Just how rapacious can Big Pharma be?

Makers hype more drugs as nation faces opioid drug abuse epidemic

• In the face of an epidemic of opioid painkiller abuse, the drug industry’s answer appears to be: push even more pills on the public. The Washington Post notes that “six in 10 American adults take prescription drugs, creating a vast market for new meds to treat the side effects of the old ones. Opioid prescriptions alone have skyrocketed from 112 million in 1992 to nearly 249 million in 2015, the latest year for which numbers are available, and America’s dependence on the drugs has reached crisis levels. Millions are addicted to or abusing prescription painkillers such as OxyContin, Vicodin and Percocet.” Drug makers’ response has been to “inundate” Americans with advertising, marketing, and promotions of new medications, including sky-high priced Super Bowl commercials. Some of the add-on meds assist in painkiller overdoses, and others provide alternatives that might ease addictions. But makers also are hyping drugs like Relistor and Movantik to deal with opioid side-effects like constipation. As the paper observes, “By promoting opioid-induced constipation as a condition in need of more targeted treatment, critics say the drug industry is creating incentives to maintain the painkillers at full strength and add another pill instead.” Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, says drug makers, by addressing small woes with painkillers, not only makes them more acceptable and increases their use, they increase their profits. He says added meds turn patients’ worth to Big Pharma from a few hundred dollars to several thousand dollars a month. “The pharmaceutical industry literally created the problem” of opioid induced constipation, Kolodny said. “They named it, and they started advertising what a serious issue it is. And now they’ve got the solution for it.”

Is ‘overactive bladder’ a drug-maker manufactured condition?

• What happens when drug makers conduct vague phone surveys, combine dubious data, and fund so-called “experts” to take natural conditions and redefine them? Presto, the Milwaukee Journal-Sentinel reports, a $3 billion medication market appears. It’s hyped relentlessly in magazines, broadcasts, and has become ubiquitous in the public imagination. But experts question whether millions of Americans really suffer from “overactive bladders,” and whether the drugs they take for it are safe, effective, and beneficial. The paper says many of the meds are risky, can harm, and have been linked to deaths. The Journal-Sentinel reporters traced the creation of the condition of the “overactive bladder” to two experts, who have received thousands of dollars from the drug industry. Big Pharma has spurred them on, partly by conducting dubious telephone marketing calls that, naturally, found that older respondents had experienced occasional urgency in their need to urinate. But the paper also reports that industry-funded “experts” built their case for a medical condition on suspect science: They combined seniors with proven incontinence (due to kidney disease, cancers, and surgeries) with older respondents who simply said they sometimes really needed to go. Doctors were targeted to prescribe overactive bladder drugs, and the hype surrounding them made urination an acceptable discussion topic for them. The Journal-Sentinel says the meds haven’t shown in rigorous research to be a huge boon — they can’t address, for example, that patients’ bladder strength and control declines with age. There also are non-drug therapies that can be effective, including: bladder training, pelvic muscle exercises, weight loss and fluid management. The drugs have side effects, including cognitive impairment that can be a major woe in older consumers.

Congress members rip firm for jacking up price of leukemia drug

• Members of Congress have opened fire on another drug maker: Ariad Pharmaceuticals, a firm that produces a medication for rare leukemias. Bernie Sanders, the Vermont Democratic senator, and Elijah Cummings, the Maryland Democratic representative, have demanded in writing that Ariad defend its hiking the price of its drug Inclusig four times in recent days, with the medication skyrocketing in annual price from $114,960 in 2012 to $198,732 in October 2016. The lawmakers said they are investigating “whether the company tried to boost profits by tweaking pill dosages and quantities to charge insurers and patients more for less medicine,” the Associated Press has reported. The news service notes that federal regulators approved Iclusig in 2012 to treat two rare types of leukemia, “but the company suspended sales the next October because of heightened concerns that patients could suffer from life-threatening blood clots. In December 2013, it relaunched with added warnings and to a smaller subset of patients.” National Public Radio notes that Congress’ brewing battle with Ariad will open another front in lawmakers’ battles with Big Pharma. Congress has had run ins already with the maker of the EpiPen over its soaring prices. Drug maker Valeant faced sharp congressional criticism in a hearing. And of course lawmakers publicly shamed the price profiteering, so-called “pharma bro” Martin Shkreli of Turing Pharmaceuticals.