What would happen… IF… ?

It  is claimed that there are 10 MILLION ESI given to pts every year in this country and that an estimated 5% of the ESI’s will cause Arachnoiditis       

That is described as a VERY PAINFUL and IRREVERSIBLE disease state/condition.

One of the medications that is typically uses is Depo-Medrol which is a suspension of Methylprednisone – but some physicians may be using other corticosteroids that are in the same class as Depo-Medrol.

Both the FDA and Pfizer – who manufacturers the medication – has come out and strongly recommended that this medication NOT BE USED in ESI’s. Many other countries have BANNED these medications being used in ESI’s.

Recently the FDAFDA Warns Against Off-Label Use of Implantable Pain Pumps

The only opiate that is approved for use in implanted pain pumps is INFUMORPH (Morphine) and often pain docs use a pharmacy compounded cocktail in the implanted pump in their pts.  BECAUSE.. it is claimed that the pain clinic can purchase the compounded product for 10%-25% of the cost of the commercial product.

The question has to be asked … why does Medicare/Medicaid and other health insurance companies pay for these product(s) and procedure(s).

What is even more questionable is that it was recently reported that Medicare was going to increase the allowable – what is paid physicians – on providing ESI’s.

I have also read statements from chronic pain pts that have indicated that their pain clinic refuse to prescribe oral opiates to pt who do not want to have ESI procedures, especially those pts who have had them in the past and they have received little/no benefit and/or benefit was very short lived, less than what would be expected. Some suggest that this may be in violation of a part of the Sherman Antitrust Act called Tying Commerce   which basically states that forcing someone to purchase something they don’t want/need in order to be able to purchase something that they want/need.

So do we have three federal agencies (FDA, DOJ, HHS) with policies in conflict.

What would happen if some pro-pain group(s) petitioned the FDA to  BAN or declare the use of these medications in these particular applications as EXPERIMENTAL. No insurance company will pay for experimental medications.

Has anyone noticed that when the DEA charges a prescriber with inappropriate (medically unnecessary) prescribing of opiates… that they are also charged with Medicare fraud ?

If the FDA won’t act, then Congress is always talking about getting rid of Medicare fraud and abuse.. maybe talking to members of Congress to get these specific medications no longer being reimbursed… may be an option.

What has the chronic pain community got to lose ?

 

 

3 Responses

  1. I refuse to have surgery. At 68 it is dangerous to my health and there have been too many failures.

  2. I feel lucky that I got “moon face ” and no help from injection’s into my spine. I have a pump now for over six years. I now have fentanyal in it and it is awesome.

  3. Don’t you see the Sherman Antitrust Act is about as effective policing today’s corporate kleptocracy as Barney Fife patrolling a Richard Spencer rally?
    Today’s Trumpublicans are so heavily bought and paid for by soooo much dark corporate money (Thank You GOP 2010 SCOTUS 5-4 for Citizen’s United!) one cannot discern where exactly it comes from. B-U-T when the FTC (GOP majority) allows the unfathomable vertical integration of a CVS/CRK acquiring Aetna…IT AIN’T TOO HARD TO CONNECT THE DOTS!
    Should disband the FTC, send the money saved to bail out more farmers going bankrupt daily in the Midwest and soon-to-be 15,000 unemployed GM workers in the Rust Belt!!!

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