Friday, May 11, 2012

The Pain Connection

U.S. Senate panel launches investigation of painkillers, drug companies

The U.S. Senate Committee on Finance has opened a bipartisan investigation into financial relationships between companies that make narcotic painkillers and various nonprofit organizations that have advocated their use for the treatment of pain.

Citing investigative reports by the Milwaukee Journal Sentinel/MedPage Today and others, the committee is seeking financial and marketing records from three companies that make opioid drugs, including Oxycontin and Vicodin, and seven national organizations.

"It is clear that the United States is suffering from an epidemic of accidental deaths and addiction resulting from increased use of powerful narcotic painkillers . . . ," said a joint statement from committee members, U.S. Sens. Chuck Grassley (R-Iowa) and Max Baucus (D-Mont.).

The senators said there was growing evidence that drug companies have promoted misleading information about the safety and effectiveness of the drugs with help from nonprofits they have donated to.

"Recent investigative reporting from the Milwaukee Journal Sentinel/MedPage Today and ProPublica revealed extensive ties between companies that manufacture and market opioids and non-profit organizations such as the American Pain Foundation, the American Pain Society, the American Academy of Pain Medicine, the Federation of State Medical Boards, the University of Wisconsin Pain and Policy Studies Group and the Joint Commission," Grassley and Baucus wrote.

In addition to the pain organizations, the committee also sought records from three leading opioid companies: Purdue Pharma, Johnson & Johnson and Endo Pharmaceuticals. It also requested records from the Center for Practical Bioethics, a Kansas City, Mo. organization that has advocated for pain treatment.

The committee said it wants records dating back to 1997.

The letter noted that a February Journal Sentinel/MedPage Today story reported that a "network of national organizations and researchers with financial connections to the makers of narcotic painkillers helped create a body of dubious information" favoring opioids. The information was found in prescribing guidelines, patient literature, position statements, books and doctor education courses.

The newspaper reported that the nonprofits pushed for expanded use of the drugs while taking in millions of dollars from the companies that made them.

Last year, a separate Journal Sentinel/MedPage Today story found that the UW Pain Group had been a national force in helping liberalize the way opioids are prescribed and viewed. While pushing a pharmaceutical industry agenda that critics say was not supported by rigorous science, the organization took in $2.5 million over a decade from opioid companies.

After that story ran in April 2011, the UW Pain group said it would stop taking money from the drug industry.

This week the American Pain Foundation shut down, saying it "must cease to exist, immediately."

The organization said its board of directors voted May 3 to dissolve the organization, according to a message on its website. It cited a lack of financial resources and funds needed to remain operational.

It was unknown whether the decision was in any way related to the Senate investigation.

"The problem of opioid abuse is bad and getting worse," Grassley said in a statement. "Something has to change. A greater understanding of the extent to which drug makers underwrite literature on opioids is a good start. Doctors and patients should know if the medical literature and groups that guide the drugs' use are paid for by the drugs' manufacturers and if so, how much. Education on the proper use of pain medication is a key step in preventing abuse and misuse, so it's important to understand what material is out there."

Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, said the pain groups, working on behalf of drug companies, applauded the Senate committee's move. Kolodny is chairman of psychiatry at Maimonides Medical Center in New York City.

"I think the Senate Finance Committee's investigation will ultimately save lives," said Kolodny, an addiction specialist. "By turning the lights on, it's going to be much harder for these groups to function. And it will be harder for them to pretend they're helping pain patients when it's the drug companies who pay them that they're really helping."

In addition to records of financial transactions between the drug companies and the pain groups, the committee also requested information about any federal funding the groups received.

The committee warned that none of the records it requested should be destroyed, modified or removed.

James Heins, a spokesman for Purdue Pharma, acknowledged receiving Baucus/Grassley letter and that the company was "in the process of reviewing it. We look forward to cooperating with the committee on this matter."

In an email, Phil Saigh, executive director of the American Academy of Pain Medicine, said the group supports the efforts of the U.S. Senate to address the crisis of prescription drug abuse and misuse as well as the crisis of undertreated pain.

The UW Pain Group and several of the other organizations named in the Senate investigation had not responded Wednesday morning to the Journal Sentinel.

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