black background with dark purple border; white text under illustrations of pills: "The Need for Big Pharma Reform: How the Industry Can Improve in the Wake of the Opioid Crisis" and "Not Standing Still's Disease"

The Need for Big Pharma Reform: How the Industry Can Improve in the Wake of the Opioid Crisis

Healthcare reform continues to be a topic of discussion throughout the country. Multiple attacks on health benefits, Medicaid & Medicare, and other health-related entities continue to pop up seemingly every day. Bills to help ease the burden on patients as well as keep companies more accountable fail to go anywhere as party lines remain divided. With the opioid crisis going on, one thing that hasn’t gotten enough press is one health-focused initiative has united over 450 municipalities across the country.

Cities, states, and counties have filed lawsuits against 23 drug companies and distributors for the roles they’ve played in the ongoing opioid epidemic. The crisis claims over 100 lives per day due to opioid overdoses, and it shows no signs of slowing down. In 2015, there were enough opioid painkillers prescribed to treat every American continuously for three weeks.

These lawsuits will likely be the court cases to watch this year, and many suits specifically call out OxyContin maker Purdue Pharma. Ohio’s lawsuit, for example, blames the company for trivializing “the risks of opioids while overstating the benefits of them for chronic pain.” Johnson & Johnson, Teva Pharmaceuticals and distributors including CVS and Walgreens have also been assigned blame.

As we watch the pharmaceutical industry come under fire for its involvement, it’s hard not to wonder how other Big Pharma practices could potentially lead to more crises down the road. As states’ efforts to combat the epidemic get underway, let us consider the areas of the industry that prioritize profits over patients in the hopes of encouraging future reforms.

First and foremost, it’s time to bring clinical trial issues into the limelight. Drug companies can misrepresent their drug’s clinical trial evidence in order to see it brought to market. Although this may be seen as a win for innovation, it often puts patients at risk.

Take Purdue Pharma’s clinical trial for the powerful opioid OxyContin. Evidence from the trials contradicted the pharmaceutical giant’s marketing claims that the drug could provide 12 hours of relief. Patients in the studies were actually unable to manage their pain for that length of time under the recommended dosage, and doctors filed complaints after the drug’s debut in 1996.

But, Purdue was dependent on this 12-hour relief because it allowed the company to have a competitive advantage over other options on the market. The manufacturer continued to stand by its marketing claims, blaming any wear-off of relief on too low of a dosage. The CDC warns that higher doses, which Purdue encouraged, could lead to increased risks when taking the drug, such as dependency and addiction. And so the epidemic began.

This misrepresentation of a drug’s clinical trial data isn’t just tied to the opioid crisis. It extends into common and often life-saving medications as well. In the case of newer anticoagulant Xarelto, manufacturers Johnson & Johnson and Bayer withheld data from its industry-funded clinical trial that would have implicated the blood thinner as less safe than more traditional options.

In the face of misleading evidence, the medication was approved in 2011 without an antidote to reverse its blood-thinning effects. The veil of supposed patient safety was lifted when thousands of individuals suffered internal bleeding complications and even death after being prescribed Xarelto. Similar to Purdue being blamed for its involvement in the opioid crisis, Johnson & Johnson and Bayer are embroiled in lawsuits because of Xarelto’s dangerous side effects.

Perhaps the most disconcerting is the amount of money Big Pharma pumps into its lobbying efforts. The pharmaceutical/health industry saw a 12.4% increase in its lobbying spend from 2016 to 2017, and the industry as a whole spends the most out of any other business sector. Although lobbying is a legal activity meant to serve as a means for citizens to have their concerns addressed to members of Congress, these high monetary donations can often sway lawmakers and influence policies to allow drug companies to stay focused on their profit margins.

Again, the opioid crisis serves as the backdrop for why Big Pharma should make reforms. Multiple states have attempted to pass laws that would limit opioid prescribing habits, but these efforts have been met with severe pushback from drug companies. The Pain Care Forum, funded by the industry, spent upwards of $740 million over the past decade to lobby against these laws aimed at halting the crisis. It’s evident that Big Pharma’s deep pockets and profit-focused mentality influence more than just the medications we’re being offered. It can have a direct impact on the very extent of our healthcare.

It will take many efforts on multiple fronts to bring about an end to the opioid epidemic, but thankfully these efforts are now underway. For one, the overdose antidote naloxone has become more widely available and discussions of pain management approaches, especially for those who suffer from chronic pain, are finally taking place. But, the greatest approach we can and should consider is reforming the very industry that is supposed to be an advocate for our health.

Only then will we stand a chance of making real progress in the name of healthcare.

Morgan Statt is a health & safety investigator who spends her time writing on trending news, consumer health, and public safety topics. When she isn’t researching, she can be found crafting Spotify playlists for every life situation. Follow her on Twitter @morganstatt

Does Your Doctor Get Kickbacks?

Today, I want to share about this site called Open Payments. It is a badass “federally run transparency program that collects information about these financial relationships” to make it free and easy to find.
Here’s why this is important – doctors who get kickbacks or have relationships with organizations are more likely to prescribe medications from certain pharma brands, etc. This doesn’t necessarily imply improper relations. I’m more likely, for example, to recommend products when I’ve had more interactions with their brands.
Still, this is an important issue to note. As patients seeing physicians who aren’t infallible, we need this information. One of my former doctors is on the list and, while I can’t see what ties there were, it explains some of the interactions we had.
Make sure to visit Open Payments and see what your doc’s history of involvement with health care organizations like pharma is. Note that the data is currently available up to 2015.

 

8 ways to get the most out of your doctor appointments

I hear a lot of complaints from other patients on how difficult it can be to work and communicate with physicians, especially given how short appointments often are now. I work with physicians for a living, so I get their side of it too – they have a lot of pressure to hit certain benchmarks and have a certain number of patients, etc.

Docs don’t like the current system any more than patients do.

Short of overhauling the whole system, which is a great idea but a topic for another day, what can patients do in order to get the most from physicians?

First things first, an initial appointment with a provider can be quite difficult. There is so much to cover and examine, especially for us that are chronically ill, that we often stick with that provider with little examination of that choice.

The first appointment with a provider should be treated like an interview.

Yes, there will be things that have to be covered, but you have the power to guide the conversation and, indeed, make it a two-way conversation rather than a one-way dictation on their part.

 

  • Ask them what they know about your current diagnoses and the medications you’re on.If they don’t know much, are they willing to learn? If not, hightail it out of there!
  • Make sure they are willing to communicate with various providers.My rheumy works with my PCP, ophthalmologist, and my dentist. My PCP in turn works with everyone else. This way, my PCP and rheumy are all on top of what is going on with me. It allows them to know much more about my personal care than I could really tell them.It also helps my dentist know when to pre-medicate for dental procedures.
  • Ask about their feelings on involvement in patient organizations like the Arthritis Foundation.My rheumy is on the local AF board. Many others are at least somewhat involved with chronic illness organizations. Ask them which ones they like and why – it could lead you to more resources.Likewise, you can help your physician learn about great organizations out there, too.
  • Ask about their feeling on utilizing technology to communicate versus phone calls.I love MyChart. So much. As someone with anxiety, phone calls are not my favorite – and if I’m not doing well, the last thing I want to do is wait on hold and then leave a message and then wait for a call back from the nurse, who has to talk to the doc…If your doc loves MyChart and you do too? Go for it! If neither of you does, that’s fine too.

    The most important thing is to set up the main communication method.

  • Ask how they feel about engaged patients bringing in information for them to review.If you’re the type of person who likes to read the latest medical journals for new research and medication information and your doctor doesn’t like that, you won’t be a good fit for each other. It’s neither bad nor good, just an incompatibility.
  • Bring someone with you.If you’re having a bad brain fog moment, having another person at your appointments really helps.It can especially help because we really only take in a small amount of what is discussed at an appointment, no matter how our brain fog is doing.

    What I do is text my hubby right as I’m leaving my appointments. It helps me go over main points and allows me to scan my brain for others things that were discussed.

  • Prepare for visits.I’m a list person. So many lists. Very write.What I do to prep for my appointments is I’ll look back over my social media for the last few weeks to see how I’ve been doing publicly versus how I think I’ve been doing. The reality is I’m always slightly worse than I think I am in the moment, so checking social media helps.

    Then I write down on a little half sheet of paper the basic topic with some trigger words. I might even print out a blog post if it seems like it will help.

    Some people use diaries. Others write on their calendars or use apps.

    Whatever works for you, make sure you bring topics to address and don’t let the doc go until you’ve hit all the topics on your list.

  • Tape record or videotape visits, with the consent of your provider.Not all physicians will be down with this and it’s certainly something you need to discuss. However, I know many people whose physicians will record appointments so that brain fog and memory issues don’t get in the way.This is also handy for showing loved ones how the appointment went and ask for their help on certain tasks.
What are your tips for getting the most from a doctor’s appointment?

Happy birthday Sir George!

Sir George Frederic Still was born on February 27th, 1868. If you haven’t guessed by now, Still’s disease is named after him. He also did a lot of work with ADD and meningitis.

There is much to know about this man, and to know the full story you can pop in on my sources here and here. This is going to be the short-ish version.

In 1894, Sir Still went to work at the Hospital for Sick Children and began to study a form of arthritis occurring in children similar to adult RA but with new specifics like organ involvement. He wrote a thesis on this new juvenile arthritis in 1897, becoming a savior in my eyes. His hard work eventually earned him a sweet permanent position as the first-ever Professor of Children’s Diseases at King’s College Hospital.

He did a ton of work with diseases in children, but never really wrote about the disease that bears his name after that thesis. Dude had all sorts of honors though, from serving as princess Elizabeth’s doctor to being knighted to writing textbooks and all sorts of appointments.

Without George Still, I have no idea where I would be right now. This man was incredibly brilliant and knew he had to study this childhood-onset arthritic disease more closely. Because of his research, I am alive today really. This disease is so rare that it’s often mistaken for things like leukemia and fifth’s disease.

With only a few minutes left in your birthday George, I thank you so much for everything you did for all these children. And I toast you with my Enbrel shot!

Healthcare

I’m going to go over some things that I heard last night in Obama’s speech about healthcare.

“neither illness or accident”

My family has been changed terribly several times by illnesses and accidents. Did we have insurance each time? Almost without exclusion, no we did not. We cannot afford health insurance for any member of our family.

“rose above weight of our politics”
I’m not entirely sure this is true. Yes, within the Democratic Party, differences were resolved in order to bring a majority vote in favor of the bill. Still, no Republicans voted for the bill and that may come back to bite the administration in the near future.
“change comes not from the top down but from the bottom up”
Changes from the top-down often end up leading to problems, but changes from the bottom-up tend to stick around longer.
“answers the prayers of every American who has hoped deeply for something to be done about a healthcare system that works for insurance companies and not the people”
Damn straight. I’ve tried to look at health insurance on my own. In my last post, I discussed the outrageous fees and lack of assistance by health insurance for those with pre-existing conditions. I’m sorry that I have a chronic illness – trust me I didn’t ask for it. Why do I currently have to pay more? I shouldn’t, and this bill should work on that.
“every parent who knows the desperation of trying to cover a child with a chronic illness and being told no over and over again”
It was about this point in the speech when I broke down crying. I remember being so sick when I was little and dealing with all the doctors. We were lucky enough that we lived in Oregon, a state with great insurance programs. I can’t imagine having to go through everything without the assistance of the government.
“it’s a victory for them, it’s a victory for the American people”
I hope that everyone will come to see this in the long run.
“will not fix everything that ails our healthcare system but it moves us decidedly in the right direction”
It is obviously not a quick fix. This isn’t like the system backed by Mitt Romney in Massachusetts, where we can flip a switch and fix everything. It will take time and hard work, but it will be worth it in the end.
“we have a solemn responsibility to do things right”
For ourselves and future generations.