Commentary

Gov. Sununu needs to veto the ivermectin bill – commentary

ivermectin tablets

The National Institutes of Health, the 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. (Getty Images)

Earlier this year, the New Hampshire Nurse Practitioner Association, representing licensed prescribers working in the state of New Hampshire, registered its members’ strong opposition to House Bill 1022, permitting pharmacists to dispense the drug ivermectin by means of a standing order to treat COVID-19.  We wrote to the House and Senate with our concerns, noting that while standing orders, when implemented responsibly, can be a valuable avenue for increasing access to care and health care resources, that is not the case with ivermectin. 

Our testimony in January to the House Health, Human Services, and Elderly Affairs Committee cited this 2021 statement from the National Institutes of Health: “There is insufficient evidence for the COVID-19 Treatment Guidelines 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.”  

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 FDA 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, the 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. 

Many clinicians were and are still hopeful that repurposed use of old drugs could be the answer to fight this new disease; however, this has not been proven to be the case as of today. Ivermectin is not a benign medication, and can interact with over 82 medications; side effects from this medication can be mild gastrointestinal symptoms, to liver and neurotoxicity, among others. We are now in the summer of 2022 and the evidence is mounting that there is not a role for ivermectin in the fight against COVID-19. There are, in fact, recently published high-quality, large randomized clinical trials both in hospitalized and non-hospitalized patient settings that determine a lack of efficacy. These studies have been published in JAMA and the New England Journal of Medicine, among others, and can be easily found online with a brief Google search.  

Early in the pandemic, the use of ivermectin as a valid treatment for COVID-19 was questioned, and the argument was that the lack of data should not discredit it as a possible treatment; however, we now have data to disprove its efficacy. The Legislature has not heeded the advice of medical professionals in New Hampshire or nationally and last month passed 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.

We do not want to see a precedent set for using standing orders that are not science-based and appear to be for political gain. Let New Hampshire health experts remain the experts. As well, we do not need a commission to study the use of ivermectin to treat COVID-19. Let’s leave this to the dedicated health research institutions who are capable of producing high quality studies that have controlled populations and thus trusted outcomes. These studies have already been done. 

The New Hampshire Nurse Practitioner Association joins with the American Medical Association, the American Pharmacists Association, the 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.  We strongly urge our governor to take the word of medical professionals and veto HB 1022.

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