"we conclude that governing law allows physicians to use FDA-approved medicines that are unproven for a particular off-label use so long as (1) reasonable medical evidence supports that use and (2) a patient's written informed consent is obtained. In the context of this ever-changing global pandemic, we note that it is appropriate to consider medical evidence outside of Nebraska and to give physicians who obtain informed consent an added measure of deference on their assessment of the available medical evidence."

"Why would ivermectin's original patentholder go out of its way to question this medicine by creating the impression that it might not be safe? There are at least two plausible reasons. First, ivermectin is no longer under patent, so Merck does not profit from it anymore. That likely explains why Merck declined to "conduct clinical trials" on ivermectin and COVID-19 when given the chance. 178 Second, Merck has a significant financial interest in the medical profession rejecting ivermectin as an early treatment for COVID-19. "[T]he U.S. government has agreed to pay [Merck] about $1.2 billion for 1.7 million courses of its experimental COVID-19 treatment, if it is proven to work in an ongoing large trial and authorized by U.S. regulators. "179 That treatment, known as "molnupiravir, aims to stop COVID-19 from progressing and can be given early in the course of the disease. "180 On October 1, 2021 , Merck announced that preliminary studies indicate that molnupiravir "reduced hospitalizations and deaths by and that same day its stock price "jumped as much as 12.3% "182 Thus, if low-cost ivermectin works better than—or even the same as—molnupiravir, that could cost Merck billions of dollars."