Indiana physician pushes back on Rokita’s legal advisory on unproven COVID treatments

Ivermectin and other drugs like hydroxychloroquine have become political flashpoints during the pandemic as anti-vaccine groups have falsely propagated the drugs as effective COVID-19 treatments. Up until now, there are no credible scientific studies that suggest that.

Now, an Indianapolis doctor on the COVID frontlines worries a statement issued by Indiana Attorney General Todd Rokita will fuel misinformation about unproven COVID treatments and sow distrust with the medical community.

On Wednesday, Rokita issued a legal opinion stating that doctors can legally prescribe ivermectin and hydroxychloroquine, which are FDA-approved for other purposes, to treat COVID-19. Five state lawmakers —  Sen. Mike Gaskill (R-Pendleton), Sen. Eric Koch (R-Bedford), Sen. James Tomes (R-Wadesville), Rep. Jim Lucas (R-Seymour) and Rep. Elizabeth Rowray (R-Yorktown) — asked Rokita, a Republican, for guidance on the matter, according to a press release.

“Off-label prescribing and use of medications is a common and widespread practice in health care and falls within the standard of competent care unless additional circumstances would otherwise qualify it as malpractice,” Rokita’s advisory opinion states.

Dr. Gabriel Bosslet, a pulmonary and critical care physician and associate professor at the Indiana University School of Medicine, said Rokita’s statement was unnecessary and likely issued for political purposes.

“Ivermectin is not standard of care at this point for COVID-19,” Bosslet said. “And so for a physician like me, it's a confusing statement, because it implies that it is within the standard of care. And it's not.”

None of the top health authorities in the U.S. or overseas recommend the use of ivermectin to treat coronavirus infections. The FDA and the World Health Organization have cautioned against its use to treat COVID-19.

And a new study published on Feb. 18 in JAMA Internal Medicine found that ivermectin does not help in treating COVID-19.

“This statement … is stoking a group of individuals out there who feel that somehow the medical establishment has decided that it's going to avoid treating COVID-19 with effective therapies, because we have some nefarious plot to make sure that the pharmaceutical companies make a lot of money from the vaccine,” Bosslet said. “None of that's true.”

Bosslet said clinical trials are conducted for a reason — to ensure treatments are effective and that any potential harms are outweighed by benefits. But too often, during the pandemic, political figures have made claims about treatments without evidence to back them up.

That’s what happened with hydroxychloroquine in the first year of the pandemic.

“Political figures felt like they found something somehow that we all missed, and … used their platform to say that we should be using this,” Bosslet said. “And when we studied hydroxychloroquine, not only did it not work, but it actually caused harm.”

Bosslet, who has been on the frontlines caring for COVID patients since the start of the pandemic, said the attorney general’s statement correctly states that off-label prescription is accepted, common practice. But by singling out ivermectin and hydroxychloroquine – two unproven drugs for COVID that have been highly politicized – Rokita is exacerbating conspiracy theories and propagating misinformation.

But a spokesperson for Rokita said he’s not singling it out, because if the Attorney General’s office received a similarly “large volume of complaints about a drug’s off-label use, and/or similar questions about that from legislators, that drug’s legal use would likely also be given a legal analysis.”

Rokita also says the opinion is not politically driven and is within his role as attorney general, because he was answering a question of law, not medicine.

“Dr. Bosslet needs to do some more civics research in his effort to become a political commentator,” a spokesperson for Rokita said in an email. “One of the statutory duties of the Attorney General’s office is to provide legal opinions to legislators, who are his clients.”

The spokesperson added that the advisory opinion “should not be construed as either recommending or discouraging the off-label use of any medication.”

This is not the first time Rokita has made attention-grabbing statements around COVID-19. In December, Rokita said during a TV interview that he didn’t “believe any numbers any more” and that COVID data had been “politicized from day one.”

Republican Gov. Eric Holcomb said those comments from Rokita were demoralizing.

“And it’s quite serious when you accuse or insinuate anyone of inflating numbers. In my book, that’s called fraud,” Holcomb said at a press conference in December.

In the press release issued Wednesday, Rokita said society needs to have honest and open discussions about COVID-19.

“That kind of dialogue involves respecting the unique relationship between doctors and patients in deciding whether to get vaccinated or use a drug such as ivermectin,” Rokita said in the release. “And it involves trusting people to exercise their liberties to make the best decisions for themselves and their families.”

Hundreds of providers across the country use telemedicine appointments to prescribe ivermectin, even if the patient is not currently sick with COVID, for as much as $300 for the phone consultation alone.

In an August 2021 report, the U.S. Centers for Disease Control and Prevention noted a 24-fold increase in ivermectin prescriptions for humans compared to pre-pandemic times and with that a significant increase in ivermectin poisoning cases.

This growing trend has caught the attention of federal lawmakers. The U.S. House Select Subcommittee on the Coronavirus Crisis, is investigating two doctors’ groups that may be making millions of dollars propagating unproven drugs like ivermectin.

Bosslet and other physicians say it is not uncommon that patients request ivermectin for their critically sick, unvaccinated loved ones at the hospital. Some patients in Indiana and across the country have chosen to sue their providers for refusing to administer ivermectin.

“For me, if you want to put out a press release about treatment of COVID-19, the press release should say, ‘I got my vaccine, go get yours.’ That would be supportive,” Bosslet said. “This is not supportive. And so if you ask me, you know how I feel about this? I feel sad.”

Contact reporter Farah Yousry at fyousry@wfyi.org. Follow on Twitter: @Farah_Yousrym.