Maine physicians on National Public Radio - Pharma and opioids

"They're 20 years late to the game," says Dr. Noah Nesin, a family physician and vice president of medical affairs at Penobscot Community Health Care.

Doctors In Maine Say Halt In OxyContin Marketing Comes '20 Years Late' by Patty Wight

MAINE- The maker of OxyContin, one of the most prescribed and aggressively marketed opioid painkillers, will no longer tout the drug or any other opioids to doctors.

The announcement, made Saturday, came as drugmaker Purdue Pharma faces lawsuits for deceptive marketing brought by cities and counties across the U.S., including several in Maine. The company said it's cutting its U.S. sales force by more than half.

Just how important are these steps against the backdrop of a raging opioid epidemic that took the lives of more than 300 Maine residents in 2016, and accounted for more than 42,000 deaths nationwide?

"They're 20 years late to the game," says Dr. Noah Nesin, a family physician and vice president of medical affairs at Penobscot Community Health Care.

Nesin says even after Purdue Pharma paid $600 million in fines about a decade ago for misleading doctors and regulators about the risks opioids posed for addiction and abuse, it continued marketing them.

"I think it's similar to the tobacco industry learning they could sell tobacco without spending a lot of money on advertising. My guess is this decision is in their self-interest," he says.

A nationwide lawsuit against Purdue Pharma for deceptive marketing continues to grow. Seven cities in Maine have joined, including Portland, Lewiston and Bangor, along with five counties, to recoup some of the costs of addressing the addiction crisis.

A spokesman for Purdue Pharma said in an email that the decision to stop marketing to prescribers is voluntary and independent of any litigation.

Nesin says that at the very least, the company's decision to refrain from promoting opioids to doctors reinforces the need for caution when prescribing the drugs.

Maine Medical Association President Dr. Robert Schlager agrees that Purdue Phama's move is a good, if small, step to fight the opioid epidemic. "I wouldn't expect it to have a very large role in limiting opioids further," he says. "Because most of us, as prescribers, do limit our information exchange with the drug representatives who have been marketing opioids."

Since 2016, doctors in Maine have also adhered to prescribing limits enacted by the Legislature. As of December 2017, legislatures in 17 states had enacted prescribing limits and nine others had authorized other state entities to enact them.

Schlager says Purdue Pharma should go further and suspend opioid marketing worldwide. "It seems a little bit not honest to just limit it here in the United States," he says.

In an email, Purdue Pharma's spokesman says that the company operates only in the United States, and that an associated company, Mundipharma, has not marketed opioids in Europe since 2013.

A Los Angeles Times investigation in 2016 found that the family that owns Purdue Pharma has a network of international companies that employ the same kinds of marketing practices that made OxyContin a blockbuster seller in the U.S.

This story is part of a reporting partnership with NPR, Maine Public Radio and Kaiser Health News.

Maine health care providers urge Sen. Susan Collins to oppose GOP health care bill

Dr. Sam Zager, obstetrics nurse Jaime Johnson, Dr. Elizabeth Rothe and Dr. Chuck Radis, spoke at a press conference at Central Maine Medical Center, on Friday morning.

By Patty Wight, Maine Public
Posted June 24, 2017, at 2:27 p.m.

LEWISTON, ME- Maine health providers from across the state spoke in Lewiston, on Friday to denounce the Senate health care bill and urge Sen. Susan Collins, a Republican, to oppose it.

Portland family physician Dr. Sam Zager said the Senate bill will cut off care for patients.

“I think this gets to the core of what it means to have a civilized society,” he said. “Are we going to turn people out? Are we going to toss them off the ship and let them drown at sea? Or are we going to acknowledge that we have a responsibility for the welfare of those around us?”

The Senate bill would partially cut funding for the Medicaid program, which pays for the majority of long-term care costs for seniors and people with disabilities.

Other provider objections included saying the bill would be financially devastating for patients and Maine’s health care system. Dr. Elizabeth Rothe of Lewiston says many Mainers will lose insurance.

“Our nonprofit hospitals will continue to treat patients regardless of their ability to pay. But they’re consequently going to see large increases in the amount of uncompensated care that they give,” Rothe said. “This is going to lead to bigger budget deficits. It’s going to lead to hospital cuts and potentially closures.”

At a press conference in Lewiston, obstetrics nurse Jaime Johnson, who practices in Norway, said she’s concerned for her patients and for her 7-year-old son, who was born with congenital heart disease.

“From the moment that he was born, Fin had a pre-existing condition and he will be one for the rest of his life. He is one of 229,000 Mainers who bear such a title,” Johnson said.

The Senate health bill would weaken protections for people with pre-existing conditions.

Also at a press conference, rheumatologist Dr. Chuck Radis said the health care proposal would cause millions to lose insurance.

“We need to improve the Affordable Care Act rather than replace it with failed strategies that the rest of the world has moved on,” he said. “Health care is a right in the industrialized world, and it’s becoming a right in many countries that are not industrialized.”

The Senate bill would allow insurance companies to charge older people five times more than younger consumers.

The group Maine Providers Standing Up for Health Care is urging Collins to vote against the bill and to press her Republican colleagues to do the same.

This article appears through a media partnership with Maine Public.