Don’t you love the “Urban Dictionary.” Here’s one of their definitions for the word “junkie.”:
Rush Limbaugh is a junkie.
As long as we’re bringing politics into this, let’s add this definition:
Applies to a doctor who is addicted to drug industry money.
ProPublica just released a great investigative piece based on what they found in a new federal database created after the “federal government mandated that pharmaceutical and medical device manufacturers publicly report payments made to doctors and teaching hospitals,” in other words, an exploration of the “pusher/junkie” relationship between drug companies and physicians.
According to ProPublica's analysis of this database, “In the last five months of 2013, the companies spent nearly $19.4 million on doctors and teaching hospitals," and “the drugs most aggressively promoted to doctors typically aren't cures or even big medical breakthroughs” but rather are “newer drugs that manufacturers hope will gain a foothold, sometimes after failing to meet Wall Street's early expectations.”
"They may have some unique niche in the market, but they are fairly redundant with other therapies that are already available," said Dr. Joseph Ross, an associate professor of medicine and public health at Yale University School of Medicine. "Many of these, you could call me-too drugs."
In almost all cases, older, cheaper products are available to treat the same conditions.
(ProPublica created a tool that lets you look up any drug, device or company and compare it with any other.)
Notably, “largely absent from the top of the list were drugs that cure disease, such as a new class of hepatitis C treatments, or those that significantly extend life, particularly for cancer patients.”
[A] few of the most heavily promoted drugs, including Samsca, which treats low sodium levels in the blood, have serious side effects that came to light after their approval by the federal government. The manufacturers of several others, including Copaxone, Latuda, Xarelto, Daliresp and Humira, have been faulted by the F.D.A. for improper promotion.”
Subsys, approved in 2012 to treat cancer pain, ranked 23rd in spending on doctors. It's often prescribed for off-label, or unapproved, uses; in November, The New York Times reported that some of the doctors paid the most to promote the drug had disciplinary or legal troubles. In a statement to The Times, Insys Therapeutics, the drug's maker, said its marketing of Subsys was appropriate.
The medical device associated with the most payments to doctors was Intuitive Surgical's da Vinci surgical robot system, which the company has marketed as an effective, less invasive option for an array of procedures. Critics have complained that the device is needlessly expensive and overused, and say it has been linked to patient complications and deaths.
So what about the “junkie” in this relationship? Here’s how Intuitive works it: “half of the company's outlays for education and training were ‘pass through’ spending: Surgeons or hospitals paid the company for services, and the company, in turn, paid doctors to provide them.”
Dr. Robert Takla, an emergency room physician in the Detroit area, [who] earned about $75,000 in the last five months of 2013 by delivering promotional talks about several of the most heavily marketed anticoagulants and blood thinners, particularly Brilinta, according to Open Payments.…
He said he no longer spoke on behalf of [blood thinner] Pradaxa because of what he characterized as public backlash against it, driven by a spate of lawsuits against its manufacturer, Boehringer-Ingelheim. (The company agreed to pay $650 million last year to settle the suits.) He accepts fees to speak about Xarelto, a drug he has taken himself for a deep vein thrombosis.
"It's a very fertile and very robust marketplace right now," he said of the anticoagulants.
Music to an addict’s ears!