Pharma paid patient groups
Senator: Advocates acted as opioid ‘ cheerleaders’
WASHINGTON – The five biggest opioid manufacturers shelled out more than $ 10 million to patient advocacy groups, professional medical societies and affiliated individuals — who then “echoed and amplified” messages that encouraged use of those highly addictive drugs, which set the stage for the opioid epidemic.
That’s according to a Senate committee investigation, released Monday, that examined the financial ties between the pharmaceutical industry and outside groups from 2012 through 2017.
“I think these groups were cheerleaders too often ... cheerleaders for opioids,” said Sen. Claire McCaskill, D- Mo., who launched the investigation last spring. McCaskill is the ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee, a post she has used to investigate other drug company practices.
McCaskill’s staff sought information from the five largest opioid drugmakers, measured by global sales in 2015. Those companies are: Purdue Pharma, Janssen Pharmaceuticals, Mylan, Depomed and Insys Therapeutics.
Purdue was by far the largest donor to outside advocacy groups, which often bill themselves as grassroots organizations supporting patients struggling with chronic pain.
Among the recipients of drug company largesse: the U. S. Pain Foundation, the National Pain Foundation and the Academy of Integrative Pain Management.
McCaskill said some of these organizations do good work on public policy, but others are “totally dependent” on drug companies for their funding, which casts suspicion on their advocacy.
The report charges that many of the advocacy groups, buoyed by big pharma money, used “opioidsfriendly messaging” to undercut state and federal efforts to curb opioid prescribing.
The report notes, for example, that the American Academy of Pain Medicine and the American Pain Society promoted opioids as safe and effective for treating chronic pain and minimized the risk of addiction.
The report says the American Academy of Pain Medicine and the Center for Practical Bioethics spoke out against federal efforts to limit opioid prescribing. The Centers for Disease Control and Prevention issued guidance in 2016 to doctors on when to prescribe opioid pain medication in primary care settings. The CDC recommended offering nonopioid therapies for chronic pain except in cases of active cancer treatment, palliative care and end- of- life care.
Someof the groups and their funders said a public health crisis is being created by the response to the opioid epidemic because chronic pain patients have difficulty getting narcotics, which is often the only thing that can address their unremitting pain.
“There are serious moral questions on both sides,” said John Carney, executive director of the Center for Practical Bioethics in Kansas City, Mo. The opioid epidemic is “a national crisis, but there are lives ravaged by pain, and that’s a crisis, too, and should not be ignored.”
As states moved to restrict the length and frequency of opioid prescriptions, drug companies and the patient groups fought back with aggressive lobbying campaigns.
Purdue Pharma, the maker of Oxycontin, said in a statement that it supported groups through annual dues and “unrestricted grants” when they were “interested in helping patients receive appropriate care.”
Purdue said it supports the CDC’s guidance, recommending it to doctors since it was released. Starting Monday, Purdue’s employees will no longer visit doctors offices to pitch opioids, and it will cut its sales force by half to 200 people.
McCaskill called Purdue’s announcement “a major step forward,” but said the Senate report is “the tip of the iceberg” in terms of how drug company money shapes heath care policy debates and legislative outcomes.
She said she planned to pursue legislation thatwould force advocacy groups to disclose their funding sources.
The Senate report says the Academy of Integrative Pain Management and the American Cancer Society Cancer Action Network led an effort to protect a 2001 Tennessee law that made it difficult to discipline doctors for overprescribing opioids.
Bob Twillman, the academy’s executive director, said the law was more of “an imagined impediment than a real impediment,” and his group wanted to revise it rather than repeal it.
The opioid epidemic is “a national crisis, but there are lives ravaged by pain, and that’s a crisis, too, and should not be ignored.” John Carney, executive director of the Center for Practical Bioethics