Concern as Republicans push to make dubious Covid cure prescriptions easier
Republican state lawmakers across the United States have proposed – and in some cases passed – legislation that they say keeps the government from interfering with doctors who want to prescribe ivermectin and hydroxychloroquine to help prevent and treat Covid-19.
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But those treatments have not proven effective at preventing or treating Covid and infectious disease experts see the bills as examples of rightwing lawmakers politicizing medicine – a trend that is increasing as the pandemic wears on in America into its third year amid an increasingly fraught political atmosphere.
And so it goes with the latest suspect Covid-19 treatment that has become about more than just a drug, but rather about whether to trust established public health organizations or doctors who stray from their guidelines, and podcast and cable news hosts.
“We really need to have the politicians step aside and let scientists and public health officials make the decisions on what is going to be beneficial in preventing and treating Covid,” said Sunil Parikh, an associate professor of epidemiology and infectious diseases at the Yale School of Public Health.
Kansas is one of at least 11 states, according to Buzzfeed, where Republican lawmakers have proposed, and in some cases passed, legislation to limit medical licensing boards’ ability to take action against providers who prescribe ivermectin and hydroxychloroquine, another drug that has not been shown to be effective against Covid but nevertheless promoted by some politicians on the right.
“We are leaving it up to medical professionals like it should be, not bureaucrats trying to maintain a single message,” said the Kansas state senator Richard Hilderbrand, the chair of the committee that sponsored the legislation.
The Kansas bill requires a pharmacist to dispense a prescription for hydroxychloroquine sulfate and ivermectin and states that it protects pharmacists or prescribers from liability for prescribing the drugs for Covid-19.
Hilderbrand said he introduced the bill in part because the Kansas Board of Healing Arts was going after doctors for prescribing medication for off-label use.
Fellow Republican state senator Mark Steffen, an anesthesiologist and pain-management specialist, disclosed during a recent hearing that the board had been investigating him more than 18 months over comments he made while serving as a county commissioner, according to the Washington Post.
Ivermectin is an anti-parasitic treatment mainly used for animals but approved in different doses to treat some parasitic worms in humans – but not for preventing or treating Covid.
In addition to Republican lawmakers, promotion of ivermectin has come from public figures such as comedian and podcast host Joe Rogan, who said he used the drug to treat himself when he became sick with Covid, and the Fox News hosts Tucker Carlson and Laura Ingraham.
But Parikh said there have been no trials that “in most scientists’ minds show any evidence of ivermectin being beneficial” for the prevention or treatment of Covid.
“The drug doesn’t work against Covid – full stop,” said Dr Michael Saag, a professor of medicine and infectious diseases at the University of Alabama at Birmingham. “There are countless studies – randomized, well-conducted clinical trials – that show no benefit, so why would you want to use a drug that doesn’t work?”
Regardless of ivermectin’s efficacy against Covid, Saag said legislation such as the bill in Kansas is unnecessary because doctors can still prescribe it for off-label use, even if it doesn’t work.
“Any physician in the United States has the ability to write a prescription of a drug for a purpose that has not been formally approved by the FDA,” Saag explained.
Steven Stites, the chief medical officer of the University of Kansas Health System, sees legislation in Kansas as problematic not only because it provides doctors authority they already have, but because it removes providers and pharmacists from liability for prescribing or dispensing hydroxychloroquine and ivermectin.
“You have taken the risk away from the doctor. You have taken the risk away from the pharmacist, so that means the two people who are completely trained for this type of question have now had their risk removed, so the patient holds the risk,” said Stites. “The least informed, least trained person in the room now holds all the risk.”
Hilderbrand, the Kansas state senator, said lawmakers planned to remove the language in the legislation that shields doctors from liability and the portion that requires pharmacists to fill prescriptions for the drugs.
When asked about the assessment that the drug has not been proven effective against Covid and could be dangerous, Hilderbrand said, “where is their evidence that it doesn’t” work?
“If the doctor and patient think that is the best course of action on a novel virus, then they should have that opportunity,” said Hilderbrand, who represents a district in south-eastern Kansas.
There are ongoing studies of ivermectin’s ability to treat Covid at the University of Minnesota and Duke University.
Parikh said he hoped studies demonstrate that ivermectin can be effective with Covid, “but we have not seen that”.
He also points out that there are new treatments that have proven effective in treating Covid, like Paxlovid.
What does he expect to happen if the trials at Minnesota and Duke show that ivermectin is not effective against Covid?
“If these studies were done well”, Parikh said, “and really do show in these settings that ivermectin is not impactful … I just can’t see any reason to continue this debate.”