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Friday, May 11, 2012

In the Eyes of Big Pharma: Tombstones and Dollar Bills

Senate Finance Committee Chairman Max Baucus (D-Mont.) and senior Committee member Chuck Grassley (R-Iowa) initiated an investigation May 8, 2012, into the connections of drug manufacturers Purdue Pharma, Endo Pharmaceuticals, and Johnson & Johnson with medical groups and physicians who have advocated the increased use of narcotic painkillers, or opioids. The Senators also asked seven other medical groups to produce information about their financial ties and collaborations with opioid manufacturers.
The following text represents portions of the letter sent
to Purdue Pharma President and Chief Executive Officer John H. Stewart.

"There is growing evidence pharmaceutical companies
that manufacture and market opioids
may be responsible,
at least in part, for this epidemic
by promoting misleading information
about the drugs’ safety and effectiveness."

-Max Baucus and Chuck Grassley

"In addition to illegal off-label marketing, which has been prevalent in the pharmaceutical and medical device industries, drug and device companies have been found to engage in marketing, regulatory, and public relations activities through supposedly independent medical organizations financed by industry. Recent investigative reporting from the Milwaukee Journal Sentinel/MedPage Today and ProPublica revealed extensive ties between companies that manufacture and market opioids and non-profit organizations such as the American Pain Foundation, the American Pain Society, the American Academy of Pain Medicine, the Federation of State Medical Boards, and the University of Wisconsin Pain and Policy Study Group.

"According to the Milwaukee Journal Sentinel/MedPage Today, a "network of national organizations and researchers with financial connections to the makers of narcotic painkillers…helped create a body of dubious information" favoring opioids "that can be found in prescribing guidelines, patient literature, position statements, books and doctor education courses." For example, the Sentinel reported that the Federation of State Medical Boards, with financial support from opioid manufacturers, distributed more than 160,000 copies of a model policy book that drew criticism from doctors because "it failed to point out the lack of science supporting the use of opioids for chronic, non cancer pain."

"In a ProPublica story published in the Washington Post, the watchdog organization examined the American Pain Foundation, a "health advocacy" organization that received "nearly 90 percent of its $5 million funding from the drug and medical device industry." ProPublica wrote that its review of the American Pain Foundation’s "guides for patients, journalists, and policymakers play down the risks associated with opioids and exaggerate their benefits. Some of the foundation’s materials on the drugs include statements that are misleading or based on scant or disputed research."

"In 2003, a GAO report pointed to Purdue’s partnership with the Joint Commission on Accreditation of Healthcare Organization (JCAHO) as possible means for Purdue to have "facilitated its access to hospitals to promote OxyContin." The report revealed that Purdue "funded over 20,000 pain-related educational programs through direct sponsorship or financial grants" in addition to funding the Joint Commission on Accreditation of Healthcare Organization’s (JCAHO) pain management programs.

"We look forward to hearing from you by no later than June 8, 2012."

Victims of rx drug abuse, grass roots groups of concerned citizens, health officials, legislators, law enforcement officers, investigative reporters, and many others lit a lamp revealing a national health epidemic likely fueled by a reprehensible alliance.

For many years now, these informed, concerned citizens have urged Congress to investigate suspect drug manufacturers, medical groups, and physicians to reveal any illegal practices and improprieties they find and to reform opioid marketing and use.

From the floor of the United States Senate, Baucus and Grassley have taken the torch of illumination to the doors of Big Pharma. In their investigation, these senators will, undoubtedly, discover an open Pandora's box of evil that cannot be undone. As they begin the arduous duty of applying culpability for unleashing and perpetuating the rx health epidemic, they will face stiff opposition from those who profit from "the business of pain." The scope of their investigations will surely be staggering to most.

But, with unprecedented support from the American public, Baucus and Grassley can lead the efforts to close the immense coffers and restore sanity in a Prescription Nation. As the killing fields continue to swell with the casualties of abuse, we all must take upon ourselves the responsibility to act immediately as part of the "cure."

The profiteers will say, "Your exaggeration of the problem is laughable."

The pessimists will say, "You can't influence big business or big government."

The indifferent will say, "Help yourself. Drug abuse doesn't affect me."

Facts say: "Narcotic painkillers now kill nearly 15,000 people a year -- more than heroin and cocaine combined. Painkiller sales have increased fourfold since 1999.  Yet, the American Pain Foundation wants to preserve access to the drugs over those who worry about their risks: They continue to argue that pain remains widely undertreated. The group claims industry money has had no effect on its advocacy."

I say, "Wake up, America. How long must we suffer the consequences of rx abuse?"

I understand that opiates have their purpose. For example, they are a vehicle for relieving the severe pain of a terminal cancer patient. I don't want to deny anyone proper means of pain relief. A driving   analogy if you will -- I don't want to curb and disable your Chevy. You likely need access to a safe, dependable automobile. Still, responsibilities in vehicle operation do abound, so as you take the wheel and operate the vehicle, I do want you to

* Be a properly trained driver,
* Have a legal license,
* Be unimpaired by alcohol or drugs,
* Operate a safe vehicle that doesn't jeopardize your health or the health of others,
* Drive defensively to save innocent lives of those like children,
* Stop driving and seek help if you find yourself incapable of controlling your vehicle.

Is our government operating the vehicle of opioids correctly? I'm sure you are aware that drugs now kill more people than motor vehicle accidents in the U.S. Dr. Leonard Paulozzi, medical epidemiologist at the CDC's division of unintentional injury prevention, said prescription drugs are driving up the death toll.

"There has been a dramatic increase in use of prescription drugs as physicians have become more liberal in prescribing them," said Paulozzi, adding that the bulk of drug-related deaths stems from accidental opioid painkiller overdoses. "And with the decrease in the motor vehicle crash mortality rate, drug-induced deaths have now passed motor vehicle crash deaths."

You, your relatives and your friends are in jeopardy in a country that cites these kind of statistics. I propose a rally to demand complete transparency of the operations of Big Pharma and the FDA. Let's give senators Baucus and Grassley our support. And, remember the efforts of others in government too.

U.S. Representatives Mary Bono Mack (CA-45), Hal Rogers (KY-05) and Stephen Lynch (MA-09) are re-establishing the bi-partisan Congressional Caucus on Prescription Drug Abuse. The goal of the caucus is to raise awareness of abuse and to work toward innovative and effective policy solutions, incorporating treatment, prevention, law enforcement and research. 

May the collective lights of millions of people help illuminate their way.

Read the entire collection of Baucus, Grassley letters here:

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