Expansion of ‘right to try’ law for off-label drug use advances from Iowa House panel

A major expansion of Iowa’s so-called “right to try” law, which allows the use of off-label drugs for certain patients, advanced in an Iowa House subcommittee despite the bill sponsor’s acknowledgment that the language needs work.

House File 225 would allow patients with a “debilitating” illness to use “off-label” drugs, or those not approved by the Food and Drug Administration for treatment of their prescribed illness.  Current law, approved last year, requires patients to have a “life-threatening” illness or be on a ventilator to qualify.

Rep. Brooke Boden, R-Indianola, chaired a subcommittee on the bill Wednesday. She said her sister lives with multiple sclerosis and she wants to expand eligibility to people who have that chronic, degenerative disease or others such as Parkinson’s.

“If you’re facing life-threatening illness without any possible opportunity, it’s chance at hope for folks. So the goal is simply to try to give more options to folks who don’t have any options,” Boden said.

The “right to try” bill originally was aimed at allowing hospitalized patients to try unapproved COVID-19 remedies such as ivermectin, a drug used to treat some parasitic diseases. The bill allows hospitalized patients to use off-label treatments even if not prescribed by their own doctor.

Rep. Austin Baeth, D-Des Moines, a physician, said he understands the “spirit” of the bill but said it was so broadly written as to allow people to experiment with drugs that have not even been proven safe or advanced beyond FDA Phase 1 trials.  “That’s what a Phase 1 trial is, to see if it kills you. And without that provision, this is a right to be a guinea pig.”

Baeth said the legislation also opens the door to “predatory practices,” by prohibiting the Board of Medicine from revoking the license of physicians who prescribe unapproved medications – even if the drug was “cooked up in their garage.”

He said the bill also opens the door for insurance companies and government health plans to pay for “individualized investigational” treatments, which could cost millions for a single dose.

Boden said she thinks there is some middle ground and will continue to work on the bill. “I’m going to tell you that if I’m facing the end of my life and I’m given no hope and they are giving me nothing, I’m willing to be a guinea pig.”

Rep. Eddie Andrews, R-Johnson, also agreed to advance the bill, which moves to the House Health and Human Services Committee. The bill is not currently scheduled for a committee hearing and it would need full committee approval to meet this week’s “funnel” deadline to remain eligible for debate.