Judge approves Teva’s $85 million opioid settlement with state of Oklahoma

Teva had reached an agreement with the state of Oklahoma last month, just two days before the drugmaker was set to face a trial alongside Johnson & Johnson.
Health and Science

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David Sackler, whose family owns Purdue Pharma, says the company is not to blame for the opioid epidemic

David Sackler, whose family owns Purdue Pharma, is defending the company and his family against what he describes as “vitriolic hyperbole,” saying they’re not to blame for the opioid crisis ravaging the nation.


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Opioid Operators: How Surgeons Ply Patients With Painkillers

Even as awareness of the opioid crisis grew, prescribing habits of surgeons changed very little from 2011 to 2016, found a data analysis by Kaiser Health News and Johns Hopkins School of Public Health. Our team looked at surgeons whose Medicare patients filled a prescription for opioids within a week of having one of seven common surgical procedures. (See the methodology for more information.)

Kaiser Health News

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Expert witness: Johnson & Johnson’s role in opioid crisis may be ‘worse’ than Purdue’s

One of the nation’s top experts on opioid addiction said Tuesday that Johnson & Johnson’s role in the current epidemic may be even “worse” than that of Purdue Pharma, the maker of OxyContin.


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Legalizing medical marijuana doesn’t curb opioid overdose deaths, study says

Lawmakers and marijuana advocates have argued that legalizing weed to manage chronic paid can help reduce opioid addiction, but researchers at Stanford University's School of Medicine say otherwise.
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Tearful father of Oklahoma football star who overdosed testifies at landmark opioid trial

Craig Box couldn’t hold back tears in an Oklahoma courtroom on Wednesday as he described his late son Austin as “a special young man.”


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Big drug distributor pays $22 million to settle US opioid charges

Morris & Dickson, one of the largest U.S. wholesale drug distributors, agreed to pay $ 22 million in civil penalties to settle U.S. government charges that it failed to report thousands of suspicious orders of the opioids hydrocodone and oxycodone.
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Opioid company executives found guilty of racketeering

Five top executives of Insys Therapeutics — maker of Subsys, a version of the extremely powerful synthetic opioid fentanyl — were found guilty Thursday on federal racketeering charges for bribing doctors to prescribe the painkiller to people who didn’t need it. They were also convicted of defrauding Medicare and private insurance.


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Federal court to consider news outlet access to opioid data

A three-judge panel will hear arguments on whether federal data about how prescription opioid drugs were distributed should be made public
ABC News: Health

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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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Three Weeks Pass And Boston Panel Still Has No Verdict In Insys Opioid Trial

The lengthy deliberations of the 12-person jury focus on a scam prosecutors say funneled hundreds of thousands of dollars to doctors nationwide to prescribe highly addictive Subsys more often and at higher doses. News on the opioid epidemic comes from Massachusetts, Ohio, New Hampshire and California, as well.
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Study: Opioid dose variability may be a risk factor for opioid overdose

DENVER Patients prescribed opioid pain medications whose doses varied over time were 3 times more likely to experience an overdose than patients prescribed stable opioid doses, according to an observational study from Kaiser Permanente published today in JAMA Network Open. The study also showed that patients who discontinued long-term opioid therapy for 3 or more months had half the risk of opioid overdose.

“Our study suggests that safely managing long-term opioid therapy is complex,” said Ingrid Binswanger, MD, senior investigator at Kaiser Permanente Institute for Health Research in Colorado and co-author of the study.

Ingrid Binswanger, MD
Ingrid Binswanger, MD

“This study suggests going up and down on opioid doses — also called dose variability — could present an increased risk of overdose,” Dr. Binswanger said. “Through this study, we also found eventually discontinuing opioid therapy may prevent overdoses. With continued studies, we hope to find out how care providers can help patients with their pain without putting them at unnecessary risk due to rapid changes in their dose.”

The 12-year study included more than 14,000 Kaiser Permanente members in Colorado who were prescribed long-term opioids. Researchers used electronic health records to track the history of patients to see if they had dose changes and overdoses from opioid pain medications and other opioid drugs.

The research team obtained a follow-up $ 2 million, 4-year grant from the National Institutes for Health. The study will look at how patients and doctors manage changes in opioid doses, including any long-term risks and benefits of discontinuing opioid pain medications.

Jason Glanz, PhD
Jason Glanz, PhD

“Kaiser Permanente, like many health care organizations across the country, has made significant changes to safely reduce opioid prescriptions for our members,” said Jason Glanz, PhD, senior investigator at the Institute for Health Research and co-author on the study.

“This study represents the first of many investigations that we plan to do on the topic,” Dr. Glanz said. “Our goal is to help identify the most safe and effective approaches for managing long-term opioid therapy. We want to be able to minimize patients’ pain and reduce their risk for overdose.”

This study was funded by the National Institute on Drug Abuse and conducted by researchers at Kaiser Permanente’s Institute for Health Research.

Additional study authors include Susan Shetterly, MS; Komal J. Narwaney, MPH, PhD; and Stan Xu, PhD.


About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.4 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.

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U.S. FDA approves Teva’s generic nasal spray to treat opioid overdose

Generic drugmaker Teva Pharmaceutical
Industries Ltd on Friday received approval from the
U.S. Food and Drug Administration (FDA) to market its generic
nasal spray for opioid overdose, the health regulator said.


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Researchers investigate the impact of the statewide opioid crisis on teachers

Researchers have evaluated the impact of the opioid crisis in classrooms across the Mountain State through a survey of 2,205 teachers in 49 counties.
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Johnson & Johnson acted as opioid ‘kingpin,’ Oklahoma attorney general says

Johnson & Johnson acted as an opioid “kingpin” by using a web of foreign and domestic subsidiaries to supply raw materials “necessary to manufacture the opioid pain medications thrust upon the unsuspecting public since the 1990s,” Oklahoma Attorney General Mike Hunter alleged in court filings.


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These states have been hit the hardest by America’s opioid epidemic

While there’s early evidence that the explosive rate of opioid deaths has started to slow, opioids killed more than 49,000 people in the United States in 2017, according to preliminary data. A new study reveals which part of the country has been affected the most by the ongoing epidemic.


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Sackler family, fortune and philanthropy under scrutiny amid opioid lawsuits

A series of lawsuits spurred by the opioid epidemic has thrust one of America’s richest yet little-known families into a spotlight they’ve long sought to avoid.


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County By County, Researchers Link Opioid Deaths To Drugmakers’ Marketing

Researchers sketched a vivid line Friday linking the dollars spent by drugmakers to woo doctors around the country to a vast opioid epidemic that has led to tens of thousands of deaths.

The study, published in JAMA Network Open, looked at county-specific federal data and found that the more opioid-related marketing dollars were spent in a county, the higher the rates of doctors who prescribed those drugs and, ultimately, the more overdose deaths occurred in that county.

For each three additional payments made to physicians per 100,000 people in a county, opioid overdose deaths were up 18 percent, according to the study. The researchers said their findings suggest that “amid a national opioid overdose crisis, reexamining the influence of the pharmaceutical industry may be warranted.”

And the researchers noted that marketing could be subtle or low-key. The most common type: meals provided to doctors.

Dr. Scott Hadland, the study’s lead author and an addiction specialist at Boston Medical Center’s Grayken Center for Addiction, has conducted previous studies connecting opioid marketing and opioid prescribing habits.

“To our knowledge, this is the first study to link opioid marketing to a potential increase in prescription opioid overdose deaths, and how this looks different across counties and areas of the country,” said Hadland, who is also a pediatrician.

Nearly 48,000 people died of opioid overdoses in 2017, about 68 percent of the total overdose deaths, according to the Centers for Disease Control and Prevention. Since 2000, the rate of fatal overdoses involving opioids has increased 200 percent. The study notes that opioid prescribing has declined since 2010, but it is still three times higher than in 1999.

The researchers linked three data sets: the Centers for Medicare & Medicaid Services Open Payments database that shows drugmakers’ payments to doctors; a database from the CDC that shows opioid prescribing rates; and another CDC set that provides mortality numbers from opioid overdoses.

They found that drugmakers spent nearly $ 40 million from Aug. 1, 2013, until the end of 2015 on marketing to 67,500 doctors across the country.

Opioid marketing to doctors can take various forms, although the study found that the widespread practice of providing meals for physicians might have the greatest influence. According to Hadland, prior research shows that meals make up nine of the 10 opioid-related marketing payments to doctors in the study.

“When you have one extra meal here or there, it doesn’t seem like a lot,” he said. “But when you apply this to all the doctors in this country, that could add up to more people being prescribed opioids, and ultimately more people dying.”

Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, said these meals may happen at conferences or industry-sponsored symposiums.

“There are also doctors who take money to do little small-dinner talks, which are in theory, supposed to educate colleagues about medications over dinner,” said Kolodny, who was not involved in the study. “In reality this means doctors are getting paid to show up at a fancy dinner with their wives or husbands, and it’s a way to incentivize prescribing.”

And those meals may add up.

“Counties where doctors receive more low-value payments is where you see the greatest increases in overdose rates,” said Magdalena Cerdá, a study co-author and director of the Center for Opioid Epidemiology and Policy at the New York University School of Medicine. The amount of the payments “doesn’t seem to matter so much,” she said, “but rather the opioid manufacturer’s frequent interactions with physicians.”

Dr. G. Caleb Alexander, who is the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness and was not affiliated with the study, said that the findings about the influence of meals aligns with social science research.

“Studies have found that it may not be the value of the promotional expenditures that matters, but rather that they took place at all,” he said. “Another way to put it, is giving someone a pen and pad of paper may be as effective as paying for dinner at a steakhouse.”

The study says lawmakers should consider limits on drugmakers’ marketing “as part of a robust, evidence-based response to the opioid overdose epidemic.” But they also point out that efforts to put a high-dollar cap on marketing might not be effective since meals are relatively cheap.

In 2018, the New Jersey attorney general implemented a rule limiting contracts and payments between physicians and pharmaceutical companies to $ 10,000 per year.

The California Senate also passed similar legislation in 2017, but the bill was eventually stripped of the health care language.

The extent to which opioid marketing by pharmaceutical companies fueled the national opioid epidemic is at the center of more than 1,500 civil lawsuits around the country. The cases have mostly been brought by local and state governments. U.S. District Judge Dan Polster, who is overseeing hundreds of the cases, has scheduled the first trials for March.

In 2018, Kaiser Health News published a cache of Purdue Pharma’s marketing documents that displayed how the company marketed OxyContin to doctors beginning in 1995. Purdue Pharma announced it would stop marketing OxyContin last February.

Priscilla VanderVeer, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, or PhRMA, said that doctors treating patients with opioids need education about benefits and risks. She added that it is “critically important that health care providers have the appropriate training to offer safer and more effective pain management.”

Cerdá said it is also important to consider that the study is not saying doctors change their prescribing practices intentionally.

“Our results suggest that this finding is subtle, and might not be recognizable to doctors that they’re actually changing their behavior,” said Cerdá. “It could be more of a subconscious thing after increased exposure to opioid marketing.”


KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Kaiser Health News

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Odds of dying from accidental opioid overdose in the US surpass those of dying in car accident

For the first time on record the odds of accidentally dying from an opioid overdose in the United States are now greater than those of dying in an automobile accident.


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Controversial tool emerges in opioid fight: fentanyl test strips

A controversial tool has emerged in the fight against opioid overdose deaths. It’s a strip that allows people who use street drugs such as cocaine and heroin to test whether their drugs are laced with fentanyl.


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