Editorial: Country can’t afford moral, ethical faults of big pharma

From The Register-Herald of Beckley:

We have known for some time that the pharmaceutical industry in the United States, as demonstrated in one opioid drug distribution story after another – to say nothing of noxious pricing and marketing schemes – is morally and ethically bankrupt.

Now, with the release of a bombshell study and yet another tale of opioid drug marketing gone terribly awry, maybe – just maybe – Congress can demand far more rigid regulations and punitive penalties on Big Pharma so that our country can heal from what has truly become a national crisis.

For background, let’s review the statistics: Drug overdose deaths in 2016, according to the National Center for Health Statistics, continued to climb despite efforts to nurse the overdose epidemic.

Estimates of deaths for the first nine months of 2016 were higher than the first nine months of the previous year. In 2015, the country reached an all-time high of 52,404 drug overdose deaths. Of those, more than 33,000 were attributed to opioid drugs including legal prescription painkillers as well as illicit drugs like heroin and street fentanyl.

The rate of such deaths in the third quarter of 2015 was 16.7 for every 100,000 in population; this year, 19.9.

In West Virginia? The rate is more than double the national average, and in coal country, the bodies are piling up. In Wyoming County, the rate is 78 deaths per 100,000 people. Others include Raleigh at 56, Nicholas at 42, Monroe at 44, McDowell at 70, Fayette at 45 and Summers at 37.

So, yes, we have skin in this game.

Add on top of that a report last month in the American Journal of Preventative Medicine that found the number of drug overdoses involving opioids between 2008 and 2014 was underestimated – by about 24 percent.

Against this statistical backdrop comes a report from a Senate committee that details the actions of a major pharmaceutical company that misrepresented and lied about its powerful opioid product for profit, putting people at risk.


Plain and simple, an insatiable appetite for increased profit margins. In a word: greed – ticker symbol INSY.

Insys Therapeutics, which manufactures the fentanyl drug Subsys, misrepresented the product to get insurers to pay for it, according to the committee’s report. The company sold its product to people who didn’t need and shouldn’t have had access to such a powerful drug.

And then came the damning evidence. Caught on an audio recording, an Insys employee asked a pharmacy benefit manager to order Subsys for a patient who was suffering from back pain and fibromyalgia. This happened repeatedly. Subsys, by the way, was designed as a breakthrough treatment for pain associated with cancer – not back pain, not nerve pain.

Outcome? The patient died of a fentanyl overdose.

Insys was so hell-bent on pushing its pills that employees at its reimbursement center reportedly received financial incentives for pushing pills. Management added sales quotas and individual bonuses to boost sales – no matter the patient outcome.

If this sounds all too familiar, you might recall the dastardly tale of Purdue Pharmacy after it put OxyContin on the market in the mid-1990s, marketing its product as a long-term use for chronic pain.

Purdue, too, was caught in a lie, and as a result of its misleading claims, the company and several of its chief executives were ordered to pay more than $600 million in fines.

Meanwhile, the opioid drug overdose death rate began ticking upward. And, according to the most recent stats, it moves higher unabated.

In the world of professional sports, if players are caught cheating by using banned substances, they face suspension and, ultimately, expulsion. Entire university sports programs face the “death penalty” from the NCAA if their sins are egregious.

Maybe that is the route Congress could take with the likes of Insys and Purdue: If pharmaceutical companies break agreed upon ethical codes of conduct, off with their heads – shut them down. Entirely.

Medicine should benefit patients and society as a whole. And all patients have a name. The one who died of overdosing on Subsys? Her name was Sarah Fuller. And now she is a statistic – one of a record number of people, all with names, who have died from a drug overdose in the United States in a single year – this year.

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