Can pharmaceutical companies hold States hostage ?

Roche decided to withdraw an innovative oncology medicine from the Greek market, claiming that its price has fallen more than 50% because of the government’s regulatory interventions in the pharma area…

Roche decision to remove the drug from the prescribed medicines list means that its cost can no longer be covered by the state…

“There is a need to develop strong and systematic synergies in the policy area of pharmaceuticals, particularly on bargaining power in order to prevent unfair trading practices that are especially inappropriate in this very sensitive area,”

the Greek Council delegation said, adding that the case goes beyond narrow national interests.

More Information – Press Releases

  • Drug pricing debate to take place in heated atmosphere, euractiv, December 8, 2017.
  • Athens brings its dispute with pharma industry to the EU Council, euractiv, November 24, 2017.
  • Pharmaceutical company gives free access to drug after clash with Greek government, euractiv, Nov 2, 2017.
  • Greek health minister fumes at pharmaceutical company after drug withdrawal, euractiv, October 31, 2017.
  • Pharmaceutical company withdraws oncology drug from Greek market, euractiv, Oct 30, 2017.
  • Greek government on collision course with pharmaceutical companies over innovative drugs, euractiv, Oct 25, 2017.
  • New Commission study fuels generic drugs industry ‘manufacturing dispute’, euractiv, Oct 13, 2017.
  • Special Report – Protecting innovation in the pharmaceuticals market, euractiv, Oct 13, 2017.
  • Southern EU states present unified front in drug talks, euractiv, May 10, 2017.

Subsys, Fentanyl Spray Nationwide Bribery Scam : Opioid Manufacturer Insys Therapeutics ex-CEO Arrested

Dangerously Addictive Painkiller Prescribed for Patients Who Shouldn’t Have Received It

Opioid crisis in the USA : D. Trump declares a state of emergency health for this scourge that causes 100 deaths / days, while the ex-CEO of Insys Therapeutics, producing Subsys, Fentanyl Spray, is arrested for corruption.

“the company looked to bribe doctors into prescribing Subsys, a fentanyl spray, outside the usual course of their professional practice”

“the company started misleading insurers and agents into authorizing payment for the Fentanyl Spray”

Press Releases

  • Drug company’s billionaire ex-CEO arrested in nationwide bribery scam, abcnews, Oct 26, 2017.
  • Insys Founder Arrested Over Subsys Fentanyl Spray Marketing, Resigns from Company Board, rxinjuryhelp, October 30, 2017.
  • Dangerously Addictive Painkiller Prescribed for Patients Who Shouldn’t Have Received It, Says Whistleblower, nbcnews, JUN 5 2017.

Industry gifts to doctors linked to their branded and costly prescriptions, and should be banned

Influence of pharmaceutical marketing on Medicare prescriptions in the District of Columbia

Health care professionals who received gifts from the pharmaceutical industry not only wrote more prescriptions, but also more costly ones (including more brand name medications), than colleagues who did not receive such gifts.

2017 Study Abstract

Importance
Gifts from pharmaceutical companies are believed to influence prescribing behavior, but few studies have addressed the association between industry gifts to physicians and drug costs, prescription volume, or preference for generic drugs. Even less research addresses the effect of gifts on the prescribing behavior of nurse practitioners (NPs), physician assistants (PAs), and podiatrists.

Objective
To analyze the association between gifts provided by pharmaceutical companies to individual prescribers in Washington DC and the number of prescriptions, cost of prescriptions, and proportion of branded prescriptions for each prescriber.

Design
Gifts data from the District of Columbia’s (DC) AccessRx program and the federal Center for Medicare and Medicaid Services (CMS) Open Payments program were analyzed with claims data from the CMS 2013 Medicare Provider Utilization and Payment Data.

Setting
Washington DC, 2013

Participants
Physicians, nurse practitioners, physician assistants, podiatrists, and other licensed Medicare Part D prescribers who participated in Medicare Part D (a Federal prescription drug program that covers patients over age 65 or who are disabled).

Exposure(s)
Gifts to healthcare prescribers (including cash, meals, and ownership interests) from pharmaceutical companies.

Main outcomes and measures
Average number of Medicare Part D claims per prescriber, number of claims per patient, cost per claim, and proportion of branded claims.

Results
In 2013, 1,122 (39.1%) of 2,873 Medicare Part D prescribers received gifts from pharmaceutical companies totaling $3.9 million in 2013. Compared to non-gift recipients, gift recipients prescribed 2.3 more claims per patient, prescribed medications costing $50 more per claim, and prescribed 7.8% more branded drugs. In six specialties (General Internal Medicine, Family Medicine, Obstetrics/Gynecology, Urology, Ophthalmology, and Dermatology), gifts were associated with a significantly increased average cost of claims. For Internal Medicine, Family Medicine, and Ophthalmology, gifts were associated with more branded claims. Gift acceptance was associated with increased average cost per claim for PAs and NPs. Gift acceptance was also associated with higher proportion of branded claims for PAs but not NPs. Physicians who received small gifts (less than $500 annually) had more expensive claims ($114 vs. $85) and more branded claims (30.3% vs. 25.7%) than physicians who received no gifts. Those receiving large gifts (greater than $500 annually) had the highest average costs per claim ($189) and branded claims (39.9%) than other groups. All differences were statistically significant (p<0.05).

Conclusions and relevance
Gifts from pharmaceutical companies are associated with more prescriptions per patient, more costly prescriptions, and a higher proportion of branded prescriptions with variation across specialties. Gifts of any size had an effect and larger gifts elicited a larger impact on prescribing behaviors. Our study confirms and expands on previous work showing that industry gifts are associated with more expensive prescriptions and more branded prescriptions. Industry gifts influence prescribing behavior, may have adverse public health implications, and should be banned.

More Information

The Real Reason Hospitals Are So Expensive

Adam Ruins The Hospital – Season 2 | Ep 203, 2017

American healthcare might not be the best in the world, but it is the most expensive. Adam Conover explains that inflated hospital costs have created a system that’s unaffordable and unfair.

60 MiNueTs : Toxic Money

UCSF Program on Reproductive Health and the Environment, 2017

The University of California San Francisco (UCSF) Program on Reproductive Health and the Environment (PRHE)’s mission is to create a healthier environment for human reproduction and development through advancing scientific inquiry, clinical care and health policies that prevent exposures to harmful chemicals in our environment.

PRHE is housed within the Department of Obstetrics, Gynecology and Reproductive Sciences, in the UCSF School of Medicine, one of the nation’s most prestigious medical schools. The Department is renowned for promoting cutting-edge reproductive science research, extending the frontiers of multidisciplinary women’s health care and professional education, advocating for women’s health at local, state and national levels, and engaging community involvement.

More Information

60 MiNueTs : Toxic Research

UCSF Program on Reproductive Health and the Environment, 2017

The University of California San Francisco (UCSF) Program on Reproductive Health and the Environment (PRHE)’s mission is to create a healthier environment for human reproduction and development through advancing scientific inquiry, clinical care and health policies that prevent exposures to harmful chemicals in our environment.

PRHE is housed within the Department of Obstetrics, Gynecology and Reproductive Sciences, in the UCSF School of Medicine, one of the nation’s most prestigious medical schools. The Department is renowned for promoting cutting-edge reproductive science research, extending the frontiers of multidisciplinary women’s health care and professional education, advocating for women’s health at local, state and national levels, and engaging community involvement.

More Information

Pharmaceutical industry payments and oncologist drug selection

Payments linked to higher odds of doctors prescribing certain cancer drugs

In preliminary findings that will be presented at the American Society of Clinical Oncology Annual Meeting 2017 in Chicago on Saturday, June 3, researchers show that when physicians had to choose between multiple, on-patent drugs for metastatic kidney cancer and chronic myeloid leukemia, they were more likely to prescribe drugs from companies they had received general payments – for meals, talks, travel, etc. – from.

2017 Study Abstract

Background
Financial relationships between physicians and the pharmaceutical industry are common, and have the potential to influence clinical practice in potentially inappropriate ways. Oncology may be an ideal setting to study the influence of industry payments on physician drug choice given the high levels of competition for market share and high prices commanded by orally administered oncologic drugs.

Methods
We linked the Open Payments database of industry-physician financial transactions with the Medicare Part D Prescriber file by physician name and practice location. We used McFadden’s conditional logit model to determine whether receipt of industry payments was associated with higher odds of using a drug manufactured by the same company. We applied this model to clinical scenarios in which oncologists may choose between multiple, on-patent drugs: metastatic renal cell cancer (mRCC) (sunitinib, sorafenib, and pazopanib) and chronic myeloid leukemia (CML) (imatinib, dasatinib, and nilotinib). The primary, binary independent variable was receipt of payments from a manufacturer of one of these drugs in 2013; the primary dependent variable was choosing that manufacturer’s drug in 2014. We divided industry payments into two categories, research payments and non-research “general” payments (including meals, travel, lodging, and speaking/consulting fees), and analyzed each payment type separately.

Results

More evidence that drug companies are able to influence prescribing practices through gifts to physicians.

Physicians who received general payments from a manufacturer had increased odds of prescribing that manufacturer’s drug for both mRCC (OR: 1.78, 95%CI 1.23-2.57, mean payments $566) and CML (OR: 1.29, 95%CI 1.13-1.48, mean payments $166). Research payments were associated with an increased odds of manufacturer drug use for mRCC (OR: 2.13, 95%CI 1.13-4.00, mean payments $33,391) but not CML (OR: 1.10, 95%CI 0.83-1.45, mean payments $185,763).

Conclusions
Receipt of general payments from pharmaceutical companies is associated with increased prescribing of those companies’ drugs. An association between research payments and prescribing was less consistent. This study suggests that conflicts of interest with the pharmaceutical industry may influence oncologists in high-stakes treatment decisions for patients with cancer.

Sources and Press Release

The New War on Cancer

50-Year War on Cancer: Can We Win?

The signing of the National Cancer Act by President Richard M. Nixon on December 23, 1971, was considered a declaration of war on cancer.

In a multi-part series, the National Post explores why we need a new war on cancer.

Cancer nation

Where you live could affect your odds of getting cancer or dying from it.

Interactive map: Cancer is an indiscriminate disease, affecting rich and poor, old and young. Still, Canadians’ odds of getting sick depend surprisingly on where they live.

Why we need a new war on cancer

Over-treating and over-screening is doing patients more harm than good

The issue: Advances in screening and diagnosis are sending some cancer patients down aggressive treatment paths that they shouldn’t be on.
The solution: A new war on cancer and a rethinking of resources.

Drug money

Some cancer treatments cost as much as $33,000 a month, but fall well short of being wonder cures

A Post analysis of 17 cancer drugs that cost between $4,700 and $33,000 a month reveals only three had evidence that they extended lives when approved by Health Canada.

Bankrupt by cancer

Cancer is not just a life-threatening disease ― but a financial disaster.

In Canada, a country that prides itself on looking after the sick, no matter their ability to pay, Canadians are declaring bankruptcy because of cancer.

The fundraising complex

Of the $2.7 billion that cancer charities spent in 2013, only 45 per cent went towards fighting cancer.

The Post’s analysis of cancer funding reveals the depth of inefficiencies in the sector. In 2013, more than half of total funds went to salaries and overhead.

Learning to live with cancer

As science gets better at controlling cancer for longer periods of time, it might be best to kill the battle rhetoric

Nowhere else in medicine is the battle rhetoric more entrenched than in cancer. And its defeating people. Who wants to go war with their own bodies?

Prevention as the ultimate cure

Prevention saves more lives than any cancer drug

However, in the multi-billion-dollar cancer business, efforts to stop people from contracting the illness account for as little as five per cent of what’s spent.

Comment garder son indépendance face à l’industrie pharmaceutique?

Téléchargez le livret du collectif d’étudiants en médecine de La Troupe du Rire

Téléchargez le livret du collectif d’étudiants en médecine de La Troupe du Rire.

Les liens d’intérêts et l’influence de l’industrie pharmaceutique constituent un risque sanitaire non négligeable.

  • Où se cache cette influence dans notre parcours de soignant ?
  • Comment se manifeste-t-elle ?
  • Pour quelles conséquences ?

C’est à ces interrogations que ce petit livret tente de répondre..

En savoir plus

Our health care, health system and the pharmaceutical industry

Cartoon by Simon Kneebone, 1985

Cartoon by Simon Kneebone for a 1985 article “DES – the wonder drug you should wonder about“.
As pertinent today as 31 years ago!