Welcome to this month’s Comp Medical News recap. Death from overwork, a new treatment for chronic low back pain, and the toll of under-exercising are your headlines for August 2016.
First, drug companies are in hot water for rapidly increasing wholesale prices of the generic opioid overdose reversal drug naloxone, and prescription labels generally are under scrutiny:
Naloxone Prices Rapidly Increase as Demand and Need for the Drug Grows
As the Obama administration continues to grapple with policy changes that could curb the rise in overdose deaths from prescription painkillers and heroin, some drug companies have hiked prices of the opioid “antidote” drug naloxone (AKA Narcan) by 20-1000 percent. According to the Los Angeles Times, the price increases and rising demand have caused overall sales of naloxone to nearly quadruple in the last four years, increasing to $81.9 million last year from $21.3 million in 2011.
In June, U.S. Senators Susan Collins (R-Maine) and Claire McCaskill (D-Montana) wrote to five drug makers, asking why they had increased prices for naloxone during a public health crisis. Companies responded by pointing to the need to invest in making the product easier to use and to maintain purity. They also cited donations of naloxone kits to various local law enforcement departments as evidence of their commitment to ending the opioid epidemic. One of the companies, Virginia-based Kaleo, introduced its naloxone auto injector in a package of two for $690 in 2014 – now, the price is $4,500 for the same product.
Read further coverage here.
Medication Purpose Labels Could be the “Sixth Patient Right”
Health professionals publishing in the New England Journal of Medicine have called for including the purpose of medications on prescription labels to inform patients and enhance safety. “Currently, even though there is a widespread commitment to sharing drug information with patients, the reason for a medication prescription is generally not recorded or shared when it is being written and is therefore missing a key piece of information,” wrote Gordon D. Schiff, MD, the lead author.
The piece argues that including a label describing the purpose of a prescription could encourage patients to take ownership of their own care, explaining that: “Beyond the ‘five rights’ for safe medication ordering and use—the right patient, right drug, right dose, right time and right route—a sixth element must be correct: the indication.
Read more via Pain Medicine News here.
Next, new technology could shake up the way two major issues are treated in workers’ comp – co-morbidities such as diabetes and low back pain:
Gene Testing Could Help Streamline Treatment for Injured Workers with Co-Morbid Conditions
In a guest post for WorkCompWire, Nancy Grover, previously Program Chair of the National Workers’ Compensation and Disability Conference & Expo, and Editor of Workers’ Compensation Report, writes about the promising return on investment workers’ comp payers can potentially expect from pharmacogenetic testing (PGT). According to Grover, “one growing area of interest is in genetic tests that can identify injured workers most at risk for addiction and abuse.” However, predictive performance in clinical settings is not yet at a level where such use can be widespread. On the other hand, genetic testing for drug response is much more reliable.
Grover explains: “Injured workers with preexisting conditions and/or those that develop comorbid conditions post-injury may especially benefit from PGT, as they may be receiving multiple medications that could potentially elevate their risk for drug-drug and gene-drug interactions.” PGT information could also help the clinician better understand whether drugs prescribed for comorbid conditions will be effective or if the patient has certain genes that predispose them to metabolize opioids faster or slower than the average person.
Read the article in full here.
FDA Approves Nerve Ablation System for Low Back Pain Tx
The FDA has granted clearance for the Intracept Intraosseous Nerve Ablation System (from Relievant Medsystems). According to the company, the Intracept system is the first specific therapy to relieve chronic low back pain (LBP) of at least six months duration and caused by changes associated with degeneration of spinal vertebral bodies and the associated intervertebral disks, that has not responded to six months or more of conservative care. The system uses “specially designed instruments” to deliver radiofrequency energy to the basivertebral nerve (BVN). The BVN is a sensory nerve within each vertebral body that transmits the sharp, aching or throbbing pain experienced with spine degeneration. Spine specialists can use the Intracept system to treat one or more levels between L3 and S1 in the lower spine.
Read more here.
Lastly, excessive time on the job and lack of exercise plague workers around the world and drive up health costs:
Japan Tries to Increase Awareness to Reduce Karoshi, or “Death by Overwork”
The length of the average work day continues to increase around the world even as wages have remained stagnant, a problem that is particularly visible in Japan, where suicide and exhaustion deaths from overwork are a cultural phenomenon. As the Washington Post reports, since the 70s, Japan has had a working culture where spending long hours at the office, or in compulsory socializing with superiors after work, is the norm. Twelve hour work days are incredibly common there, even as the global economy has tanked in the 2000s and the “sharing economy” has created a legion of temporary workers to fill jobs previously occupied by stable (and benefit eligible) employees.
The relentless schedule has led to karoshi – either from a fatal heart attack or stroke, or a suicide triggered by overwork – which is now a recognized cause of death in the country. Once a death is classified as karoshi, a victim’s family is automatically entitled to workers’ compensation-like benefits. The number of claims for karoshi-related cases rose to a record high of 2,310 in the past year. However, experts estimate that less than a third of applications are successful, which also results in underreporting of karoshi.
Read further coverage here.
Lack of Exercise Kills Five Million Per Year and Costs the World $67.5 Billion
A study of one million people has found that physical inactivity costs the global economy $67.5 billion a year in healthcare and productivity losses, but an hour a day of exercise could eliminate most of that. Researchers explained that sedentary lifestyles are linked to increased risks of heart disease, diabetes and cancer, but simple activities like walking could counter the higher mortality risk linked with sitting for eight or more hours a day.
At a briefing in London, the international team of researchers warned there has been too little progress in tackling a “pandemic of physical inactivity” and one even said that current World Health Organization (WHO) recommendations (150 minutes per week) were insufficient. The $67.5 billion global cost estimate was derived from five major diseases caused at least in part by lack of exercise – heart disease, stroke, diabetes, breast cancer and colon cancer.
Read more from Reuters here.
Image Credit: The Med Circle