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February 10, 2022

For patients seeking ivermectin, the answer may be in telemedicine

Daily Briefing

Ivermectin, an antiparasitic drug, has not been approved as a Covid-19 treatment, but many patients still seek it out—often turning to a small number of doctors willing to prescribe the drug, primarily through telemedicine, Geoff Brumfiel writes for NPR's "Shots."

Some Covid-19 patients continue to seek ivermectin as a treatment

Last year, interest in ivermectin as a treatment for Covid-19 grew after several small, early studies on the drug suggested that high doses of it could effectively neutralize the coronavirus in laboratory cell cultures.

However, several large studies later indicated that ivermectin's effects on Covid-19 are either small or nonexistent. Currently, FDA, the National Institutes of Health, the American Medical Association, and two pharmaceutical societies all discourage the prescription of ivermectin as a Covid-19 treatment, Brumfiel writes.

Despite ivermectin not being a recommended or authorized treatment for Covid-19, many patients, particularly those who are skeptical of vaccines, have continued to seek out the drug. According to CDC, ivermectin prescriptions, which first surged during the delta wave last year, increased again during the latest omicron wave.

And because many doctors and hospitals have refused to treat patients with ivermectin, some people have turned to protests and lawsuits to gain access to the drug. In fact, some courts have sided in favor of patients, ordering hospitals to administer ivermectin or allow other physicians to administer the drug.

Some patients prescribed ivermectin via telemedicine

According to Kolina Koltai, a misinformation researcher at the University of Washington, many ivermectin prescriptions are made through telemedicine by a small number of doctors, many of whom often promote anti-vaccine conspiracy theories.

For example, Ben Bergquam, a right-wing journalist who was hospitalized with Covid-19 in January, filmed a video showing an ivermectin prescription he received from a group called America's Frontline Doctors. According to Brumfiel, the group's leader Simone Gold is well known for spreading anti-vaccine information and has told people to call the group for prescriptions of ivermectin and other unproven Covid-19 treatments—a call for which the group charges $90.

"They're profiting off misinformation, using their medical expertise as currency," Koltai said. "I would reckon that telehealth and telemedicine is one of the major income-generating streams for America's Frontline Doctors."

In addition, the physician who prescribed Bergquam ivermectin, Kathleen Cullen, has had a "troubling professional history," Brumfiel writes.

For example, the state of Alabama revoked her medical license after a lengthy investigation last year. "She was working with a telemedicine company and was utilizing her medical license to further their ability to generate billable events, without actually providing health care to the patients," said E. Wilson Hunter, general counsel for the Alabama Board of Medical Examiners.

Cullen has also had her medical license suspended by the state of Kansas, and her American Board of Internal Medicine certification has lapsed. However, she is still licensed in Florida and North Carolina, Brumfiel writes, which allows her to continue writing prescriptions for America's Frontline Doctors.

Ashley Bartholomew, a nurse with No License for Disinformation, said Cullen's situation highlights the failures of the United States' medical licensing system, which has allowed her to continue writing prescriptions for questionable Covid-19 treatments despite losing her license for poor telehealth practices.

"Where is the accountability in all of that?" Bartholomew said. "How many patients have to suffer from disinformation until we actually have action?" (Brumfiel, "Shots," NPR, 2/9)

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