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re: federal prosecutors open massive criminal probe of multiple opioid painkiller companies
Posted on 11/26/19 at 3:14 pm to GEAUXT
Posted on 11/26/19 at 3:14 pm to GEAUXT
quote:
With laws the way they are now, and have been for awhile, the biggest "incentive" a doctor may get from a device or pharmaceutical company is some chick fil a or panera for lunch one day.
I thought this was the case now. Not sure why people still think Drs are getting Hawaii vacations for reaching some prescription quota.
Posted on 11/26/19 at 3:15 pm to HailHailtoMichigan!
How you going to prosecute a company for people who abuse its product? I’m not following.
Seems like some would take the same approach to prosecute firearm companies.
Seems like some would take the same approach to prosecute firearm companies.
Posted on 11/26/19 at 3:20 pm to Adam Banks
quote:
The government told hospitals they weren’t going to get paid unless they “treated pain” and “pain is the fifth vital sign”.
Now the government is investigating others for doing what they wanted
Yeah, this was a real, very serious issue, and I agree that the government shares a lot of the culpability here. How much (if any) influence did the pharmaceutical lobby have on this policy, though?
Honest question — I really don’t know, but it wouldn’t surprise me at all if the government only proceeded with this kind of action because the policy makers in question believed they could use that angle to shift blame onto private corporations.
Posted on 11/26/19 at 3:22 pm to Adam Banks
quote:
In the text it also notes that from 2000-2002 the pacu morphine went up 50%.
Acute postprocedural pain management doesn't normally precipitate addiction.
Posted on 11/26/19 at 3:31 pm to Obtuse1
quote:
Obtuse1
Your example doesn't negate the point that there have been widespread changes in the way physicians are compensated by drug and device makers. The overwhelming majority of physicians see no meaningful compensation of any kind by drug or device makers these days. Citing two examples out of hundreds of thousands of people is not a strong argument and ignores the meaningful reform that has come about in the past 20 years.
I do like your point that everyone in the chain should be held accountable and I agree. Truth is, like you said, this is a complex issue and many are to blame. Intellectually lazy to simply single out the manufacturers...or the MDs either.
Posted on 11/26/19 at 3:32 pm to Adam Banks
quote:
It increased by 50 million in the ten years before and 90 million in the ten years after per their chart. In the text it also notes that from 2000-2002 the pacu morphine went up 50%.
From 1991-2001, it increased from 76 to 138 million. That's an increase of 62 million.
From 2001-2011, it increased from 138 to 219 million. That's an increase of 81 million.
US Population/Prescriptions per American
1991: 253.5 million / 0.245
2001: 285.0 million / 0.484
2011: 311.6 million / 0.703
From 1991-2001, the prescriptions per American increased by 0.219.
From 2001-2011, the prescriptions per American increased by 0.239.
I wouldn't call that skyrocketing. The trend line from 1991 to 2011 is basically straight, not exponential.
I agree with you that placing all of the blame on the pharmaceutical industry is silly. There are no simple answers or causes for what essentially amounts to lots of people in various parts of industry, government, and society pursuing their own interests. It's a big mess.
Posted on 11/26/19 at 3:33 pm to Obtuse1
quote:
Charles Decook family medicine 280 payments from 16 companies in 2018 totaling $7.4 million dollars.
PROMOTIONAL SPEAKING/OTHER
14 $7.09M
CONSULTING
72 $330K
TRAVEL AND LODGING
91 $33,688
FOOD AND BEVERAGE
103 $4,686
Mostly device manufacturers but just one example of a golden child.
Jain Rakesh psychiatry got 1140 "payments" in 2018 from 18 drug companies totaling $878k.
Looking at the entire population...what's the median?
I get what you're trying to say...I'm just disagreeing with this line of argument from you.
This post was edited on 11/26/19 at 3:35 pm
Posted on 11/26/19 at 3:36 pm to GeauxDoc
Don’t think this is tanking. Down 5% today.
McKesson Corporation (NYSE:MCK) is now up well over 30% since the start of the year.
McKesson Corporation (NYSE:MCK) is now up well over 30% since the start of the year.
Posted on 11/26/19 at 3:40 pm to DeepBlueSea
quote:
Yeah, this was a real, very serious issue, and I agree that the government shares a lot of the culpability here. How much (if any) influence did the pharmaceutical lobby have on this policy, though?
Honest question — I really don’t know, but it wouldn’t surprise me at all if the government only proceeded with this kind of action because the policy makers in question believed they could use that angle to shift blame onto private corporations.
More likely is that pharmaceutical companies lobbied for the new policies. Look at it this way, the ROI of lobbying government for a policy that improves your bottom line is much higher than the expected ROI of any particular R&D project. Companies that spend thousands lobbying receive millions in benefits. Companies that spend millions receive billions. You would have a difficult time beating that return on the stock market even if you could see the future. It's why the larger a company gets the more attractive it is to lobby rather than innovate.
Posted on 11/26/19 at 3:40 pm to Obtuse1
quote:
Obtuse1
Those are obviously extreme examples.
However, like I said before, those are doctors who are traveling the country giving talks and presentations and such. The compensation is ridiculous, but they're being compensated for a service, and not for just presrcibing meds or using certain plates and screws.
Posted on 11/26/19 at 4:06 pm to Adam Banks
quote:
LINK
This is from the joint commission themselves
Funny how that paper doesn't support your claims:
"Changes in Prescription Opioid Use Immediately after the release of the standards in 2001, some raised concerns that the standards could lead to inappropriate use of opioids.24 Total opioid prescriptions had been steadily increasing in the U.S. for at least a decade before the standards were released (see Figure 1 below).31 Between 1991 and 1997, the number of prescriptions increased from 76 million to 97 million. This was likely due to advocacy work by pain experts, as described above. From 1997 to 2013, the rate of increase appears to have been somewhat more rapid. Some of this acceleration in the rate of increase in opioid prescribing may have been due to the 1995 approval of the new sustained-release opioid OxyContin.32 The Food and Drug Administration (FDA) approved labeling saying that iatrogenic addiction was “very rare” and that the delayed absorption of OxyContin reduced the abuse liability of the drug.32 These same claims were used in marketing campaigns to physicians and in more than 40 national pain-management and speaker training conferences for which all expenses were paid.32 The FDA required removal of these unsubstantiated claims from OxyContin’s labeling in 2001. However, the concept that iatrogenic addiction was rare and that long-acting opioids were less addictive had been greatly reinforced and widely repeated, and studies refuting these claims were not publish until several years later.33,34 Because of the steady rise in opioid prescriptions in the decade preceding release of The Joint Commission standards and the other forces encouraging opioid prescribing in the years before the release of the standards, it is difficult to draw conclusions about whether the standards or educational materials related to the standards had an independent effect on the upward trend."
Posted on 11/26/19 at 4:19 pm to GEAUXT
quote:
Those are obviously extreme examples.
However, like I said before, those are doctors who are traveling the country giving talks and presentations and such. The compensation is ridiculous, but they're being compensated for a service, and not for just presrcibing meds or using certain plates and screws.
I agree they are extreme but it was to show they exist and neither are the most extreme by far.
20k and a trip to Hawaii aren't just for giving that 15 minute talk. Switch a large ortho practice to Zimmer/Biomet implants and you can expect to gather a tidy compensation package.
No ill to Zimmer or Biomet, they are no different than any other, and I have a bunch of Biomet swag from my FIL.
Posted on 11/26/19 at 4:32 pm to HailHailtoMichigan!
And this is why when I fell and tore a muscle and couldn’t walk or sleep, the doctor only gave me useless tramadol which did nothing.
Posted on 11/26/19 at 4:34 pm to Horsemeat
quote:
opioid based painkillers for injuries that didn't need it
Frick them ibuprofen 800mg sucks. Give me my damn opioids.
I did enjoy my dentist prescribing me opioids when I had a tooth pulled in 2011. I just saved them until my next kidney stone. Opioids for a pulled tooth is extreme.
This post was edited on 11/26/19 at 4:37 pm
Posted on 11/26/19 at 4:36 pm to DiamondDog
quote:
How you going to prosecute a company for people who abuse its product? I’m not following.
Right. If government really cared, it’d prosecute fast food and sugar industry.
Posted on 11/26/19 at 4:38 pm to biglego
quote:
Right. If government really cared, it’d prosecute fast food and sugar industry.
They could start being ending corn subsidies which resulted in the cheap high fructose corn syrup that's in almost everything these days.
Posted on 11/26/19 at 4:39 pm to biglego
quote:
Right. If government really cared, it’d prosecute fast food and sugar industry.
No kidding. The corn and sugar industry will be viewed like the tobacco industry in the near future.
Posted on 11/26/19 at 4:42 pm to DiamondDog
quote:
Seems like some would take the same approach to prosecute firearm companies.
I'd liken this to a firearm company selling products as "safe for children, adult supervision not necessary." Pharma reps were telling doctors that they had brand new research that proved opiods were non addictive when used for pain. I'm not saying the pharma companies are entirely to blame here, but without their full court marketing press in the nineties, opiod use doesn't explode.
Posted on 11/26/19 at 4:50 pm to Jim Rockford
quote:
Speaking hypothetically here, because I dont know the particulars of your situation:
Patient A goes to doctor B for some painful condition, who writes an opiod script when maybe the patient didnt need it, because pharma rep C sold him on a new formulation that "all the latest research shows is non-addictive when used as directed." Who bears responsibility?
This is a real life scenario because the pharma companies spent a lot of money marketing the idea that opiods werent addictive when used to treat pain, that the whole addiction problem was with recreational use.
I think they all bear some responsibility. My situation involves prescriptions prescribed by a doctor. Went to a psych and was prescribed 4 xanax bars a day (8 mg). Was the doctor negligent in prescribing that insane of an amount? frick yes he was. Was I negligent in walking into that death trap with eyes wide closed? frick yes I was.
I remember walking out of that doctor's office with a script for 120 xanax bars with 3 refills and felt like I hit the lottery. When the wife found the bottle 8 months later and flushed the pills down the toilet the withdrawal damn near killed me. Grand mal seizures, hallucinations, psych ward for a week. It was awful.
Posted on 11/26/19 at 5:37 pm to HailHailtoMichigan!
quote:
Maybe justice finally to come???
Maybe you'd better start praying to whatever god you believe in now that "justice" doesn't happen. Otherwise, when no company dares produce opioids because "justice" came, those last days when you're dying from end stage stomach cancer and are lying in that bed in agony you'll be cursing him.
This is typical short-sighted round-about government bullshite that always happens when government meddles and their meddling backfires. They helped cause the opioid crisis and now they're pointing fingers as if their hands are clean. The people are the only ones who will suffer once this is done.
This post was edited on 11/26/19 at 5:53 pm
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