‘Pill Mill’ Docs Only Partly to Blame for Opioid Epidemic – US News & World Report

Finally, a study has come out in the journal Addiction, with some real data to counter the hysteria at the Federal and State level that has been shutting down high volume opioid providers, a class of doctor that was created and supported by the very Federal Government that is now shutting them down with no warning. This crisis, which was created because just twenty years ago because the medical establishment was urged to provide opioids as pain relief, now finds itself resorting to lies and raids on doctors that usually have ended up, after years of court time, having the Feds drop all the charges. Rather than treat these physicians and pharmacies like criminals, they should be working cooperatively to rein them in and offer their patients relief.

The study also found that “opioid shoppers” — people who obtain prescriptions from multiple doctors and pharmacies — accounted for just 0.1 percent of opioid users in the study.

Our local physicians here on the Peninsula have often been complicit in this behavior, shunting high pain patients to the one doctor who was willing to work with them, then talking behind his back about how he was somehow “a renegade” and not coming to his defense  when he was raided. They had nothing to say  when the charges were finally dropped.

All prescribers of opioid pain medications — not just high-volume prescribers — play a role in the U.S. epidemic of opioid abuse and overdoses, a new study says.

“This crisis has been misconstrued as one involving just a small subset of doctors and patients,” senior author Dr. G. Caleb Alexander said in a Hopkins news release. “Our results underscore the need for targeted interventions aimed at all opioid prescribers, not just high-volume prescribers alone,” Alexander added.

https://health.usnews.com/health-care/articles/2017-11-30/pill-mill-docs-only-partly-to-blame-for-opioid-epidemic

full abstract and article available at

http://onlinelibrary.wiley.com/doi/10.1111/add.14068/full

Heated And Deep-Pocketed Battle Erupts Over 340B Drug Discount Program – Kaiser Health News

This is an ugly story from both sides of the issue. The big Pharma companies are looking to claw back some of their profits, and some hospital districts, such as Jefferson County Healthcare, may be using the system in a way it was not intended, meaning that it is unclear that the patients who were intended to benefit from this, actually are seeing benefits. JHC has a relationship to somehow share these discounts with Safeway, where they send patients for filling the discounted drug.  Is the patient actually seeing a discounted price or is the hospital somehow using this to generate more profits? I am under the impression that Kitsap County is using the program more as it was originally intended, meaning that the monies are passed directly to the consumer who benefits from the discount. Is that not true here? It appears not to be.

The program, known as 340B, requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients.

Under 340B, named after the section of the Public Health Service Act that authorizes it, eligible hospitals buy drugs at a discount from the pharmaceutical companies and then are reimbursed for those purchases from Medicare. The drugs are purchased under the Part B program, which covers expensive chemotherapy and other treatments in a hospital, doctor’s office and clinics.

Heated And Deep-Pocketed Battle Erupts Over 340B Drug Discount Program

Letter to Center for Medicare & Medicaid Services on changes to 340B hospital programs

This was sent out by the Jefferson Healthcare on their concerns to changes to the 340B program. This program has been used to theoretically fund low cost prescriptions. There are a variety of points of view about what the program has actually achieved, but the hospital is adamantly opposed to the cuts to it.  We likely can discuss this more at the next Citizen’s Healthcare Access group meeting in September in Port Townsend.

340b letter PDF file. Here’s the first page so you can decide if you want to read the whole PDF.

340b letter_Page_1

The Myth of Drug Expiration Dates – ProPublica

Following the discussion we had with Dr. Art Zoloph this month on the subject of stockpiling medicines, is this superb story by ProPublica. It begs the question of why not spend the money to appropriately test drug potency over time, given the expense of buying them?

Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer.
by Marshall Allen
ProPublica, July 18, 2017

https://www.propublica.org/article/the-myth-of-drug-expiration-dates

Some possible good news on prostate cancer- The Guardian

This was in today’s Guardian.

Prostate cancer trial stuns researchers: ‘It’s a once in a career feeling’ – Study with ‘powerful results’ finds that combining two existing therapies could extend the life of men with advanced, high-risk prostate cancer by 37%. Combining two existing prostate cancer therapies could extend the life of men with advanced, high-risk prostate cancer by 37%, according to a study presented at the world’s largest cancer conference. The new findings could change how doctors first approach treatment of prostate cancer.

https://www.theguardian.com/society/2017/jun/03/prostate-cancer-therapy-study-abiraterone?utm_source=esp&utm_medium=Email&utm_campaign=GU+Today+USA+-+Collections+2017&utm_term=229027&subid=9822000&CMP=GT_US_collection

Payer snubs PTC’s Emflaza, signaling pricing trouble ahead of launch – FiercePharma

Washington State continues to battle for lower cost prescriptions. This is your government in action. It’s a good thing.

As Washington State’s HCA noted, PTC Therapeutics has not announced its new price. But the group published a report (PDF) stating that prednisone—at a cost of 5 cents per tablet and $55 per year—will be its preferred corticosteroid for DMD patients. It’s the “lower cost, equally effective” option, according to HCA.

Read the whole story here:

http://www.fiercepharma.com/pharma/policy-report-washington-s-largest-healthcare-purchaser-snubs-ptc-s-emflaza