Pharmacy News: OxyContin prescriptions by Ontario MDs vary greatly, study finds
OxyContin prescriptions by Ontario MDs vary greatly, study finds
Some doctors are writing significantly more prescriptions for such powerful painkillers as OxyContin than their colleagues, a new study suggests — a practice some are blaming on the influence of pharmaceutical companies.
A new study highlights the issue of opioid-related deaths, which have surged in recent years to the point where they are now considered more common in North America than deaths from HIV. The report, which looks at data from 2006, was published in this month’s issue of Canadian Family Physician.
It found Ontario’s most frequent opioid-prescribing family doctors wrote 55 times more prescriptions for the narcotics than physicians who prescribed the drugs the least.
Those doctors handing out the most prescriptions had the highest numbers of patient deaths linked to the drugs, according to researchers at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences, both in Toronto.
“We know that the drugs are useful in particular patient populations, and we also know that they’re potentially very dangerous,” said the study’s lead author, Dr. Irfan Dhalla, who called the variation in prescription rates striking.
“The drugs need to be used and prescribed with great care.”
A 2009 report by the College of Physicians and Surgeons of Ontario found that opioid-related deaths in Ontario increased 49 per cent between 2002 and 2006.
Deaths linked to oxycodone — the active ingredient in OxyContin, also known as Hillbilly Heroin — shot up 240 per cent between the same years.
Dhalla is calling for better education of physicians when it comes to appropriately handing out the drugs.
“I think education needs to occur at all levels,” he said. “Medical students don’t receive enough education about these issues, and until recently at many universities, the education was being delivered — at least in part — by people who have ties to the pharmaceutical industry and were presenting information that was potentially biased.”
St. Michael’s physician Dr. Philip Berger pointed to pressure from the pharmaceutical industry as a reason for the spike in prescriptions.
“It is important to recognize that one reason opioids are prescribed so often is that the pharmaceutical industry has marketed these drugs very aggressively,” Berger said in a statement.
He later told Postmedia News that pharmaceutical companies’ “unethical and unbelievably aggressive marketing” practices are unfairly influencing Ontario’s overstressed family physicians.
“With that nudge and push from the pharmaceutical companies, they may be more eager to just prescribe a drug without exploring other methods of relieving pain,” he said. “They make it appear that it’s normal to prescribe medications in situations where they should not be.”
The University of Toronto revised the curriculum for one of its pain-management courses in 2010 after a 371-page pain-management book funded and copyrighted by Purdue Pharma, the manufacturer of OxyContin, was distributed to students in the course.
From 2002 to 2006 the course was funded in part by donations from drug companies — a practice the U of T curtailed in 2007.
Purdue Pharma, the manufacturer of OxyContin, could not be reached Tuesday for comment.
The study looked at prescription records for Ontarians aged 15 to 64 who qualified for provincial drug coverage.
In 2006, 166 of the 408 people in the province whose deaths were linked to opioid use received at least one prescription for the drugs in the 12 months prior to their death.
Of that group, 102 received their final prescription before death from a family physician.
Sixty-two per cent of patients who died while in the care of a family physician had a doctor who was among the group of most frequently prescribing physicians.
According to the Ontario government, between 1991 and 2009 the number of prescriptions for oxycodone skyrocketed 900 per cent.
The drug is about 1.5 to two times more powerful than morphine.
The Ontario government responded in November 2010 with the Narcotics Safety and Awareness Act, which will allow the Ministry of Health to monitor the prescription of opioids and stop addicts from obtaining drugs from multiple doctors at the same time.
A spokesman for the Ministry of Health said the department is currently developing plans to work with the health-care sector to educate doctors on appropriate prescribing methods as part of its narcotics strategy. There is no timeline for the launch of the education program.
Prescribed pain by Corporate America
During the ultimate scene of betrayal in the movie Wall Street, a young stockbroker named Bud Fox learns that his idol, the golden-calf worshipping Gordon Gekko, has not only lied to him but left his father’s company exposed to the whims and hunger of the wolves of Wall Street. In a climactic moment, Fox asks Gekko, “how much is enough? How many yachts can you water ski behind?”
Even though this film was mid-1980s fare, one can once again repeat that old refrain, the more things change the more they stay the same. Perhaps not for the actor who played Bud Fox, Charlie Sheen, who should share Natalie Portman’s Oscar for real-time transformation into the Black Swan.
But for the rest of us, who have watched as greed has become the foundational structure upon which much of our modern economy is built, it is often difficult to see how we might close the Pandora’s Box and return to saner times. You know, back when being Donald Trump wasn’t considered an asset in a hair-club-for-men commercial, much less a race to be President of the United States.
There is nowhere this greed is more pervasive than among those companies responsible for the health of roughly 300 million of Americans – Big Pharma. You know, the guys who got a better sweetheart deal from George Bush’s Medicare prescription drug benefit than Ana Nicole Smith did from that old rich guy.
Later, re-importation from Canada and bulk negotiation for Medicare prescription drugs were written out of any Obama healthcare plan, even though each was at the heart of Democratic Party campaign promises in 2006 and 2008.
Maybe money can not buy you love – but the halls of Congress have a more Heidi-Fleiss-kind-of ethic to them.
Steve Lendman of RINF.com, in providing a summary of David Sirota’s bestselling book, Hostile Takeover, clarifies:
This industry is one of the most profitable in the country making about 18 cents profit on every dollar of sales; it is aided by government using our tax dollars to fund about one third of all research on new drugs the industry gets at no charge; the industry spends about twice as much on advertising, promotion and administrative costs as they do on R & D to develop new drugs; the prices charged for prescription drugs in the US are inordinately high compared to the rest of the world and are rising at about four times the rate of inflation; these rising costs plus those for most all health services are rising so fast, companies are forcing their employees to pay a greater share of them or are reducing overall health care benefits.
Ever feel like you are the bank and they are Dillinger? If not, you probably should.
I can attest to their greed personally, from working with preeminent plaintiff’s lawyer Ed Blizzard, who has challenged the right of pharmaceutical companies to poison Americans, like it is part of their business model. It is Blizzard who made Vioxx drug-maker Merck pay dearly – to the tune of $4.85 billion – for the scores of Americans who lost mothers, fathers, brothers and sisters, because Vioxx promised to help with arthritis and instead delivered sudden cardiac arrest.
Now, because a lack of any regulation, Americans are being poisoned by hip implants created by Johnson & Johnson subsidiary Depuy Orthopaedics Inc., that are not only not tracked by any regulated registry, but in many cases were never even tested before being put into people’s bodies – so the inside of victims hips could come to resemble a post-Deepwater Horizon Gulf of Mexico.
You can tell they’re confident that their 93,000 recalls, which they had been warned about as early as 2008, but did not do anything to address until 2010, aren’t proof of any wrongdoing. That is probably why Depuy’s President, David Floyd, just resigned.
Even worse, the chromium poisoning that is destroying victims’ bone and muscle is nothing new, in fact, you may remember a town of people who got cancer due to its ill effects from the movie Erin Brockovich. Now, they have Depuy and Johnson & Johnson to thank for this honor.
So one understands we are talking about real people here, one of Blizzard’s clients, 58 year-old construction worker Larry Barnett of Modesto, Illinois, “suffered debilitating pain – he had trouble even walking or standing after receiving the part” and now is “at much greater risk for cancer.” Barnett told reporter Mike Cronin of The Daily, that Depuy’s ASR hip replacement has “screwed up my life for three years.” This man was a hard-working construction worker, who “only wants to get back to work”.
One wonders if any pharmaceutical company had to give up income for three years, which they would do first – hand off the bill to American taxpayers or make Canada to accept re-importation of drugs from the United States for 150 per cent of the price.
As Blizzard has said, “nobody signed up for an oil spill in their body.” They did not sign up for cancer either.
So let me ask the question this time, as Sheen is a bit preoccupied with other matters: When is enough, enough?
India makes strong pitch for pharma exports to China
India made a strong pitch to push exports of its pharmaceuticals to China in a big way asserting that a good opening exists for its USD 21 billion strong pharma industry to make forays into China, if Chinese government cleared hurdles to provide market access.
Indian Ambassador to China, S Jaishankar along with the an Indian pharma delegation, headed by N R Munjal, President, Indian Drug Manufacturers Association, met officials of State Food and Drug Administration (SFDA) and Chinese Ministry of Commerce today and urged them to take steps for faster clearance of licences for Indian products.
Jaishankar said the delegation tried to impress upon Chinese officials that while the Chinese companies trading in Active Pharmaceutical Ingredients (API) were getting clearances in about an year, it is taking three to five years for an Indian companies to clearances in China.
China’s API exports to India touched USD 3.3 billion last year, while Indian drugs struggled to post USD 500 million worth of exports to China, even though Indian companies boasts of USFDA approved facilities, exporting to 170 countries, Jaishankar said.
“We tried to make out a case that like India making use of Chinese machinery to expand its infrastructure, China, too, should take advantage of well placed Indian pharmaceutical industry which can help to make the basic drugs available for far cheaper prices benefiting the Chinese public,” Jaishankar told PTI after meeting the officials.
He said though bilateral trade crossed USD 60 billion last year, it tilted heavily in favour of China with its exports crossing over USD 40 billion.
It would be difficult to continue sustaining bilateral trade on the basis of current trends, he said.
It would be even more difficult if, as expected, some of India’s current major exports actually started to decline, he said, pointing to the decline Indian raw material exports like iron ore and cotton.
“There is an urgent need to change the trade basket and introduce elements where India has proven competence.
Pharmaceuticals readily fit the bill, he said adding for its part India is organising campaigns to create awareness of Indian products IT and Pharmaceuticals.
India is pushing for market access based on the assurances by Chinese Prime Minister Wen Jiabao, to address the trade imbalance, he said, adding an Indian pharma delegation is visiting China for the first time to closely interact with their Chinese counterparts.
He said during today’s interaction, Chinese officials had proposed to a nodal body comprising of SFDA officials and Chief Controller of Drugs of India to interact on the market access issues, which will be seriously considered.