Tuesday, Sen. Bernie Sanders (I-Vermont) issued a report slamming the U.S. prices of drugs and executive pay of three major drug manufacturers—Johnson & Johnson (J&J), Merck, and Bristol Myers Squibb—just before a Feb. 8 hearing.

Thursday the CEO’s of all three drug manufacturers had to appear before a hearing to be grilled by Sanders, prepared by staff associated with the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP Committee). The New York Times reports that they testified on their behalf Feb. 8, telling their side of the story.

Americans, hands down, pay the most for life-saving drugs compared to other countries, the senator’s report summarized. In some cases, Americans are paying nearly 10 times the price as what Germans pay. Sanders’ detailed report outlines how the three companies are spending more on executive pay and stock buybacks than drug research and development (R&D).

“The United States pays, by far, the highest prices in the world for prescription drugs,” the report reads, written by staff and headed by Sanders as Chair. “At a time when one out of four Americans cannot afford the medicine their doctors prescribe, ten large pharmaceutical companies made over $112 billion in profits in 2022 while paying their chief executives exorbitant compensation packages and spending billions of dollars on stock buybacks and dividends to make their wealthy stockholders even richer.”

If you’re an American on the life-saving cancer drug Keytruda, you’re paying more than twice the amount that citizens in Germany—a highly industrialized nation—pay out of pocket. Merck began selling Keytruda in 2015 at an annual cost of $147,000 in the U.S. and $132,000 in Germany. 

Keytruda now costs $89,000 annually in Germany, but $191,000 in the U.S. In Japan, Ketruda costs $44,000 annually, which is less than one-fourth of what Americans pay. The drug Eliquis, which prevents strokes, costs $770 annually in Germany but $7,100 in the U.S.—nearly 10 times as much.

“The current industry business model is based on ripping off the American people,” the report reads. “For some of their most popular drugs, Johnson & Johnson, Merck, and Bristol Myers Squibb made more money in the U.S. than the rest of the world combined.

Report’s Key Findings

The report includes a few key findings: In 2022, Johnson & Johnson made $17.9 billion in profits and its CEO received $27.6 million in compensation. J&J spent $17.8 billion that same year on stock buybacks, dividends, and executive compensation, compared to just $14.6 billion on R&D). 

“In other words, the company spent $3.2 billion more enriching executives and stockholders than finding new cures,” the report reads. 

In 2022, Bristol Myers Squibb made $6.3 billion in profits and its former CEO made $41.4 million in compensation. Bristol Myers Squibb spent $12.7 billion the same year on stock buybacks, dividends, and executive compensation, compared to just $9.5 billion on R&D. “Just like Johnson & Johnson, Bristol Myers Squibb spent $3.2 billion more enriching executives and stockholders than finding new cures,” the report reads. 

In 2022, Merck made $14.5 billion in profits and its CEO made $52.5 million in compensation. That year, the company spent over $7 billion on dividends and executive compensation, and $13.6 billion on R&D. 

“If Merck’s cancer drug Keytruda was its own company, its 2022 sales would rival McDonald’s annual revenue, and exceed the revenue of the hotel chain Marriott,” it reads.

Other Attempts to Limit Drug Manufacturers

Senators have introduced bills to hold pharmaceutical drug companies accountable for pricing as well as other related practices.

One angle to lower the cost of drugs has been bills that aim to reduce the cost incentive for pharmacy benefit managers (PBMs) to prioritize more expensive drugs because they receive higher payouts for higher priced drugs.

In September 2023 Senate Finance Committee Chair Ron Wyden, (D-Oregon), and Ranking Member Mike Crapo, (R-Idaho) introduced the Modernizing and Ensuring PBM Accountability (MEPA) Act, a bill to brings more transparency, accountability and competition to pharmacy benefit manager practices in the pharmaceutical supply .

Sen. Menendez (D-New Jersey), a senior member of the U.S. Senate Committee on Finance, said the Modernizing and Ensuring PBM Accountability (MEPA) Act includes his own inclusion, the Patients Before Middlemen (PBM) Act.

HIV drugmaker Gilead Sciences was slammed for its PBM Express Scripts because it jacked up the prices of its lifesaving hepatitis C cures Sovaldi and Harvoni. But Gilead later changed its tune and joined a chorus of drugmakers—turning on PBMs.

With the committee hearing Thursday, Sen. Bernie hopes to hold accountable the companies spending the least on drug development and the most on executive kickbacks.

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The DEA has rescinded a 2023 directive which previously ordered a pharmaceutical company to shutter operations after they were found to have helped perpetuate the nationwide opioid crisis.

Morris & Dickson, a multi-billion dollar Big Pharma giant which has been in business since 1841 will be permitted to continue selling drugs to Americans as per the result of a settlement reached with the DEA on Wednesday. This comes just under a year after the pharmaceutical wholesaler had their license revoked for continuing to produce and distribute suspicious shipments of controlled substances for years after a judge recommended their license be revoked for “cavalier disregard” of controlled substance laws. They also failed to report thousands of shipments of hydrocodone and oxycodone to the DEA. 

“Of all the cases I handled as an administrative law judge for the DEA, Morris & Dickson’s violations were the most blatant and egregious,” Judge Charles Dorman told the Associated Press. “In addition, I saw no real acceptance of responsibility for their violations.”

According to the DEA, Morris & Dickson will pay a $19 million fine and submit to heightened reporting requirements for five years as well as forfeit one of their two DEA Certificates of Registration, but they will be permitted to continue producing controlled substances from schedule two to five of the Controlled Substances Act. They also admitted all wrongdoing for their past actions.

“Drug distributors like Morris & Dickson have a responsibility to protect the safety and health of customers and maintain effective controls against diversion of highly addictive controlled substances. At the height of the opioid crisis, Morris & Dickson failed to uphold that responsibility, and turned a blind eye as thousands of unusually large orders for hydrocodone and oxycodone went out the door,” said DEA spokesperson Katherine Pfaff. “Today, Morris & Dickson takes an important first step by admitting wrongdoing and paying for its misconduct, and today’s settlement will ensure that such irresponsible practices will not continue in the future.”

Morris and Dickson’s legal wrongdoing came to light as the result of an Associated Press investigation in 2023 which not only found that the nation’s fourth largest drug distributor was playing it fast and loose with dangerous opioids, but also that the four-year delay in DEA action may have been the result of the so-to-speak “revolving door” between public entities and private companies which can lead to biased decision making at the government level.

In the case of Morris and Dickson one such DEA employee, Louis Milione, spent 21 years working with the DEA in the Office of Diversion Control before retiring in 2017. After that, the Associated Press found that Milione became a consultant for the companies he was previously a regulator of, including Morris and Dickson, who hired him on a $3 million contract to essentially save their ability to produce and supply painkillers after the DEA accused the company of turning a blind eye to large suspicious orders of opioids. 

Milione advocated for Morris & Dickson in court to little or no avail as the judge presiding over the case wrote a long scathing 159-page report recommending Morris and Dickson have their license revoked. According to the Associated Press, it was not until four years later when the AP asked the DEA to comment on their investigation into Morris and Dickson that the DEA finally followed through on what the judge recommended and revoked their license, only to reinstate it with this recent order less than a year later.

“If the DEA had issued its order in a timely manner, one could then credibly believe that its second-in-command was not involved despite an obvious conflict of interest,” said Craig Holman, an ethics expert at the watchdog group Public Citizen in Washington to the Associated Press in 2023. “The mere fact that its action has been delayed four years just raises red flags. It casts the entire process under grave suspicion.”

Morris & Dickson released a brief statement on their website regarding the DEA’s decision to reverse the original license revocation, choosing to give a very general thank you to the DEA rather than going into specifics about the case.

“Morris & Dickson wants to thank the DEA for their recognition of our extensive efforts over the past five years to expand and improve our compliance system for suspicious order monitoring. We appreciate the DEA’s collaboration with us on our shared commitment to patient safety, and we are pleased that the DEA’s actions acknowledge both our current state-of-the-art compliance program and our commitment to continued enhancements into the future,” Morris & Dickson said.

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The U.S. Food and Drug Administration last week announced the voluntary recall of a medicine used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy after the manufacturer of the drug revealed that the wrong pills were found in packages of the medication. The recall covers one lot of the drug Zenzedi, an ADHD and narcolepsy medication manufactured by Massachusetts-based Azurity Pharmaceuticals.

In a notice about the recall, the FDA noted that a pharmacist had reported finding pills of an antihistamine, carbinoxamine maleate, in a package of Zenzedi. The voluntary recall was announced by Azurity on January 24 and covers packages of Zenzedi 30 milligram tablets with lot number F230169A and an expiration date of June 2025.

The recalled medication was distributed nationwide through retail pharmacies. Pharmacies and drug wholesalers have reportedly pulled the drug from their shelves to comply with the recall. Customers who purchased packages of the recalled lot of Zenzedi are urged to return any remaining pills to the place of purchase. Patients who take the mislabeled medication and have adverse reactions are encouraged to see their doctor. 

Drugs Have Opposite Effects

The two drugs have opposite effects when taken, according to a report from CBS News. Carbinoxamine maleate is an antihistamine that is used to treat allergies and has a sedative effect on some patients, while Zenzedi, a brand name for the drug dextroamphetamine sulfate,  is a stimulant that generally increases a patient’s attentiveness. Zenzedi is used to treat narcolepsy, a sleep disorder that causes overwhelming daytime drowsiness, and ADHD.

The FDA added that patients who take carbinoxamine maleate instead of Zenzedi will experience undertreatment of their symptoms. Patients can also have a potentially deadly elevated risk of accidents or injuries and may have drowsiness, increased eye pressure, urinary obstruction and thyroid disorder, among other symptoms, according to the FDA’s recall notice.                                           

“Patients who take carbinoxamine instead of Zenzedi® will experience undertreatment of their symptoms, which may result in functional impairment and an increased risk of accidents or injury,” the FDA wrote in a notice about the recall. “Patients who unknowingly consume carbinoxamine could experience adverse events which include, but are not limited to, drowsiness, sleepiness, central nervous system (CNS) depression, increased eye pressure, enlarged prostate urinary obstruction, and thyroid disorder.”

Azurity Pharmaceuticals sent recall notification letters to drug wholesalers on January 4 via an overnight letter and has arranged for the return of all affected product at the wholesale level. The company said that no reports of serious injury have been made as a result of the mixup.   

Recall Comes During Shortage of ADHD Meds

The Zenzedi recall comes in the midst of a nationwide shortage of medications used to treat ADHD. The shortage has been affecting supplies of the drug Adderall since a manufacturer experienced production delays in Fall 2022, according to a report from CNN.

At least 11 manufacturers of Adderall or generic versions of the drug were listed on the FDA’s shortage list in September 2023. The shortage of ADHD medication has left many patients struggling to fill their prescriptions, according to healthcare professionals. 

“A lot of the young people that I’ve been treating have had difficulties getting their medications month to month,” Dr. Warren Ng, a professor of psychiatry at Columbia University Medical Center who also serves as president for the American Academy of Child and Adolescent Psychiatry, told CNN.

When taking their prescribed medication, many patients with ADHD are able to function better. But when they run out of their medication, it can have a tremendous impact on their self-esteem.

“I’ve seen kids who want to drop out of school, don’t want to continue with their educational path or drop out of college suddenly making the honor roll,” Ng said. And “instead of seeing, being seen as being lazy or dumb or slow, they can envision themselves really utilizing all of their mental, psychological and intellectual abilities to really see themselves for who they are, which is so much more.”

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It’s time for Big Pharma companies that were caught lying to the public to pay up. 

A new report compiled by ConsumerShield suggests the past decade was defined by record-high settlements and penalties in the pharmaceuticals sector, totalling over $80 billion in fines and penalties.

ConsumerShield’s report, “The Pharmaceutical Industry: Balancing Profits, Penalties, and Public Safety,” was published on Oct. 17, and it shows that the lion’s share of violations involve synthetic opioids that clearly cause dependence and are powerful enough to stop breathing.

London Loves Business reports that the study shows that since 2010, the pharmaceutical industry has incurred $82.8 billion in penalties during over 500 instances of recorded violations due to drug and medical device safety non-observance, unapproved promotion of medical products, breaches of the False Claims Act, and other violations.

The biggest culprit—Johnson & Johnson—clocked in with over 45 violation records during the study period, leading to a total of  $24.5 billion in penalties. Johnson & Johnson paid $18 billion USD in penalties over the past five years in opioid and talc cases alone. Next is Teva Pharmaceuticals with penalties of $8.5 billion, AbbVie with penalties of $7.1 billion, GSK plc with penalties of $5.6 billion, and Pfizer with penalties of $3.2 billion.

The report also lists significant settlements, with one case standing out: the Purdue Pharma case, resulting in an order to pay $8.3 billion. On Oct. 21, 2020, the Department of Justice announced a massive fine culminating its criminal and civil investigations into the opioid manufacturer Purdue Pharma, and a civil resolution of its civil investigation into individual shareholders from the Sackler family.  

Purdue and the Sacklers continued to market OxyContin and opioid products to over 100 health care providers despite the company knowing there was good reason to believe they were diverting opioids and reporting misleading information to the DEA to boost Purdue’s manufacturing quotas. 

Hundreds of thousands of people overdosed and died in the process. Nearly 88% of opioid-involved overdose deaths involved synthetic opioids, and opioids were the cause of 80,411 overdose deaths in 2021—75.4% of all drug overdose deaths, the CDC reported in 2021 when overdoses peaked. Compare that to heroin overdoses, which caused just 9,000 overdoses in 2021 unless they were mixed with opioids. Almost ten times more OD’d on synthetic opioids.

“The abuse and diversion of prescription opioids has contributed to a national tragedy of addiction and deaths, in addition to those caused by illicit street opioids,” said Deputy Attorney General Jeffrey A. Rosen.  “With criminal guilty pleas, a federal settlement of more than $8 billion, and the dissolution of a company and repurposing its assets entirely for the public’s benefit, the resolution in today’s announcement re-affirms that the Department of Justice will not relent in its multi-pronged efforts to combat the opioids crisis.”

Most of us know about the ravages of the opioid epidemic, but what’s the deal with talc? Pharmaceuticals can kill you in other ways. Talcum powder lawsuits claim consumers were diagnosed with cancer after using talc-based Johnson & Johnson baby powder.

A Solemn Warning

The ConsumerShield report kicks off with a solemn warning:

“It is with a sense of urgency and responsibility that we delve deep into the prevailing paradigms of the pharma industry,” the report reads. “Our investigation is geared towards understanding whether the soaring profits are inadvertently overshadowing the paramount need for consumer safety, ethical promotions, and pioneering research initiatives.

“The stark discrepancy between R&D investments and marketing expenditures, coupled with the persistence of unethical practices despite soaring penalties, necessitates a comprehensive examination of the industry’s commitment to ethical practices and consumer well-being.”

ConsumerShield representatives say that what the data shows is disturbing.

“The juxtaposition of soaring revenues and escalating penalties is alarming,” ConsumerShield Senior Analyst Jane Doe told London Loves Business. “But what’s even more disturbing is the obvious disparity between companies’ spending on research and development (R&D) and their enormous marketing budgets.”

The False Claims Act is the federal government’s primary litigation tool in combating fraud against the government, and part of that includes consumer protections.

“Pharmaceutical companies that have engaged in illegal off-label marketing or promotion of their drugs have paid the Government hundreds of millions of dollars as a result of Federal False Claims Act cases, often times brought by pharmaceutical sales representatives, sales managers, compliance officers, other pharmaceutical company employees, physicians, nurses and/or employees of hospitals or physician practices,” the False Claims Act Pharmaceutical Fraud summary reads.

The report shows the repercussions of marketing opioids despite receiving warnings about its enormous deadly impact, notwithstanding the people who actually need opioids to deal with high levels of pain.

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The biggest manufacturer of Adderall will not be increasing production to address national shortages of ADHD medication, despite a call from the U.S. government for drug makers to do exactly that.

Teva Pharmaceuticals Chief Executive Officer Richard Francis told Bloomberg that they are operating at “full capacity” at the moment and blamed their decreased output in previous years to COVID-induced work shortages which they have only just barely recovered from. Should they wish to increase the amount of Adderall they produce, they would have to buy or build more factories as their current infrastructure cannot handle bigger output. The company has declined to comment on whether or not they plan to invest in such infrastructure.

The pharmaceutical giant valued at just under $11 billion manufactured about 565 million Adderall tablets in 2021 but that was not enough, even with all the other producers in the market, to supply an exponential growth in national demand for ADHD medication or to address what drug makers have alleged are shortages in the materials needed to synthesize such medications. 

The Adderall shortage began in Fall of 2022, marked by an FDA notice acknowledging the shortages with an estimate that things would be resolved in a month or two. That is not the case, however, as issued a joint notice on August 1 acknowledging that the shortage had been “understandably frustrating” for patients and providers.

“The current shortage of stimulant medications is the result of many factors. It began last fall due to a manufacturing delay experienced by one drug maker,” the joint notice said. “While this delay has since resolved, we are continuing to experience its effects in combination with record-high prescription rates of stimulant medications. Data show that, from 2012 to 2021, overall dispensing of stimulants (including amphetamine products and other stimulants) increased by 45.5 percent in the United States.” 

The joint notice did not give any kind of an estimated date this issue is expected to be resolved by, but instead urged drug makers to increase production to meet their allotted limits for production of a controlled substance. In fact, by the estimate provided, drug manufacturer’s only sold 70% of their collective allotment for these particular types of medications, which by the government’s own estimate equated to about a billion doses that did not get produced or sold.

“We (DEA and the FDA) have called on manufacturers to confirm they are working to increase production to meet their allotted quota amount,” the joint notice said. “If any individual manufacturer does not wish to increase production, we have asked that manufacturer to relinquish their remaining 2023 quota allotment. This would allow DEA to redistribute that allotment to manufacturers that will increase production. DEA is also committed to reviewing and improving our quota process.”

The American Society of Health-System Pharmacists also reported last week that 141 different doses or formulations of ADHD medications were in short supply. The shortage was originally isolated to Adderall but as buyers and patients alike sought alternatives, supply of competing drugs like Vyvanse and Ritalin quickly dwindled. The ASHSP also indicated there were no estimated times for the majority of the shortages to be resolved, other than a short list of select medications produced by Sandoz Pharmaceuticals which are estimated to be back in stock sometime around mid-October.

No matter the cause, the shortages don’t appear to be going away anytime soon, especially with Teva unable to produce more than they currently are. Patients everywhere have reported issues refilling their prescriptions. A friend of mine told me she often ends up getting charged extra (double or triple the usual amount) for out-of-network pharmacies and extra doctor visits because pharmacies either don’t have the medication in stock or refuse to fill prescriptions for controlled substances. This process often delays access to medication that, without getting too redundant, is very unpleasant to go without when you have to take it regularly.

“We are calling on key stakeholders, including manufacturers, distributors, pharmacies, and payors, to do all they can to ensure access for patients when a medication is appropriately prescribed,” the FDA/DEA joint notice said. “We want to make sure those who need stimulant medications have access. However, it is also an appropriate time to take a closer look at how we can best ensure these drugs are being prescribed thoughtfully and responsibly.”

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Built-in structures to incentivize jacking up drug prices in pharmacies, and prey on seniors, could soon be whittled down.

Sens. Maggie Hassan (D-NH) and Bob Menendez (D-N.J.) were among those who voted Wednesday to advance a bipartisan bill she personally helped develop to reduce the rocketing cost of prescription drugs and the way pharmacy managers benefit from rising drug prices. 

The Modernizing and Ensuring PBM Accountability (MEPA) Act, which passed the Finance Committee July 26 on a bipartisan basis, reduces the cost incentive for pharmacy benefit managers (PBMs) to prioritize more expensive drugs because they receive higher payouts for higher priced drugs.

Drugmakers say that the rising rebates they must pay PBMs are forcing them to jack up prescription drug prices. According to a recent analysis, drugmaker rebates to PBMs increased from $39.7 billion in 2012 to $89.5 billion in 2016, partially offsetting list prescription drug price increases. PBMs say, however, that they have been passing along a larger share of the money to insurers.

“Last year, we took on Big Pharma by giving Medicare the ability to negotiate drug prices, and we must continue to stand up to the health care industry and help people afford the medications that they need,” said Senator Hassan. “This bipartisan legislation will ensure that pharmacy benefit managers don’t push people to more expensive drugs just so that they can get a larger payout, saving seniors their hard-earned money while also saving taxpayer dollars.”

HIV drugmaker Gilead Sciences was slammed for its PBM Express Scripts because it jacked up the prices of its lifesaving hepatitis C cures Sovaldi and Harvoni. But Gilead later changed its tune and joined a chorus of drugmakers—turning on PBMs. “I have never met, in this entire experience, a PBM or a payer outside of the Medicaid segment that preferred a price of $50,000 over $75,000 and a rebate back to them,” Jim Meyers, executive VP of worldwide commercial operations for Gilead told Bloomberg in 2017. “We have a system that’s incentivized upon rebate revenue.”

What Would Change Under The Modernizing and Ensuring PBM Accountability Act

The bill would lower prescription drug costs and is estimated to save $1.7 billion in taxpayer dollars. It makes a few adjustments to common PBM practices and transparency requirements under Medicare Part D, which the Senator outlined as follows:

• PBMs often prioritize coverage of more expensive drugs because part of their compensation is calculated through the list prices of drugs. This legislation will break the link between drug prices and how much pharmacy benefit managers are paid, so there is no longer a financial incentive for these companies to push patients to buy more expensive medication.
• This legislation will ban the practice of “spread pricing” in Medicaid, in which pharmacy benefit managers negotiate a lower price with a pharmacy but charge a higher price to the health plan, pocketing the difference.
• The legislation also includes a bipartisan measure that Senator Hassan led to ensure that pharmacy benefit managers report transparently on how they price low-cost generics and biosimilar medications, allowing more visibility into whether people can easily access these generics.

Sen. Menendez (D-N.J.), a senior member of the U.S. Senate Committee on Finance, said the Modernizing and Ensuring PBM Accountability (MEPA) Act includes his own inclusion, the Patients Before Middlemen (PBM) Act, joined by Marsha Blackburn (R-TN), alongside Senate Finance Chairman Ron Wyden (D-OR), Senate Finance Ranking Member Mike Crapo (R-ID), Sen. Jon Tester (D-MN), and Sen. Roger Marshall (R-KS).

“For too long, PBMs have held a vise grip over the prescription drug supply chain—price gouging hardworking families and seniors alike. Through the current incentive structure, whereby they turn a profit as a percentage of the list price of a prescription, PBMs wield their influence to have health insurers cover more and more expensive drugs—even when cheaper options are available,” said Sen. Menendez. “My Patients Before Middlemen Act, which I’ve introduced alongside Senators Blackburn, Wyden, Crapo, Marshall, and Tester, would replace the complicated scheme of opaque rebates and administrative charges with a flat fee—one that is negotiated before entering into a contract. By delinking PBM compensation from drug prices, we help lower prescription drug costs for Medicare Part D beneficiaries and better align incentives in the market. Our bipartisan Patients Before Middlemen (“PBM”) Act would curb the biggest abuses in the PBM industry today.”

Multiple factors impact skyrocketing drug prices—and when it’s a lifesaving drug, people will pay anything. Between 2007 and 2018, the cost of some insulin products increased by over 200%, according to a study published in 2022 in The Lancet. Most famously, “Pharma Bro” Martin Shkreli jacked up the price of lifesaving antiparasitic medication Daraprim, for people with HIV, in 2015 by 4000%. He also allegedly created an elaborate scheme to deny the entry of generic drug competition from getting a piece of the pie.

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Members of the Sackler family–the wealthy owners behind Purdue Pharma and OxyContin—paid upwards of $19 million in donations to The National Academies of Sciences, Engineering and Medicine, a powerful institution that advises U.S. opioid policy, according to a bombshell report by The New York Times.

The Times outlined a series of events that pose a possible conflict of interest. Dr. Raymond Sackler, his wife, Beverly, and the couple’s foundation started donating large sums of money to the Academies in 2008, according to treasurer reports. They died in 2017 and 2019, respectively. Dame Jillian Sackler also made millions of dollars’ worth of donations to the Academies beginning in 2000. The Academies invested the funds, growing to over $31 million by the end of 2021.

The allegations continue: The Pain Care Forum, a group co-founded by Burt Rosen, the Purdue lobbyist at the time, pushed for legislation introduced in 2007 and 2009 that included plans calling for an Academies report to “increase the recognition of pain as a significant public health problem.”

If the allegations are true, they present a serious conflict of interest. So the Times called upon Michael Rehn Von Korff—a medical researcher who studies the treatment of chronic pain, among other fields, for insight on the matter.

“I didn’t know they were taking private money,” Von Korff told The New York Times. “It sounds like insanity to take money from principals of drug companies and then do reports related to opioids. I am really shocked.”

Last Prisoner Project founder Steve DeAngelo posted the report on Instagram and called the revelations “disgusting.” Medical cannabis is frequently used as an alternative to opioids for some situations.

The Role of OxyContin in the Opioid Crisis

OxyContin was developed and patented in 1996 by Purdue Pharma L.P. and was originally available in multiple doses, the U.S. Department of Justice notes. At first, it appeared that OxyContin revolutionized medicine, but then the opioid epidemic unfolded. 

According to the U.S. Department of Health & Human Services, (HHS) over 760,000 people have died since 1999 from a drug overdose, with nearly 75% of drug overdose deaths in 2020 involving an opioid. The Centers for Disease Control and Prevention reports that the number of drug overdose deaths “quintupled since 1999.”

A 2011 The National Academies of Sciences, Engineering and Medicine report claims that 100 million Americans suffered from chronic pain—one-third of the entire U.S. population—and while that’s often cited by government organizations, now that number is being challenged as preposterous. That report influenced the U.S. Food and Drug Administration to approve at least one powerful opioid, Zohydro, which is a slow release hydrocodone.

In 2016, just months after the National Academies scooped up a $10 million Sackler family donation, the F.D.A. asked the institution to form a committee to create new recommendations on opioids. But the Academies were blamed for having sketchy ties to opioid makers, including Purdue Pharma. Four people were removed from the panel after that incident.

The National Academies of Sciences, Engineering and Medicine was created by Abraham Lincoln, and U.S. laws are shaped by the data it releases. For the past few decades though, the academy was utilized to combat the American opioid crisis.

The opioid crisis is complex and it’s difficult to distinguish between people who are addicted and people who genuinely have high levels of pain. But the overdose death toll is impossible to ignore as it surpasses death toll numbers from war and sickness. In 2017, the HHS declared the opioid crisis a public health emergency.

There is also another side to the story. Megan Lowry from the National Academies told The New York Times that the Sackler donations “were never used to support any advisory activities on the use of opioids or on efforts to counter the opioid crisis,” and that they are prevented from returning the Sackler donations because of legal restrictions.

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“He was already a billionaire when this started, and this made him even richer,” said Assistant U.S. Attorney Nathaniel Yeager at big pharma drug dealer John Kapoor’s trial. On Thursday, the Insys Therapeutics founder saw the price of that greed. After pleading not guilty, Kapoor was convicted of orchestrating a criminal conspiracy and sentenced to five and a half years in jail. 

To date, pharmaceutical industry-encouraged, elevated rates of opioid abuse have claimed some 400,000 lives in the United States. In 2017, 68 percent of the 70,000 people who died from a drug overdose perished from opioid abuse.

76 year old Kapoor was the CEO of an Arizona drug company that sold Subsys, an oral fentanyl spray. The drug is every bit as addictive as it sounds. Executives were proven to have been aware of the disastrous effects the spray was taking on patients. But as court documents show, from 2012 to 2015 they employed underhanded techniques to convince doctors to prescribe the drug at high levels, and were unafraid to use bribes, sexual attention, and outright deceit to get the job done. 

The Insys executives were tried under the Racketeer Influenced and Corrupt Organizations Act [RICO], which rarely has been wielded against kingpins in supposedly legal industries. Many of those tried under RICO have been cartel or mob bosses. 

Seven others from the company found themselves named as defendants, and all were sentenced to jail time. Michael Gurry, former vice president and Richard Simon, national director of sales, each got 33 months. Former CEO Michael Babich got 30 months. Regional sales director Joseph Rowan was sentenced to 27 months. Alec Burlakoff, vice president of sales, received 26 months. Sunrise Lee, regional sales director, was sentenced to serve a year and a day.

But prosecutors had asked for much longer sentences — in Kapoor’s case, 15 years. The mother of a woman who overdosed on Subsys was incensed by what she saw as the Insys executives getting off easily compared to the weight of their crimes. 

“They all got away with murder because that’s exactly what they did because it’s more than Sarah that died from it,” said Deb Fuller, who attended Kapoor’s sentencing at a Boston courthouse. Fuller testified during the trial that her daughter’s death had left her family in “constant, agonizing grief.” 

Big Pharma Pushers Held Accountable

Some hope that the court’s precedence of jail time for executives responsible for the deaths of the opiate crisis will mean other offenders are brought to justice. 

“I think this is just the tip of the iceberg,” former federal prosecutor Brad Bailey told NPR. “It’s a template that prosecutors will continue to use.”

US Attorney Andrew E. Lelling shared that sentiment in a written statement he released in response to the sentencing; “Just as we would street-level drug dealers, we will hold pharmaceutical executives responsible for fueling the opioid epidemic by recklessly and illegally distributing these drugs, especially while conspiring to commit racketeering along the way.”

That may not be enough to get back all the lives lost to the opiate crisis, but it’s a good step towards holding some of the nastiest high level criminals in our society accountable.

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