Senator Raises Red Flags About Conflicts of Interest With Federal Pain Panel
http://www.painmedicinenews.com/Policy-Management/Article/04-16/Senator-Raises-Red-Flags-About-Conflicts-of-Interest-With-Federal-Pain-Panel/35772/ses=ogst
US SENATOR RON WYDEN is UP FOR RE-ELECTION THIS NOV.. He has been in Congress since JAN 1981. For you counting that is THIRTY SIX YEARS when this term is up… It would appear that Senator Wyden.. supports the CDC’s reduction of opiates available .. even to those who have a medical necessity for them. Maybe it is time for Senator Wyden to share the “pain” of the chronic pain community. He is already 67… maybe it is time that he goes into RETIREMENT ? Only the voters in Oregon can impose some term limits on this LONG TERM Senator ?
Should members of the Interagency Pain Research Coordinating Committee (IPRCC) with financial ties to the pharmaceutical industry be allowed to continue to serve? Perhaps not, according to U.S. Sen. Ron Wyden (D-Ore.), who is alarmed about potential conflicts of interest on the panel.
As the highest-ranking Democrat on the Senate Finance Committee, Sen. Wyden drafted a letter dated Feb. 5 to Health & Human Services (HHS)Secretary Sylvia Mathews Burwell, outlining his concerns.
Concerns Over Industry Ties
“Many members of the committee appear to have monetary connections to several pharmaceutical companies,” said Taylor Harvey, a spokesman for Sen. Wyden. “The senator is asking Secretary Burwell to provide information regarding the process by which the members are selected, and if there is a conflict of interest or not. Did these individuals properly disclose their ties to the industry?”
The letter stated in part that “these financial and professional relationships raise serious concerns about the objectivity of the panel’s members that deserve additional review.” The letter also mentions several IPRCC members with potential conflicts of interest, including Myra Christopher and Richard Payne, MD, both of whom are employed by the Center for Practical Bioethics, which receives funding from a variety of drug manufacturers. Ms. Christopher holds a center chair, which began as a $1.5 million donation from Purdue Pharma, according to the letter.
“I am concerned that this single organization with significant ties to a major opioid manufacturer had two paid staff sitting as committee members at the same time,” Sen. Wyden wrote in his letter.
Sen. Wyden sent a separate letter, also dated Feb. 5, to Tom Frieden, MD, director of the Centers for Disease Control and Prevention (CDC), supporting the CDC draft guideline to reduce opioid abuse (the IPRCC has questioned the proposed guideline recommendations as not being evidence based). “Sen. Wyden wants to ensure that the CDC guidelines regarding opioid prescription guidelines are not unduly influenced by the companies that are manufacturing opioids,” said Mr. Harvey, noting that Oregon has the fourth highest rate of nonmedical use of pain relievers.
“Sen. Wyden feels it is important to have transparency in government and to ensure that the public has all the information necessary about the people that are working on important issues related to their everyday life,” Mr. Harvey said.
“The facts speak for themselves. There are several members of the panel who have significant financial ties to industry,” said Jane Ballantyne, MD, president of Physicians for Responsible Opioid Prescribing (PROP) and professor of anesthesiology and pain medicine at the University of Washington, in Seattle. “I think that probably influences the way they think about the issue.”
Dr. Ballantyne, who accepts no pharmaceutical money, believes that for those with strong financial ties, “the tendency is to promote the use of the drugs from which they benefit financially.” She also noted that many IPRCC members are affiliated with ethical groups and palliative care. “These ethical groups, in turn, have been funded by pharma,” she said. Moreover, many people who are strong advocates for maintaining the present-day level of access to opioids “are actually palliative care specialists, rather than the wider spectrum of chronic pain patients, for example, young people with chronic low back pain, who actually do much better without using opioids.”
Dr. Ballantyne was a member of the panel that advised the CDC on drafting guidelines for prescribing opioids for chronic pain. She concedes that her affiliation with PROP can be considered a conflict of interest because she has a bias. “We are a group of physicians who believe that we are harming people by overusing opioids,” she said. “But PROP is not funded at all.”
A Different Kind of Litmus Test
Lynn R. Webster, MD, a past president of the American Academy of Pain Medicine, vice president of scientific affairs for PRA Health Sciences and member of the Pain Medicine News editorial advisory board, said the true litmus test for conflict of interest should be whether a panel member has integrity and is concerned about the health and well-being of all Americans. “Can they look at data and information objectively, minimizing personal biases?” Dr. Webster asked. “Because, to one degree or another, personal biases exist within everyone. In fact, every level of HHS has a conflict of interest of some type.”
Dr. Webster pointed out that as a payor, the Centers for Medicare & Medicaid Services (CMS) is concerned about saving costs on drugs and services. “Job security for a CMS staffer may be determined by panels like this one,” he said. “The FDA also receives payments from pharmaceutical companies and must oversee the industry’s drug developments.”
According to Dr. Webster, such association does not disqualify FDA staff from committee participation, nor is the CDC barred from issuing recommendations about immunizations, “though it receives pharmaceutical industry and insurance company funds,” he said. “One publication, which regularly runs articles excoriating the pharmaceutical industry, has banner ads featuring prescription drugs, run by the publication, no doubt, to help pay its writers’ fees. Thus, association is not necessarily a conflict.”
Dr. Webster believes that if a person could personally profit from taking a particular position, “he or she should recuse themselves from the discussion. However, just because a panel member belongs to a group that receives money does not mean the individual is an agent for the entity providing the funds. Furthermore, members of advocacy groups do not personally benefit from contributions to the nonprofit.”
Dr. Webster honestly thinks that the general public is less concerned about the representation of the panel than the special interest groups opposed to prescribing opioids, particularly for persistent pain. “Conflict of interest has to be managed by disclosures,” he said. “Although I do not believe all conflicts of interest can be eliminated, it is important that panel members disclose their relationships—financial and otherwise—so the public can decide if there is improper influence in the discussion.”
Dr. Webster said there appears to be a concerted effort to eliminate anyone on the panel who may advocate for people in pain, “because advocates for people in pain realize that opioids are necessary for some people,” he said. “Nonprofits that receive money for advocacy are being treated as if they are lobbyists for opioid manufacturers, which is absurd. To solve the problem of unrelieved pain, we need the voices of people in pain,” said Dr. Webster. “They cannot be ignored, or we will shun a large swath of society in desperate need of help. That would be cruel. Would we deny people with cancer a voice in cancer research , or caregivers of people with Alzheimer’s an opportunity to share their struggles and hopes for a cure? I hope not.”
—Bob Kronenmeyer
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I got a call from a Pain practitioner at the Hospital where I had my surgery
When I was in the hospital the OPIATE POLICE must have violated my HIPPA rights and told the Chronic Pain dept. that I was taking what they thought to be a HIGH DOSE. I got a call from them today inviting me to join their pain program at the Hospital. They even told me that they would supply my pain meds from the hospital pharmacy monthly if I where to move from my doctor of over 5 plus years to them. Their intent is to lower me or take me off all together. I thought I had to give permission for my records to be moved to some other un-involved dept?? I am so very tired of the PAIN POLICE. I have always taken my medication as directed or less than directed.
From a pharmacist: How our policies enable the opioid addiction epidemic
The route to addiction often begins with an opioid prescription for managing pain; there are more than 257 million opioid prescriptions written each year. Not all of these prescriptions are necessary, and more importantly, many are not managed in a way that provides the needed pain relief but avoids unintentional abuse or addiction. Without proper management of these medications, it’s easy to become dependent.
