This legislative session, Louisiana state Sen. Mike Fesi has proposed a bill to make ivermectin an over-the-counter medication, basically meaning that it can be obtained without a prescription from a licensed provider. The question will be asked of this law that should be asked of all laws: why do we need it?
Let us examine that question, but first, let’s look at a brief history of the drug that changed the world in the 80s, but only achieved popular fame due to the controversy of COVID-19. The active compound in ivermectin was discovered by providence in soil on a golf course in Japan. It was found to be a potent inhibitor or parasitic worm growth and was developed by Merck into a drug for that purpose. First used in livestock, in the late 80s it found broad human use, mainly in the third world, treating river blindness, which historically had been a top cause of preventable blindness worldwide. Billions of doses have been given and the efficacy of the drug against difficult-to-treat parasitic disease earned its inventors a Nobel Prize in 2015.
In the United States, ivermectin is FDA-approved for use to treat parasitic infections and head lice. The drug became the source of political controversy when it was prescribed “off-label” for the treatment of COVID-19. Let us defer, for the time being, debate about the wisdom of using ivermectin to treat COVID patients, but acknowledge that there are many practitioners who believe it is effective, and many patients who believe they benefited from its use.
Problems arose when prescriptions for ivermectin were not filled. Not because it was unavailable, but because the pharmacist, or perhaps more likely their corporate overlords at the big box pharmacies, made a unilateral decision that they knew better than the licensed doctor writing a valid prescription for their patient. This was way out of bounds and represents an unprecedented level of overreach by pharmacies into the doctor-patient relationship for purely political reasons. Unable to obtain the medication in human form, many people turned to the feed store leading to potentially unsafe dosing.
“Off-label” use is a well-established practice. Drug manufacturers conduct clinical trials to prove the safety and efficacy of a particular medicine to treat a specific condition. These trials take years, are very expensive, and it would be impossible to conduct a new trial for every possible use of a medication. It is understood that many of these drugs, once FDA approved, will be used to treat other conditions and diseases that were not tested for in the trial. Without off-label use, we would not have eye drops after cataract surgery or ibuprofen for migraines. This concept deserves further protection in law.
Making Ivermectin over the counter will ensure access to the human form of the medication in safe dosing from a pharmacy and avoid driving people to the feed store. Billions of doses have been given worldwide, and when used in appropriate quantities, the drug is probably safer than many current OTC meds. As with any medication, this drug can have side effects and should be used only after consulting a licensed provider on dosing and duration. We support the passage of the bill – not because we believe ivermectin is some sort of miracle pill for all that ails you, but primarily because we believe medical decision-making occurs within the sacred doctor-patient relationship free from third-party interference to the maximum possible degree. This bill removes another potential source of that interference with the medical autonomy of the individual. Tennessee, Arkansas, and Idaho have already passed similar bills through their legislature. It is time that Louisiana join them.
