Should health insurance companies be FOR-PROFIT ?

Posted on November 17, 2016 by Pharmaciststeve

UnitedHealth Hit Again in Drug Price Litigation Wave

http://www.bna.com/unitedhealth-hit-again-n57982082861/

By Jacklyn Wille

Nov. 16 — UnitedHealth Group is once again in the crosshairs of a lawsuit by a health plan participant who claims she was secretly overcharged for prescription drugs ( Fellgren v. UnitedHealth Group Inc. , D. Minn., No. 0:16-cv-03914, complaint filed 11/15/16 ).

The newest lawsuit, filed Nov. 15 as a proposed class action, attacks the insurer’s relationship with its pharmacy benefit manager, OptumRx. The complaint alleges UnitedHealth and OptumRx added “hidden bogus fees” to sales of prescription drugs that had retail prices below an insured patient’s copayment amount. When a copayment exceeds the retail price of a given drug, the defendants “claw back” that excess copayment amount as “pure, undisclosed profits,” according to the complaint.

The lawsuit follows investigations into prescription drug costs by a New Orleans television station, and it marks at least the third time in the past six weeks that UnitedHealth has been sued over its relationship with Optum. Similar lawsuits were filed on Oct. 4 and Oct. 14, and Cigna Corp. and Humana have been sued over similar alleged schemes.

According to the latest complaint, these clawback amounts are “not insignificant” and can sometimes exceed the total cost of a given medication. This means that pharmacy benefit managers such as OptumRx “are often collecting for themselves more than the prescription even costs, while the patient’s insurance plan provides no benefit to the patient,” the complaint alleges.

Fox 8 Investigation

All five pending lawsuits cite a 2016 investigation into health insurance clawbacks conducted by New Orleans television station Fox 8. The investigation found that some insured patients may be paying more for prescription drugs than they would pay if they lacked insurance altogether.

Lee Zurik, anchor and chief investigative reporter for Fox 8, told Bloomberg BNA that smaller insurance companies may be engaged in similar clawback practices. Zurik said he knew of other attorneys looking into these issues, adding that it “definitely wouldn’t surprise me if more suits are filed.”

The latest lawsuit also takes aim at UnitedHealth’s alleged use of contractual “gag clauses” that prohibit pharmacists from telling patients the true cost of their prescription drugs.

Zurik said that these gag clauses make it “extremely difficult” for patients to know if they’re being overcharged for drugs, which in turn makes it hard to estimate how many people may be affected by these practices.

However, Zurik said that this may be changing—at least in some states.

In June, Louisiana Gov. John Bel Edwards (D) signed a law that aims to prevent patients from overpaying for prescription drugs at the pharmacy. Arkansas lawmakers enacted similar legislation in 2015.

Litigation

The five lawsuits vary considerably in terms of legal theories, although all five bring claims under the Racketeer Influenced and Corrupt Organizations Act.

The most recent lawsuit against UnitedHealth also raises claims under Minnesota and Florida law, while the Humana lawsuit was filed under Kentucky law. The lawsuit against Cigna is largely based on the Employee Retirement Income Security Act, as is the first lawsuit against UnitedHealth filed on Oct. 4.

The latest complaint was filed in the U.S. District Court for the District of Minnesota by Keller Rohrback LLP and Lockridge Grindal Nauen PLLP. The other law firms leading this litigation push are Izard Kindall & Raabe LLP, Sarraf Gentile LLP, Gray Plant Mooty, Scott & Scott, Wood Law Firm, Davis & Taliaferro LLC, Lemmon Law Firm and Zimmerman Reed LLP.

UnitedHealth didn’t immediately respond to Bloomberg BNA’s request for comment.

To contact the reporter on this story: Jacklyn Wille in Washington at jwille@bna.com

To contact the editor responsible for this story: Jo-el J. Meyer at jmeyer@bna.com

For More Information

Text of the complaint is at http://www.bloomberglaw.com/public/document/Fellgren_v_UnitedHealth_Group_Incorporated_et_al_Docket_No_016cv0.

Bloomberg Law®, an integrated legal research and business intelligence solution, combines trusted news and analysis with cutting-edge technology to provide legal professionals tools to be…

Bloomberg BNA’s ERISA Litigation TrackerTM is a one-of-a-kind resource designed specifically to help attorneys stay on top of key ERISA cases as they are filed and litigated in federal courts. Organized and summarized for quick accessibility, ERISA Litigation Tracker delivers full text of complaints, briefs, motions, decisions, and other important documents. No more waiting until court decisions are made — ERISA litigators and compliance attorneys can now have next-day access to court filings.

Benefits & Compensation Management Update

Stay alert to regulatory changes affecting compensation and benefits, find out about industry trends, and review current surveys and statistics with Benefits & Compensation Management Update.

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Surgeon General: Addiction Is A Chronic Brain Disease, Not A Moral Failing

Posted on November 17, 2016 by Pharmaciststeve

Surgeon General Vivek Murthy: Addiction Is A Chronic Brain Disease, Not A Moral Failing

http://www.huffingtonpost.com/entry/vivek-murthy-report-on-drugs-and-alcohol_us_582dce19e4b099512f812e9c

If addiction is now being – FINALLY – declared a MEDICAL CONDITION… why is the DEA/judicial system still in charge of doling out “treatment” for those who abuse opiates ?

The way forward includes needle exchanges and calling addiction what it is: a medical condition.

Surgeon General Dr. Vivek Murthy hopes his new report on drugs and alcohol will call attention to the public health crisis of addiction in America.

In 1964, U.S. Surgeon General Dr. Luther Terry issued a landmark report on tobacco and health that changed the course of American history, spurring the decline of smoking in the United States.

More than 50 years later, Surgeon General Dr. Vivek Murthy hopes he can do something similar for addiction. Murthy’s new report on alcohol, drugs and health is the first in which a surgeon general addresses substance use disorders as a disease the nation can address.

In the more than 400-page report “Facing Addiction in America,” released Thursday, Murthy recommends evidence-based early interventions for young people, expanding treatment programs that have been proven to work, and investing in substance use prevention and treatment research.

A few specific recommendations include adding addiction screenings in primary health care settings and hospitals, creating recovery-based high schools and colleges, and establishing community forums to emphasize the medical nature of addiction. According to this post, the addictiontreatmentrehab.co.uk rehab center will help those suffering from addiction recover, a span of which is indicated in their program. Also, Carrara Treatment Center in Los Angeles specializes in luxury drug rehab. Their programs offer a unique blend of effective treatment and luxury amenities.

It’s also a cultural call to action.

“I’m calling for a cultural change in how we think about addiction,” Murthy told The Huffington Post. “For far too long people have thought about addiction as a character flaw or a moral failing.” 

“Addiction is a chronic disease of the brain and it’s one that we have to treat the way we would any other chronic illness: with skill, with compassion and with urgency,” he added. 

For far too long people have thought about addiction as a character flaw or a moral failing. Surgeon General Vivek Murthy

Indeed, America’s addiction problem is urgent. There are more than 20 million Americans who have a substance use disorder and 12.5 million who reported misusing prescription painkillers in the last year. Opioid overdose deaths have quadrupled in the U.S. since 1999.

Murthy toured the country earlier this year interviewing Americans about their concerns, and addiction was a big one. Many people didn’t want to talk to the surgeon general if the press was around, because they were afraid of losing their jobs and friends if anyone found out about their substance use disorder, Murthy explained. They also worried that doctors might treat them differently. 

The numbers bear out that fear of stigma. According to the new report, only 10 percent of people with substance use disorder receive any type of treatment for their addiction.

Addiction treatment should be part of routine doctors’ visits

The overarching theme of the new report is that substance use disorders are medical problems, and the logical next step is integrating substance use disorder care into mainstream health care.

According to the report, mainstreaming addiction treatment can improve the health of millions of Americans, regardless of income and social status, and save the health care system money. 

This idea dovetails nicely with the letter Murthy sent to 2.3 million doctors and medical professionals in August, asking for their help to solve the United States’ opioid epidemic and requesting they sign a pledge to screen patients for opioid use disorder, connect them with evidence-based treatment and discuss addiction as a chronic illness. 

“We need to take the next step and ensure that these kinds of services are available to everyone. That’s where, right now, we have some real challenges as a country,” Murthy said. “We know that despite the evidence that treatment works, not everyone can get access to it.”

Harm reduction is a key part of Murthy’s plan 

One of the more radical elements of the new report is that it embraces harm reduction strategies including overdose prevention education, needle exchanges and access to the overdose reversal drug naloxone. 

Although critics of harm reduction say it encourages drug use, evidence from the new report shows otherwise. It argues harm reduction connects drug users to health care so that when they are ready to stop using, they have the resources to do so. It also reduces the spread of infectious disease. 

“Safe syringe programs have been an effective strategy at reducing infectious disease transmission ― like reducing HIV and hepatitis C,” Murthy said, noting that when an HIV erupted in Indiana last year, it was instituting a needle exchange program that finally curbed the outbreak.

Addiction treatment without Obamacare

As it stands, not all Americans have access to substance use treatment, and the resources that are available aren’t equally distributed across the country.

There’s also the looming question of what will happen if the Affordable Care Act is repealed after President-elect Donald Trump takes office. The ACA currently requires that most U.S. health plans offer prevention, short interventions and other substance use disorder treatments to insurance holders.

While it’s unclear what steps Trump’s administration will take toward dismantling the ACA, if any, the Congressional Budget Office estimates that rolling back the ACA would leave 22 million additional Americans uninsured.  

There are still millions of people in our country who are struggling without insurance coverage.

“We’ve had 20 million-plus people who have gained coverage over the last several years through health reform efforts,” Murthy said. “Whatever we do going forward, in terms of additional policies that we adapt, we have to ensure that we are protecting and expanding insurance coverage.”

“As much progress as we’ve made, there are still millions of people in our country who are struggling without insurance coverage, who can’t get access to substance use treatment services,” he added. 

Regardless of politics what happens with the ACA, Murthy stressed that changing our attitudes about addiction is one things that everyday Americans ― and doctors, policymakers and law enforcement officials ― can do to get involved.

“What’s really at stake here are our family and friends,” he said. “Addiction is not a disease that discriminates and it has now risen to a level that it is impacting nearly everyone.”

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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DEA Rosenberg: we don’t regulate the practice of medicine

Posted on November 17, 2016 by Pharmaciststeve

DEA chief Chuck Rosenberg on America’s “growing” opioid epidemic

http://www.cbsnews.com/news/america-opioid-prescription-pills-problem-drug-enforcement-agency-chuck-rosenberg/

Rosenberg misquotes so many things about the TRUE FACTS… I get tired of trying to point out these obvious MISSTATEMENTS OF THE TRUTH.  Hopefully Rosenberg is at the end of his career as head of the DEA.. with the incoming President Trump. If you can’t see the video, you can go to the link on the post to view it directly on CBS… for some reason CBS gives you the code to embed a link to the video … but I have not had one yet that will allow it to play on my blog.

A groundbreaking new report calls substance abuse one of America’s most pressing public health problems. And according to Chuck Rosenberg, acting administrator of the Drug Enforcement Administration, the problem is “growing fast.”

Rosenberg blames it on the excess of prescription pills. According to him, a “pill problem” ultimately becomes a “heroin and opioid problem.”

“We know that 4 out of 5 new heroin users started on prescription pills, and most of the people who start on prescription pills get them out of someone’s medicine cabinet, get it ‘legitimately.’”

According to the surgeon general’s first report dedicated to addiction, 12.5 million Americans abused prescription painkillers in the last year. On an average day in the U.S., more than 650,000 opioid prescriptions are dispensed, 580 people start using heroin, and 78 people die from opioid-related overdose – more than from car accidents or gun violence.  

“There’s plenty of blame to go around,” Rosenberg said, referencing both the over-prescription of painkillers by doctors and their illicit sale on the street. 

“We are 5 percent of the world’s population, we consume in one way or another 99 percent of the world’s hydrocodone. That’s crazy, that’s crazy.”

But the DEA has been blamed for being part of the problem. Back in July, Sen. Richard Durbin ripped the agency at a Senate Judiciary Committee Hearing, saying: “The Drug Enforcement Agency has decided to floor America with opioid pills, far beyond any medical purpose.”

Rosenberg said he didn’t think that characterization was “accurate,” and has since met with Durbin and his colleagues to clear “some misunderstandings.”

But the DEA has the power to set the limit for the manufacture of pills. In 2014, an estimated 14 billion opioids were dispensed.

“That seems too high,” co-host Norah O’Donnell said. 

“It’s very high, but we don’t regulate the practice of medicine. We do allocate the amount that folks can manufacture,” Rosenberg responded.

“But why not bring down that amount?” O’Donnell asked.

Rosenberg said the DEA has brought the number down, but that there is still “plenty of capacity.”

“The DEA is really good at supply reduction. We’re a traditional law enforcement. We attack that unholy alliance between international cartels and violent street gangs,” Rosenberg said. 

But he said that’s not enough, and that the issue must be tackled in “other ways,” especially in reducing demand.

“We’re not going to enforce or prosecute [ourselves] out of this mess, so we have to do demand reduction,” Rosenberg said.

 “How do you reduce the demand?” co-host Charlie Rose asked. 

“Public education is part of it, but we’ve got to teach, we’ve got to rehabilitate, we’ve got to treat,” Rosenberg said. One example of the DEA’s efforts is its collaboration with Discovery Education, to bring a STEM-based curriculum to schools to teach the science of opioid addiction and open up conversations for students, teachers and parents. 

Then there’s National Prescription Drug Take-Back Day – an opportunity for people to dispose of unwanted pills anonymously, “no questions asked.”

“So we did it twice in the past year. Here’s a big number. We took in 1.6 million pounds of unwanted and expired drugs,” Rosenberg said. “Now by some estimates, only about 10 percent of what we get on take-back are opioids. That’s still 160,000 pounds of opioids out of medicine cabinets and off the streets. So this is a good thing.”

Rosenberg touted the work of the DEA, but said there is still “a lot of help to be had.”

“The men and women of DEA are amazing. They have a really hard job, they have a dangerous job. But we need help,” Rosenberg said, calling on doctors, pharmacies, manufacturers, and Congress. 

Filed under: General Problems | 4 Comments »

Controversial question: Is pot part of the answer to the heroin epidemic?

Posted on November 17, 2016 by Pharmaciststeve

Controversial question: Is pot part of the answer to the heroin epidemic?

fox8.com/2016/11/17/controversial-question-is-pot-part-of-the-answer-to-the-heroin-epidemic/

If we are a country that works by “majority rule” and the MAJORITY of states has made marijuana LEGAL… why isn’t the Feds conforming to the voice of the majority of our country ?

CLEVELAND – One week after seven additional states legalized some form of marijuana use, a controversial question is now getting more serious attention.

And that is: with so many people now dying from addictions to opiate painkillers (about 47,000 nationwide this year alone, and close to 700 just in Cuyahoga County), should we be looking more closely at marijuana as a possible alternative for treating pain?

“This isn’t some stoner stereotype about ‘getting high man'”, says 38 year-old Bob Ellison, “this saved my life.”

Ellison has bone-on-bone arthritis in his right knee. He says his doctor put him on opiates for the pain, but soon, he felt the need to take more and more to try and control the pain.

“I was taking twelve, fourteen, sixteen pills a day,” he says, “I was suppose to be taking three.”
Worried that he was soon going to overdose in his sleep, Ellison made a radical decision: to switch from taking opiates to using marijuana to help control his pain.

“I want to take medical marijuana for pain because I don’t want to be an opiate drug addict,” he says.

While states have been legalizing medical marijuana at a rapid rate recently (Ohio did so in September), the federal government still classifies marijuana use as illegal.

And many experts in medicine and law enforcement regard marijuana as a so-called “gateway drug” that leads users to to other, harder drugs.

The Drug Enforcement Administration classifies many opiates as “Schedule 2” drugs – meaning they can be abused, but have medical value.

But the DEA classifies marijuana on “Schedule 1” – meaning it can be abused, and has no medical value.

“We have to end the DEA’s monopoly on medical marijuana research,” says Sen. Cory Booker of New Jersey.

Sen. Booker and Sen. Kirsten Gillibrand of New York testified at a hearing this year on Capitol Hill that more research needs to be done into marijuana, but that its Schedule 1 classification prevents a lot of work from being done.

“The problem,” Sen. Gillibrand testified, “is the law.”

“(Marijuana) is harder to study because there are more restrictions on it,” says DEA Acting Administrator Chuck Rosenberg, “but the restrictions are there for a reason. But the most important thing – it’s not impossible.”

The DEA bases its decision of how to schedule drugs on scientific studies reviewed by the Food and Drug Administration.

But, in its most recent review, the FDA found only eleven studies that met its criteria, and said that sample size was too small to draw any conclusions.

Still, the FDA wrote that “the studies reviewed produced positive results, suggesting marijuana should be further evaluated as an adjunct treatment for neuropathic pain….”

“A lot of studies have not been done simply because of the classification that the drug currently has,” says Jim Besier, PhD., the Director of Pharmacy at University Hospitals’ Rainbow Babies and Children’s’ Hospital.

“I believe,” he adds, “additional research would certainly be helpful.”

Sen. Booker says the experience of many Americans shows that marijuana deserves more study.

And, speaking just about his own life, Bob Eillison couldn’t agree more.

“I don’t think I’d still be alive today if I were still on opiates and not marijuana,” he says, “it saved my life.”

 

 

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Disease shaming because of cost of treatment – prelude to “DEATH PANELS” ?

Posted on November 17, 2016 by Pharmaciststeve

High-dollar Prescribers Proliferate in Medicare’s Drug Program

https://www.propublica.org/article/high-dollar-prescribers-proliferate-in-medicare-drug-program?

Forty-one health providers prescribed more than $5 million in drugs in 2011. Last year, that jumped to 514. “The trends in this space are troubling and don’t show any signs of abating,” a federal official said.

by Charles Ornstein and Ryann Grochowski Jones
ProPublica, Nov. 17, 2016, 5 a.m.

Medicare’s failure to monitor what doctors are prescribing has wasted billions of taxpayer dollars on excessive use of brand-name medication and exposed the elderly and disabled to drugs they should avoid.

(Craig F. Walker/The Boston Globe via Getty Images)

This story was co-published with NPR’s Shots blog.

The number of doctors who each prescribe millions of dollars of medications annually in Medicare’s drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica shows.

The number of providers who topped the $5 million mark for prescriptions increased more than tenfold, from 41 in 2011 to 514 in 2015. The number of prescribers—mostly physicians but also nurse practitioners–exceeding $10 million in drug costs jumped from two to 70 over the same time period, according to the data.

The Doctors and Drugs in Medicare Part D

Use this tool to compare how your doctor prescribes medications in Medicare’s drug program with other doctors in the same specialty and state. Explore the app.

Most of the doctors atop the spending list prescribed Harvoni or Sovaldi, relatively new drugs that cure hepatitis C. Other providers on the list prescribed pricey drugs to treat cancer, multiple sclerosis and rheumatoid arthritis.

Medicare’s drug program, known as Part D, covers more than 41 million seniors and disabled people. In 2015, it accounted for $137.4 billion in drug spending, before factoring in rebates from drug companies. That was up from $121.5 billion a year earlier.

“The trends in this space are troubling and don’t show any signs of abating,” said Tim Gronniger, deputy chief of staff at the Centers for Medicare and Medicaid Services, the federal agency that runs Medicare. “It’s going to be a pressure point for patients and the program for the foreseeable future.”

During the recent presidential campaign, both Hillary Clinton and Donald Trump pledged to tackle the rising costs of prescription drugs. Since his election, however, President-elect Trump’s transition agenda for health care hasn’t featured the topic, a shift the Los Angeles Times reported.

Medicare has released top-level data on drug spending for 2015, including the number of doctors who prescribed medications worth more than $1 million. But the agency has only published data on individual doctors up to 2014.

Dr. Ben Thrower, medical director of the Multiple Sclerosis Institute at the Shepherd Center in Atlanta, was near the top of the list in 2014. He prescribed medications costing $11.5 million that year, mostly for multiple sclerosis drugs. “We get that it’s very expensive,” Thrower said. “I think all the MS providers working in the U.S. would like to see the costs go down.” But prices have climbed steadily in recent years for drugs used to treat the neurological condition, even those that have been on the market for quite a while.

Most of the spending on Thrower’s prescriptions – $8.5 million — was for MS drugs Tecfidera and Copaxone, which can slow progression of MS and reduce the chance of relapse. Thrower has received payments from the makers of those and other MS drugs, but said he cut ties with the companies in January of this year.

“It was kind of exciting when the first one came out,” Thrower said. “The problem we’ve seen is the cost for these drugs has just gone up and up and up.”

Thrower said he no longer prescribes Tecfidera to new patients because it can lower white blood cell counts, putting them at risk for infections.

Medicare Part D Totals by the Numbers, 2014

37.1MBeneficiaries with Part D Claims
1.4BPrescriptions (Including Refills)
$121.5BRetail Price of All Prescriptions
1.35MNumber of Prescribers
38Average Prescriptions Per Beneficiary
$85.82Average Retail Price of a Prescription
46%Portion of Claims to Patients Receiving Low-Income Subsidy
10.1Average Prescriptions Per Patient, Per Provider*

Notes: Counts include initial prescriptions and refills dispensed. Retail price includes patients’ out-of-pocket costs but does not reflect drug maker rebates. *Average prescriptions per patient, per provider has been adjusted to give more weight to doctors who treat more patients. (The unadjusted average is 5.6).

Just because a doctor prescribes costly drugs doesn’t mean he or she has done anything wrong, Gronniger said. “It’s much more about drug pricing … than it is about the behavior of any individual physician, many of whom are equally concerned about the price of these products as we are.”

Today, ProPublica is updating its Prescriber Checkup online tool, which allows you to look up your doctor and see how his or her prescribing in Medicare Part D compares to others in the same specialty and state. Our tool covers the year 2014. You can compare the percentage of each doctor’s prescriptions that were for brand-name medications, the average cost per prescription and the average number of prescriptions per patient, among other things.

Allyson Funk, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said Medicare’s figures leave out important context.

“It is important to note physicians’ prescribing patterns are dynamic and based on individual patient needs,” she said in a statement. “When looking at Medicare Part D, government data on spending at the point of sale does not include the substantial rebates for brand name medicines negotiated between manufacturers and plans and therefore does not accurately reflect actual prescribing dollars or program spending.”

These rebates are confidential by law, but Medicare said this week that the average rebate for brand-name drugs in 2014 was 17.5 percent.

The new data on high-spending prescribers is the latest indication of the burden of drug prices on government health programs.

$10 Million Prescribers

Total prescribers under Medicare’s Prescription Drug Program who wrote at least $10m in prescriptions, 2011-2015

 
Source: The Centers for Medicare & Medicaid Services.

In the past couple of years, Medicare’s drug tab has surged, in large part because it picks up the vast majority of the cost of drugs once enrollees exceed a certain threshold each year. In 2015, beneficiaries over the limit, which was $4,700, spent $51.3 billion on drugs. In 2013, the figure was $27.7 billion, government data shows. (Taxpayers, through Medicare, pick up 80 percent of the cost of this so-called catastrophic benefit.) The Associated Press first reported the ballooning cost in July.

Another sign could be seen in a drug dashboard released by Medicare this week. It showed that 1 percent of drugs prescribed in the Part D program accounted for more than one-third of the program’s cost in 2015 (before rebates). Some drugs were incredibly expensive. The drug H.P. Acthar Gel, used to treat several conditions, such as multiple sclerosis relapses and a rare kidney disease, cost an average of $162,371 for each of its 3,104 users—a higher per-user cost than any other drug in the program. That’s up significantly from several years ago, when ProPublica flagged the drug’s expense.

Harvoni, used by more than 75,000 people, cost an average of $92,847 per person, for a total cost of $7 billion (also before any rebates).

Michael Chernew, a professor of health care policy and director of the Healthcare Markets and Regulation Lab at Harvard Medical School, said the number of high-dollar prescribers in Medicare doesn’t surprise him. Given the increased cost of prescription drugs and the latest treatment advances, “the entire distribution is shifting to the right.”

Chernew said that, in the long term, Medicare and insurance companies have to examine the total cost of caring for patients with certain diseases, taking into account drugs, hospital visits, medical tests and more. Only then can anyone tell if certain expenses, such as a pricey new drug, are justified.

For now, he said, “How do we know what’s good or bad?”

Use Our Data

Download the data behind this story from the ProPublica Data Store.

Physicians say their top priority must be the patients in front of them, not the costs to the system.

Dr. Bruce Bacon, a liver specialist at St. Louis University, had the highest total Part D drug costs in 2014, $22.7 million. He was a frequent prescriber of Sovaldi and Olysio, another expensive hepatitis C medication.

Bacon did not return a call for comment for this story. In a 2015 interview, he said he did not realize his prescriptions were so costly to Medicare.

“I really don’t think about the cost,” he said. “I think about taking care of the patients. Should I not take care of the patients because the cost is expensive?”

Thrower, the multiple sclerosis specialist, said the high cost of drugs frustrates him and his colleagues, but ultimately the successful treatment of patients comes first.

“On one hand, we get that,” he said. “On the other hand, when you’re sitting in the exam room and looking someone in the eye, you can’t say, ‘I’m not going to treat you because of the cost.’”

Filed under: General Problems | 1 Comment »

Mental health/addiction problems .. no one is exempt !

Posted on November 17, 2016 by Pharmaciststeve

Ex-cop who helped police with addiction dies in CVS parking lot

http://www.palmbeachpost.com/news/cop-who-helped-police-with-addiction-dies-cvs-parking-lot/86uQQsMugPqhFA9ZPYnALN/

One of the BIGGEST things that our bureaucracy professes as the MEANS to keep people from abusing some substance and becoming addicted.. is EDUCATION…  It is hard to argue that this cop was very knowledgeable about substance abuse and addiction and yet he succumb to his genetic inclination of becoming addicted to Heroin… Shouldn’t we look at this example as a STRONG SUGGESTION that EDUCATION is not a end all…be all… to stop abuse/addiction to some substance ? 

A 28-year veteran with the Palm Beach County Sheriff’s Office, Terry Marvin used to bust drug dealers for a living. He later helped open a treatment center to help first responders with addiction problems.

But Marvin also battled his own addiction demons for years. On June 23, 2015, he died in his Chevy Camaro in front of a CVS pharmacy in West Palm Beach after overdosing on heroin. He was 56.

Click to read the special report“I knew Terry’s drug of choice was alcohol. How the hell did he get to heroin? That’s like leaping football fields,’’ his friend Sean Riley wrote in a blog post, “but with the disease of addiction there is no logic, excuses or explanations for the things we do.’’

Click to read more about Terry

 
 
 
 

 

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Doctor fills us in after feds search office

Posted on November 17, 2016 by Pharmaciststeve

FBI & DEA AT OFFICE_frame_13063.jpg

Doctor fills us in after feds search office

http://news4sanantonio.com/news/local/doctor-fills-us-in-after-feds-search-office

SAN ANTONIO- A local doctor fills us in on why his practice was raided Tuesday by the FBI and Drug Enforcement Administration or DEA. Dr. Javier Bocanegra and his attorney say the allegations and investigation by the DEA and FBI are not directed at him or his medical practice.

“My patients, they are part of my practice and I want them to continue to trust me because they have trusted me up until now and I will do the right thing for them every single day,” said Dr. Javier Bocanegra with Community Family

Dr. Javier Bocanegra says the DEA and FBI’s joint investigation regarding allegations of over billing and prescription fraud have nothing to do with him personally or anyone at his practice.

“There was no allegations against me, I specifically asked them, do you have any charges against me and they said no,” said Dr. Bocanegra.

Instead he says that 3 companies who provided services to his patients are being investigated.

“They provide compounding medications, those are the local medicines you apply to areas of arthritis, injuries and usually patients that can’t tolerate or are at risk if they take like ibuprofen or Aleve,” said Dr. Bocanegra.

The DEA is not going into any details as to what they are looking into, but simply confirm a search warrant was issued Tuesday morning at Community Family Health. We were there as patient files were removed from the office. Dr. Bocanegra says they have between 8 and 10 thousand active patients right now.

He says he has always practiced legally and nothing will change going forward.

“I know with my insurance, they have billed it correctly because I look at the statements,” said patient Sandra Demaree.

“I am very careful especially when they change the classifications of medications, I follow that, I go by the medical practice act almost by the book, because I don’t want to lose my license I have worked too hard for it,” said Dr. Bocanegra.

The DEA also raided a doctor’s office in Corpus Christi on Tuesday. The DEA says it is an ongoing investigation and they do not know if this raid is linked to the one here locally.

Filed under: General Problems | 1 Comment »

Daughter Says Untreated Pain Led to Mother’s Suicide

Posted on November 17, 2016 by Pharmaciststeve

marsha2Daughter Says Untreated Pain Led to Mother’s Suicide

www.painnewsnetwork.org/stories/2016/11/16/daughter-blames-doctors-for-mothers-suicide

By Pat Anson, Editor

Suicides are never easy to accept. Especially if they involve a loved one. Even more so if they could have been prevented.

Lacy Stewart says her mother never would have killed herself if she’d been given proper medical care for her chronic fibromyalgia pain.

“I feel angry about the way she was treated,” says Stewart, a registered nurse who believes the healthcare system not only failed to treat her mother, but drove Marsha Reid to suicide at age 59.

“Her life was taken from her is the way I feel,” says Stewart. “I know it was. A person can only handle so much pain for so long. It takes its toll on every area — your mind, your body, everything. And she just couldn’t do it anymore. She’d had enough. Because nobody would help her. Nobody.” 

Stewart says her mother was fit and physically active – handling all the chores at her 10-acre farm in north Texas — until she slipped on ice and landed hard on her face in 2009. Reid broke a few teeth and sustained nerve damage in the fall — injuries that evolved into the classic symptoms of fibromyalgia: chronic widespread pain, anxiety, fatigue, insomnia and depression.

“Of course she sought out help. Searching for doctors that would take her on, she encountered road block after road block. Many doctor’s offices would just flat out say, ‘We don’t take fibromyalgia patients,’” recalls Stewart.

“So you take that and couple it with the fact that pain medication is often required for these patients and now the CDC has regulations that deter a physician from wanting to prescribe pain medication at all and you end up here. Zero help for a woman suffering day in and day out for all these years. She lost her job, her home, her independence.”

In January, Reid checked into a hotel room and tried to kill herself by taking a full bottle of Xanax. The failed suicide attempt left Reid even more depressed and her health deteriorated further. She started having hallucinations, hearing voices and seeing dead people.

In July, Stewart drove her mother for five hours to see a pain management doctor.

“I was appalled at the treatment from the physician. We explained the pain and the issues with her mind, and he said he could only treat one or the other. Not both! Not the whole patient! When I brought up pain medication you would have thought I had asked him for heroin,” says Stewart.

“I’ll never forget the conversation I had with him in the hall on the way out. I looked him in the eye and said the pain is so severe she will kill herself! It’s only a matter of time. He basically said his hands were tied because of the regulations and what I was asking was for him to lose his license! I was furious and felt betrayed by the field I loved, medicine.”

One treatment was suggested for her mother.

“They wanted her to go to water aerobics,” said Stewart. “The woman could barely take a bath and they wanted her to go to water aerobics! I read in the CDC (opioid) prescribing guidelines that they wanted doctors to use alternative measures for pain relief such as water aerobics and physical therapy. They never spent a day in pain in their lives, obviously. Because then they would know that is ridiculous. It’s almost a joke to me, the guidelines that I have read.”

Crisis in Pain Care

In recent months, Pain News Network has been contacted by dozens of pain patients who say they are contemplating suicide. It’s not just the difficulty in getting opioid pain medication. The growing crisis in pain care has reached a point where many patients are unable even to get a doctor’s appointment.

“I have been on a wait list for pain treatment for a year now. I am suffering needlessly and am questioning my ability to be able to live like this much longer,” said Isabel Etkind, a Connecticut woman who suffers from severe arthritis pain.

“I don’t want to die but I can’t live like this either. I know that many other people are experiencing the same thing, but knowing that does not really help! It is inhumane and cruel to treat people this way. If I were a dog, cat or horse, the animal rights people would be all over it, but torturing humans is OK. As is usually the case, the elderly, the military and the poor are suffering the most.”

Another woman, who suffers from chronic back pain, asked that we not use her name. She works in the emergency room of a hospital in southern California that recently adopted a policy of not prescribing opioids unless all other pain treatments have failed.

“Since November 1, we have seen a huge increase in overdoses from street drugs. Nearly all of these patients are chronic pain sufferers who are now getting their medications off the streets. A 33-year old fibromyalgia patient died from fentanyl overdose this week,” she wrote to PNN. “I understand the desperation these patients feel and try to educate the ER doctors about chronic pain from a layman’s point of view. This new effort to stigmatize and demonize chronic pain sufferers has got to stop!

“We have full time jobs, pay mortgages, raise families. All this, while in levels of pain that normal people couldn’t handle. We hate having to be chained to pill bottles and doctors and pharmacists. What other choice do we have? Curl up and die? I hope the new Trump administration will appoint people to DEA and CDC who will think of us as humans and help us instead of hurting us.”

Suicides Increasing

According to the CDC,  suicides increased by 24 percent from 1999 to 2014, and are now the 10th leading cause of death in the United States.  

In 2014, nearly 43,000 Americans killed themselves, three times the number of deaths that have been linked to prescription opioid overdoses.  

Marsha Reid died of a self-inflicted gunshot wound on November 2, leaving behind a grief stricken daughter who will always wonder if things would have turned out differently if her mother had gotten the pain treatment she needed

“She talked about this a lot, about suicide. That was her plan. She couldn’t deal with this much longer. And that’s what breaks my heart the most is that I was unable to help,” says Lacy Stewart.

“Just mention the heartache she has left behind. Because if another fibromyalgia patient is out there contemplating this and they come across this story, I want it noted that I lost my mom forever and I’m 32 years old. And I’ll never have her back.”

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Iowa veteran takes his life after VA has him wait for treatment

Posted on November 17, 2016 by Pharmaciststeve

Iowa veteran takes his life after VA has him wait for treatment

JOHNSTON, Iowa — He was a son, a father, a boyfriend and a veteran. After serving two tours in Iraq as a combat engineer, 32-year-old Curtis Gearhart found love and friendships. What he didn’t find was timely help from the V.A., reports WHO.

Gearhart took his own life on Monday, Nov. 7.

He had sought help from the V.A. nearly two months ago after experiencing recurring headaches.

“He previously had a tumor. He was worried about it and they told him it would be five to six weeks,” Gearhart’s girlfriend Valesca Steffens told WHO. “They send these soldiers over so young to fight these wars and then they don’t live up to their promises of taking care of them when they come home.”

CLICK HERE for Gearhart’s full obituary.

Less than 24 hours before he was laid to rest, Steffens found out she was pregnant. She says the news is bittersweet but will allow his memory to remain.

“I hope someday I’m gonna be able to look into his eyes again and that’s a lot to look forward to,” she said.

After hearing about Curtis Gearhart’s death from WHO-TV, Sen. Joni Ernst responded saying:

The loss of Curtis Gearhart is truly tragic and my prayers are with Curtis, his family and friends at this time. We absolutely must ensure our men and women who have selflessly sacrificed in defense of our freedoms receive the quality, timely care they deserve.  I am looking into what happened between the VA and Curtis, and what steps can be taken to prevent such tragedies in the future.”

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Many States Have Legalized Medical Marijuana, So Why Does DEA Still Say It Has No Therapeutic Use?

Posted on November 16, 2016 by Pharmaciststeve

Many States Have Legalized Medical Marijuana, So Why Does DEA Still Say It Has No Therapeutic Use?

http://www.forbes.com/sites/ritarubin/2016/11/16/many-states-have-legalized-medical-marijuana-so-why-does-dea-still-say-it-has-no-therapeutic-use/#fe4723d35a1e

More than half the states–28, to be exact–including Arkansas, Florida and North Dakota as of the Nov. 8 election, and the District of Columbia have legalized marijuana for certain medical conditions.

And yet, the Drug Enforcement Administration still classifies marijuana as a Schedule I drug, defined by the 1970 Controlled Substances Act as a drug that has a high potential for abuse and no accepted medical use (emphasis is mine) in the United States. Other Schedule I drugs include heroin, LSD and ecstasy.

Only the Food and Drug Administration can determine whether marijuana has an accepted medical use, according to the DEA, and so far, it hasn’t. Because marijuana is a Schedule I drug, doctors can only “recommend” it to patients, not write prescriptions for it that they can fill at a drugstore.

But Congress has the authority to reclassify controlled substances, and the president can ask his attorney general, who oversees the DEA, or his Health and Human Services secretary, who oversees the FDA, to initiate rulemaking to reclassify them, Brookings Institution senior fellow John Hudak told me.

 Don’t expect Congress or the Donald Trump administration to take those steps, though.

The closest Congress has come recently were identical bills introduced in early 2015 in the House and the Senate, neither of which came up for a vote. The Compassionate Access, Research Expansion and Respect Status, or “CARERS,” Act, which had bipartisan support, would have reclassified marijuana from Schedule I to Schedule II, which includes drugs such as morphine and oxycodone that have a high potential for abuse but also have an accepted medical use. The CARERS Act also would have amended the Controlled Substances Act to say that its provisions related to marijuana did not apply to people complying with state medical marijuana laws.

And while Democratic presidential nominee Hillary Clinton said she would reclassify marijuana as a Schedule II drug, Trump was vaguer during the campaign. At a rally a year ago, he said only that “I think medical should happen” when asked about marijuana.

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