Essential Updates: Comp Medical News February

Welcome to this month’s edition of Comp Medical News. Compound creams, Purdue testimony, and insurance coverage for opioids are your headlines for February 2019.

Annals of Internal Medicine: Pain Creams Have Little Chronic Pain Benefit

New research published in the Annals of Internal Medicine by Walter Reed National Military Medical Center and Johns Hopkins has found that custom pain creams did not perform better than placebo in a large study. According to Reuters, after one month, 36 percent of patients who used pain creams and 28 percent who got placebo creams reported less pain than they had at the start, a difference that was too small to rule out the possibility that it was due to chance.

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FDA Issues Statement on “Orange Book” to Foster Drug Competition

The FDA is touting its efforts to update and maintain the Approved Drug Products with Therapeutic Equivalence Evaluations Publication (also known as the Orange Book). This is a list of drug products approved by the FDA under the Federal Food, Drug, and Cosmetic Act that includes patent and exclusivity information and identifies whether a drug is currently being marketed or has been discontinued. The FDA says it is taking several steps to improve the Orange Book including new draft guidance.

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Racial and Income Disparities Affect Opioid Overdose Rates

A group of new studies published in JAMA Internal Medicine found that opioid prescribing rates and opioid overdose deaths vary due to racial and economic factors. A California study found that people in areas with the highest proportion of white people and lowest incomes had the highest average annual prevalence of opioid prescriptions (44.2 percent) from 2011 to 2015. By contrast, people in areas with the lowest proportion of white people and highest incomes had the lowest opioid prescription rate (16.1 percent.) A different study out of New York looked at racial differences in deadly overdoses. Among young people ages 15 to 34, heroin and/or fentanyl overdose deaths per 100,000 people were higher among non-Latino whites (22.2) than blacks (5.8) or Latinos (9.7). Among older people ages 55 to 84, however, heroin and/or fentanyl deaths were higher among blacks (25.4) than whites (9.4).

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Previously Sealed Testimony from OxyContin Maker Shows Attempts to Hide Epidemic

ProPublica and STAT released a series of reports based on sealed testimony it obtained regarding Purdue Pharma. The testimony is that of Dr. Richard Sackler, one of the owners of the privately held Purdue Pharma, the maker of OxyContin and one of the main companies targeted by a wealth of lawsuits from states and municipalities seeking damages for costs related to the opioid epidemic. According to ProPublica, in the 2015 testimony it is revealed that a Purdue executive told Sackler he did not want to correct the false belief among doctors that OxyContin was weaker than morphine, because the myth was boosting prescriptions. Sackler agreed to keep sales high. A decade later, Purdue admitted in federal court that is understated the addiction risk of OxyContin and and agreed to pay $600 million in fines and penalties.

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FDA Reveals Plan to Expand Buprenorphine Treatments for Opioid Addiction

FDA Commissioner Scott Gottlieb, M.D. released a statement on the agency’s efforts to expand buprenorphine treatments for addiction. “Our goal is to advance the development of new and better ways of treating opioid use disorder to help more Americans access successful treatments,” Gottlieb said. “Unfortunately, far too few people who are addicted to opioids are offered an adequate chance for treatment that uses medications. In part, this is because private insurance coverage for treatment with medications is often inadequate. Even among those who can access some sort of treatment, it’s often prohibitively difficult to access FDA-approved addiction medications.” The FDA issued a final guidance document to this end: “Opioid Use Disorder: Developing Buprenorphine Depot Products for Treatment,” which outlines the FDA’s current thinking about drug development and trial design issues relevant to the study of buprenorphine depot products.

Read more here.

Politico: Insurance Companies’ Reluctance to Pay for Alternatives to Opioids Prolongs Crisis

A new editorial published on Politico asks why insurance companies have been unwilling to cover alternative pain treatment modalities for chronic pain patients often treated with opioids. The author points out that though both federal and state regulations that curbed painkiller prescriptions, restricting supply has not helped the most vulnerable pain patients who can end up dependent on opioids.

Read more here.

Image Credit: WSHU

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