Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Medical Marijuana Can Save Lives - Here's the Evidence

Medical Marijuana Can Save Lives - Here's the Evidence | Pharmaguy's Insights Into Drug Industry News |

This week, Attorney General Jeff Sessions paused a discussion of the opioid epidemic to, once again, go after marijuana. He suggested that addictive pain medication wasn’t the only problem and that many heroin addicts start out “with marijuana and other drugs.”


There is a relationship between cannabis and opioids, but Mr. Sessions has it backward. Marijuana isn’t a gateway drug to opioid addiction; it’s a safer alternative to pain medicines. Mr. Sessions’s vow to crack down on marijuana will only make the opioid epidemic worse.


We know that 40 percent of all opiate overdose deaths involve a prescription opiate. So having legal access to cannabis as another option for pain relief may actually reduce consumption of opiates.


I know it sounds counterintuitive, but consider the evidence. To start, a large study assessed the effect of medical-marijuana laws on opiate-related deaths between 1999 and 2010 in all 50 states and reported a 25 percent decrease in opiate overdose mortality in states where medical marijuana was legal, compared with those where it wasn’t. The study found that in 2010, medical-marijuana laws resulted in an estimated 1,729 fewer deaths than expected.


Other epidemiologic studies found similar results. A study published last year examined opiate-related deaths in Colorado between 2000 and 2015. Researchers compared mortality rates before and after the state legalized recreational cannabis in 2014. For controls, they chose two nearby states: Nevada, which legalized only medical cannabis, and Utah, where all cannabis use is illegal. The study found a 6.5 percent drop in opiate-related deaths after recreational cannabis became legal in Colorado.


Likewise, other researchers examined the link between medical cannabis and opiate use in a group of patients with chronic pain in New Mexico, one of the states hardest hit by the opioid crisis. They reported that subjects who had access to medical cannabis were 17 times more likely to stop using opiates for pain compared with those not using cannabis.


Because these are all observational studies, they cannot prove a causal link between cannabis use and lower opiate-related mortality. Still, the consistent epidemiologic evidence is hard to ignore.


Why might cannabis work so well as an alternative to opioids? It does offer some mild pain relief. But more significant, both opiates and cannabis — like all recreational drugs — cause the release of dopamine in the brain’s reward pathway. That signal conveys a powerful sense of pleasure and craving. Thus, cannabis might pre-empt some of the rewarding effects of opiates, decreasing the general desire to use them.


There is also intriguing preliminary evidence that cannabidiol, a major component of marijuana, can blunt craving in individuals with opioid dependence following a period of abstinence.


If cannabis were actually a dangerous gateway drug, as the attorney general suggested, it would be very easy to see in the data. We would find that medical-marijuana laws increased opiate drug use and overdose deaths, when in fact just the opposite has happened.


Author: Richard A. Friedman is a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College


Further Reading:

Danny Bilow's comment, June 20, 2018 12:39 PM
Michael, What an interesting read! I think the younger generation is starting to be more accepting as far as using marijuana for medicinal purposes. As we move forward I think Cannabis will become accepted more and more as an alternative to pharmaceuticals. This is especially important to get people off of opiates and use cannabis as a treatment for pain.
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Marvin Grinin's curator insight, October 7, 2018 10:14 PM
Doctors: Marijuana Can Save Lives
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Trump’s Opioid Commission is a “Sham” and For Victims of the Opioid Epidemic It’s Been a “Government Shutdown from the Start”

Trump’s Opioid Commission is a “Sham” and For Victims of the Opioid Epidemic It’s Been a “Government Shutdown from the Start” | Pharmaguy's Insights Into Drug Industry News |

The Republican-led Congress has turned the work of the president's opioid commission into a "charade" and a "sham," a member of the panel told CNN.

"Everyone is willing to tolerate the intolerable -- and not do anything about it," said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. "I'm as cynical as I've ever been about this stuff."

President Donald Trump declared the opioid epidemic a 90-day public health emergency in October, but did not make any new funding available. In November the president said he would donate his third quarter salary to the Department of Health and Human Services to help fight the crisis.

Trump to donate part of his salary to combat opioid addiction
Critics say the declaration did virtually nothing to change the status quo and that overdose deaths have continued to mount in the months since. The public health emergency declaration was, in fact, set to expire on January 23, but as the government was headed toward a shut down on Friday, Acting Secretary of the Department of Health and Human Services Eric Hargan renewed the national public health emergency for another 90 days.

"This and the administration's other efforts to address the epidemic are tantamount to reshuffling chairs on the Titanic," said Kennedy. "The emergency declaration has accomplished little because there's no funding behind it. You can't expect to stem the tide of a public health crisis that is claiming over 64,000 lives per year without putting your money where your mouth is."

CNN sought to catch up with the six members of the opioid commission, including former New Jersey Governor Chris Christie who headed the panel, about their views on progress made and what more needs to be done. We also wanted to speak with Kellyanne Conway, the White House's point person on the opioid crisis.

Only Kennedy and Bertha K. Madras, a deputy director of the White House Office of National Drug Control Policy during the George W. Bush administration, agreed to speak.

With the recent government shutdown, Kennedy blasted Trump for "playing politics instead of pursuing solutions for issues that impact the lives of Americans."

"For people and families struggling with addiction in this epidemic, it's essentially been a government shutdown from the start," he said.

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Which Opioid Addiction Treatment Reigns Supreme? Vivitrol or Suboxone?

Which Opioid Addiction Treatment Reigns Supreme? Vivitrol or Suboxone? | Pharmaguy's Insights Into Drug Industry News |

A long-awaited study has found that two of the main medications for treating opioid addiction are similarly effective, a finding likely to intensify the hard-fought competition between drugmakers seeking to dominate the rapidly expanding opioid treatment market.


The study, funded by the federal government, compared Vivitrol, which comes in a monthly shot and blocks the effects of opioids, and Suboxone, which is taken daily in strips that dissolve on the tongue and contains a relatively mild opioid that helps minimize withdrawal symptoms and cravings.


Researchers found that 52 percent of those who started on Vivitrol relapsed during the 24-week study, compared with 56 percent of those who started on Suboxone.


But the study, conducted with 570 adults addicted mostly to heroin, also found a substantial hurdle for Vivitrol. Because the medication can be started only after a person is completely detoxed from opioids — a process that can take over a week — more than a quarter of the study participants assigned to Vivitrol dropped out before being able to take their first dose. Suboxone can be started shortly after withdrawal symptoms begin, and only six percent of those assigned to take that drug dropped out before taking an initial dose.


Drug manufacturers have been competing fiercely to develop and market medications to treat opioid addictions, which have propelled a steep increase in the number of drug deaths in the United States. Last year, 64,000 Americans died from drug overdoses, up 22 percent from the previous year.


There is significant money at stake. Under a law passed by Congress in 2016, the Trump administration is sending $1 billion to states to deal with the epidemic over the next two years, with directions to prioritize so-called medication assisted treatment. Mr. Trump’s opioid commission recently implored Congress to swiftly appropriate more money.


Suboxone, made by Indivior, is the older, cheaper, and much more widely studied and used of the two medications. The manufacturer of Vivitrol, Alkermes, has tried to catch up by marketing its drug as a cleaner alternative, emphasizing that Vivitrol is the only federally approved addiction medication that does not contain an opioid.


Vivitrol is also the most expensive addiction medication, with Medicaid paying about $500 per shot, according to Alkermes, and private insurers paying $1,000. Suboxone tends to cost a third to half as much.


Further Reading:

  • “Alkermes - Maker of Powerful Opioid Zohydro - Lobbies Hard for Its Expensive Treatment for Addiction!”;
Pharma Guy's insight:

Don't you just love it when a company that helped create the current opioid addiction crisis may profit from its treatment?

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America's Opioid Epidemic: From Evidence to Impact

America's Opioid Epidemic: From Evidence to Impact | Pharmaguy's Insights Into Drug Industry News |

On October 30, 2017, the Clinton Health Matters Initiative and the Johns Hopkins Bloomberg School of Public Health will co-host a forum focused on elevating high-impact solutions to the nation’s opioid epidemic. Speakers, panelists, and thought leaders representing diverse stakeholders affected by the crisis will consider critical components needed to reduce the injury and death rates nationwide. Evidence-based recommendations that reflect the most current science will be the focus, and translating that evidence to action will be the goal. Speakers & Panelists 

• Ellen J. MacKenzie, PhD ’79, MSc ’75, Dean, Johns Hopkins Bloomberg School of Public Health 

• Elijah Cummings, U.S. Congressman, Maryland’s 7th District 

• President Bill Clinton, Founder and Board Chair, Clinton Foundation; 42nd President of the United States 

• G. Caleb Alexander, MD, MS, Co-Director, Johns Hopkins Center for Drug Safety and Effectiveness 

• Michael Botticelli, MEd, Executive Director, Grayken Center for Addiction at Boston Medical Center; Distinguished Policy Scholar, Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management; Former Director of National Drug Control Policy 

• Carol Forster, MD, Physician Director, Pharmacy & Therapeutics/Medication Safety, Mid-Atlantic Permanente Medical Group 

• Tom Geddes, CEO, Plank Industries 

• Andrea Gielen, ScD, Director, Johns Hopkins Center for Injury Research and Policy 

• Jim Hood, CEO, Facing Addiction 

• Erica Poellot, Project Director, Shaping Sanctuary, Senior Community Minister, Judson Memorial Church, Director of Faith and Community Partnerships, Harm Reduction Coalition 

• Tom Synan, Chief of Police, Newtown, Ohio 

• Randi Weingarten, President, American Federation of Teachers 

• Leana Wen, MD, MSc, FAAEM, Baltimore City Health Commissioner

Via johnmacknewtown
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Trump Has Not Grasped What’s Needed to Combat Opioid Crisis, Says NYT. Channels Nancy Reagan.

Trump Has Not Grasped What’s Needed to Combat Opioid Crisis, Says NYT. Channels Nancy Reagan. | Pharmaguy's Insights Into Drug Industry News |

In what was billed as a major speech on Thursday, Mr. Trump demonstrated that he has not grasped what’s needed to combat the opioid problem and, more important, the ways in which his own policies impede recovery for millions of Americans.


He declared the opioid epidemic a national public health emergency, which sounds urgent but doesn’t free any significant new money to fight it. In doing so, he ignored the plea of his own opioids commission to declare a full-on national emergency, which would immediately free billions of dollars for emergency response, addiction treatment and efforts to stop the flow of illegal opioids into the country — a comprehensive approach that is so far missing.


Combine this with his repeated attempts to gut health care for poor and middle-class Americans, and the president has offered few tangible solutions for a scourge that now kills about 50,000 Americans a year.


Mr. Trump said he would address the flow of deadly, illegal synthetic opioids into this country during his coming trip to China, and repeated old promises to stop drug trafficking from Mexico by building the wall.


[I predicted that Trump would bring up the issue of Mexico and the wall. Read “Thoughts on Trump Declaring Opioid Epidemic a National Emergency”;]


He said the administration would produce “really big, really great advertising” aimed at young people because, “If we can teach young people not to take drugs, it’s really, really easy not to take them.” This is sloganeering reminiscent of the ineffective, Reagan-era “Just Say No” programs, when the ravages of drug abuse in black and Hispanic communities were treated with harsh punishment, rather than the empathy and care that is being called for today.


[I predicted that Trump would revive the old “Just Say No” approach. Read “Thoughts on Trump Declaring Opioid Epidemic a National Emergency”;]


At least Mr. Trump said on Thursday that the administration planned to roll back a rule preventing Medicaid funding from being used for treatment in large inpatient addiction facilities, a recommendation made by the opioids commission in late July.

But it is still not clear who will lead the response to the epidemic, since Mr. Trump has yet to appoint a number of officials who could do so. He was forced to withdraw his nominee to head the Office of National Drug Control Policy, Representative Tom Marino, Republican of Pennsylvania, after news emerged that Mr. Marino had helped drug wholesalers make it harder for the Drug Enforcement Administration to crack down on black-market opioid distribution. Tom Price, Mr. Trump’s former health and human services secretary, lost his job because of his use of private jets.

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Trump’s National Health Emergency Falls Short. The Missing Piece? Naloxone

Trump’s National Health Emergency Falls Short. The Missing Piece? Naloxone | Pharmaguy's Insights Into Drug Industry News |

The Trump administration’s designation of the opioid crisis as a public health emergency on Thursday paves the way for officials to increase access to inpatient addiction treatment, redirect some federal resources, and launch a major public education campaign [but read “Does Trump's Opioid Crisis National Health Emergency Offer Anything That Hasn't Already Been Implemented?”;].


But the announcement included nothing about access to naloxone, the overdose-reversal drug that first responders across the country have credited with saving innumerable lives.


“I think this was a missed opportunity,” said Regina LaBelle, the chief of staff for the Office of National Drug Control Policy under former president Barack Obama. “They could have purchased naloxone and distributed it to hard-hit areas, to local governments as well as to community groups.”


Another policy expert in Capitol Hill circles indicated the administration could also put out a bid document for drug manufacturers for naloxone and addiction treatment drugs. After negotiating a new and deeper price discount, the federal government could allow state and local governments access to the drug at the cheaper price point — an action the administration has not yet taken.


While LaBelle and other drug policy authorities celebrated the administration’s push to expand treatment capacity and allow telemedicine-based access to medication-assisted treatment, many said President Trump’s announcement had fallen short of recommendations from a commission he created in March to address the opioid crisis.

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Is There a Role for Medical Cannabis in Combating the Opioid Epidemic?

Is There a Role for Medical Cannabis in Combating the Opioid Epidemic? | Pharmaguy's Insights Into Drug Industry News |

The current opioid epidemic is forcing many physicians to reevaluate their use of prescription opioids for pain control and to consider alternative pain management strategies. There is an emerging body of evidence that suggest that medical cannabis (smoked, vaporized or ingested) can effectively manage and control chronic non-cancer pain, reduce opioid consumption and help to lower opioid overdose deaths.

While cannabis is not approved as a treatment for pain in the US, there is a growing body of evidence from states where medical cannabis is legal that cannabis reduces opioid consumption in chronic pain patients. Several studies in the US and around the world showed that opioid use dropped by as much as 50% among chronic pain patients when they were given access to cannabis.



Pharma Guy's insight:

Guest post by Cliff Mintz who writes for Cannabis Science Blog.

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@Richmeyer Says Pharma Not to Blame for Opioid Epidemic

@Richmeyer Says Pharma Not to Blame for Opioid Epidemic | Pharmaguy's Insights Into Drug Industry News |

According to the Atlantic “opioid abuse is rampant in states like Ohio, where paramedics are increasingly spending time responding to overdoses and where coroners’ offices are running out of room to store bodies. In 2012, there were 793 million doses of opioids prescribed in the state, enough to supply every man, woman, and child, with 68 pills each”. But is pharma really to blame?


Who is responsible for the opioid epidemic? Some attorneys general and advocates are now asking, in court, whether the pharmaceutical companies who marketed the drugs and downplayed their addictive nature can be held legally responsible for—and made to pay for the consequences of—the crisis.


Individual plaintiffs who have sued pharmaceutical companies over how opioids have been marketed have rarely been successful, according to Richard Ausness, a professor at the University of Kentucky College of Law. Courts have made clear that they believe that individual victims are largely responsible for their addiction. People who die of overdoses are often using the pills not as they were prescribed, but are obtaining the pills on the black market. They are disregarding doctors’ prescriptions and taking more than is safe. “It is difficult to persuade courts that FDA-approved prescription drugs are defective and that their warnings are inadequate,” Ausness said.


Now you can say what you want about drug company marketing and I agree they bear some responsibility, but does anyone really believe that a reputable doctor is going to believe any drug company marketing that opioids are not additive?


Finally, it’s no coincidence that high opioid addiction has a strong correlation with economically depressed areas of the country.   As the number of pills begins to decline heavy opioid users are going to turn to more dangerous street drugs like heroin. Let’s put the blame where it belongs.


Further Reading:

Pharma Guy's insight:

I have a lot of problems with Rich's position. First, he thinks doctors don't believe what pharma sales reps tell them. Maybe not now after they have read in the news how pharma sales reps lied & told them opioids are not addictive. But the over prescribing of opioids has been going on for many years and still continues. Second, he claims that when less opioids are prescribed, heavy opioid users are going to turn to heroin. Does he mean patients who get previously got legitimate opioid prescriptions? Or patients who illegally obtained these prescriptions from "pill mills?" Third, he does not specific where to put the blame but hints that low income/poverty may have something to do with it. Hmmm... now that the crisis has spread to middle income families in EVERY socioeconomic bracket, it's difficult to blame it on problems associated with low income. 

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LIVE NOW! Addiction in America: A Nation Responds (Maybe) 

LIVE NOW: The Washington Post brings together lawmakers, industry leaders and journalists to discuss how the nation is responding to America’s opioid epidemic. The program also features an inside look at a joint Washington Post-CBS "60 Minutes" investigation on the drug industry and the U.S. Drug Enforcement Administration

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"Opioid Avenger" Fights Big Pharma - 40 States May Join In Fight Against Opioid Epidemic

"Opioid Avenger" Fights Big Pharma - 40 States May Join In Fight Against Opioid Epidemic | Pharmaguy's Insights Into Drug Industry News |

Former Mississippi Attorney General Mike Moore, who famously led a campaign to punish tobacco companies for lying about the dangers of smoking, has set his sights on the pharmaceutical industry, according to Bloomberg Businessweek.


Moore, a University of Mississippi alumnus who served as the state’s attorney general from 1998 to 2004, was the first state AG to file a lawsuit against Big Tobacco and won the largest corporate settlement in history—$246 billion for 50 states, with the money earmarked to fund smoking cessation and prevention programs.


Since exiting the political sphere, Moore has continued to practice law with two partners in the Mike Moore Law Firm, headquartered in Flowood. But the national opioid epidemic has brought him back into the media spotlight.



When his nephew nearly died of an overdose of fentanyl—a powerful synthetic analog to the opium poppy and the drug that killed Prince—Moore decided the legal strategy that had proven so successful against the tobacco industry could also work against pharmaceutical companies. In the case of Big Tobacco, a coalition of state attorneys general, led by Moore, bombarded companies like Phillip Morris and RJ Reynolds with individual, costly lawsuits, forcing them into negotiating a single—and massive—settlement rather than fighting each suit separately.


Bloomberg Businessweek hailed Mississippi AG Mike Moore as the “Opioid Avenger.”


According to Bloomberg Businessweek, Moore and his legal team have assembled another coalition, including 10 states and dozens of counties and cities, to file suits against pharmaceutical companies like Purdue Pharma, Endo and Johnson & Johnson’s Jannsen Pharmaceuticals. All totaled, 40 states are looking into the viability of launching their own suits

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Opioids Are the New Tobacco: Investigations of #Pharma Companies Taking Page from Tobacco Settlement of the 90's

Opioids Are the New Tobacco: Investigations of #Pharma Companies Taking Page from Tobacco Settlement of the 90's | Pharmaguy's Insights Into Drug Industry News |

As investigations target major drug producers for their alleged roles in the nation's opioid abuse crisis, at least one expert says a 20-year-old settlement with tobacco companies could add perspective to the legal battles to come.


Starting in the mid-1990s, authorities in 46 states began filing lawsuits against major tobacco firms, arguing they knew their products were addictive and unsafe, and thus holding them responsible for health care costs incurred by the states to treat tobacco customers. Phillip Morris Inc., R.J. Reynolds, Brown and Williamson and Lorillard agreed to pay a minimum of $206 billion over the first 25 years of the agreement.


Scott Burris, professor of law and public health at Temple University’s Beasley School of Law, said 41 state attorneys general now investigating pharmaceutical companies and distributors and their role in the opioid abuse epidemic are essentially looking for evidence to support a similar argument: that opioid producers downplayed the dangers of their products.


“It makes sense, given plenty of evidence that (pharmaceutical) companies were marketing the hell out of these drugs, that it warrants an investigation,” Burris said.


Pennsylvania Attorney General Josh Shapiro told reporters Tuesday at Upper Dublin High School that the companies were being investigated to find any internal documents that might prove the companies knowingly misrepresented the addictiveness or danger of opioid painkillers.


“If they are infecting Pennsylvania with these poisons in an irresponsible, unethical or unlawful way, we’re going to hold them accountable,” Shapiro said.


Shapiro identified the companies currently under investigation as manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries and its U.S. subsidiary, Cephalon Inc., Allergan Inc. and Purdue Pharma, as well as distributors AmerisourceBergen, Cardinal Health and McKesson.


Further Reading:

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Fueling the Opioid Epidemic: A “Key Strategic Imperative” for Insys #Pharma

Fueling the Opioid Epidemic: A “Key Strategic Imperative” for Insys #Pharma | Pharmaguy's Insights Into Drug Industry News |

In early 2015, an Insys Therapeutics employee called an insurer and provided misleading patient information in order to win clearance for a prescription for its Subsys painkiller. The conversation — in which the employee pretended to call from a physician’s office — was about a woman named Sarah Fuller, whose family later claimed she died because she was inappropriately prescribed the drug.


The phone call was made scarcely a year after a consultant warned the drug maker that it lacked needed policies for governing such activities, but Insys executives failed to take corrective action, according to U.S. Sen. Claire McCaskill (D-Mo.), who released a copy of the consultant’s report and a recording of the phone call as part of an ongoing investigation into the opioid crisis (see report here:


The details of both the phone call and the report help flesh out what is already a disturbing picture of unchecked pharmaceutical marketing that has emerged from a growing raft of documents in criminal cases and civil lawsuits involving the beleaguered drug maker. And the report arrives as opioid makers, in general, are accused of deliberately downplaying risks and improperly encouraging prescribing.


To boost prescriptions for Subsys, which contains the highly addictive fentanyl opioid, Insys allegedly employed numerous tactics. These included a familiar page from the pharmaceutical playbook in which some physicians were rewarded with speaking fees and other forms of compensation for writing outsized numbers of prescriptions, according to court documents.


Central to the Insys marketing plan, however, was a so-called reimbursement center, which was created specifically to contact insurers and persuade them to authorize prescriptions. In the health insurance world, prior authorization is an extra step that insurers use to weed out unnecessary prescribing. Often, this proves to be a challenging hurdle, especially when a medicine is pricey.


But Insys created this “center” because many insurers and pharmacy benefits managers often declined to green-light prescriptions that were not for breakthrough cancer pain patients. Authorities say the company sought to widen the market for its drug by illegally inducing doctors to prescribe the pill for other sorts of pain. This is known as “off-label” prescribing, which doctors are permitted to do.


An Insys spokeswoman did not respond to a request for comment.


Further Reading:

Pharma Guy's insight:

A smoking gun if ever I saw one!

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Ohio Flooded with Ridiculous, Unproven, Hi-tech "Solutions" to the Opioid Crisis

Ohio Flooded with Ridiculous, Unproven, Hi-tech "Solutions" to the Opioid Crisis | Pharmaguy's Insights Into Drug Industry News |

More than 4,100 people fatally overdosed in Ohio in 2016, even though state officials spent nearly $1 billion to combat the crisis. That prompted Gov. John Kasich this spring to announce that $20 million would be devoted to funding new research related to opioid abuse.


“We know more needs to be done.” David Goodman, director of the Ohio Development Services Agency, told STAT. “So we’re looking for new technologies to see if we can find other ways to fight this problem.”


Ohio’s Third Frontier Commission, an economic development initiative focused on tech startups, recently asked companies to submit funding requests. Over the summer 44 initial proposals flooded into the commission. These proposals have come from all kinds of applicants — doctors and device makers, biotech execs and engineers, scientists and recovery advocates — working on solutions as wide-ranging as the people touched by the opioid crisis.


Osteopathic physician Dr. Ben Bring wants $75,000 for his prototype of a micro-spandex glove called the MyoGlove to help doctors perform massage therapy for lower musculoskeletal pain — thereby keeping people away from opioids. Brad Pulver, president of Innovative Medical Equipment, hopes $810,000 would fund a clinical trial for the ThermaZone — an FDA-approved device that treats pain using a continuously cooled water pad (instead of frozen peas) — to study whether it reduces opioid use after surgeries.


More ridiculous, unproven, hi-tech “solutions”…

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HHS Tweet Touts the Trump Administration’s “Accomplishments” Like Its “Sham” Response to the Opioid Crisis, Withdrawing Regulations, and Cutting Open Enrollment Budget by 90%!

HHS Tweet Touts the Trump Administration’s “Accomplishments” Like Its “Sham” Response to the Opioid Crisis, Withdrawing Regulations, and Cutting Open Enrollment Budget by 90%! | Pharmaguy's Insights Into Drug Industry News |

A new report released by the Department of Health and Human Services highlights the greatest hits of the Trump administration in 2017.


Among the highlights touted: efforts to identify federal regulatory burdens that hurt patients, as well as ways to lower high prescription drug costs. The result, the report said, was a “net decrease in the burden imposed by HHS regulations as well as positive reforms in a range of Medicare payment rules, actions from the Food and Drug Administration, and ongoing reviews of further areas for action.”


Regulatory rollbacks

To reduce burdensome regulations, the report notes that HHS withdrew 70 regulatory actions taken by the Obama administration, took 68 deregulatory actions and only introduced 27 regulations. In addition, CMS Administrator Seema Verma went on a listening tour to talk to providers, doctors and clinicians about regulatory burdens.


Open enrollment cutbacks

But many of the accomplishments listed in the report were controversial. For example, HHS says it conducted a “successful, consumer-friendly open enrollment period at significantly lower cost than in previous years, attracting similar levels of enrollment with more focused investments in marketing:” Yet the enrollment numbers are generally credited to the fact that private insurers stepped up advertising efforts to compensate for the fact that the federal government cut its ad budget by 90% and the amount of time citizens had to enroll in plans.


Response to opioid crisis

The report is also proud of the administration’s work to combat the opioid crisis in the U.S., citing Trump’s declaration that the epidemic was a national public health emergency and raising public awareness to the issue. But the response has been criticized by many who note that without funding, the declaration was meaningless. Last week former Democratic Rep. Patrick Kennedy, one of six members appointed to a bipartisan commission in March by President Trump to address the opioid crisis, called the work done by the task force a sham because the administration hasn’t put any money behind the actions the group suggested to combat the epidemic (

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Crisis in $12B U.S. Opioids Market? From Cannabis?


The U.S. opioids market was valued at US$ 12,046.3 million in 2015 and is expected to witness a moderate CAGR of 5.2% during the forecast period (2016–2024).


According to the New York Times analysis of state data, in 2016, drug overuse led to death of 59,000 to 65,000 people in the U.S. and majority (about two-third) of death were due to opioids overuse and this number is witnessing an increase. According to a survey of National Institute of Drug Abuse (NIDA), deaths due to the overdose prescription of opioid pain relievers have more than tripled in the past 20 years, escalating to 16,651 deaths in the U.S. in 2010. It can be concluded from the analysis of the data (data from the survey and New York Times data), that death due to opioids have more than doubled in the past six years.


In October 2016, though the Government of the U.S. declared opioids crisis as an emergency. The declaration is expected to help in increasing awareness among the public about overuse of opioids. It would also make doctors and pharmacy stores hesitant to over-prescribe or overstock opioids. The government has approached leading pharmacy chains, insurance companies, and others, for cooperation. For instance, Attorney General of over 35 states sent a letter to the America’s Health Insurance Plans, national association whose members provide coverage for health care and related services, urging its members to reconsider coverage policies that may be fueling the opioid crisis in October 2017. Such measures can ensure proper usage of opioids and favors the market players in the U.S. opioids market.



Increasing incidences of chronic pain is expected to drive growth of the U.S. opioids market

According to the American Academy of Pain Medicine (AAPM), 2011, around 1.8 billion people suffered from chronic pain. Moreover, according to the National Institute of Health (NIH) estimates in 2015, one in 10 people in the U.S. suffered from chronic pain. Increasing prevalence of chronic pain is expected to result in high prescription of opioids pain relievers, which in turn is expected to fuel the market growth. Easy availability and favorable insurance policy are other major drivers for growth of the U.S. opioids market.


The analysis of Medicare prescription drug plans, which covers 35.7 million people in the second quarter of 2017, by ProPublica — an investigative journal and The New York Times — a leading U.S. newspaper, revealed that only one-third of the covered people had any access to other types of pain killer and less-risky opioids. This was attributed to low cost of opioids drugs. The scenario might change, however, due to strict monitoring from government and regulatory bodies. 


Cannabis as potential alternative for pain relief can be a threat to the U.S. opioids market

Cannabis could be the alternative therapy for opioids. Currently, medical marijuana is legal in 28 states and the District of Columbia even though it is illegal under federal law. According to a research published in Annals of Internal Medicine, in majority of cases, between 45% and 85%, medical marijuana is used for pain management. However, there is some ambiguity about medical marijuana effectiveness in pain management. Cannabis could be used as effective therapy after establishment of clinical trials. 

Some major players operating in the U.S. opioids market include Purdue Pharma L.P., Titan Pharmaceuticals, Inc., Boehringer Ingelheim GmbH, Janssen Pharmaceuticals, Inc., Sanofi S.A., Sun Pharmaceuticals Industries Limited, Mallinckrodt Pharmaceuticals, Egalet Corporation, Endo Pharmaceuticals plc, Allergan, plc, and Pfizer Inc.


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"Abuse-Deterrent" Drugs Are Not the "Holy Grail" Pharma, i.e., Purdue, Claims It to Be

"Abuse-Deterrent" Drugs Are Not the "Holy Grail" Pharma, i.e., Purdue, Claims It to Be | Pharmaguy's Insights Into Drug Industry News |

The pharmaceutical industry was listed as one of the “Contributors to the Current Crisis” in the final report of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. The report cites decades of aggressive marketing and industry-sponsored physician “conferences” aimed at expanding opioid use by minimizing the dangers of addiction. Lawsuits by state attorneys general, counties and local jurisdictions allege that the industry fostered the epidemic by overpromoting its products, while raking in billions as Americans became addicted and overdosed. “To this day,” the commission says, “the opioid pharmaceutical industry influences the nation’s response to the crisis.”


It sure does. In its response to an epidemic that now kills 50,000 Americans a year, the Trump administration wants to spend tens of millions of dollars in part to help the industry responsible sell ostensibly nonaddictive pain medications and “abuse deterrent” opioids that are as addictive as the original opioids.


Purdue executives call abuse-deterrent opioids, along with highly effective non-opioid pain products, the “holy grail” for the pharmaceutical industry.


“Abuse-deterrent is a marketing term used to mislead,” says Dr. Adriane Fugh-Berman, a pharmacology and physiology professor at Georgetown University who directs PharmedOut, a group that monitors pharmaceutical industry marketing efforts. “At least half of prescribers think that abuse-deterrent means less addictive.” It does not; abuse-deterrent pills are simply harder to crush or alter for injection or snorting. “It doesn’t prevent you from swallowing them, which is the most common way of abusing opioids,” Dr. Fugh-Berman said.


The N.I.H. began its public-private initiative this summer with a series of closed-door meetings with pharmaceutical companies and academics. An N.I.H. spokeswoman, Renate Myles, said the research would include work on non-pharmacological approaches, but “we need to develop new nonaddictive medications for pain. These medications can only be brought to market with the active participation of the pharmaceutical industry.”


Purdue participated in the N.I.H. initiative. In June, in response to a call for public comments, J. David Haddox, the company’s vice president for policy, sent a letter to the commission outlining Purdue’s proposed “policy options,” including recommending that the F.D.A. “convert” the opioid market to predominately abuse-deterrent formulations.


The commission’s report includes important recommendations like expanding Medicaid coverage for inpatient treatment; expanding treatment with buprenorphine, methadone and other medications, including some still being developed; establishing a national curriculum and standards for opioid prescribers; and expanding an alternative system of drug courts that encourage treatment. Those should be the immediate priorities, not channeling money for more meds to drug companies, from the pockets of Americans whose pain was the industry’s gain.

johnmacknewtown's curator insight, November 11, 2017 9:04 AM
Pharmaceutical companies that produce and market opioids need to step up with funding for solutions to the opioid addiction crisis they "contributed to". I have some ideas regarding local programs that can benefit from such funding.
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Dancing with Fentanyl: Insys Sales Reps Caught Rapping to Boost Sales

Dancing with Fentanyl: Insys Sales Reps Caught Rapping to Boost Sales | Pharmaguy's Insights Into Drug Industry News |

You can't make this stuff up!

According to Huffington Post, "Pharmaceutical sales representatives selling an opioid-based drug 50 times more powerful than heroin filmed a company-made rap video in which they danced with a giant bottle of their deadly fentanyl spray, a federal grand jury alleged in an indictment unsealed this week (for more about that, read "Founder of Insys Indicted for Bribing Docs to Illegally Prescribe Fentanyl. Lock Him Up!").

"The grand jury alleged that 'prominent' sales reps at Insys Therapeutics Inc. appeared in a 2015 music video that used a song by rapper A$AP Rocky, which was played at the company’s national sales meeting that year...Court documents didn’t say which A$AP Rocky song was used in the video, but the indictment documents strongly suggested it could be the 2012 song “Fuckin’ Problems."

Pharma Guy's insight:

The video ended with the company’s vice president of sales removing the Fentanyl Spray costume, revealing his identity. The vice president of sales, Alec Burlakoff, was previously indicted back in December. Burlakoff has been accused of trying to boost drug sales by controversial means before.

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Founder of Insys Indicted for Bribing Docs to Illegally Prescribe Fentanyl. Lock Him Up!

Founder of Insys Indicted for Bribing Docs to Illegally Prescribe Fentanyl. Lock Him Up! | Pharmaguy's Insights Into Drug Industry News |

The founder of Insys Therapeutics Inc. was arrested Thursday and charged with allegedly bribing doctors to improperly prescribe Insys drugs containing the powerful opiate Fentanyl — the biggest arrest in a nationwide crackdown that’s already netted two convictions in Mobile.


John N. Kapoor, 74, was arrested in his home state of Arizona Thursday and charged with RICO conspiracy as well as other felonies including conspiracy to commit mail and wire fraud and conspiracy to violate the Anti-Kickback Law. To date, Kapoor is the most prominent pharmaceutical executive to be charged in any drug conspiracy.


John Kapoor, billionaire founder of pharmaceutical company Insys Therapeutics, was arrested and charged with leading a drug conspiracy on Oct. 26, 2017. (

Kapoor, the former Executive Chairman of the Board and CEO of Insys, founded the company in the late 1990s.

He resigned after six former Insys executive board members were indicted in December 2016, though he has remained an active boardmember and majority owner of the company.


The month after those indictments, the Department of Justice turned its attention to Mobile, where Dr. John Patrick Couch and Dr. Xiulu Ruan — owners and operators of Physicians Pain Specialists of Alabama — were being tried on many of the same charges Kapoor himself now faces.


After a seven-week trial, Ruan and Couch became the first medical professionals in U.S. history to be convicted on federal RICO charges that were originally intended to combat organized crime. They were each sentenced to at least 20 years in federal prison, and the federal government has since seized millions of dollars in cash, cars and property from both.


What ties the two local pain docs to Kapoor are the drugs that his company produced and marketed, most notably the fentanyl-based product Subsys. Intended and FDA approved to treat “breakthrough pain in Cancer patients,” Ruan and Couch were accused of prescribing the drug to non-cancer patients without a legitimate medical purpose.


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Does Trump's Opioid Crisis National Health Emergency Offer Anything That Hasn't Already Been Implemented?

Does Trump's Opioid Crisis National Health Emergency Offer Anything That Hasn't Already Been Implemented? | Pharmaguy's Insights Into Drug Industry News |

Prescriber training


Trump said he would require prescribers who work for the federal government to “receive, finally, special training” for prescribing opioids. It’s not clear what sort of education campaign Trump is envisioning, but the Obama administration in 2015 also announced a training program in opioid prescribing for prescribers who worked for the federal government.


[In the beginning of October, 2017, the FDA sent letters to 74 manufacturers of immediate-release opioids, notifying them that they will have to fund the development of courses for doctors, nurses and pharmacists. For more on that, read “FDA Requiring Makers of Fast-Acting Opioids to Pay for Physician Training”;] 


Pain treatment


Federal health officials are going to launch a task force to come up with best practices for treating pain, Trump announced. This speaks to something that is often lost when discussing the opioid epidemic: There are still lots of patients who need pain medication, and there are some concerns that because of new prescribing limits and the fear of feeding addiction, they are not able to get access to them.


Whatever best practices the task force comes up with will likely be scrutinized by advocates both for pain patients who worry about not being able to get medication they feel they need and those who support stronger prescribing limits. (At the event, Trump highlighted CVS Caremark’s recent announcement that it was imposing prescription limits for first-time opioid prescriptions.)


[Meanwhile, “Is There a Role for Medical Cannabis in Combating the Opioid Epidemic?”;]


‘Bad actors’


Trump said the federal government will “pretty soon” start suing “bad actors,” including people and companies that are “hurting our people.” He offered no specific details, but dozens of cities, counties, and states have filed lawsuits against drug makers and drug distributors for their alleged roles in seeding the opioid crisis.


[Read “Attacking the Root of the Opioid Crisis - Pharmaceutical Companies”; and “Opioid Avenger" Fights Big Pharma - 40 States May Join In Fight Against Opioid Epidemic; ]


Public education


Trump said “it’s really, really easy” not to use drugs if you never start — and suggested public education would be an important strategy for the government.


["Just Say No!"déjà vu all over again?]

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Healthcare Distribution Alliance Defends Law Weakening DEA. A Law It Helped Finance.

Healthcare Distribution Alliance Defends Law Weakening DEA. A Law It Helped Finance. | Pharmaguy's Insights Into Drug Industry News |

A major trade association for pharmaceutical distributors defended a law that weakened the Drug Enforcement Administration (DEA), while ignoring key facts about how the now-stripped power once let the agency suspend distributors that shipped alarming numbers of opioid pills.


The pharmaceutical industry – including the Healthcare Distribution Alliance – spent millions lobbying for the Ensuring Patient Access and Effective Drug Enforcement Act, which made it nearly impossible for the DEA to suspend drug distributors if their opioid-based painkiller shipments reached suspicious volumes, The Washington Post and 60 Minutes jointly reported (read “How Congress Allied with Drug Company Lobbyists to Derail the DEA’s War on Opioids”;


The alliance called the DEA’s suspensions a “hit-and-miss approach” that jeopardized legitimate patients’ access to opioid-based painkillers.


The alliance has also argued that, prior to the new law, the DEA didn’t set clear guidance on how large pill shipments would be considered suspicious, and that the agency didn’t communicate well enough with distributors.


But the Healthcare Distribution Alliance ignored examples in the WaPo/60 Minutes report where the DEA suspended distributors that were shipping especially large numbers of pills.


In one instance, 11 million painkillers were shipped to a West Virginia county with a population of 25,000, according to the WaPo/60 Minutes investigation. In another, some Walgreens pharmacies in Florida sold more than one million opioid pills a year – nearly 14 times the number sold by a typical pharmacy.


The trade association also said the primary source for the WaPo/60 Minutes investigation was a former DEA official who consults trial lawyers suing the pharmaceutical industry. But the article included interviews with other several other sources and quotes from a significant number of documents.


The DEA’s aggressiveness with suspensions was already hampered before the law passed, according to the WaPo/60 Minutes investigation. Officials were forced to present more evidence before suspending distributors and the agency’s management became more willing to cooperate with the pharmaceutical industry.


Meanwhile, dozens of DEA officials left the agency and took jobs with drug companies over the past few years, according to the investigation.


Additionally, the Healthcare Distribution Alliance spent $3.5 million on lobbying in support of the legislation between 2014 and 2016, WaPo/60 Minutes found, which the association didn’t address in its statement.

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Pharma “Patient Centricity” Aids & Abets the Opioid Epidemic

Pharma “Patient Centricity” Aids & Abets the Opioid Epidemic | Pharmaguy's Insights Into Drug Industry News |

The machinations of Washington are complex, but it’s hard to overstate the influence — often behind the scenes — of lobbyists. For years, the opioid industry has been funding nonprofit organizations that promote patient access to their drugs. These medical organizations pushed for Congress to approve Marino’s Ensuring Patient Access and Effective Drug Enforcement Act, which serves the interests of major drug distributors and retailers.


On Jan. 26, 2015, a number of organizations nominally interested in ensuring legitimate access to pain medication wrote to Marino, Rep. Peter Welch, D-Vt., Rep. Marsha Blackburn, R-Tenn., and Judy Chu, D-Calif., praising their fight for the now controversial legislation. They argued that the country needs need a balanced approach to the opioid abuse crisis that ensures access for pain patients while stopping drug abusers. Among the groups were the Alliance for Patient Access, which describes itself as “a national network of physicians dedicated to ensuring patient access to approved therapies and appropriate clinical care” and the American Academy of Pain Management (since renamed the Academy of Integrative Pain Management), which describes itself as an organization advancing “integrative pain care approaches” defined by the National Institute of Health.


As of June 2017, the Alliance for Patient Access’ list of associate members and financial supporters contains over two dozen pharmaceutical companies, including Pfizer and Purdue Pharma. The latter’s marketing practices have been blamed for fueling the opioid epidemic.


“Federal agencies, law enforcement, pharmaceutical industry participants and prescribers each play a role in working diligently to prevent drug abuse and diversion,” they wrote. “However, it is also imperative that legitimate patients are able to obtain their prescriptions without disruption.”


Andrew Kolodny, the co-director of opioid policy research at Brandeis University, said this argument — that legitimate pain medication patients should not pay the price for the fight against drug abuse — is how the opioid lobby has framed (and continues to frame) the issue of prescription abuse from the beginning.


“These pain organizations make the case for the opioid lobby. But if you scratch the surface, you’ll find that the pain organizations that signed the letter are receiving money from the opioid lobby,” Kolodny told Yahoo News.


Kolodny said the opioid lobby often uses “phony front groups” to support its efforts in blocking any reduction in prescribing — and uses them very effectively.


An explosive investigation by the Washington Post and “60 Minutes” released Sunday revealed that Marino had accepted large donations from the pharmaceutical industry while pressing for the legislation that they favored (read “How Congress Allied with Drug Company Lobbyists to Derail the DEA’s War on Opioids”;


The next day, Missouri Sen. Claire McCaskill, the top-ranking Democrat on the Homeland Security and Governmental Affairs Committee, announced that she would introduce legislation to repeal the law.


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How Congress Allied with Drug Company Lobbyists to Derail the DEA’s War on Opioids

How Congress Allied with Drug Company Lobbyists to Derail the DEA’s War on Opioids | Pharmaguy's Insights Into Drug Industry News |

In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets.


By then, the opioid war had claimed 200,000 lives, more than three times the number of U.S. military deaths in the Vietnam War. Overdose deaths continue to rise. There is no end in sight.


A handful of members of Congress, allied with the nation’s major drug distributors, prevailed upon the DEA and the Justice Department to agree to a more industry-friendly law, undermining efforts to stanch the flow of pain pills, according to an investigation by The Washington Post and “60 Minutes.” The DEA had opposed the effort for years.


The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market. The industry worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns.


The chief advocate of the law that hobbled the DEA was Rep. Tom Marino, a Pennsylvania Republican who is now President Trump’s nominee to become the nation’s next drug czar. Marino spent years trying to move the law through Congress. It passed after Sen. Orrin G. Hatch (R-Utah) negotiated a final version with the DEA.


As Rep. Tom Marino’s Pennsylvania district was reeling from the opioid crisis, he sponsored a bill that, current and former Drug Enforcement Administration officials say, undermined the DEA's efforts to stop the flow of pain pills. 


For years, some drug distributors were fined for repeatedly ignoring warnings from the DEA to shut down suspicious sales of hundreds of millions of pills, while they racked up billions of dollars in sales.


The new law makes it virtually impossible for the DEA to freeze suspicious narcotic shipments from the companies, according to internal agency and Justice Department documents and an independent assessment by the DEA’s chief administrative law judge in a soon-to-be-published law review article. That powerful tool had allowed the agency to immediately prevent drugs from reaching the street.


Political action committees representing the industry contributed at least $1.5 million to the 23 lawmakers who sponsored or co-sponsored four versions of the bill, including nearly $100,000 to Marino and $177,000 to Hatch. Overall, the drug industry spent $106 million lobbying Congress on the bill and other legislation between 2014 and 2016, according to lobbying reports.


“The drug industry, the manufacturers, wholesalers, distributors and chain drugstores, have an influence over Congress that has never been seen before,” said Joseph T. Rannazzisi, who ran the DEA’s division responsible for regulating the drug industry and led a decade-long campaign of aggressive enforcement until he was forced out of the agency in 2015. “I mean, to get Congress to pass a bill to protect their interests in the height of an opioid epidemic just shows me how much influence they have.”


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No wonder that Pennsylvania Underestimates Death Due to Opioids by More Than Half!: 

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PhRMA Says Limiting Prescriptions of Opioid Painkillers "Right Thing to Do"

The pharmaceutical industry now supports limiting prescriptions of opioid painkillers to a seven-day supply for acute pain management, PhRMA CEO Stephen J. Ubl announced Wednesday at a meeting of the White House’s opioid abuse commission.


“Too often, individuals receive a 30-day supply of opioid medicines for minor treatments for short term pain,” Ubl said. “Overprescribing and dispensing can lead to patients taking longer than necessary and excess pills falling into the wrong hands.”


The trade group PhRMA’s announcement follows steps by some pharmacy benefit managers to restrict the supply of opioids to first-time users, as well as new prescribing rules set by states — all part of the burgeoning effort to fight the opioid epidemic.


Ubl acknowledged that PhRMA’s recommendation could be seen as drug companies interfering with patient and clinician choices, alluding to the broader debate that efforts to limit pain pills are hurting patients who can no longer get the treatment they and their doctors feel they need. But he said in this case, it was a necessary step.


“We’ve always supported physician autonomy and the preservation of the physician-patient relationship, Ubl said, “but as you know, given the scope of this crisis, we believe it’s the right thing to do.”


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Subpeonas served to opioid producers in national investigation

Subpeonas served to opioid producers in national investigation | Pharmaguy's Insights Into Drug Industry News |

The subpoenas Monday for documents and information on business practices from the companies are a significant step forward in an investigation involving 41 attorneys general, Shapiro said.


“This multi-state group of attorneys general is the best public-interest law firm in America, and the attorneys in the Public Protection Division of the Pennsylvania Office of Attorney General are at the helm of this national investigation,” Shapiro said.


In June, Shapiro announced his office had joined the bipartisan commission of state attorneys investigating what role opioid manufacturers and distributors may have played in the growth of the opioid epidemic in Pennsylvania and across the nation.


Shapiro did not name any companies targeted in the investigation then. However on Tuesday he said the following companies are under investigation:


  • Endo International
  • Janssen Pharmaceuticals
  • Teva Pharmaceutical Industries and its U.S. subsidiary, Cephalon Inc.
  • Allergan Inc.
  • Perdue Pharma
  • AmerisourceBergen
  • Cardinal Health
  • McKesson


AmerisourceBergen, Cardinal Health and McKesson are distributors of the opioids, while the rest of the companies are opioid manufacturers.


Shapiro said the investigation was aimed at companies that make opioids and companies that transport them because both had a responsibility to curb the spread of addiction in the state and country.


“Manufacturers have had, and still have, a responsibility to tell patients, doctors and the public everything that they know about these incredibly addictive and dangerous drugs,” Shapiro said. “And distributors have a responsibility, give how hazardous these drugs are, to report suspicious shipments.”


Except for Perdue Pharma, the maker of OxyContin, all of the companies listed Tuesday have locations in Pennsylvania, but Shapiro told reporters “no one will be off limits during this investigation.”


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Pharma Guy's insight:

One PA opioid producer NOT on this list and "off limits" is KVK Tech, located right in my hometown of Newtown, PA! 

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Pennsylvania's Treasurer Says Big Pharma Must be Held Accountable for Its Role in Opioid Crisis

Pennsylvania's Treasurer Says Big Pharma Must be Held Accountable for Its Role in Opioid Crisis | Pharmaguy's Insights Into Drug Industry News |

Every day across the commonwealth [of Pennsylvania], 13 people die as a result of a drug overdose involving illicit or prescribed opioids. Those 13 people taken from us leave children without parents, students without teachers, and families with missing seats at the dinner table.


None of us has the luxury of claiming that this is not our problem. This is a Philadelphia crisis, a Pennsylvania crisis, a crisis that hits all of us. And just as other leaders are called upon to use the power at their disposal to fight the epidemic, I have a responsibility to use mine, as state treasurer, to do the same.


For the last 20 years, the pharmaceutical industry has been whitewashing the lasting impact of highly addictive narcotics through its use of marketing, effectively encouraging doctors and other providers to prescribe these powerful drugs in increasing, extremely dangerous levels.


This has infused our neighborhoods with the plague of addiction and significant misuse of drugs, leading to children being removed from their homes, overcrowded prisons, and a stagnant economy, as otherwise able-bodied Americans find themselves unable or unwilling to find work.


As Pennsylvania’s treasurer, my responsibilities include overseeing our state investments — your taxpayer dollars. These investments include Big Pharma companies, as the providers of the medicine and devices that our friends and neighbors need on a regular basis to survive.


Recently, I joined state treasurers from West Virginia and Illinois to demand that Big Pharma takes the necessary steps to combat the epidemic at its source. McKesson, located in San Francisco, is one of the nation’s largest prescription-drug wholesalers. While flooding communities with opioids, McKesson’s revenues have more than doubled from $93 billion to $199 billion over the past 10 years, with a $60 billion jump in 2015 alone.


These companies need to step forward and take active steps to address the growing challenges facing millions of prescription drug users across the nation.


Joe Torsella is treasurer of Pennsylvania. @JoeTorsella.

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