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CNN Exclusive: The more opioids doctors prescribe, the more money they make (archive)
The data:
The CNN/Harvard analysis looked at 2014 and 2015, during which time more than 811,000 doctors wrote prescriptions to Medicare patients. Of those, nearly half wrote at least one prescription for opioids.
Fifty-four percent of those doctors -- more than 200,000 physicians -- received a payment from pharmaceutical companies that make opioids.
Among doctors in the top 25th percentile of opioid prescribers by volume, 72% received payments. Among those in the top fifth percentile, 84% received payments. Among the very biggest prescribers -- those in the top 10th of 1% -- 95% received payments.
On average, doctors whose opioid prescription volume ranked among the top 5% nationally received twice as much money from the opioid manufacturers, compared with doctors whose prescription volume was in the median. Doctors in the top 1% of opioid prescribers received on average four times as much money as the typical doctor. Doctors in the top 10th of 1%, on average, received nine times more money than the typical doctor. [...]
Some studies have looked at whether the amount of money a doctor receives makes a difference. Studies by researchers at Yale University, the George Washington University Milken Institute of Public Health and Harvard Medical School have all found that the more money physicians are paid by pharmaceutical companies, the more likely they are to prescribe certain drugs.
The story:
Angela Cantone says she wishes she had known that opioid manufacturers were paying her doctor hundreds of thousands of dollars; it might have prompted her to question his judgment.
She says Dr. Aathirayen Thiyagarajah, a pain specialist in Greenville, South Carolina, prescribed her an opioid called Subsys for abdominal pain from Crohn's disease for nearly 2½ years, from March 2013 through July 2015.
Subsys is an ultrapowerful form of fentanyl, which is 50 to 100 times more potent than morphine, according to the US Centers for Disease Control and Prevention.
"He said it would do wonders for me, and it was really simple and easy. You just spray it in your mouth," Cantone said.
She says Subsys helped her pain, but it left her in "a zombie-like" state. She couldn't be left alone with her three young children, two of whom have autism and other special needs.
"I blacked out all the time. I'd find myself on the kitchen floor or the front lawn," she said.
She says that if she missed even one day of the drug, she had uncontrollable diarrhea and vomiting.
She said she brought her concerns to Thiyagarajah, but he assured her it couldn't be the Subsys that was causing her health problems.
"I trusted him. I trusted my doctor as you trust the police officer that's directing traffic when the light is out," she said.
She says that when she eventually asked Thiyagarajah to switch her to a non-opioid medication, he became belligerent.
"He said it was Subsys or nothing," she said.
Cantone would later learn that from August 2013 through December 2016, the company that makes Subsys paid Thiyagarajah more than $200,000, according to Open Payments, the federal government database that tracks payments from pharmaceutical companies to doctors.
CNN compared the $190,000 he received from 2014 to 2015 with other prescribers nationwide in the same medical specialty and found that he received magnitudes [50 times] more than the average for his peers.Nearly all of the payments were for fees for speaking, training, education and consulting.
Dr. Aathirayen Thiyagarajah wrote nearly twice as many opioid prescriptions per patient annually compared to his colleagues
The rebuttal:
Dr. Patrice Harris, a spokeswoman for the American Medical Association, said that the CNN and Harvard data raised "fair questions" but that such analyses show only an association between payments and prescribing habits and don't prove that one causes the other.
It's "not a cause and effect relationship," said Harris, chairwoman of the association's opioid task force, adding that more research should be done on the relationship between payments and prescriptions.
"[We] strongly oppose inappropriate, unethical interactions between physicians and industry," she added. "But we know that not all interactions are unethical or inappropriate." Harris added that relationships between doctors and industry are ethical and appropriate if they "can help drive innovation in patient care and provide significant resources for professional medical education that ultimately benefits patients."
(Score: 4, Informative) by NotSanguine on Tuesday March 20 2018, @02:01PM (15 children)
There's quite a bit quoted material and references to several studies and interviews.
However, there are zero links to the studies, the data associated with those studies or the interviews from which people are quoted.
Sure the information in TFS seems legit, but I'd like to dig a little deeper. Except I can't because there is NO TFA to back up the statements in TFS.
TFS has interesting information and makes significant claims. But there are no attributions whatsoever. From where was this sourced? USA Today? The Guardian? The Denver Post? Breitbart? RT? The Manila Bulletin?
I'd point out that the TFS is pretty much the same as the original submission [soylentnews.org]. Neither has any links to the quoted material.
Was this an oversight, or is SoylentNews moving to an attribution-free format?
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 2) by The Mighty Buzzard on Tuesday March 20 2018, @02:05PM (3 children)
If only we had an editor around to fix these things...
My rights don't end where your fear begins.
(Score: 2) by NotSanguine on Tuesday March 20 2018, @02:12PM (2 children)
Unfortunately, that wouldn't have made a difference in this case, as the original submission [soylentnews.org] had no such information.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 3, Touché) by The Mighty Buzzard on Tuesday March 20 2018, @04:11PM (1 child)
Quit messing up my perfectly good zingers with your damned Vulcan logic.
My rights don't end where your fear begins.
(Score: 2) by NotSanguine on Tuesday March 20 2018, @05:08PM
There is a multi-legged creature crawling on your shoulder. May I kill it?
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 4, Informative) by NotSanguine on Tuesday March 20 2018, @02:11PM
One of the major reasons why I'm pushing on this is because AFAIK, there is no national controlled-substance prescription monitoring program [usdoj.gov]. And most, but not all states have such programs.
One can certainly get data about payments to physicians from pharmaceutical companies [cms.gov].
I'd love to see where the studies cited sourced their data. But I can't, because there are no TFAs, no links to the studies themselves or any corroborating information. At all.
Again I ask: WTF?
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 3, Informative) by cocaine overdose on Tuesday March 20 2018, @02:11PM (4 children)
(Score: 2) by NotSanguine on Tuesday March 20 2018, @02:17PM (3 children)
Thank you. I look forward to reading the article. I appreciate you submitting this.
This
https://www.cnn.com/2018/03/11/health/prescription-opioid-payments-eprise/index.html [cnn.com]
was exactly what I was looking for.
Please note that the above link has autoplay video (assholes!).
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 2) by bzipitidoo on Tuesday March 20 2018, @02:35PM (1 child)
Firefox is better than Chrome at stopping autoplay, though the control is buried in about:config, instead of being easily accessible in the settings/options/preferences dialogs. Set media.autoplay.enabled to false. That takes care of HTML5 video. As for Flash, starting in Firefox 57, they stopped autoplay of that by making no play the default, and now the user has click on this little brick icon they added to the URL bar whenever Flash is detected, to pop up a menu that asks if you want to play Flash videos from that site.
Chrome's options to disable autoplay don't work on an awful lot of web sites.
(Score: 2) by NotSanguine on Tuesday March 20 2018, @05:14PM
I am aware of this.
Thanks for posting the instructions anyway.
Truth be told, I just wanted to vent about assholes who think autoplay video is a good idea.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 3, Insightful) by Runaway1956 on Tuesday March 20 2018, @02:42PM
I have found myself in that position. Someone quotes something from out of the blue, and I wonder "Where the hell did that come from?" So, I just copy part of the relevant text, and stuff it into a search query. For, example, "Angela Cantone says she wishes she had known that opioid manufacturers were paying her doctor hundreds of thousands of dollars; it might have prompted her to question his judgment.
She says Dr. Aathirayen Thiyagarajah, a pain specialist in Greenville, South Carolina, prescribed her an opioid called Subsys for abdominal pain from Crohn's disease for nearly 2½ years, from March 2013 through July 2015." goes into DuckDuckgo.
duckduckgo.com/?q=++++Angela+Cantone+says+she+wishes+she+had+known+that+opioid+manufacturers+were+paying+her+doctor+hundreds+of+thousands+of+dollars%3B+it+might+have+prompted+her+to+question+his+judgment.++++++She+says+Dr.+Aathirayen+Thiyagarajah%2C+a+pain+specialist+in+Greenville%2C+South+Carolina%2C+prescribed+her+an+opioid+called+Subsys+for+abdominal+pain+from+Crohn's+disease+for+nearly+2½+years%2C+from+March+2013+through+July+2015.&t=ffsb&ia=web
I get a boatload of hits, 9 of which appear to contain that quote, exactly. I can't know WHICH of those 9 hits the submitter copied from - but it's reasonable to assume that he used one of them. I can now read any or all of those sources.
Yeah, I understand, and agree, that submitter *should have* included a link. However, if he doesn't make regular submissions, he probably wasn't aware that block quotes don't copy his link into the submission.
Sometimes, you just gotta go the extra mile, because the submitter thought he had already run that mile, and finished the race.
(Score: 2) by takyon on Tuesday March 20 2018, @04:24PM (4 children)
Way too much text is quoted too. I blame bytram.
Added link finally, and archive link (adblocker).
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 1) by cocaine overdose on Tuesday March 20 2018, @05:08PM (2 children)
(Score: 0) by Anonymous Coward on Wednesday March 21 2018, @12:47AM (1 child)
Maybe you should just cut a couple of lines every every hour or for the Eds, so they could stay awake all night doing ed stuff.
(Score: 1) by cocaine overdose on Wednesday March 21 2018, @01:02AM
(Score: 2) by NotSanguine on Tuesday March 20 2018, @05:10PM
Thanks Takyon.
It's much appreciated!
No, no, you're not thinking; you're just being logical. --Niels Bohr