We’re still paying a price — literally — for the pandemic’s ivermectin cheerleaders

It never bothered me that during the height of COVID-19, some folks treated themselves with horse deworming pills.

At the time, I figured they were entitled to their misguided opinions. I’d read that ivermectin is effective against parasites — so effective that the doctor who discovered it was awarded a Nobel Prize. I knew it had changed the lives of people in Africa who faced “river blindness” disease.

I also knew studies showed no evidence it worked against COVID. Despite its antiparasitic prowess, it didn’t really make a dent in a virus’s ability to wreak havoc. But if folks wanted to score some at their local feed store and administer it to themselves or their loved ones, my attitude was, “Knock yourself out.”

Then one day last November, I woke up with an itchy rash on my torso. It looked suspiciously like shingles, which I’d had almost a year ago to the day. At the time, I assumed the welts were bug bites because I’d spent the previous day raking leaves. When my doctor examined me back then, he took barely a nanosecond to render his diagnosis: shingles.

Yet, here I was a year later, getting welts on my torso the day after raking leaves. Hmmmm. Not being a fan of coincidences, I consulted Dr. Google, typing in the search words, “raking leaves, rash.”

Up popped something called “pin oak itch mites.” Yep, I had indeed been raking pin oak leaves, and yep, the welts itched like crazy.

Thus, I became the rarest of patients: The person who diagnoses herself from the internet and actually manages to convince her doctor. The coincidence of two apparent cases of shingles almost a year to the day apart, combined with the welts appearing on either side of my torso’s midline, had him agreeing with my research. (Shingles progresses along a nerve branch, thus heading away from the spine in only one direction, he explained.)

Oak itch mites are tiny little buggers that drop from pin oak trees they’ve infected. Once they land on skin, they burrow in, like chiggers. They’ve already shown up in Lancaster County, and there was little reason to doubt they hadn’t made their way to my neck of the woods in northwestern New Jersey.

Unlike conventional bug bites, in which the insect does its thing, then flies or crawls away, the mites hang around. In your body. They are, in short, classic parasites.

My doctor prescribed a parasiticide: the very ivermectin of COVID fame. When I went to the pharmacy to pick it up, however, the clerk tapped his computer keyboard, then looked quizzically at his screen. The medication required prior authorization, which he found odd, given its price tag of a measly $26.

Normally prior authorization is required only for expensive medications, he said. Perhaps he’d forgotten that at the height of the pandemic, multiple insurers began requiring an advance OK from a physician after their industry was billed for about $130 million annually for the drugs.

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I could seek approval from my insurer, he said, but that could take up to a week. Or I could pay for it out of pocket, then seek reimbursement.

Mindful that mites were currently burrowing in my body, I paid for the pills, then submitted the paperwork for reimbursement.

My claim was denied. Why? My doctor sent my insurer his notes, but they continued to insist he should’ve obtained prior authorization. My appeal was denied.

Sheer stubbornness compelled me to spend two hours on the phone (an idiotic use of my time, I concede) protesting it was ridiculous to expect prior authorization, given that it could take up to a week to get approved. “I had parasites in my body!” I said, trying not to shout. At one point I offered to send the agent a photo of my torso rash. “No, that won’t be necessary,” she said hastily. “I believe you.”

I don’t blame my insurer. I get why it’s reluctant to cover a drug that has been so roundly misused that Merck’s own website discourages people from taking it. (And wasn’t that a big clue, ivermectin conspiracy fans, that Big Pharma didn’t want to sell you these pills?)

Sure, I was only out $26, but that’s not the point. What was affordable to me might be a hardship to someone else. That person might choose to postpone treatment for something like scabies while waiting for the pre-authorization to come through.

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Scabies most often affect young children and old folks living in nursing homes.

The ivermectin crowd wanted to be free to take the stuff, blind to the reality that their actions had broader consequences. They were so insistent on their rights that they threw a monkey wrench in the entire health-care system. Their actions triggered the creation of bureaucratic roadblocks for people with genuine parasites to get timely, affordable treatment.

No man is an island, as the poet says, and if a bunch of people start using a medication most often prescribed for horses, somewhere down the road an old man will be waiting in a nursing home for his scabies meds.

The ivermectin cheerleaders couldn’t have known that, but that doesn’t absolve them entirely.

They owe me $26. And the rest of us an apology.

Kathleen O’Brien is a former newspaper columnist who lives in New Jersey.