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Is it a shock-horror for M.D.s to prescribe you a medication that hasn't been proved effective for the use in question? No, it's completely normal. I explain "off-label prescribing" and its relationship to COVID-19 care at @dcexaminer /1 washingtonexaminer.com/opinion/to-fig…
The news hook is the flap over use of chloroquine and hydroxychloroquine in treating #COVID19 patients and the suggestion that there's something not on the up-and-up about doing so since they aren't FDA approved for that. /2
"It’s both legal and utterly routine for doctors to prescribe a drug for indications other than the one for which it has been approved — so-called “off-label prescribing.” In fact, an estimated 20% of pharmaceuticals reach patients that way," I write. /3
The catchphrase “has not been proven effective” is, in truth, more a legal statement than a medical one. And it will be true almost by definition in the case of treatments aimed at a newly emergent malady, for which there will be no compounds proven effective yet. /4
What leaves the issue so confused is that it's completely okay for docs to seek for and find valuable uses for drugs other than the original indication, but double-plus-illegal for a drug marketer to talk about that, even if entirely truthfully. /5
"There’s a good chance that if some compounds prove useful against COVID-19, the first such will be discovered among those already prescribed for other indications." If so, it will be another instance, among many, of drugs that are prescribed off-label saving lives. /6
Related, this recent line from @slatestarcodex is so apt: "Just like the legal term for 'not proven guilty beyond a reasonable doubt' is 'not guilty', the medical communication term for 'not proven effective beyond a reasonable doubt' is 'not effective'". slatestarcodex.com/2020/03/23/fac…
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