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Governor Mike Parson signed a bill into law that allows pharmacists to prescribe the ivermectin and hydroxychloroquine without potential licensing repercussions.
It just got a little harder for regulators to stop off-label use of ivermectin and hydroxychloroquine.
On June 7, Governor Mike Parson signed a bill into law that allows pharmacists to prescribe the two drugs — which some believe treat and prevent COVID-19 but are not recommended by the FDA or the National Institutes of Health — without potential licensing repercussions. The bill also prohibits pharmacists from contacting physicians or patients to dispute the effectiveness of either drug.
Dr. Evan Schwarz, division chief of medical toxicology at Barnes-Jewish Hospital, says that too much of either drug, when not taken for its intended, on-label use, can be harmful. In his practice, Schwarz has seen a patient with ivermectin poisoning.
“We’ve had someone get very sick, get very altered and confused,” he says.
If ingested by humans, the Missouri Department of Health and Senior Services warns ivermectin could lead to nausea, seizures or even death in extreme cases.
The Department of Health and Senior Services is aware of the new law, according to representative Lisa Cox. In an email, she noted that “several papers on the potential use of ivermectin to treat COVID-19 have been retracted.”
According to Schwarz, those who overdose on hydroxychloroquine — a drug created to treat malaria — can suffer severe cardiac issues.
“That’s the more concerning one, I would think,” he says. “People have died from that.”
The FDA has also strongly condemned use of either drug as a treatment for COVID-19, citing studies that found they weren’t effective and could be dangerous.
The clause about ivermectin and hydroxychloroquine was tacked onto a larger bill relating to licensing practices in the Senate by Senator Rick Brattin (R-Harrisonville).
In an email to the RFT, Brattin disparaged government agencies who tried to “force conformity in COVID treatment.”
“There's no reason doctors should be disciplined for or prevented from prescribing these proven drugs for off-label use,” Brattin wrote. “Doctors know their efficacy and they know their patients.”
The bill also impacts other licensure policies in a variety of medical fields.
Representative Patty Lewis (D-Kansas City), who was on the committee that handled the bill, pointed out that much of the rest of the measure aims to open access to health care in Missouri.
She says that the committee determined that the potential harm of passing the clause related to ivermectin and hydroxychloroquine was outweighed by the benefits of the remainder of the bill.
“There was certainly a lot of good in the bill, addressing many of the issues that we see in the state with regards to workforce and barriers around health care,” she says.
The law allows nurse practitioners to prescribe home health care and approves a pilot program designed to examine new methods of extending dental care to underserved communities.
Lewis says that the committee determined that the potential harm of passing the clause related to ivermectin and hydroxychloroquine was outweighed by the benefits of the remainder of the bill.
The review committee also ran the bill’s language past the Missouri Pharmacists Association, Lewis says.
Even if the drugs are ‘prescribed lawfully,’ Schwarz says that the real issue with the clause is that it blocks pharmacists from contacting physicians or patients if a prescription of either drug is concerning.
“Pharmacists really serve as a check and balance to ensure the prescriptions aren't going to be harmful. When you take that away, you're going to increase the chance that patients suffer,” Schwarz says. “This bill would really make it much harder for them to say, ‘Hey, I think this is a problem.’”
Lewis, however, was confident that the bill would have been shot down if Republican senators hadn’t been allowed to add the section about ivermectin and hydroxychloroquine.
Without the language on ivermectin and hydroxychloroquine, she says “the bill would have died.”
“What these buzzwords do, basically, [is] make it OK for some folks in the Senate,” Lewis says.
Other midwestern and southern states, including Ohio, Kansas and Tennessee, are on similar paths to approve bills allowing looser laws and fewer checks on the prescription of ivermectin and hydroxychloroquine.
