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Public hearing on HB146 spotlights split views over standing orders for ivermectin
Summary
A Health Committee public hearing on House Bill 146 drew split testimony: physicians and advocacy groups urged standing orders to expand safe access to ivermectin, while the state medical association and the Board of Medical Examiners urged using existing collaborative-practice frameworks and warned of monitoring, safety and resistance concerns.
Representative Rigsby introduced House Bill 146 and a public hearing drew two supporters and two opponents, the committee chair said. The bill would allow a physician, physician assistant or nurse practitioner to write a standing order authorizing pharmacists to dispense ivermectin to qualifying patients over age 19.
The sponsor told the committee the measure is an access and safety mechanism, not an attempt to make ivermectin over the counter. "This bill is a mechanism bill. It is an access bill," the sponsor said, adding the bill would allow a prescriber to define eligibility, evaluation and dosage in a standing order.
Supporters said expanded standing-order access would keep patients from using veterinary formulations. Dr. Stuart Tankersley, a practicing physician and co-president of Concerned Doctors, told lawmakers he has treated "over 2,000 COVID patients ... zero deaths" and urged safer, regulated access rather than patients seeking veterinary ivermectin. "Given the utter collapse of confidence ... we need to help the citizens, we need public access," Tankersley said.
Opponents urged caution and pointed to existing state processes. Nico Corley of the Medical Association said he filed as an opponent but is "not an opponent" to the drug; his objection is procedural. He asked the committee to consider a substitute that would use a 2019 collaborative-practice process sponsored by Senator Tom Butler rather than create a parallel pathway. "Let's not build a highway when we can fill in potholes," Corley said.
Matt Hart, an attorney with the Board of Medical Examiners, echoed that view and recommended placing ivermectin within existing collaborative-practice agreements to preserve safeguards such as adverse-event follow up and recordkeeping. "These collaborative practices contain important safeguards and provisions that we think are very important to patients and care," Hart said.
Committee members pressed the sponsor on safety, monitoring and scope. A committee member with clinical credentials cautioned that standing orders are typically reserved for interventions with strong evidence and narrow risk profiles and listed factors — body weight, liver disease, neurological conditions, concurrent medications and pregnancy — that affect ivermectin risk. Representative Rafferty raised concerns about the potential for antiparasitic resistance if use became widespread, citing scientific literature on emerging resistance in other settings.
The sponsor said those and other limits (for example, how often a medication could be dispensed) could be defined in individual standing orders. A patient who testified described long COVID and said she would prefer a physician-directed prescription and follow-up rather than a broadly available standing order. The committee concluded the public hearing without taking a vote on HB146 that day.
Next steps: HB146 remains at the committee level following the public hearing; the committee did not record a committee vote during this meeting.
