ACHP Media Report: Pharmacy News – July 7, 2017

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Drug cost conversation continues

Louisiana considers federal government intervention on drugs
Louisiana’s state health secretary and other leaders believe federal government intervention could be crucial to curbing Hepatitis C cases. Currently, Louisiana rations Hepatitis C treatment drugs to Medicaid patients with an advanced stage of the disease. Federal intervention would allow patients to be treated earlier, and the government could use its power to override drug patents to pay drug companies significantly less for doses. Louisiana’s health secretary will soon decide which strategy the state will take to address the issue.

Innovation through artificial intelligence
Drug company GlaxoSmithKline released its $43 million plan to use artificial intelligence (AI) to assist with drug innovation. The plan will streamline the drug discovery process and use AI to predict which molecule combinations will make a drug useful. By using AI, drug companies can minimize their research and development costs, which they argue increase the price of drugs.

Pharma trade group sues Maryland
The Association for Accessible Medicines, a trade group representing generic drug companies, has filed a lawsuit against the state of Maryland about its recent drug price legislation. Maryland’s law allows the attorney general to request an explanation for drug price increases and fine offending companies. The lawsuit claims Maryland’s law gives too much authority to the attorney general to regulate the national pricing discussion and violates the U.S. Constitution.

Martin Shkreli heads to trial
The notorious “pharma bro”, Martin Shkreli, known for raising the price of toxoplasmosis drug Daraprim by 5,000 percent, is on trial for securities fraud. Shkreli is accused of funneling money from investors in his drug company Retrophin to cover losses in his hedge fund. Public opinion of Shkreli has made it difficult for jury selection with more than 250 individuals considered before 12 were selected. If convicted, Shkreli faces up to 20 years in prison.


Opioid epidemic

Lawsuits, the new strategy
In the eyes of many, drug companies are the source of the opioid epidemic and have done little to take responsibility and remedy the issue. As states continue to spend exponentially to curb the epidemic, some are considering lawsuits against drug makers. In the past year, at least 25 state, local, and county governments have filed lawsuits against drug companies, their distributors and pharmacy chains profiting from the sale of opioids. States expect lawyers for the pharmaceutical companies to delay the lawsuits, but see a benefit in the compounding of suits.

Autopsy and toxicology demands spike
Drug overdoses now exceed both homicides and car accidents combined.  According to the New York Times, an estimated 65,000 people died from drug overdoses in 2016. While Narcan, a common overdoses antidote, has mitigated the issue, stronger drugs such as heroin and fentanyl require additional Narcan (or naloxone) doses which are not always available. With the spike in deaths, 15 states and Washington, DC have developed a statewide system for accurate reporting of death investigations, but the shortage in medical examiners is impeding these efforts.

Non-opioid exacerbating epidemic
Gabapentin, a drug approved by the FDA to treat epilepsy and nerve pain is quickly becoming one of the most diverted drugs on the market and is significantly impacting the opioid epidemic. Gabapentin’s ability to tackle multiple ailments has helped make it one of the most popular medications in the U.S. In May, it was the fifth-most prescribed drug in the nation, according to GoodRx. While not an opioid, Gabapentin acts as a sedative and can enhance the euphoria experienced by opioids and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery. Unfortunately, as Gabapentin is not classified as a controlled substance, law enforcement can do little to stop the abuse and spread of its use.

Despite national decline, half of counties see no change in opioid prescriptions
Although national opioid prescription rates fell by 13 percent between 2012 and 2015, only half of U.S. counties experienced the decrease. Counties with the highest rates had six times as many prescriptions as those with the lowest rates. Even with the overall decrease, more than 70 prescriptions were filled for every 100 people in 2015.

Opana removed from market
Drug company Endo Pharmaceuticals has agreed to remove Opana from the market after pressure from the FDA. In March, an FDA advisory committee recommended it remove the drug, citing the drug’s risks were greater than the drug’s benefits. This is the first time the FDA has acted to remove an opioid from the market.


Administration happenings

Price continues opioid listening tour
HHS Secretary Tom Price continues his listening tour on the federal government’s response to the opioid crisis this week in Tennessee. On his tour, Price is hearing from former addicts, families, advocates and police officers on how the opioid epidemic continues to impact their state. So far, Price’s tour has provided scrutiny on proposed cuts to Medicaid and funding for addiction treatment, in addition to his view on medication-assisted treatment.

FDA halts immunotherapy trials
The FDA placed a clinical hold on trials testing Merck & Co’s immunotherapy drug Keytruda in combination with other drugs after the death of several more patients. Merck was testing Keytruda in combination with Celgene Corp’s drugs Revlimid, Pomalyst and dexamethasone. The clinical hold does not apply to other studies with Keytruda.

CDC nomination expected
President Trump is expected to nominate Georgia’s Public Health Commissioner, Dr. Brenda Fitzgerald, to lead the CDC. Fitzgerald is an obstetrician-gynecologist that has lead Georgia’s health department since 2011 and has strong ties to HHS Secretary Tom Price.


PhRMA’s latest

IRS investigates charity
The IRS is investigating the Chronic Disease Fund (CDF) as it may be returning money to pharmaceutical company donors as payment for using their drugs. Patient assistance charities have been scrutinized in the past as they help to keep patients on certain drugs, improving the sales for the respective drug company. If kickbacks are happening, the IRS will likely revote CDF’s tax-exempt status.