The House Committee on Public Health left House Bill 25 pending after a contested hearing over a proposal to make ivermectin available from pharmacists without a health‑care practitioner’s prescription.

Rep. Steve Schauffner, author of HB 25, described the measure as “making ivermectin over the counter, which by definition means without a prescription,” and said the bill would direct the Department of State Health Services commissioner to issue a statewide order authorizing licensed pharmacists to dispense ivermectin without a practitioner’s prescription. The language discussed in the hearing would require standardized procedures for pharmacists and an annual written report of the number of doses dispensed.

Why it matters: Supporters told the committee that ivermectin has a long safety record, that restricting access forced some Texans to buy veterinary or foreign-source products during COVID, and that behind‑the‑counter pharmacist access offers safer, more affordable alternatives for rural residents. Opponents, including the Texas Medical Association, said making a medication available without a physician’s diagnosis or prescription risks patient safety by removing the physician‑patient relationship and the diagnostic component that physicians provide before prescribing drugs with potential interactions.

Most important facts
- HB 25 would require the DSHS commissioner to issue a statewide order authorizing licensed pharmacists to dispense ivermectin without a health‑care practitioner’s prescription and to adopt standardized procedures for pharmacists. The bill text discussed a reporting requirement: pharmacists must provide an annual written report of the number of ivermectin doses dispensed. (Rep. Schauffner)
- Supporters argued the drug is widely used internationally, has decades of human use and a strong safety record for approved indications, and that limited access during COVID pushed some people to unsafe sources; witnesses said costs and access are barriers in rural communities. (Testimony: Michelle Evans; Travis McCormick; Nina Miller)
- The Texas Medical Association opposed the bill on the ground that prescribing is a clinical act that requires assessing comorbidities, drug interactions and follow-up: “One of the most important acts of a physician is prescribing a medication,” said Dr. Zeke Silva, who urged preserving the physician‑patient relationship and existing statutory and regulatory safeguards.
- DSHS general counsel explained that the bill’s draft included a department immunity clause for any statewide order the commissioner issues; DSHS said it typically requests that immunity when a bill would authorize a statewide order.

Substantive discussion and open questions
- Regulatory mechanics: Under the bill, the commissioner’s order would be the vehicle that authorizes pharmacists to dispense without a prescription. Committee members asked whether the commissioner’s order would require identification at dispensing, how pharmacists would assess contraindications or drug interactions, and whether a warning that ivermectin is not FDA‑approved for COVID‑19 should be required on labels or in pharmacist counseling. DSHS staff said pharmacists and the Board of Pharmacy are the relevant licensing entities; DSHS said it inspects manufacturers and distributors but does not regulate point‑of‑sale pharmacy operations in the same way.
- Safety and evidence: Supporters cited journal reviews and international use; opponents cited guidance from federal agencies (FDA, CDC, NIH) that have not approved ivermectin for COVID‑19 treatment and expressed concern about off‑label use without clinical evaluation. Representative Schauffner and witnesses cited cost and access concerns and noted four other states had acted to authorize pharmacist dispensing.
- Minor access, ID and tracking: Committee members raised concerns about minors obtaining the drug and whether purchase tracking and age verification should be required (several members compared behind‑the‑counter controls used for pseudoephedrine). The draft bill included an annual reporting requirement for the number of doses dispensed but did not require purchaser identification; DSHS said commissioners would consider implementation measures.

Quotes from the hearing (attributed to speakers)
- “Making ivermectin over the counter, which by definition means without a prescription.” — Representative Steve Schauffner (bill sponsor)
- “One of the most important acts of a physician is prescribing a medication.” — Dr. Zeke Silva, Texas Medical Association (opposing testimony)
- “By ordering that ivermectin be made available without a doctor's prescription, HB 25 empowers patients by freeing licensed pharmacists from the dread of being reported for fulfilling their duties and giving patients an avenue for accessing care.” — Michelle Evans (proponent testimony)

Action and next steps
- Outcome: The committee left HB 25 pending (no committee vote to report). Supporters indicated intent to press the policy as a priority; opponents asked for more safeguards, including explicit language about counseling, age checks and labeling.
- Implementation issues flagged for follow-up: DSHS immunity language in the draft (DHS explained the immunity clause is a typical request when a bill would authorize a statewide order), potential Board of Pharmacy rules on pharmacist consultation and whether the commissioner’s order should require purchaser identification, warnings about unapproved uses such as COVID‑19, and reporting detail beyond annual dose counts.

Ending
- The hearing exposed a sharp policy tradeoff: supporters emphasized broader, lower‑cost access for rural and underserved Texans and long clinical use overseas; opponents emphasized the diagnostic role of physicians, the risk of missed contraindications and the need for regulated prescribing. The Committee on Public Health left HB 25 pending while legislators and state agencies consider implementation details and safeguards.