That is correct . It is not a assumption. Off label is huge in the western world. The only thing that slows down off label use is that health insurance companies require some rationale data to cover the product for the intended use. I also understand that pharmaceutical companinot allowed to promote the product for any purpose other than what the FDA has approved.
https://onlinelibrary.wiley.com/doi/full/10.5694/j.1326-5377.2006.tb00689.x#:~:text=Abstract,to%2090%25%20in%20paediatric%20patients.
A huge amount of information is available about off label use.
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