Tennessee's prescription-free ivermectin market is booming as more states follow
A STAT investigation documents how Tennessee, which in 2022 became the first state to let pharmacies dispense ivermectin without individual doctor prescriptions, has developed a sizable retail market for the drug. Under “collaborative pharmacy practice agreements,” a single physician can authorize blanket prescriptions covering many pharmacies.
Dr. Denise Sibley, a vaccine opponent who pushed the 2022 law, says she has signed roughly 40 such agreements across the state and has “taken bucketloads of this stuff” herself. Pharmacies advertise the drug on billboards and websites, and some compound pills at 10 to 20 times standard strength. The Tennessee Poison Center logged more than 60 ivermectin-related calls in 2025 — its highest since 2021 — with reports of vomiting, blurred vision and neurological symptoms.
Ivermectin is an effective antiparasitic but has been shown in clinical trials to be ineffective against Covid, and it is not a proven treatment for cancer or the other conditions marketed online. The model is spreading: Arkansas, Idaho, Louisiana and Texas passed similar laws in 2025, and at least 24 other states have introduced comparable bills. The trend shows how state legislation can route around the prescribing controls that normally gate access to a drug for unapproved uses.