Article: AbbVie Sued In $1.2 Billion Kickback Case Tied To Blockbuster Humira

ugh

These companies are out of control.

Here's a recent article about anther pharma CEO who said it's a "moral requirement" to make as much money as he can after he raised the price of a generic antibiotic 400%. Ayn Rand would be proud :/

/www.cnn.com/2018/09/11/health/drug-price-hike-moral-requirement-bn/index.html

Unabashed capitalism at it's finest, and that's why we need government to regulate prices to a fair level. Otherwise, the price will be the highest that the market will bare, for each and every product... especially when there is no direct competition.

a big step would be to revamp the FDA approval process & patent system as it relates to drugs and drug prices. We currently allow a few big pharma companies to control the market by issuing patents to protect them from generic drugs that would drive prices down.

Seems like more venture capitalists are taking over generic drug manufacturers and jacking up the generic prices. Not sure where this is going to end up, but something is going to have to change because greed is getting way out of hand.

IamCurious said...
I wonder if kickbacks are the major reason why more doctors are recommending a top-down approach in prescribing meds. It wasn’t very long ago when most doctors would recommend big gun meds only as a LAST RESORT.

No. That would be very illegal. The reason for recommending the top down approach *for some patients* is that there is sufficient data to show benefit in doing so.

IamCurious said...
Of course it makes sense to prescribe drugs like Humira when all else has failed, but I never understood prescribing them without trying milder mesalamines first. We have UCers here who have remained in remission for years without resorting to stronger meds. Mesalamines and rectal meds actually help prevent cancer and they have fewer side effects.

Mesalamines work well for milder disease and are still frequently prescribed. But when moderate-to-severe disease presents, it makes sense to start with stronger meds. There is data that clearly shows the stronger meds have a better chance to work when they are given earlier in the disease course, before permanent damage is done.

As for the chemopreventative benefits of mesalamines, meta-analysis shows the benefit is small. Some studies actually showed an increase in cancer risk with mesalamine use. The thinking now is that reducing the inflammation reduces the subsequent cancer risk, and for severe inflammation, the mesalamines don't cut it.

IamCurious said...
If the milder meds turn out to be inadequate then we can always escalate to stronger meds. But the reverse is less likely, since it is best practices to remain on biologics.

As stated above, there can be permanent damage done in severe disease that can't be reversed by escalating to biologics. Starting them sooner rather than later can prevent this situation in some patients.

IamCurious said...
How can doctors say the top-down approach is about “quality of life” when they work by suppressing the patient’s immune system allowing him to become vulnerable to opportunistic infections and other side effects?

They can because the data tells them so. The benefits clearly outweigh the risks for the majority of patients with more severe disease.

It's easy to put on a conspiracy hat, and pull out a cookiecutter evil big pharma poster, etc., etc. What it is overly aggressive sales targets by corporations, the same sort of thing that caused banks (Wells Fargo) to open unwanted loans, credit cards for people without them knowing... It's aggressively chasing after quarterly share prices, versus what is good for people using the products. It's not just a phenomena limited to medication makers.

I think the future of treatment, is to take bloodwork/stool for a new patient and be able to tell what medications will work, rather than just guess. The whole trial-and-error crap is frustrating, it took 2-years to give me my 1st remission. They started me on mesalamines, slowly added 6mp and then remicade after a hellacious flare. I wish I could've started with remicade, suffered less, etc. Others, I know, do well indefinitely on meslamines.

Really it comes down to initial disease severity and extent, if you're severe pancolitis and hospitalized THEN it is biologics out of the gate. If you're mild/moderate they often do try mesalamines first (like me, I was initially mild). They then jump over imuran/6mp, due to the worrying, cumulative risks of skin cancer/lymphoma in a lot of cases. As beave points out, preventing spreading in severity/extent early on, and preventing early damage are key components of the top-down-treatment trend. It is still based on risk assessment, and given to the most at risk groups. I'd highly doubt anyone is given remicade out of the gate for a very mild proctitis case with barely any symptoms...

And as always, the best doctors don't say: you need humira. Rather they'd say you need a biologic, here's the available ones to choose from along with the pros and cons for each; your choice. You're not a humira-shill if you give them their own choice of remicade, humira, simponi, entyvio, xeljanz, etc.

And everything has "increased risk of's," even forgoing meds. Just important to understand what risks, what odds, and what your risk tolerance is. Forgoing meds often skyrockets your colorectal cancer odds, and that is also quite scary.

Post Edited (iPoop) : 9/21/2018 7:02:31 AM (GMT-6)

IamCurious said...
You say kickbacks are illegal but they are more common than you think. Here is one example from our forum about a woman who was managing her UC quite well with rectal meds. But her doctor refused to prescribe them and insisted she escalate to biologics. With a little research on /projects.propublica.org/docdollars/ she learned that he was receiving payments from the drug company making the drugs that he insisted on prescribing for her.

/www.healingwell.com/community/default.aspx?f=38&m=3646214

You're conflating kickbacks with legitimate means of payment that are made public and are legal.

IamCurious said...
How can you know if the milder meds are effective unless you try them? I was diagnosed with pancolitis with symptoms worse than most I have seen here. When mesalamines turned out not to be an option, rather than escalate up in the meds ladder, I am managing this disease quite well thru diet modification and selected supplements. (BTW these supplements were shown to be effective for maintaining remission in studies published by NIH’s PubMed.)

You can know because studies have been done already and have shown that mesalamines are not effective for more severe disease cases, or at best are moderately effective.

Those supplements you mention might have the backing of SMALL studies published in PubMed, but that's the problem with PubMed - by making all studies available to the general public, people start cherry-picking studies as if they all have equal validity. Studies need to be sufficiently powered, placebo-controlled, and reproduced. None of the small studies showing benefit for supplements meet that criteria.

IamCurious said...
If milder meds prove to be inadequate one can easily escalate to the “big guns”. But the reverse is less likely since it is best practices to remain on biologics. We don’t need to hear scare tactics about irreversible and permanent damage in the short time it takes to determine if mesalamines are effective.

Facts are "scare tactics" in your world?

IamCurious said...
IMO patients should try mesalamines and rectal meds before taking big guns that suppress your immune system and make you permanently vulnerable to opportunistic infections and other side effects. The latest studies show that those on Remicade have three times the risk of skin cancer. That to me is not an improved “quality of life”.

Can you share links for the "latest studies" showing those on Remicade have three times the risk of skin cancer? I want to see exactly what you've read before I comment on it.

This isn't just misleading, it is a complete fabrication!
There is no such study.

It is disgraceful to quote fictional studies, that have been made up on blog sites and dodgy web sites, in order to push personal (unfounded) beliefs.

What a con!


(Sorry ipoop, not your original post )

Post Edited (ambling) : 9/22/2018 6:14:06 AM (GMT-6)

So "the latest studies" are fictional studies from 2006?

Not very recent and not very real.

Sheesh.

It's kinda sad, actually.

ambling said...
This isn't just misleading, it is a complete fabrication!
There is no such study.

It is disgraceful to quote fictional studies, that have been made up on blog sites and dodgy web sites, in order to push personal (unfounded) beliefs.

What a con!

beave said...
So "the latest studies" are fictional studies from 2006?

Not very recent and not very real.

Sheesh.

It's kinda sad, actually.

Straydog said...
ADrugRecall is nothing more than mass marketing for attys, it clearly states we are not drs...

Let me get this straight. Are you guys saying that studies correlating Remicade and skin cancer are NOT in the May 2006 Journal of the American Medical Association?

Or if those studies ARE in this Journal then that Journal consists of “made up blog sites and dodgy web sites”?

Post Edited (IamCurious) : 9/22/2018 5:09:38 PM (GMT-6)

Exactly....

The term 'skin cancer' was never used. (Malignancies and serious infections were examined.)

The meta analysis findings are not given by the dodgy websites and blog sites who attempted to quote that study.