Physician Pharmacist Collaboration Scores a Victory for Patients

We have heard so much from frustrated patients and doctors throughout the pandemic about the poor access to early therapies and unacceptable care processes and outcomes of hospitalization, that many of us feel like there is nowhere to turn. At times the hardships endured by patients and families scrambling for medication with the threat of hospitalization and death looming on the horizon seem unbearable.


In this issue of the McCullough ReportDr. Denise S. Sibley, from Johnson City, TN, tells our audience how she successfully worked with the legislature of her state through a great deal of effort to ultimately bring into reality, collaborative agreements allowing pharmacists to dispense weight-based dosing courses of oral human ivermectin to ambulatory patients with acute COVID-19.1

In 2022, she provided expert testimony and medical insights to legislators. She was commended for her exemplary service to the community with a resolution passed by the House and Senate and signed by the Governor.2 Now that physicians have had experience with all of the antivirals: hydroxychloroquine, ivermectin, Paxlovid, and mulnipiravir, many doctors have concluded that the most rapidly acting agent is ivermectin, and at 0.6 mg/kg per day for 5-10 days, it is the most effective and the safest of all of the drugs in this class of medications.3

While there have been no large (>20,000 patients) clinical trials of ivermectin, the clinical practice experience is now very broad and convincing. Ivermectin has been officially adopted for early treatment in all or part of 22 countries (38 including non-government medical organizations). Combined with several other drugs, most commonly doxycycline, budesonide or prednisone, and aspirin, the medical regimen for the quick-striking Omicron BA.4/5 variants are now streamlined and very easy to administer.

The legislation cited for Tennessee serves as an aspirational model for the rest of the nation as COVID-19 continues to linger and find fully vaccinated individuals as the majority of de novo cases in the last nine months.

 
References:




Legal Updates: 
  • Several states gave healthcare providers an immunity guarantee for the use of ivermectin and hydroxychloroquine for COVID. 
  • Kansas: Kansas’ Senate voted to strengthen religious exemptions and give safe harbor to those prescribing ivermectin.
  • New Hampshire: On May 5, 2022, New Hampshire’s Senate adopted a bill that allows licensed providers to create a standing order for pharmacists to dispense ivermectin (for a legitimate medical purpose). The bill also prohibits medical, nursing and pharmacy boards from disciplining licensees based on that standing order.
  • Indiana State: Attorney General opinion: "Physicians and other HCPs with prescription authority licensed in Indiana may prescribe medication off-label for the treatment and prevention of COVID-19 (in.attorneygeneral/Opinion-2022-1.pdf)
  • Nebraska: The State Attorney General of Nebraska issued an opinion the included: " ... available data does not justify filing complaints against physician simply because they prescribe ivermectin or hydroxychloroquine to prevent or treat COVID-19 ..." https://ago.nebraska.gov
  • Oklahoma: Oklahoma State Attorney General stated that no legal basis exists to discipline medical professionals for prescribing ivermectin or hydroxychloroquine to treat COVID-19 (https://www.oag.ok.gov/articles/attorney-general-oconnor)
  • Ohio: A bill introduced in Ohio (April 2022) would prevent health departments, healthcare facilities and pharmacies from refusing to promote or expand access to ivermectin and hydroxychloroquine for COVID.
  • South Carolina: The Attorney General of South Carolina issued an opinon that included: "... doctors have the right to make important medical decisions, as long as they have the informed consent of their patients. In fighting COVID ... ” https://www.scag.gov/covid-19/
  • Tennessee: Tennessee's legislature made ivermectin essentially an over-the-counter drug in April 2022. The state’s Senate overwhelmingly voted 66-20, and the House voted 22-6 in favor of the bill.  

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