An array of Republican state lawmakers and activists are pressing Gov. Mike Dunleavy’s administration and the state pharmacy board to make it easier for Alaskans to get access to ivermectin, the unproven COVID-19 treatment that state and federal agencies caution against using.
In recent weeks, Palmer GOP Sen. Shelley Hughes has spoken with Dunleavy and his health commissioner to encourage them to consider supplying Alaskans with vitamins and drugs, including ivermectin, “that some Alaskan physicians are prescribing but pharmacies aren’t filling,” she said.
Three Republican representatives and a pair of Dunleavy’s appointees to the Alaska Commission on Aging, meanwhile, also testified about ivermectin at a recent pharmacy board meeting — where some asked board members to lean on pharmacists who are denying prescriptions for the drug.
“Maybe the pharmacists could be directed — or, directed’s the wrong word — suggested that they allow the doctors to actually be doctors and do their jobs,” said Big Lake GOP Rep. Kevin McCabe. “The patient and the doctor should be the ones to decide.”
Pharmacy board members did not endorse McCabe’s suggestion. And less than a week later, the board’s chair drafted a letter to the three representatives that laid out that pharmacists have the authority to refuse prescriptions.
But the legislators’ lobbying efforts highlight how some Alaskans’ insistence about ivermectin has persisted. That’s even with limited scientific evidence the drug is effective, and as federal regulators and an array of provider groups warn that it should not be used to treat or prevent COVID-19.
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The drug, which is approved to treat parasites in humans but not the coronavirus, has been linked to multiple cases of hospitalizations and even deaths stemming from misuse. Many vaccine skeptics, meanwhile, have championed it as a cure.
“Anyone who claims to be creating medical guidance and they don’t have vaccine as their No. 1 recommended tool are pushing misinformation,” said Coleman Cutchins, a state pharmacist. “Vaccine is our No. 1 drug for the prevention of severe disease from this virus.”
Very early in the pandemic, ivermectin showed some potential to be effective against the coronavirus in a lab setting.
But further research suggested that huge doses would be necessary to work in the human body. And while dozens of trials are still underway, the ones conducted so far have produced mixed results. One study from Egypt that linked ivermectin to a huge reduction in deaths was withdrawn, amid allegations of plagiarism and data manipulation.
“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,” the National Institutes of Health’s informational page says about the drug. “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.”
Still, people have been clamoring for access to the drug around the world, including across the United States and Alaska. In August, Kenai Peninsula Borough Mayor Charlie Pierce backed ivermectin and suggested that his area could become a testing ground for COVID-19 treatment research.
Buoyed by endorsements from lawmakers and television and radio hosts, ivermectin has been particularly popular among political conservatives, who view federal medical authorities like Dr. Anthony Fauci with increasing skepticism.
“My trust in Dr. Fauci is zero point zero zero, negative 50,” said Mike Coons, a 69-year-old conservative activist from the Mat-Su.
Coons was one of the two Dunleavy aging commission appointees who testified at the pharmacy board last month.
In a phone interview, Coons said he’s more familiar with and enthusiastic about hydroxychloroquine, another unproven drug once used to treat former President Donald Trump.
But Coons said he’s also encouraged by what he’s read about ivermectin. And when he was exposed to a neighbor who had the coronavirus, his doctor said he’d be willing to prescribe both drugs if Coons needed them.
Coons then called a local Fred Meyer pharmacy to ask if they’d fill the prescriptions. The response, he said: “Oh no, we can’t do that. Because we’re worried about liability.” Coons said he was also told that filling an ivermectin prescription written to treat COVID-19 could jeopardize a doctor’s license.
In an email, a Fred Meyer spokesperson cited warnings against the use of ivermectin by both the FDA and the U.S. Centers for Disease Control and Prevention.
“Fred Meyer supports our pharmacists’ exercise of professional judgment, including consideration of information published by the FDA and CDC, in deciding whether to fill or refill prescriptions,” the spokesperson said.
After the phone call, Coons then joined the pharmacy board’s meeting to express his frustration and issue a request.
“What we need this board to do is to tell Kroger and Fred Meyer’s and Safeway and Carr’s and Walgreens that if you’re going to operate in the state of Alaska, under state of Alaska licensure, when a doctor gives a prescription, they get that prescription out to that patient — no questions asked, other than what they’re normally supposed to be asking,” Coons testified.
While it’s rare for even one lawmaker to call into a pharmacy board meeting, each of the three Republican state lawmakers also referenced ivermectin in their testimony.
Rep. Ken McCarty of Chugiak expressed his concern about “making sure that our state has all the medications necessary.” Rep. Chris Kurka of Wasilla told board members that “we should allow doctors the freedom, if they’re using good clinical judgment, to treat their patients.”
And McCabe, the Big Lake representative, said he’s heard from doctors, physician assistants and nurses in his district who are frustrated “when they issue a prescription and the pharmacy will not fill it because it’s ivermectin.”
“Several pharmacists claim that they are being threatened, or their licenses are being threatened by this board,” McCabe said. “In times like this, where no one seems to have a cogent solution, the Alaska pharmacy board could provide leadership and guidance by at least getting out of the doctor’s way.”
Board members, however, were largely unmoved.
Chair Justin Ruffridge, a Kenai Peninsula pharmacist, pointed testifiers toward a draft ivermectin Q&A document under consideration by the board that highlights a joint position statement from three national doctors and pharmacists groups: They “strongly oppose” dispensing the drug outside of a clinical trial.
Less than a week after the meeting, Ruffridge drafted the letter to the three lawmakers emphasizing pharmacists’ potential legal liability for drugs they dispense, and said pharmacists were free to use their “professional judgment” when deciding whether to fill prescriptions. (The letter was dated Sept. 29, though after this story was published, the lawmakers said they never received it, and pharmacy board officials acknowledged that, in an error, it may not have been sent.)
The board has made no threats against pharmacists’ licenses related to ivermectin, Ruffridge said in the letter. But he noted that the reports of misuse of ivermectin to treat COVID-19 “should give most prescribers and pharmacists reason to pause.”
Hughes, the Palmer GOP state senator, bypassed the pharmacy board and took her ivermectin case directly to Dunleavy and Adam Crum, the state health commissioner.
Hughes, who responded to an interview request with a prepared statement, said she encouraged both Dunleavy and Crum to consider providing Alaskans with “therapeutic kits” for people who test positive for COVID-19, and their family members.
“I challenged Gov. Dunleavy and Commissioner Crum to make Alaska be the first state in the US to take this proactive step,” she said. “They said FDA doesn’t allow off-label use. I said, ‘Where there’s a will, there’s a way, when it comes to saving lives.’”
Crum and a health department spokesman didn’t respond to requests for comment. A spokesman for Dunleavy, Jeff Turner, said the governor “maintains that decisions regarding COVID should be left between individuals and their doctor.” Turner also referred to Dunleavy’s comments from a news conference where he was asked about ivermectin nearly two months ago.
“I know what ivermectin is — I’ve had horses and mules, and you use it for worming and other issues that horses and mules have,” Dunleavy said. “But as far as prescribing it as a therapy for humans, I haven’t heard about that.”
This story has been updated to correct a reference to Ruffridge’s letter, which pharmacy board officials originally said had been sent to the three Republican lawmakers. The legislators said they never received it, and pharmacy board officials now say that in a possible error, it may not have been sent.