Opioid Marketing Payments to Doctors Fall, ProPublica Reports: Shots

The last two years have been a time of reflection for pharmaceutical manufacturers on their role in promoting opioid drugs that fueled a national epidemic

Lawsuits and the media have accused Purdue Pharma, the manufacturer of OxyContin, aggressively market the powerful narcotic even after knowing that the drug was misused. Prosecutors have accused the founder of Insys Therapeutics and several representatives and executives of the company for their role in an alleged conspiracy to bribe doctors to use their fentanyl spray for unauthorized purposes. The state and local governments have filed lawsuits against a host of drug makers, alleging that they were marketing opioids in a misleading way and seeking to recover what it costs to treat drug addicts [19659009]. new ProPublica badyzes. Payments by pharmaceutical companies for opioids dropped significantly in 2016 compared to the previous year.

In 2016, drug companies spent $ 15.8 million to pay doctors for opioid conferences, counseling, meals and travel. This is down 33% from $ 23.9 million in 2015 and 21% from the $ 19.9 million spent in 2014. Companies are required to publicly report payments under the Medical Care Act. ] ProPublica has badyzed these payments in conjunction with our update of Dollars for Docs, an online tool that allows users to view and compare promotional payments to physicians in drug and medical device companies. We updated the tool on Thursday to add payments to doctors for 2016. It now includes more than $ 9 billion in payments since 2013 to more than 900,000 physicians.

Among the opioids, the largest decreases were for Subsys, the fentanyl criminal charges were brought against officials and representatives of drug maker Insys and Hysingla ER, a long-term version of hydrocodone manufactured by Purdue Pharma.

By-product payments increased from more than $ 6 million in 2015 to less than 2016. Payments for Hysingla increased from approximately $ 6.3 million in 2015 to $ 2.2 million of dollars in 2016.

Dr. Scott Hadland, an badistant professor of pediatrics at the Boston University School of Medicine who has studied opioid marketing, said the declines were "impressive," but not surprising given rising awareness and concerns concerning the marketing of opioids by pharmaceutical companies. it is difficult to identify a single reason behind the decline, but "it is possible that pharmaceutical companies will voluntarily reduce their marketing, realizing that they may have contributed to the overprescription."

A number of studies have shown a correlation between the marketing of opiates and prescription drugs by doctors. Hadland and his colleagues reported in May that for every meal received by a doctor related to an opioid product in 2014, there was an increase in opioid claims by this doctor for Medicare patients the following year. And a report from the New York State Health Foundation released this month found that doctors who have received payments from opioid manufacturers prescribe more opioids to Medicare patients than doctors who donâ € ™ t have. have not received the payments.

much slower reduction in the use of prescription opioids. The number of opioid prescriptions in Medicare, the public health program for the elderly and disabled, reached 81.7 million in 2014, then dropped to 80.2 million in 2015 and 79.5 million in 2016, according to the Centers for Medicare and Medicaid Services. (Registration to the Medicare prescription drug program continued to grow during this period, so that the rate of opioid prescriptions per beneficiary further declined.)

grow. Some 42,000 people died of opioid overdoses in 2016, the most recent year available, and about 40% of them were on opioid prescription. The epidemic is a bit distant from prescription drugs because more and more heroin and synthetic opioids like fentanyl are dying.

Public attention has prompted prescription opioid manufacturers to reorganize their commercial practices.

Purdue Pharma The greatest attention due to its blockbuster OxyContin, has reduced its spending on doctors, especially for programs in which doctors talk to their peers at lunch or dinner to help companies market their products . Purdue completed its speaker program for OxyContin at the end of 2016 and for Hysingla ER in November 2017. Earlier this year, it stopped any direct promotion of its opioids to prescribers and last week, the company fired its sales representatives remaining.

Purdue spokesperson Robert Josephson said in an email that payments to opioid-related doctors have declined since 2016 and that there would be very little spending in 2018.

In 2007 Purdue and three of its leaders pleaded guilty to "OxyContin and collectively agreed to pay more than $ 634 million in penalties." However, over the past few years, the company has rebuffed allegations that it has stoked the company's claim. 39, opioid epidemic, claiming that it was part of the solution.

Insys was also the subject of multiple federal and state investigations regarding its commercialization of Subsys. terminated its speakers program for Subsys earlier this year and indicated that it has refocused its sales staff primarily on oncologists who treat patients with severe cancer-related pain, which that the drug was initially allowed to treat. "Insys is a new company in important aspects, made up of people who are firmly and sincerely committed to helping patients in need and doing the right things in the right way," said spokesperson. company, Joseph McGrath. John Kapoor pleaded not guilty to charges of conspiracy to commit racketeering, mail fraud and cable fraud. Some former sales representatives, managers and doctors pleaded guilty to their role in the detailed conspiracy by federal prosecutors;

Opana ER, a pain medication manufactured by Endo Pharmaceuticals, was further promoted in 2016. The company removed the drug from the market at the end of 2017 at the request of the Food and Drug Administration, after being linked to an HIV epidemic in 2015 in rural Indiana among intravenous drug addicts who crashed Opana and he injected needles. ] Endo spent approximately $ 121,000 in payments to Opana-related physicians in 2015 and $ 229,000 in 2016.

"Pharmaceutical manufacturers are legally licensed in the United States to promote all FDA-approved products in Canada. doctors. said in a statement. That said, opioid products are used safely by millions of Americans to improve their quality of life.

That said, Endo said that she was no longer promoting Opana ER in the United States in January 2017 before voluntarily withdrawing the drug in September. "Today, Endo is not promoting any opioid products to US doctors," the company said in a statement

. Some opioids containing buprenorphine have also withstood the downward trend in physician payments. Businesses spent more than $ 4.4 million in 2016 on promoting Belbuca, Butrans and buprenorphine, which experts say are less prone to abuse and have a lower risk of overdose. That was almost double the amount spent on these drugs in 2015. Almost all the difference was attributable to Belbuca, which was approved by the FDA in late 2015.

Purdue, which manufactures Butrans, has stopped its drug program. speaker for the drug at the end of 2016. Endo marketed Belbuca until December 2016 and then returned its license to BioDelivery Sciences International Inc., which has been marketing the product since then.

Dr. Michael Barnett, an badistant professor of health policy and management at the Harvard School of Public Health, said it's hard to say why marketing has declined for opioids.

"Given the deluge of media attention with the opioid epidemic" I saw the pendulum swing in the opposite direction, "he says, considering that opioids are seen as a compbadionate means of treating pain "to be considered quite toxic and to be used only as a last resort."

Barnett The marketing of opioids continues to decline, "this is potentially good news."

"If this is actually the result of an badertion from the manufacturers:" Oh, people get themselves really care about opioids used responsibly "and they are aware that their defense and payments to doctors could be considered as pushing these drugs in an ethically dubious way, so that's a beneficial development and something that I would like to see more. "

Check to see if your doctor has received any al drug payments and medical device manufacturers using our Dollars for Docs tool

ProPublica is a New York-based nonprofit writing company, you can follow Charles Ornstein and Ryann Grochowski Jones on Twitter: @ charlesornstein and @ ryanngro .