Stories
Slash Boxes
Comments

SoylentNews is people

posted by martyb on Tuesday March 20 2018, @12:43PM   Printer-friendly
from the speechless dept.

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."


Original Submission

 
This discussion has been archived. No new comments can be posted.
Display Options Threshold/Breakthrough Mark All as Read Mark All as Unread
The Fine Print: The following comments are owned by whoever posted them. We are not responsible for them in any way.
  • (Score: 5, Insightful) by Runaway1956 on Tuesday March 20 2018, @02:29PM (9 children)

    by Runaway1956 (2926) Subscriber Badge on Tuesday March 20 2018, @02:29PM (#655393) Journal

    Sorry, Entropy, but I don't think you *really* understand what has been happening.

    You're right, of course, pain sucks. But there are many levels of pain. In fact, there are many different kinds of pain. Some stuff - you maybe need an aspirin. Other things, maybe prescription strength Ibuprofen. Something hurting a lot worse maybe requires a Tylenol 3. Opioids should be reserved for something a lot worse than a toothache, or a sprained ankle, or a hangnail.

    Yet, doctors have been rescribing opioids frivolously.

    No one is going to convince me that the profit motive played no part in all of this. "If I prescribe just 1000 more pills, I get a free pleasure cruise in the Caribbean!" Or, in the doctor's case in the story, a couple hundred thousand dollars.

    That is out and out drug pushing, FFS. The patient's health and welfare take second place to making some easy money. The more drugs we push, the more money we make - and the cops WILL NOT bust you!

    Starting Score:    1  point
    Moderation   +4  
       Insightful=4, Total=4
    Extra 'Insightful' Modifier   0  
    Karma-Bonus Modifier   +1  

    Total Score:   5  
  • (Score: 2) by Entropy on Tuesday March 20 2018, @02:48PM (2 children)

    by Entropy (4228) on Tuesday March 20 2018, @02:48PM (#655403)

    I simply disagree. As long as someone is under a doctor's supervision they can use opiates for whatever medical reason it's deemed necessary. I don't think people should have to endure pain, and Tylenol is honestly kinda useless.

    • (Score: 0) by Anonymous Coward on Tuesday March 20 2018, @06:40PM

      by Anonymous Coward on Tuesday March 20 2018, @06:40PM (#655549)

      Tylenol is honestly kinda useless.

      Absolutely! You should take paracetamol instead!

      Geez! Some people. I tell ya!

    • (Score: 2) by Fluffeh on Tuesday March 20 2018, @11:01PM

      by Fluffeh (954) Subscriber Badge on Tuesday March 20 2018, @11:01PM (#655696) Journal

      As long as someone is under a doctor's supervision they can use opiates for whatever medical reason it's deemed necessary.

      Yes, as long as the doctor is doing the right thing. This story is pointing to a lot of people who might not quite be doing the right thing. Or maybe kinda right. Or rather, not terrible... And they are getting kickbacks from it.

      It's like going to a dietitian because you are fat and want to lose weight, they sort you out with a diet, it looks delicious. You stick with it for a while, but you just get fatter. Then someone says that the dietitian is getting kickbacks from farmers if they make diets with extra burgers in them. It's food right? I mean, it's not BAD for you. You still need to eat... They could have suggested more salads, but you know they get extra cash for telling you to eat burgers.

      I don't think people should have to endure pain

      Physical pain is the body's way of saying something is wrong. I don't get why people insist on masking this important information from the body. Fix what is wrong in the body rather than just making it quiet. If the issue can't be fixed, that's another story, but a tooth ache or post surgery or even post accident - that's not cause to jump for the pain killers - that should be cause to try to understand what your body is telling you.

      Here's a great article about an American who went to Germany and needed a procedure [nytimes.com] performed.

  • (Score: 2) by Whoever on Tuesday March 20 2018, @03:30PM (5 children)

    by Whoever (4524) on Tuesday March 20 2018, @03:30PM (#655419) Journal

    Some recent research shows that in many cases, Tylenol works as well as opioids.

    • (Score: 0) by Anonymous Coward on Tuesday March 20 2018, @04:13PM (4 children)

      by Anonymous Coward on Tuesday March 20 2018, @04:13PM (#655449)

      Sure it does!
      So does thinking happy thoughts.