In the News: Big Pharma Knows Which Doctors Overprescribe, But They’re Not Telling
Over the last decade, the maker of the potent painkiller OxyContin has compiled a database of hundreds of doctors suspected of recklessly prescribing its pills to addicts and drug dealers, but has done little to alert law enforcement or medical authorities, the Los Angeles Times reports.
Purdue Pharma has compiled a database of about 1,800 doctors it suspects may have recklessly prescribed the drug to people addicted to it, as well as to drug dealers. The company has kept most of the list private.
Despite its suspicions, Purdue Pharma continued to profit from prescriptions written by these physicians, many of whom were prolific prescribers of OxyContin. The company has sold more than $27 billion worth of the drug since its introduction in 1996.
History of OxyContin
Shortly after the release of OxyContin, Purdue implemented an aggressive marketing campaign. It promoted the use of OxyContin by primary care providers, use in non-cancer pain, and its use as first line therapy for chronic pain. Its marketing was physician directed, and certain promotional claims were even cited in medical journals. Within in two years, OxyContin came to account for 80 percent of all Perdue profits.
As the use of OxyContin became more wide spread, reports of abuse began to increase exponentially. Before the release of OxyContin, all formulations of oxycodone contained an NSAID, which limited its potential for abuse. The NSAID component of the drugs also restricted the routes of administration to oral ingestion. When OxyContin was released, abusers realized that they could crush the pill to release pure oxycodone (up to 80mg in one pill), which allowed larger doses and by additional routes of administrations such as intravenous and intranasal. Due to the widespread abuse, particularly in rural areas, OxyContin came to be known as “Hillbilly Heroin.”
Soon, the lawsuits began. Purdue was accused of disseminating misleading information about OxyContin. In 2001, both the FDA and Purdue issued warnings against the recreational use of the drug. Despite the warnings, OxyContin continued to be one of the most widely abused drugs in the United States.
In 2011, to try to curb abuse of the drug, manufacturers added additional binders to the formulation to prevent the grinding of tablets for insufflation or injection, and to maintain OxyContin’s extended release characteristics. The added binders greatly reduced the recreational value of OxyContin, because they were not easily broken down.
Purdue has promoted the idea that the country’s epidemic of prescription drug deaths was fueled largely by pharmacy robberies, doctor-shopping patients and teens raiding home medicine cabinets. The database suggests that Purdue has long known that physicians also play a significant role in the crisis.
Beginning in 2002, Purdue trained its sales representatives to report “red flags” in doctors’ offices such as young patients, long lines, people nodding off in waiting rooms and frequent cash transactions. The suspect doctors are removed from the company’s sales territories and assigned to the database, known as “Region Zero.”
According to The Times, Purdue attorney Robin Abrams said the company created the database to steer its sales representatives away from risky doctors. Policing physicians, she said, was not Purdue’s responsibility.
“We don’t have the ability to take the prescription pad out of their hand,” she said.
Abrams said the company had alerted law enforcement or medical regulators to 154 of the prescribers — about 8% of those in its database.
Mitchell Katz, Director of the Los Angeles County Department of Health Services, says the company is obligated to report all the doctors in the database. “There is an ethical obligation,” he said. “Any drug company that has information about physicians potentially engaged in illegal prescribing or prescribing that is endangering people’s lives has a responsibility to report it.”
What do you think? Do the manufactureres of potent drugs have a responsibility to report unethical doctors? Tell us in the comments!
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