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Contested amendment to allow pharmacists to dispense ivermectin without prescription draws broad opposition
Summary
A proposed amendment to allow pharmacists to dispense ivermectin under a statewide standing order prompted intense testimony from clinicians, pharmacists and DHHS officials, who warned that pregnancy safety, dosing and training concerns make the change risk-prone and operationally complex.
A last-minute amendment to Senate Bill 119 would create a statewide standing order allowing pharmacists to dispense ivermectin (and some other over-the-counter items and laboratory tests referenced in the same amendment text) without an individual prescription. The House Health, Human Services and Elderly Affairs Committee heard a concentrated, often emotional debate.
Proponents: Representative Paige Beauchmin and Representative Kelly Potenza (who introduced the amendment) and others argued that ivermectin has a long history of safe use for parasitic infections, cited international practice and urged states to permit over-the-counter or standing-order access. Representative Potenza and others said consumers should have easier access to a low-cost, well-known medication.
Opponents and technical concerns: Jonathan Ballard, DHHS Chief Health Officer, cautioned the committee that the Food and Drug Administration classifies most ivermectin formulations as legend drugs (prescription medications) based on available safety data and indicated the DHHS would not adopt a position supporting the amendment. Pharmacists — represented by the New Hampshire Pharmacists Association and a local practicing pharmacist — and the New Hampshire Medical Society opposed the amendment. They said the drug requires individualized assessment for contraindications (pregnancy, small children, liver or kidney disease), dosing calculations and interaction checks that are difficult to manage without a patient-provider relationship. Pharmacists also warned that the amendment contained no training or rule-making mechanism for the Board of Pharmacy to ensure consistent training, and that community pharmacists are already overworked.
Repeated themes: Testimony emphasized (1) safety in pregnancy and in children below weight thresholds, (2) the need for informed dosing and interaction checks, (3) potential liability for pharmacists, (4) inability of Medicaid to pay for an over-the-counter dispensed medication without statutory change, and (5) that standing orders typically target emergency, time-sensitive interventions (e.g., naloxone), while this amendment would broaden standing order use.
What’s next: The amendment drew strong opposition from DHHS, pharmacist and physician groups. Committee members asked detailed implementation and liability questions and noted the potential to treat the underlying SB 119 fiscal savings measure independently of the amendment. Given the contention and technical objections from clinical and pharmacy stakeholders, the amendment’s prospects were unclear at the hearing’s end.
