Senate bill would require doctors and pharmacies to provide off-label COVID-19 treatments

Sen. Arthur Orr, R-Decatur, introduced a bill to the Senate Health Committee last week that prevents professional licensing boards from taking punitive action against doctors who prescribe ‘off-label’ drugs for treatment. of COVID-19.

At a glance, this appears to be in response to the prescription of drugs such as ivermectin and hydrochloriquine, which have become a popular alternative despite the fact that major health bodies have so far not found enough evidence to show that they are beneficial.

But the bill goes far beyond simply protecting the licenses of the few Alabama physicians who prescribe the alternative treatments, it would also require healthcare facilities to provide these drugs, procedures or devices to any patient who seeks them. request for the treatment of COVID-19. .

The bill simply defines COVID-19 treatment as “a procedure, protocol, drug, or remedy intended to prevent, mitigate, or treat COVID-19. The term includes the use of a drug, biologic, or device that has not been approved by the United States Food and Drug Administration (FDA) to treat COVID-19.

The bill in its current form does not specify who would determine that the “procedure, protocol, drug or remedy” is “intended to prevent, mitigate or treat COVID-19” and on what basis they should base the claim. .

Orr laughed off a comment he relayed that doctors might “prescribe Drano” for treatment. “We’re only talking about FDA-approved drugs, just using them off-label,” Orr said.

Although ivermectin and hydrochloriquine are perhaps the most frequently prescribed drugs as “off-label” COVID-19 treatments, there does not appear to be language in the bill that would prevent any other drugs approved by the FDA to be used as a COVID-19 treatment. 19 treatment.

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It is unclear what, if anything, would prevent a patient from requesting opioids such as oxycodone or even fentanyl under the guise of COVID-19 treatment.

A few doctors said at a public hearing on the bill on Wednesday that they must maintain the freedom to prescribe “off-label” drugs to patients.

“So I feel like if you’re taking the autonomy of a doctor to really practice, why am I studying,” said Ryan McWhorter, a family physician at Montgomery. “Why am I researching at night? I was up for hours until dawn trying to figure out what was the best thing.

However, while this bill would give doctors the autonomy to prescribe all sorts of alternative treatments for COVID-19, it would take away their autonomy to refuse those alternative treatments.

It would also remove the autonomy of pharmacists to refuse to fill those prescriptions, which Senator Tom Butler, R-Madison, challenged in committee.

“While I think the doctor should be able to do what they do, at the same time, I don’t think anyone should be dictating in this bill what I can or can’t do in terms of execution. of a prescription,” said Butler, who is a pharmacist. “I currently have the right to refuse to fill a prescription for any reason I deem necessary.”

Butler indicated that he would bring an amendment to this effect at the assembly. However, he did not raise a problem with the bill limiting the autonomy of health establishments.

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The bill would require the patient to sign an informed consent form and release everyone involved from liability, including the doctor, the facility and the licensing board. A patient could not sue any entity for allowing the drug to be used off-label, but the bill creates a cause of action against healthcare facilities and pharmacies that refuse to provide off-label COVID treatment. , and a cause of action against licensing boards for physicians.

The bill passed the Senate committee unanimously and could go to the full Senate with just seven legislative days left in the session. It is unclear when the bill will be on the calendar or if it will reach the floor in time to pass both houses of the legislature.

Norman D. Briggs