Date: September 29, 2021
To: Enrolled Physicians, Pharmacies, Hospitals, Long-Term Acute Care Facilities, Long-Term Care Providers, Local Health Departments, and Home Health Agencies
Re: No HFS Coverage for Off-Label Utilization of Ivermectin for Prevention or Treatment of COVID-19
This notice informs providers of the Department's position on use of Ivermectin for the prevention or treatment of COVID-19. This applies to the Department's fee-for-service program as well as the HealthChoice Illinois managed care plans.
Ivermectin (Stromectol®) is an antiparasitic drug used to treat parasitic diseases and certain other clinical guideline recommended conditions refractory to standard therapies. The Department's medical programs are not approving prior authorization requests for Ivermectin for the prevention or treatment of COVID-19.
Ivermectin is not authorized or approved by the U.S. Food and Drug Administration (FDA) for prevention or treatment of COVID-19. Its off-label use for COVID-19 is therefore not advised, and not covered at any level of care, including hospitals. The National Institutes of Health's (NIH) COVID-19 Treatment Guidelines Panel has determined that there are currently insufficient data to recommend Ivermectin for treatment of COVID-19. Additionally, the Centers for Disease Control and Prevention (CDC) has issued a Health Advisory warning about the risk of serious adverse effects associated with the use of Ivermectin outside of current prescribing information and guidelines. If further controlled studies demonstrate effectiveness and safety, and Ivermectin gains FDA approval for COVID-19 related indications, a revised Provider Notice will follow.
Ivermectin Current Prior Approval Criteria: Ivermectin requires Prior Authorization for reimbursement through the Illinois Department of Healthcare and Family Services Medicaid Programs. Approval will be given only for use for FDA-approved indications (strongyloidiasis and onchocerciasis) or clinical guideline recommended indications (e.g., resistant pediculosis or scabies) in patients where preferred agents have been tried and failed or justification is provided for not using preferred agents.
Questions regarding this notice may be directed to the Pharmacy Unit in the Bureau of Professional and Ancillary Services at 877-782-5565, or the appropriate HealthChoice Illinois managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs