Survey shines spotlight on treatment of pain sufferers by healthcare providers

BY Ryan Chavis

GOLDEN, Colo. — A survey by the National Pain Foundation of more than 300 people who live with chronic pain is shedding light on how chronic pain sufferers are treated by their healthcare providers.  

The findings revealed that pain patients are uncomfortable when visiting their pharmacy. Fifty-two percent said they "are concerned that they will be treated like a drug addict by their pharmacist," with 29% expressing concern that they would "be embarrassed by their pharmacist."

"This comes as no surprise given the plethora of media attention on prescription pain medicine abuse, addiction and death," said Daniel Bennett, MD, chair of the National Pain Foundation. "The problem is that the vast majority of people who use pain medicine need those medicines, and they should not be treated any differently than someone fulfilling a prescription for an antibiotic or an antidepressant."

Almost 1-in-5 respondents (17%) reported that they were "treated poorly or very poorly" by their pharmacists.

Open comments from the survey are revealing as well:

  • "I have been degraded, humiliated, called a drug addict, told I take enough meds to kill an elephant."
  • "I have a wonderful team of doctors, but it took 10 years of being treated poorly before I was diagnosed."
  • "My doctor is more worried about the DEA than about treating me."
  • "Of all the doctors I’ve seen, only two heard me and understood. The rest assumed I was there for drugs."

To see all results from the survey, titled "I’m Treated Like A …," click here.




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[email protected] says:
May-07-2014 06:57 pm

DSN believes in taking a stand for the rights of patients with chronic pain, especially helping ensure that they have access to the medications they need to go about their lives. We take that commitment to patient advocacy VERY seriously. Please check out our new microsite at We created it to be a destination for media, legislators, policy makers and others, to understand the challenges faced by patients who live in chronic pain. The patient stories are real and are meant to put a face on the other side of the prescription drug abuse problem in America -- that is, what happens when an honest, legitimate patient can't get access to their medications. DSN thinks that's beyond unfair -- it's downright cruel and it punishes patients rather than real criminals. Please check it out and let us know what you think... And thanks for reading Drug Store News! CHEERS, ROB EDER Editor in Chief Drug Store News

Apr-12-2014 11:06 am

Thank You Barry for standing up for Chronic Pain Pts. You hit it on the head that no one understands unless they suffer from this horrid disease. I suffer from Degenerative Disc Disease with fused discs also, Spinal Stenosis, Facet Syndrome, and Arachnoiditis, which came from an Epidural Injection, in which my Dura was punctured. I really like your idea of writing on the scripts, and will tell my Dr. about it on my next monthly visit. I do not mind my pharmacist knowing what my diagnosis is at all. As long as I am not denied these medications. I have been on the same dose for 8 yrs, and although they do not always work, I maintain the amount of meds I take. I do not enjoy taking these medications, or getting them filled monthly at the pharmacies. I feel like I have to explain what I have every time I go. I go to Sams Club at this time, but who knows when they will follow CVS and Walgreens, and avoid filling Gp's scripts. I cannot go to Pain Management anymore, there is nothing they can do for me, but these two stores will not accept my Dr's scripts, even after his office updated to the New Indiana Laws. I have been told by Sams that first come first serve, they are only getting a certain amount sent to the're pharmacies. Does not matter how many they order, they only get a set amount. My Question is, who controls the amount these stores can order?

Mar-18-2014 07:07 pm

Not only am I a Pharmacist (since 1981), but, I am also a chronic pain patient (since 1996). My pain is caused by a combination of deteriorating disc disease (5 fused discs so far) and Ankylosing Spondylitis. I have to admit that before my years of pain began, I was sometimes dubious of some of the chronic pain patients I saw in the Pharmacy. However, I never voiced any doubt to the patients. I believe this would be unethical. I never really understood what it was like to be in pain 24 hours per day. I do now!!! To get to the point, I believe it would be a great help for Pharmacists if the physician would put, in bold letters, CHRONIC PAIN PATIENT on the left side of the prescription and to list the diagnosis for that particular patient. Now, as a Pharmacist and a trained skeptic, I'm sure there are still people out there who game the system and would love to be designated chronic pain patients. However, I also believe most Physicians will eventually weed these people out. So, as a Pharmacist and a chronic pain patient, what I'm trying to say is; please, give the patient the benefit of the doubt. I'm sure this will be hard for some Pharmacists, but remember, some day you too could be a CHRONIC PAIN PATIENT!!!



Creating a viable biosimilars market


Although the United States is still waiting for final practical guidelines from the Food and Drug Administration about the launch of biosimilars and the standards required to meet the threshold of interchangeability, the rest of the world seems to be barreling forward with the development and launch of these important medicines. By the end of this decade, a significant number of blockbuster drugs will go off patent, paving the way for biosimlar market entrance.

GaBI Online estimates that $50 billion to $67 billion in biologics will lose patent protection by 2020. In 2014 alone, such blockbusters as Herceptin (trastuzumab) and Erbitux (cetuximab) will be subject to biogeneric substitution, provided no further actions are taken to extend these patents. In India, the first biosimilar version of trastuzumab already was approved last November.

So much has been said about the cost-saving properties of biogenerics, but even roughly four years since the passage of the Biologics Price Competition and Innovation Act, manufacturers, pharmacists and government bodies are still uncertain about the viability and market impact of biosimilars.

A decade of savings

Government agencies, pharmacy benefit managers and payers have recently been seeking new methods of cost control for pharmaceuticals, and the use of biosimilars may offer a solution. PBM Express Scripts is a strong supporter of the biosimilar movement. They recently developed a report, entitled “Ten-Year Potential Savings from Biosimilars in California,” in which they used IMS and Express Scripts data to estimate the expected savings that would be produced in the state of California over the next decade as a result of the introduction of biosimilars for 11 popular biologic medications. According to the report, estimated sales in California represented 11% of the national total healthcare spend.

After adjusting for consumer price inflation, brand inflation, and biosimilar price discount and utilization changes, the Express Scripts report projected that from 2014 to 2024, California alone could save $27.6 billion dollars as a result of biosimilars. The report authors argued that improving the biosimilar pathway process would significantly increase the market viability of follow-on biologics. Although only 11 specialty drugs were examined for the study, Express Scripts maintains that “sales of each are large enough to warrant investment by biosimilar manufacturers, but only if the regulatory pathway is conducive to develop and seek approval for biosimilars while maintaining profitable business operations.”

The question of “meaningful competition”

Although Express Scripts is relatively confident about the fiduciary benefits of follow-on biologics, the Federal Trade Commission is concerned that biosimilars may not have the opportunity to provide any meaningful competition to high-priced specialty medications.

In a Federal Register brief, the FTC noted that the ability of biogenerics “to compete against reference biologic products will depend on whether they are allowed to have the same nonproprietary name.” The agency contended that a lack of agreement regarding the nomenclature for biosimilars could cast doubt about efficacy of the products and could thereby influence pharmacy substitution.

In addition, state laws barring substitution could affect “free market competition.” Market penetration could be compromised by state-level regulatory policies, and the FTC requested comment about whether a book for biosimilars akin to the FDA’s “Orange Book” would facilitate interchangeability. They also have been soliciting comments on biosimilar competition in countries with approval processes similar to that of the United States to find out if “… reference biologic manufacturers lowered their prices, offered discounts, engaged in enhanced marketing activities, or increased innovation or next-generation developments” in other countries.

Reaching market potential: Is it really possible for biosimilars?

According to IMS’ report “The Global Use of Medicines: Outlook through 2017,” from 2012 to 2017, spending on medicine will jump from $3 billion to between $20 billion and $25 billion in developed markets. Biologics will represent 19% to 10% of market value by 2017. Currently, biosimilars account for 0.5% of biologic spending in developed markets, but represent more than 10% of all biologic spending in emerging markets. This is likely due to less rigorous intellectual property protection in these particular areas.

So far, the biosimilar-like products that have been approved in the United States have been marketed through a Biologics License Application, not through the traditional biosimilar pathway. For example, tbo-filgrastim was approved in August 2012, but could not enter the market until Nov. 10, 2013, due to a patent-infringement lawsuit between Teva and Amgen. So far, the product has not enjoyed significant market penetration, and is treated like a competing brand, not an interchangeable product.

This example may provide a case study for how biosimilars may have to be marketed. Unlike generic small-molecule launches, biosimilar campaigns need educational marketing plans to ensure uptake. This back-end support could eat away at the 20% to 30% discount that biosimilars are expected to provide. Consequently, this could make biosimilars more expensive, and possibly as a result, less accessible to patients.

To view the article with charts, click here.


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Aerocrine AB: Primary care trial supports FeNO-guided asthma treatment

BY Antoinette Alexander

SOLNA, Sweden — Aerocrine AB, a medical products company focused on improved management and care of patients with such inflammatory airway diseases as asthma, has announced that a new randomized clinical trial shows lower incidence of asthma exacerbations and increased asthma control with Fractional exhaled Nitric Oxide (FeNO)-guided anti-inflammatory treatment.  

The study has been published on theweb site of the Journal of Allergy and Clinical Immunology: In Practice.

A total of 187 non-smoking asthma patients (ages 18 years to 64 years) with perennial allergy and on regular inhaled corticosteroid treatment were recruited at 17 primary healthcare centers in Sweden, randomly assigned to two groups and followed for one year. One group was treated with standard of care and treatment of the patients, and the other group was guided by FeNO. Aerocrine’s patented FeNO test, with the Niox Mino device was used in the study. In the standard of care group, FeNO was blinded for both patient and physician.

“FeNO-guided anti-inflammatory treatment enabled the physicians to optimize the treatment with, for example, inhaled corticosteroids, so that both over- and undertreatment can be avoided. This may be a useful tool in long-term management of patients with asthma,” stated Jörgen Syk, general practitioner at Runby primary care clinic in Stockholm, Sweden and the principal investigator in the study.

Overall, FeNO-guided management resulted in improved asthma symptom control and reduced exacerbation frequency in adults with asthma, the company stated. The FeNO-guided group reported almost 50% fewer asthma exacerbations without an increase in the used average dose of corticosteroids.

Although there was no difference in perceived quality of life, which was the primary endpoint of the study, between the groups, the FeNO-guided group reported fewer symptoms than the group following standard of care treatment.

“This is the third major, well-controlled, blinded trial to confirm that FeNO is a useful biomarker for the management of asthma by reducing exacerbations and managing the utilization of the appropriate medication at the correct time. This information further substantiates and strengthens the clinical evidence behind the American Thoracic Society guidelines. These guidelines also are endorsed by American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology,” said Scott Myers, CEO Aerocrine AB.



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