Siobhan Benham and S. Nicole Condodemetraky

The New Hampshire Nurse Practitioner Association (NHNPA), representing licensed prescribers working in the state of New Hampshire, stands in strong support of Gov. Chris Sununu’s veto of House Bill 1022, permitting pharmacists to dispense the drug ivermectin by means of a standing order. Members of the House and Senate are expected to consider an override of his veto when they meet on Sept. 15.

But the governor’s reasoning was sound, as his veto message stated: “The State currently only has four instances in which pharmacists can dispense medication without a prescription. These medications are smoking cessation, contraception, substance use disorder, and treatment for sexual assault, all of which have gone through rigorous reviews and vetting to ensure they meet all the necessary protocols prior to a medication being dispensed via standing order. All drugs and medications should be subject to that same rigorous process if they are to be dispensed by standing order.”

NHNPA’s testimony on HB 1022 in January cited this 2021 statement from the National Institutes of Health: “There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.”  

Our earlier commentary on this subject observed that the Legislature heeded only part of this advice when considering HB 1022, and the result was passage of a bill that does two things: permits pharmacists to dispense the drug ivermectin by means of a standing order, and at the same time establishes a commission to study the use of ivermectin to treat COVID-19. This could be very aptly called “putting the horse before the cart” because ivermectin is most commonly used as a dewormer for horses. Further, establishing a committee to study the role of ivermectin in treating COVID-19 while we have easily accessible, high-quality, randomized, controlled studies that clearly indicate lack of efficacy and benefit is a misguided focus and waste of resources of New Hampshire lawmakers. 

In 2021, after the use of ivermectin to treat COVID-19 became a social media-inspired practice, the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration issued advisories indicating that the anti-parasitic drug is not authorized or approved for the prevention or treatment of COVID-19. The National Institutes of Health, World Health Organization, and Merck, the manufacturer of the drug, have all stated that there is insufficient evidence to support the use of ivermectin to treat COVID-19. The Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 also recommended against the use of ivermectin outside of a clinical trial.

The New Hampshire Nurse Practitioner Association joins with the American Medical Association, American Pharmacists Association, American Society of Health-System Pharmacists, and other health care advocates and organizations to strongly oppose the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial. Our legislators should listen to the experts.

This story was written by Siobhan Benham and S. Nicole Condodemetraky, both members of the New Hampshire Nurse Practitioner Association, where this story first appeared.