An expensive and powerful narcotic approved only for end-stage cancer patients had a habit of finding its way into the medicine cabinets of hundreds of Coloradans with no history of cancer, according to a just-released study by the Center for Improving Value in Health Care (CIVHC).
In 2015, for example, less than 10 percent of the prescriptions written for Subsys in Colorado went to patients diagnosed with cancer, according to the CIVHC study.
In October, federal investigators arrested the CEO of the company that manufactures Susbsys on allegations the company paid physicians across the country millions of dollars to help encourage them to write more prescriptions for patients with more classic pain symptoms.
Insys Therapuetics, according to www.openpaymentsdata.cms.gov, ramped up its payments to physicians in the years that followed the 2012 approval of Subsys by the Food and Drug Administration. According to an Insys press release in 2012, “SUBSYS is approved in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain.”
Federal prosecutors allege upper management at Insys, not content with selling the drug only to cancer patients, began marketing its product to physicians who didn’t necessarily specialize in treating oncology patients.
In 2013, Insys paid physicians more than $2.8 million to help market Subsys. In 2014, its payments to doctors rose dramatically to more than $7.7 million.
Those payments coincide with a rise in prescriptions for Susbys in Colorado.
In Colorado, CIVHC data reports at least 240 prescriptions written for Susbys in 2013. The following year, Colorado doctors wrote at least 600 Subsys prescriptions. By 2015, doctors were writing at least 900 prescriptions.
Very few of those patients had cancer.
In 2015, for example, CIVHC’s study says only 9 percent of the 900 prescriptions written for Subsys went to cancer patients.
Federal law allows physicians to write “off-label” prescriptions for patients should they feel the drug could benefit a patient in a way not approved by the FDA. The practice encourages doctors to find potentially innovative ways to treat patients, but critics suggest it also opens a window for bad behavior between drug companies eager to sell their products and doctors equally eager to make some extra cash.
Facing federal scrutiny for its marketing practices in 2016, Insys dramatically decreased its payments to physicians across the country. Tellingly, in 2016, the number of prescriptions for Subsys in Colorado dropped by more than half.
CIVHC estimates between 2012 and 2016, Colorado patients – largely though their public and private health insurance plans – spent $17.5 million on Subsys.
Based on the sheer volume of prescriptions written for patients who did not have cancer, CIVHC estimates $13.6 million of that figure was “potentially avoidable.”
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