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