If you read anything about the TOGETHER trial in the past few weeks (and you didn’t read it here) chances are you heard the tired trope that ivermectin doesn’t work.
When the study was published, the media urgently blasted out clickbait headlines to this effect, uncritically rehashing Big Pharma propaganda. The Wall Street Journal blared “Ivermectin Didn’t Reduce Covid-19 Hospitalizations in Largest Trial to Date” and The New York Times trumpeted, “Ivermectin Does Not Reduce Risk of Covid Hospitalization, Large Study Finds.”
The problem, as ever, is that the study was designed to fail. In a piece published by The Brownstone Institute, Dr. Pierre Kory highlights the study’s flaws:
There were no explicit exclusion criteria for trial participants on ivermectin, meaning both trial groups had access to the same drug. This is an indefensible omission given that in Brazil, where the trial was conducted, ivermectin is available over-the-counter and widely used.
The treatment window was set for only three days, an obvious “tell” of underdosing given, for example, that both Merck’s molnupiravir and Pfizer’ Paxlovid require five days. The trial actually started out testing only a single dose, presumably until the investigators realized they could never disprove anything with that regimen.
And the trial was conducted during the throes of the massive gamma variant surge, one of the most virulent and deadly COVID variants. The dosage of the trial was far lower than everyday Brazilian clinicians were prescribing patients at the time to match the strength of the strain.
It’s amazing to see so many powerful headlines for such a half-baked study, when a similar, far larger study published in January showing ivermectin led to massive reductions in COVID infection, hospitalization and mortality received virtually no media coverage.
Pierre highlights a particularly aggravating example:
Clicking on a Reddit thread featuring MDs, PhDs and public health professionals discussing the randomization of the TOGETHER trial first brings users to an ominous page with a “quarantine” caveat, urging readers to “please consult your physician.”
The most grotesque perversions imaginable are readily available to any child on the Internet, but informed medical conversations come with a warning label.
To fight the malevolent forces behind these campaigns, we need to reform our dysfunctional drug approval process. Pierre’s outlines what needs to happen:
An independent board free of pharma industry conflicts must be established to oversee trials for re-purposed medicines. Recommendations should be based on trials designed by impartial experts and actual results, not the desired ones, and policymakers or prescribers who ignore the findings should be held accountable.
We must also remind academia and the regulatory agencies that observational trials data—wherein a sample of population who take a drug are compared to those who do not is equally valid at informing policy. Since Covid, regulators and academic medical centers have erroneously placed greater emphasis on large, expensive randomized controlled trials. While these trials can yield useful information, but their complexity, costs, and delays to treatment lead to errors and effectively shut out low-cost drugs from the approval process, regardless of their efficacy.
If our leaders in government fail to heed this advice, greed will continue to corrupt scientific study and erode the practice of medicine until doctors and patients are further relegated as little more than cogs in a billing machine.
You can read Pierre’s op-ed in full at The Brownstone Institute.