AUSTIN (Nexstar) — The Texas House of Representatives has given the nod to a bill permitting pharmacists to provide ivermectin, an antiparasitic medication, without requiring a doctor’s prescription. House Bill 25 is set to proceed to the Senate for consideration.

The path to approval was not without contention, as Republicans and Democrats openly clashed over issues of medical autonomy and public safety. What began as lighthearted exchanges featuring horse-related humor escalated into heated debates on the House floor.

An attempt by a Democratic House member to rename the proposal to the “Darwin Awards Act” added to the tension. State Rep. Rafael Anchía, D-Dallas, took a moment to elucidate the concept of this satirical award for fellow legislators who might be unfamiliar with it. “It acknowledges the contribution to the improvement of the human genome, celebrating those who unintentionally eliminate themselves from the gene pool in a particularly noteworthy fashion,” stated Anchía.

State Rep. Joanne Shofner, R-Nacogdoches, the author of the bill, responded to Anchía’s amendment by saying, “Not today, Satan.”

There was an additional tense exchange between Anchía and Shelley Luther, R-Tom Bean, about medical care access.

“Do you have constituents in your area that cannot afford to go to a doctor?” Luther asked.

“I imagine, yes, I do, certainly,” Anchía responded.

“Are you barring them from accessing the pharmacy directly and obtaining care they personally believe will benefit them?” queried Luther in response.

“Absolutely not,” Anchía retorted. “On the contrary, I advocate for expanded healthcare access, which includes allowing visits to healthcare providers—something you often vote against, thereby denying my constituents such access. So, please refrain from suggesting I restrict them in this regard.”

Luther countered, “All I’m comprehending is that individuals should be able to discern what’s suitable for them and choose their medication, yet you’re obstructing that,” before leaving the podium on the House floor.

Republicans ultimately argued that Texans should have the right to take ivermectin if they want to — similar to how people choose to take aspirin — but Democrats worry the lack of consultation with a doctor could lead someone to accidentally harm themselves.

What is ivermectin?

Ivermectin is approved by the Food and Drug Administration (FDA) to be used to treat conditions caused by parasitic worms. There are human forms of ivermectin and animal forms of the drug that can help treat both internal and external parasites.

The drug was awarded the Nobel Peace Prize in Physiology in 2015 for its use in treating parasitic infections.

There are off-label uses of the drug and the FDA does say, “health care professionals may choose to prescribe or use an approved human drug for an unapproved use when they judge that the unapproved use is medically appropriate for an individual patient.”

During the COVID-19 pandemic, there was a growing trend of people using ivermectin to treat the virus. The FDA does not authorize ivermectin to treat or prevent COVID-19, but Shofner believes Texans should have the right to make medical choices for themselves.

“It’s so important that we allow our citizens discretion to use the medicines they want and allow them, you know, to be able to take care of their own health needs,” Shofner said when laying out her bill on the House floor. She argues this bill gets rid of obstacles to healthcare for Texans in rural areas of the state.

Republicans on the House floor shared personal stories of how ivermectin is used in their lives. State Rep. Keresa Richardson, R-McKinney, said her doctor recommends she use the drug to keep her cancer from reoccurring, while State Rep. Terri Leo Wilson, R – Galveston, said her doctor prescribed it to her in the early 2000s to treat her Rheumatoid Arthritis.

The argument for Republican House members is the drug is safe, it has far-reaching uses other than for parasitic infections, and it provides a medical avenue for people who can not afford to go to the doctor. But Democrats pushed back against those claims and raised concerns about public health.

Impact on public health

State Rep. Nicole Collier, D-Fort Worth, questioned Shofner about whether there would be an age limit on who could buy ivermectin. She asked, “Are you in support of a 14-year-old being able to request the dispersion of ivermectin?”

“I can’t even imagine a teenager or a young person going to a pharmacist and asking for medicine, especially ivermectin,” Shofner responded. She added any rules about how pharmacists dispense the medication would be developed by the Texas State Board of Pharmacy (TSBP).

Currently, people can get ivermectin from the pharmacy with a valid prescription from their doctor. Democrats believe that is reasonable because it ensures a medical professional who knows the health history of their patient would know if it is safe for someone to take the drug.

“The removal of doctors from this equation and simply allowing pharmacists to do this through rules at the pharmacy board, in my view, makes no sense, because risks of use of any prescription drug, including ivermectin, have side effects when combined with other drugs,” Anchía explained.

The FDA does warn consumers about the dangers of taking large doses of ivermectin or taking it with other medications. “Even doses of ivermectin for approved human uses can interact with other medications, like blood-thinners. You can also overdose on ivermectin, which can cause nausea, vomiting, diarrhea, hypotension (low blood pressure), allergic reactions (itching and hives), dizziness, ataxia (problems with balance), seizures, coma and even death,” according to the FDA.

However, Republicans claimed prescriptions for ivermectin from doctors were not being filled by pharmacists. State Rep. Dr. Tom Oliverson, R-Cypress, is an anesthesiologist. He is one of the co-authors of the bill.

“I believe we are doing no harm today by passing this legislation, and we are addressing a wrong, which has been perpetuated against the medical community, which is the unwillingness to follow a doctor’s advice and a doctor’s treatment plan with regards to a prescription, which is being prescribed for a valid, albeit off-label use,” Oliverson said.

The TSBP said there are reasons a pharmacist may not fill a prescription. Those include:

• concern the medication will interact badly with another drug a patient is taking
• belief an excessive quantity has been prescribed
• belief the prescription is fake

Democrats were not just worried about the possible adverse side effects of ivermectin mixing with another drug, but that it may also prevent people from seeking help from a medical professional.

“As the misinformation continues to spread, more and more people will simply get ivermectin because they think it’s a miracle cure, instead of actually going to the doctor to see what’s wrong with them and get actual treatment,” State Rep. Gene Wu, D – Houston, said to the House chamber. As he was speaking, Republican State Rep. Wes Virdell held up a makeshift sign behind him that read, “NOT TRUE.”

What’s next?

The bill passed along party lines 87-47 and now heads to the Senate. It will have to go through a committee hearing, be voted out of committee, and receive two majority votes on the Senate floor before the governor can sign the bill into law.