URGING THE HAWAII STATE DIRECTOR OF HEALTH TO ISSUE A STATEWIDE ORDER TO ALLOW FOR THE SALE AND PURCHASE OF NEBULIZED BUDESONIDE WITHOUT A PRESCRIPTION OR CONSULTATION WITH A HEALTHCARE PROVIDER.

HR126

HOUSE OF REPRESENTATIVES

H.R. NO.

126

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

HOUSE RESOLUTION

urging the hawaii state director of health to issue a
statewide order to allow for the sale and purchase of nebulized budesonide
without a prescription or consultation with a healthcare provider
.

����
WHEREAS, budesonide
in nasal spray form was previously prescription-only but has since been
converted to over-the-counter status due to its excellent safety profile; and

����
WHEREAS, budesonide
was proven to be life-saving by the STOIC Trial conducted by Oxford University
in the treatment of COVID-19, a highly contagious respiratory virus; and

����
WHEREAS, the
study found that early administration of inhaled budesonide reduced the need
for urgent medical care, shortened recovery time, and lowered the risk of
hospitalization for COVID-19 patients; and

����
WHEREAS,
additional findings suggest that �inhaled budesonide reduced the relative risk
of requiring urgent care or

hospitalization by 90% in the 28-day study period�; and

����
WHEREAS, the
Saudi Journal of Anesthesia published a study in 2017 demonstrating that
patients with acute lung injury or acute respiratory distress syndrome (ARDS)
experienced improved oxygenation, decreased edema in lung tissue, and reduced
lung scarring following treatment with nebulized budesonide; and

����
WHEREAS, millions
of American lives were saved through home treatments of nebulized budesonide
during the COVID-19 crisis; and

����
WHEREAS, Dr.
Richard Bartlett�s published protocol demonstrated that nebulized budesonide,
when used in an outpatient setting, provided significant benefits for treating
COVID-19, reducing the risk of pneumonia and improving patient outcomes; and

����
WHEREAS, the
U.K. PRINCIPLE Trial, the largest randomized trial for community treatment of
COVID-19, confirmed that inhaled budesonide improved recovery time and reduced
hospital admissions or deaths among high-risk patients; and

����
WHEREAS, the
Brazil TOGETHER Trial demonstrated that combining inhaled budesonide with oral
fluvoxamine reduced the progression of COVID-19 and the need for
hospitalization

among high-risk outpatients; and

����
WHEREAS, the
World Health Organization (WHO) recognizes budesonide as an essential medicine,
confirming its global importance in treating respiratory conditions; and

����
WHEREAS, the
U.K. Department of Health recommended inhaled budesonide for adults over fifty
with COVID-19, citing its benefits in reducing symptoms and preventing
complications; and

����
WHEREAS, the
Australian Department of Health included budesonide in its clinical guidelines
as a treatment for at-risk COVID-19 patients who do not require oxygen support;
and

����
WHEREAS, the
India Ministry of Health and Family Welfare officially recommended budesonide
for COVID-19 treatment, reinforcing its global acceptance in respiratory
therapy; and

����
WHEREAS,
research has identified antiviral properties of budesonide against SARS-CoV-2,
demonstrating its potential to reduce viral replication and inflammation in
infected individuals; and

����
WHEREAS, FDA
regulations prohibit Emergency Use Authorization (EUA) for experimental
COVID-19 vaccines if there is an adequate, approved, and available alternative
treatment, and budesonide, as an effective and FDA-approved therapy, meets this
criterion; and

����
WHEREAS,
other medicine with more dangerous safety profiles are classified as
over-the-counter, justifying the need for nebulized budesonide and nebulizer
machines to be accessible without a prescription; and

WHEREAS, allowing nebulized
budesonide and nebulizer machines to be sold over the counter will provide the
public with greater access to effective respiratory treatments without
unnecessary delays or restrictions; now, therefore,

����
BE IT
RESOLVED by the House of Representatives of the Thirty-third Legislature of the
State of Hawaii, Regular Session of 2026, the Hawaii State Director of Health
is urged to issue a statewide order to allow for the sale and purchase of nebulized
budesonide without a prescription or consultation with a healthcare provider;
and

����
BE IT FURTHER
RESOLVED that the Director of Health may recommend to the public that nebulizer
machines may be sold or purchased over the counter without a prescription; and

����
BE IT FURTHER
RESOLVED that the Board of Pharmacy is urged to adopt any necessary rules to
implement this request including but not limited to:

����
(1)
�
Ensuring product labeling includes appropriate
dosages and usage instructions; and

����
(2)
�
Requiring pharmacies and retailers to provide
customers with written instructions on the proper use of nebulized budesonide
and nebulizer machines; and

����
BE IT FURTHER
RESOLVED that certified copies of this Resolution be transmitted to the Hawaii
State Director of Health and Chair of the Board of Pharmacy.

OFFERED BY:

_____________________________

Report Title:
�

Budesonide;
Nebulizer; Over-the-Counter Medication; Health; Board of Pharmacy