards, hospitals and pharmacists who are blocking access to off-label COVID-19 treatments or threatening to investigate doctors for dispensing them.

Several states are considering legislation of varying specificity to authorize dispensing of drugs such as ivermectin and hydroxychloroquine to treat COVID. One was introduced by a physician-lawmaker under investigation for prescribing ivermectin to COVID patients.

Oklahoma Attorney General John O'Connor announced Tuesday that his office would not prosecute doctors for prescribing FDA-approved drugs for off-label COVID treatment.

A state medical licensure board has "no legal basis" to discipline a licensed physician for "exercising sound judgement and safely prescribing" ivermectin or hydroxychloroquine for COVID, he said. "Our healthcare professionals should have every tool available to combat COVID-19. Public safety demands this."

Legislators' interest is part of a broader movement against federal authorities' repeated denunciations of cheap potential COVID treatments. The FDA has misleadingly insinuated that ivermectin is a horse-only treatment, a popular misconception that has stuck despite the antiparasitic's wide use in humans worldwide.

Yale University public health professor Harvey Risch has accused the feds of relying on "fake studies" that conflate two very different study populations — hospitalized and outpatient — to portray hydroxychloroquine and ivermectin as ineffective and dangerous.

In an advisory Tuesday, the Association of American Physicians and Surgeons said "it is perfectly legal" for physicians to prescribe ivermectin for off-label indications, though in the current climate the drug may be obtainable "only from compounding pharmacies." The group recently accused the American Medical Association of "suppress[ing] independent thought."

The bill that narrowly passed the South Dakota House Health and Human Services Committee Thursday is the most vague reviewed by Just the News.

"A practitioner may, in accordance with accepted medical standards, dispense ivermectin to a person with or without a prior prescription," HB 1267 reads. Republican Rep. Phil Jensen, the prime sponsor, said doctors would no longer be risking "their licenses or livelihood," The Center Square reported.

The bill, however, says nothing about shielding doctors from investigations by licensing boards, overruling hospital bans or requiring pharmacists to fill prescriptions. Jensen told Just the News Friday afternoon "we’re looking at a couple of amendments that would tighten things up" and that he would call later to explain.

The committee voted down an amendment by Rep. Fred Deutsch to change "dispense" to "prescribe" and require a prescription. He and Rep. Tamara St. John, both Republicans, said they wouldn't support the bill on the floor without further amendments, the Mitchell Republic reported.

The Kansas legislation is far more prescriptive as introduced, with liberal use of the mandate word "shall."

SB 381 says "a prescriber may prescribe, and a pharmacist shall dispense" FDA-approved drugs "including, but not limited to, hydroxychloroquine sulfate and ivermectin" for off-label COVID treatment, "even if the patient has not been exposed to or tested positive for COVID-19."

Prescribers and pharmacists "shall be immune from civil liability for damages, administrative fines or penalties for acts, omissions, healthcare decisions" while acting pursuant to the bill. Their actions "shall not be considered unprofessional conduct."

Neither will a "recommendation, prescription, use or opinion" related to COVID treatment that is "not recommended or regulated by the licensing board," Department of Health or FDA. This section is retroactive to disciplinary action going back to March 12, 2020, with licensing boards required to review and rescind such actions.

The bill was introduced last month by Republican Sen. Mark Steffen, an anesthesiologist, who soon disclosed he had been under investigation for the past year and a half for prescribing ivermectin, the Kansas Reflector reported.

The Kansas Board of Healing Acts is using the investigation "to hold over me to think they're going to silence me as I serve as a state senator," he said, claiming it's not based on patient complaints but rather his public statements. 

Steffen's license is current and has not been subject to board action, but another doctor, Amy Hogan, testified at a bill hearing that a pharmacist reported her to the board for allegedly prescribing "dangerously high doses of ivermectin." 

The bill page for SB 381 has not changed since Jan. 25 because its contents were added to a different bill (HB 2280) that the Kansas Senate Public Health and Welfare Committee then approved, Steffen told Just the News Friday night.

Before that, Steffen successfully added provisions from another bill (SB 398) requiring schools and childcare facilities to approve vaccine exemptions if parents sign a "religious exemption statement," which includes moral and ethical objections.

The Topeka Capital-Journal characterized the maneuver as a "gut and go" because the original HB 2280 passed the House last session. Steffen told Just the News he wasn't sure if the bill page was "updated to accurately reflect its contents."

The Reflector reported that Steffen also amended the bill to remove the civil liability provisions and require pharmacists to approve any drug for COVID treatment sought by doctors.

The bill page says the committee report recommended the passage of the "substitute bill" Wednesday, but it was withdrawn from the calendar and re-referred to the committee the next day. It does not list any action since Thursday.

Steffen cited a "technical error" that will be corrected, clarifying that "pharmacists still have responsibility to verify, validate, and authenticate the prescription. They cannot refuse to fill based solely on the known or assumed diagnosis of Covid."

The Pennsylvania House Health Committee approved an amended bill (HB 1741) Feb. 7 that had been introduced the previous summer. It splits the difference between the South Dakota and Kansas bills.

Pharmacists "may" dispense FDA-approved therapeutics to doctors "for off-label use to the patient for prophylaxis or for at-home, early-stage outpatient or hospital inpatient treatment" for COVID, with no "suspected exposure" required. Licensing boards or commissions couldn't deem such actions "unlawful, unethical, unauthorized or unprofessional conduct."

The amended version removed ivermectin and hydroxychloroquine as specifically named treatments. It also added one situation where boards or commissions may take action: "recklessness or gross negligence."

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