Tennessee pharmacists are working on guidelines for new ivermectin law

Legislature has allowed dispensing without doctor's prescription under collective agreements

A new Tennessee law signed by Gov. Bill Lee during the recent legislative session created a pathway for pharmacists to dispense ivermectin directly to patients who would like to use the treatment for COVID-19.

The law authorizes pharmacists to provide ivermectin to patients 18 years of age or older through a "collaborative pharmacy practice agreement," which is an agreement under which a pharmacist and a prescriber - such as a physician - establish procedures for the pharmacist to diagnose certain conditions and dispense related medications on their own. It does not require the prescriber ever to see the patient.

The law also directs the state pharmacy board to adopt rules to establish standard procedures for pharmacists providing ivermectin through a collaborative practice agreement, including rules to provide the patient with a standardized fact sheet regarding ivermectin - though such agreements can already be struck without the board's rules.

(READ MORE: Tennessee Republican lawmakers working to ease ivermectin access)

Pharmacy board members began tackling that directive at their most recent meeting in May but decided to punt the issue to their July meeting in order to get more information. One of their main concerns was that a patient who doesn't have a provider overseeing their care could miss out on other, more useful or necessary treatments.

Ivermectin's manufacturer, Merck, states on its website there is "no scientific basis for a potential therapeutic effect against COVID-19," based on preclinical studies, and a large, randomized trial published in the New England Journal of Medicine in March 2022 essentially ruled out the drug as an effective COVID-19 treatment.

"What I don't want is for a patient to just come to a pharmacy and get ivermectin and try to self-treat at home all of their symptoms when they may need more care than that," said Katy Wright, an Oak Ridge-based pharmacist and member of the Tennessee Board of Pharmacy.

During the Senate's debate in April, bill sponsor Sen. Frank Niceley, a Republican farmer from Strawberry Plains, said the law was needed because Tennesseans are already trying to treat themselves with ivermectin - which is sold over the counter at most farm supply retailers to treat parasitic infections in horses.

The drug gained popularity early in the pandemic when clinicians were experimenting with an array of existing drugs and some initial trials suggested ivermectin may be able to quell COVID-19.

(READ MORE: Ivermectin and outrage: The viral aftermath for a conservative Chattanooga activist who lost his brother to COVID-19)

Poison control agencies across the country have since reported instances of people ingesting toxic levels of ivermectin intended for livestock in an attempt to treat or prevent COVID-19 infections.

"It's a lot safer to go to your pharmacist and let him tell you how much ivermectin to take than it is to go to the co-op and guess what size horse you are," Niceley said.

Jordan Morrison, pharmacist at Access Family Pharmacy in Hixson, said the new law doesn't change much and creates more confusion around the issue.

Pharmacists can already dispense ivermectin with a prescription and establish collaborative practice agreements, he said.

Morrison said patients also already call the pharmacy asking if they can get the drug without a prescription, which they can't because Access doesn't have a collaborative practice agreement to do so - though he said the pharmacy has filled prescriptions for the drug.

"We'd have to have some physician sign off and say, 'Hey, this is the protocol we want you to use if you have someone come in and test positive for COVID," Morrison said. "The majority of pharmacies in the state are not going to bother [setting up an agreement] because they won't dispense [ivermectin] anyway."

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673. Follow her on Twitter @ecfite.