OPINION: Pharmaceutical fraud drives the opioid crisis

By Jayme Hykes*

In 2015, the National Institute on Drug Abuse estimated 2 million people in the United States suffered from “substance use disorder” related to prescribed pain relievers. Pharmaceutical companies introduced opioids to healthcare providers in the 1990s claiming they were nonaddictive. Since then, opioid addiction has become a well-known epidemic and has taken thousands of Americans’ lives. The problem is twofold: pharmaceutical fraud is relative to opioid distribution, and corrective action for those addicted is lacking. It is time for the United States to take action to stop the cycle of white-collar crimes in pharmaceutical corporations.

Pharmaceutical fraud has been thought to be the cause of the opioid epidemic. For example, recently in West Virginia Cardinal Health purportedly accidentally delivered millions of painkillers to the state with the highest opioid death rate and highest percentage of babies born with addiction. The opioid epidemic has devastated West Virginia – in a single day in 2017, Huntington witnessed 26 overdoses in less than four hours. Along with the high death rates from overdoses, West Virginia has a stretch of the interstate through the eastern panhandle known as “Heroin Highway.”

Pharmaceutical companies are using states like West Virginia to “pill dump” to increase their revenue, and continue to find different ways to accomplish this. One way is through “Average Wholesale Inflation.” This occurs when the average wholesale price for a specific drug is increased to receive a higher reimbursement from Medicare. This increase in reimbursement gives a higher “kickback” to the healthcare provider, which makes it more likely the healthcare provider will continue to buy the product from that pharmaceutical company. The more opioids doctors prescribe, the more money they make. To try to stop kickback fraud, the government established the Anti-kickback Statue and the Federal False Claims Act in 2010. However, a CNN news report from March 2018 revealed that in 2014 and 2015 opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting, and other services. This led to thousands of other doctors to be paid over $25,000 during this time frame.

With more attention being brought to the damage pharmaceutical fraudulence has caused with the opioid epidemic and their schemes to increase their revenue, government officials and federal programs are working together to try to put an end to this epidemic. One treatment that is being studied is an antidote for opioid addiction. This drug, buprenorphine, was patented by Richard Sackler. Sackler belongs to the family that owns Purdue Pharma, a multi-billion-dollar company responsible for the development of OxyContin. In 2007, the top three current and former employees from Purdue Pharma pleaded guilty to criminal charges for falsely leading doctors and their patients to believe OxyContin was less likely to be abused than other drugs in its class. To make up for damages caused, Richard Sackler patented buprenorphine, which is a mild opioid to help ease withdrawal symptoms. However, people are outraged that the same man who made billions for OxyContin will now make even more money for his opioid antidote.

West Virginia, in their mission to fight against the over prescription of opioids, established new data collections systems to improve their prescription drug monitoring program and eradicate prescription duplication. To try to decrease its overdose and death rates, West Virginia has also been fighting against the pharmaceutical industry by limiting the number of pharmacies people can use to get prescriptions refilled. The state has received a waiver to help fund treatment facilities and reimburse antidotes for opioid overdose, like naloxone.

Other steps that can help are treatment facilities for addiction, educational programs for patients and healthcare providers, and disposal facilities for unused opioids.  Many States have created treatment facilities with the help of the Trump Administration, which released $485 million dollars in grants to governors of all 50 states for evidence-based prevention and treatment activities. States are also taking action by better educating their healthcare professionals on opioid addiction, and how to appropriately prescribe them. Some states, like Ohio, have established more than 250 sites where people can dispose of unused and unwanted prescription drugs. This will help prevent opioids from falling into the wrong hands. We may not be able to stop large pharmaceutical companies upfront, but we can help cure and try to prevent further problems associated with opioid abuse.

In summary, it is important to have a comprehensive view of opioid and substance disorders and to develop corrective action as a nation. Fraudulence in pharmaceutical sales directly contributes to the public health emergency of the opioid epidemic. Pharmaceutical companies commit crimes such as price inflation and kickback fraud to increase their overall revenue and their profits. Even though it is almost impossible to fight against pharmaceutical companies and their extensive greed promotes this problem, the people and the country itself can implement treatment programs, educational resources, and ways to dispose of unused or unwanted prescription drugs. These tactics can help reduce the opioid epidemic and better educate the people on what effects opioids can cause.

*This opinion article fulfills a requirement of the AB honors program and is published as a courtesy of Battler Columns. The views expressed herein do not necessarily reflect the opinion of Battler Columns.

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