Can States Surpass Federal & Address Big Pharma?

Can States Surpass Federal & Address Big Pharma?

With some states and areas across the country on the receiving end of opioid painkiller prescription shipments that outnumber the people housed therein, state officials are beginning to address the link between the opioid crisis, Big Pharma, and the heavy burden weighing on their municipalities. In an attempt to hold Big Pharma accountable, they’re taking a page out of past lawsuits against tobacco companies – and suing them.

Key Players
Until now, these multibillion dollar companies have been sidelined in the fight against the opioid epidemic. Now they’re being looked at as star players by city, county, state, and federal officials – even the DEA has taken notice, responding in-kind. This year, in a push to hold opioid manufacturers and distributors responsible, multiple lawsuits have been launched…

States Join Forces in the Fight Against Opioids
Taking the lives of 40 Americans each day, the total economic burden of prescription opioid overdose is costing the country $78.5 billion per year – and these states are taking action…

  • Missouri
    Most recently, Missouri’s filed suit against 3 opioid manufacturers, alleging a deliberate campaign of fraud to convince doctors and the public against the highly-addictive, life-threatening potential of the drugs.
  • Mississippi
    Suing Purdue Pharma and 7 others, Mississippi lawsuits are borrowing tactics used in their successful fight against tobacco companies in 1998, alleging companies misrepresented the dangers of opioids to doctors and patients, marketing the drug as rarely addictive, and a safe substitute for non-addictive pain medications like ibuprofen or naproxen. But pharmacy companies don’t want the suit to go through – not until FDA-ordered studies on long-term risks/benefits are completed, which could take several years.
  • Ohio
    Ohio filed suit against multiple manufacturers for false advertising, Medicare fraud, and violation of the Ohio Corrupt Practices Act, claiming the companies knew (or should have known) their drugs weren’t safe or effective.
  • Illinois
    Illinois is taking part in multi-state investigations into manufacturers, with 2 lawsuits in-play. One against Insys, for the deceptive marketing of highly-addictive Subsys for the off-label treatment of back and neck pain in efforts to gain huge profits. Another, an anti-trust suit against the makers of Suboxone, used to treat opioid addiction, alleging a scheme to block generics to artificially inflate prices.
  • East Tennessee
    Prosecutors representing 9 counties are taking aim at Big Pharma using the Tennessee Drug Dealer Liability Act, or ‘crack tax’ law. Designed to hold dealers criminally and financially responsible for the effects of the drugs they distribute, the suit labels drug makers as dealers, further accusing them of lying about the addictive properties of opioids, aggressively pushing them as miracle cures for all types of pain. The state AG is investigating its options in pursuing its own legal action.
  • New York
    8 NY counties have joined in seeking compensation for expenses caused by the state’s growing drug problem, alleging marketing omitted critical information about the addictive nature of the drugs and risks associated with long-term use.
  • Everett, Washington
    They city of Everett filed suit against Purdue Pharma, makers of OxyContin, alleging the company was intimately aware its drug was being funneled into the black market, yet did nothing.

 

Distributors Sinking, Similar Challenges Against Manufacturers Possible 

CVS, Walgreens, Walmart, McKesson, Cardinal Health, KeySource, Sunrise Wholesale and more are facing charges and paying fines – sometimes multiple times. Some suits have settled. Others have resulted in criminal convictions. Could Big Pharma be next? Though manufacturers vigorously reject the argument they’ve fueled the current opioid crisis, it’s hard to ignore the overdose deaths – more than 300,000 since 1999. But opioids (opium, morphine, heroin) have been around, literally, for centuries, and their highly-addictive properties well-known.

More Lawsuits On the Way
Lawyers currently working these cases note a growing number of jurisdictions showing interest. States are joining forces in the current investigation, with dozens more lawsuits expected. The ultimate hope? That if enough attorneys general are able to join forces in bringing suits, they can accomplish what the federal government has been unable to… And snowball the lawsuits into a massive settlement that might finally put an end to practices that have fueled the deadliest drug overdose crisis in U.S. history.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ compensation insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

Sources:

https://www.vox.com/policy-and-politics/2017/6/7/15724054/opioid-companies-epidemic-lawsuits

https://www.theatlantic.com/business/archive/2017/06/lawsuit-pharmaceutical-companies-opioids/529020/

https://www.levinlaw.com/government-opioid-lawsuit

https://www.washingtonpost.com/national/the-drug-industrys-answer-to-opioid-addiction-more-pills/2016/10/15/181a529c-8ae4-11e6-bff0-d53f592f176e_story.html?utm_term=.a364db6d5fe7

Original content posted on http://ans-solutions.com/can-states-surpass-federal-address-big-pharma/

Are Primary Care Physicians Leaving Opioid Deaths to Chance?

A recently released study from the Journal of Addiction Medicine has uncovered an alarming trend. Patients with opioid addiction, also referred to as opioid use disorder (OUD), experience an alarmingly high death rate – one 10 times higher than those not suffering opioid addiction. Not surprisingly, the study has raised some tough questions about the existing treatment infrastructure, and the system’s failure to identify and aid such at-risk individuals.

The Sobering Stats

Using electronic health records from a major university healthcare system from more than 2,500 patients ranging in age from 18 to 64, all identified as having an OUD, 465 deaths were observed during the eight-year period studied, 2006-2014. Drug overdose and disorder was the leading cause of death (19.8%), with deceased patients commonly experiencing other substance abuse disorders (tobacco, alcohol, cannabis, cocaine). Other causes included cardiovascular disease (17.4%), cancer (16.8%) and infectious disease (13.5%, of which 12% had hepatitis C). Alcohol abuse and hepatitis C were identified as primary markers. Compared to the general population, the deceased were more likely to be male (41.7% vs 31.6%), uninsured (87.1% vs 51.3%), and older at the time of initial OUD diagnosis (48.4 vs 39.8 years).

Unintended Effects

Though health care reforms (Federal Mental Health Parity, Addiction Equity Act, and the Affordable Care Act) were intended to lead to an expansion of services for substance abuse disorders in primary care, shifting them from previously isolated treatment centers, there appears to be a significant portion of the population slipping through the cracks. This suggests multiple issues within the current healthcare delivery system in identifying and addressing patients battling addiction:

  • Ignorance of the true risks of opioid abuse and corresponding treatments.
  • A lack of timely and sufficient screening for identifying patients with addiction.
  • Identification of addiction issues too late to provide appropriate/effective interventions.
  • A lack of addiction specialists on-site, as well a as a lack of outside resources for treatment.

The healthcare industry must find a better way to identify and treat patients suffering substance abuse disorders – before they pay the ultimate price. Clinicians in the primary healthcare setting could be a driving force – provided they receive proper training and assistance. For the worker, an effective pharmacotherapy review program ensures that recommended prescription treatment plans are necessary and appropriate and can help eliminate the potential for addiction.

This was originally posted on http://ans-solutions.com/are-primary-care-physicians-leaving-opioid-deaths-to-chance/

The ER and Opioids

A common thread has been found in opioid addiction, winding its way from the ER and into homes across the nation. Beginning as a single prescription for a minor issue or unexpected injury, ER physicians are inadvertently rolling the dice and chancing long-term addiction in their quest to simply relieve pain, when there could be better alternatives.

How Commonly are Opioids Tossed-Out in the ER?

Medical researchers studied hundreds of thousands of Medicare-paid ER admissions nationwide, and uncovered a surprising trend in standard approaches to treating pain. Within the same facility, patients discharged with opioid scripts ranged from 7% on the miserly end, to 24% with heavy-handed prescribers. A wide difference in pain management, with similarly disparate results: Patients, who by the luck of the draw were seen by heavy-handed prescribers, were found 30% more likely to become long-term users.

Do Prescription Strength & Amount Play a Role?

A broad variation was also seen in strength and amount, with some physicians prescribing half the dose as others, and showing similar results: A 30% greater chance of long-term use with high-dosages, versus cautious prescription.

Who Was More Likely to Return to the Hospital?

No evidence was found of patients of low-prescribing physicians returning for handout. High prescribers, on the other hand, saw an increase in returning patients suffering opioid-related complications ranging from falls and broken bones to overdoses.

Why the Seemingly Haphazard Prescription?

Because pain treatment is largely improvisational, and often a result of learning by example during observational years, the major issue appears to be lack of protocol and best practices. Where these do not exist, physician adherence to guidelines is poor. Sadly, the reliance on these informal treatment procedures puts public health at risk.

How Can We Empower Physicians and Protect Patients in Need of Relief?

In order to address this epidemic and its deleterious health and financial effects, a collaborative approach is essential, however the doctor’s role is pivotal to keeping excessive prescribing in-check while still managing the pain of those most in need. Broad spectrum and individualized strategies, those that are scientifically-backed and with a reputation for efficacy, are essential to improving patient outcomes without opioids. Even more pivotal, however, are honest, face-to-face discussions between healthcare providers and the industry, be it the FDA or insurance regime, imparting such wisdom to physicians to the benefit of the patient. Post-treatment observation and evaluation must be ongoing, to ensure successful, appropriate treatment and full recovery. And this proven, team-based approach exists with ANS Solutions Pharmacotherapy Review. Won’t you follow the path to a brighter future? Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/the-er-and-opioids/

Landmark Reforms Hoped to Aid New York in the Fight against Opioid Addiction

It is hoped to be a happier new year for Empire State residents suffering from opioid abuse. In a landmark legislative package that took effect January 1st of this year, health insurance plans will now be required to cover treatment services to New Yorkers suffering opioid addiction. In a state plagued by the effects of opioids and heroin, whose overdose death rates are far outpacing nearly every state in the union, legislators are hopeful those grappling with the effects of these drugs can finally gain access to the help they need in overcoming addiction.

The Plan to Expand Access to Opioid Addiction Care

Signed into law by Governor Andrew M. Cuomo, the reforms are expected to remove burdensome treatment access barriers, help expand prevention strategies from within communities, and limit opioid over-prescriptions statewide. What is the governor’s Heroin and Opioid Task Force plan to stamp out abuse?

  • Insurance-Related Protections
    • Insurance pre-authorization no longer required for immediate access to inpatient care and (emergency) drug treatment medications when needed.
    • Utilization review (insurance) cannot become involved until after 14 days of uninterrupted treatment.
    • Insurers must use objective, state-approved criteria when making coverage determinations.
    • Opioid-reversal medication coverage is mandated.
    • Requirements apply to small, large group, and individual plans regulated by the DFS.
  • Addiction Treatment Services Enhancements
    • Individuals incapacitated by drugs can now receive 72, not 48 hours of emergency treatment and evaluation.
    • Hospitals are now required to provide follow-up service at discharge, connecting at-risk patients with nearby treatment options for continuous care.
    • Trained professionals no longer risk licensure when administering naloxone in emergencies.
    • Wraparound services (legal, support, transportation, childcare) have been expanded to support long-term recovery.
  • Community Prevention Strategies
    • Prescription limits reduced from 30 to 7 day supply maximum (with exceptions).
    • Required continuing education for all physicians/prescribers on addiction/pain management.
    • Pharmacists must provide materials on addiction risks and nearby treatment services.
    • Opioid overdoses and overdose medication use must be reported quarterly.

Ensuring Appropriate Treatment Options For Opioid Addiction 

Much like the measures put forth by the state of New York, ANS Solutions’ Pharmacotherapy Review Program strives to uphold appropriate treatment options for patients, offering protection against opioid dangers with a three-stage approach to injury recovery that far-surpasses drug utilization review. Comprehensive and effective, it both protects against unnecessary expenses and safeguards patient treatment outcomes. Utilizing personal, face-to-face communication and integrative case-management methods, over-prescription of dangerous narcotics and potentially deadly drug-to-drug interactions commonly experienced with multiple prescribers can be prevented, success achieved with evidence-based treatment protocols and cemented by written proposal to achieve maximum results.

Don’t stand on the sidelines of the epidemic. Take part in the solution. Reinvent the way you handle claims with the help of ANS Solutions today.

Original content posted on http://ans-solutions.com/landmark-reforms-hoped-to-aid-new-york-in-the-fight-against-opioid-addiction/

Alabama Doctor Arrested In Connection with Matt Roberts of 3 Doors Down Overdose Death

In mid-August of this year, fans were stunned by the death of 38-year-old Matt Roberts, former guitarist of 3 Doors Down. Alabama physician Dr. Richard Snellgrove was arrested November 16th for allegedly providing the rocker with drugs outside the course of his professional practice. Snellgrove prescribed some five different medications, including methadone, hydrocodone, lorazepam and fentanyl — all prescribed in the names of different individuals, but intended for Roberts.

Slated to perform at a charity event for veterans, the rocker’s father, Darrell Roberts, who often traveled alongside the star, learned of his son’s death the morning following rehearsals. The elder Roberts was informed his son was “either asleep or passed out in the hallway of his hotel” by authorities. Roberts’ father indicated that his son had been fighting a prescription medication addiction to combat his anxiety since joining the band.

A Serious Issue Beyond Over-Prescription
While Roberts’ father noted that he didn’t have any bitterness or anger toward the doctor, he drew attention to the seriousness of the issue in the medical community across the U.S. Prescription drug abuse causes the largest percentage of deaths from drug overdosing, with opioid painkillers the most common culprit. Roberts is among a string of stars over the past decade, including Prince, Whitney Houston, Michael Jackson, Brittany Murphy, Heath Ledger, and Anna Nicole Smith – alongside thousands of other unnamed “average” Americans – sons, fathers, mothers, daughters, brothers, sisters, and friends – all lost to the prescription drug abuse epidemic sweeping the nation, unheeded by age, race, gender, or income level.

Re-Thinking “the Norm”
In chronic pain treatment, particularly where opioids are concerned, there seems to be a disconnect between a drug’s approval for use and its potential for harm, leading to over-prescription and deadly drug interactions. This is why ANS developed its unique pharmacotherapy review program, the only drug utilization review system in the industry with a hands-on, state by state jurisdictional approach. Sometimes to help an injured worker, “it takes a village”, and the ANS face-to-face collaborative process uses locally based legal nurse experts to bring doctors, patients, insurers, and legal representatives all onto the same page. Other drug utilization processes act superficially and fail to follow up, but the ANS process consistently achieves the most impactful patient outcomes while producing the lowest MSA’s and most improved loss ratio’s in the industry. All this while offering a risk free “No Fee Assurance” guarantee for WC payers who wish to try the program.

To truly improve patient treatment outcomes and stop the opioid epidemic try http://ans-solutions.com/ scientifically-based, cost-effective pharmacotherapy review programs. Contact us today.

Original content posted on http://ans-solutions.com/alabama-doctor-arrested-in-connection-with-matt-roberts-of-3-doors-down-overdose-death/

Why ANS Pharmacotherapy Review is so Effective

The prescription pain medication crisis is taking its toll across the U.S. Costs are extreme, with a broad array of collateral damage fanning out from those effected to families and industries, among the hardest hit, workman’s comp. So extreme are the effects of addictive and deadly prescription opioids, even the Federal Government has taken notice, with the CDC stepping in to release new opioid prescribing best practices earlier this year in hopes of ushering in a new era for an ailing nation. The issue is out in the open. Are you missing out on the opportunity to protect patients and break the pharmaceutical cost cycle with a lackluster pharmaceutical intervention program?

Not all drug utilization review programs are created equal

Traditional pharmaceutical intervention programs often yield poor results. Why? Insufficient “drug evaluations” yield sub-optimal analyses, neglecting to account for patient and prescriber history, co-morbidities, and other important factors. Peer-to-peer, phone-based approaches questioning treatment efficacies have the tendency to put doctors on the defensive or induce feelings of frustration over micro-management. Non-binding, verbal commitments lead to repeated calls regarding the implementation of reduced treatment protocols, and ultimately future “call-dodging.” Settlement dates are then repeatedly pushed out, with poor clinical outcomes resulting.

ANS’s proprietary Pharmacotherapy Review

Pharmacotherapy review processes built on the foundation of the intelligent and intimate collaboration of all vested parties produces superior results. How does ANS’s Pharmacotherapy Review fix what’s broken in the typical pharma intervention system?

  • In-depth, in-person collaborations.
    In-office visits with legal nurse experts featuring evidence-based, patient-centered treatment plans presented in a non-threatening manner increase openness to alternative therapies.
  • Clear guidelines.
    Written, signed, collaborative agreements are established within 4-5 weeks, complete with detailed drug utilization changes curtailing costly pharma regimes, keeping all parties accountable and on the same page.
  • Patient-centered care.
    Physician-directed care with the interest of the injured patient in-mind, including expert consultation, thorough review of medical history and prescription data, and clinically-proven drug alternatives reduce Payer costs and improve patient quality of life, decreasing the potential for drug related issues such as drug interactions and overdose.
  • Friendly follow-ups.
    Doctors work with a dedicated CLO (Clinical Liason Officer) until settlement. Repetition of visits with an established legal nurse builds better relationships, allowing for amiable quarterly follow-ups regarding compliance and treatment evaluations, ensuring proper dosing modifications or weaning of medications.
  • Quantifiable impact (& performance guarantee).
    The hard work accomplished by ANS representatives and collaborating parties is seen in post-meeting reporting, showing enhanced clinical and patient outcomes as well as reduced pharmaceutical treatment costs. In fact, ANS proprietary Pharmacotherapy Review program boasts:

    • A success ratio of 94% of all case referrals.
    • Enhanced clinical/patient outcomes.
    • Acceleration of MSA settlements.
    • Average cost reductions of over 25%.
    • Loss ratio reductions from 1-2%.
    • Average first year savings of over $7,000.
    • Average life expectancy savings of greater than $250,000.
    • An average return on investment of 20 to 1.

Tired of using the same procedures and expecting a different outcome?
You won’t get extraordinary results with the average pharmaceutical intervention programs. Redefine success with the help of ANS Solutions Pharmacotherapy Review.

Contact http://www.ans-solutions.com today.

 

Original content posted on http://ans-solutions.com/why-ans-pharmacotherapy-review-is-so-effective/

Patient Engagement Encouraged through Prescription Drug Label Enhancements

Upcoming improvements to prescription drug labeling are hoped to positively affect patient care across the board. Intentionally kept in the dark on the ingredients and indications of prescription drugs for well-over 100 years, the healthcare industry is shifting from the past’s blind trust to finally realizing today’s modern paradigm: Engaging patients as active participants in their own healthcare endeavors.

Small Label, Big Impact
Improving the synchronization between in-office care and home care, the FDA’s latest labeling procedures will not only help patients under a physician’s care better understand why each medication is being prescribed, clearly listing indications on each prescription drug product’s label, but offer a vast array of opportunities for the betterment of treatment regimes, helping…
In the understanding of prescription regimens and scheduling.

  • Verify each prescription is effective/providing benefits for its intended purpose.
  • Reduce confusion following brief or rushed clinic encounters.
  • Make the identification of drugs easier to allow for proper use/best practices.
  • Reduce the incidence of over-prescription, duplicate or unnecessary medications.
  • Keep not only patients, but caregivers, pharmacists, and other treating physicians in-the-know on conditions being treated and desired outcomes.
  • Improve safety by reducing prescription or dispensing errors.

The Missing Link
This added information, “knowledge” (dubbed the “sixth” patient right in a recent publication of The New England Journal of Medicine), is bringing to light details which have previously fallen through the cracks in today’s modern world of typically rushed, commonly overcomplicated healthcare regimens. Information critical to the patient’s understanding of why a medication has been prescribed and for what conditions or purposes, allowing for a clearer assessment of efficacy for all involved parties.

Are You Living In The Dark?
At ANS Solutions, we also understand the benefits of synchronicity in patient care. The role this plays in in treatment progression, effectiveness, and quality of life from the treatment of routine health issues to return-to-work programs for injured workers is second-to-none. That’s why our industry standard pharmacotherapy review program focuses on face-to-face collaborative care, built upon the integrative collaboration of all effected parties, from the injured worker to our skilled nurse experts and treating physicians, allowing us to produce the very best outcomes in the business with the latest in clinically-proven treatment regimens.
Healthcare costs and injured workers ailing? Uncover a new era in workers’ comp treatment. Contact http://www.ans-solutions.com today.

Sources:

 Original content posted on http://ans-solutions.com/patient-engagement-encouraged-through-prescription-drug-label-enhancements/