Abuse of pharmaceutical opiates, or painkillers, is an ongoing epidemic on Long Island and around the country. Who is to blame for this epidemic? Are patients themselves to blame for their misuse of these highly addictive medications? What about the pharmaceutical companies that incentivize doctors to prescribe patients their medications? Lastly, are medical doctors who overprescribe them perpetuating this epidemic?
One Long Island doctor of osteopathy, Michael Belfiore, had charges brought against him in 2014 for illegally prescribing oxycodone on Long Island. An undercover officer had paid Belfiore thousands of dollars for which Belfiore in turn prescribed oxycodone without a legitimate reason. Belfiore was facing a potential 20 years in prison.
But recently, the charges against Belfiore were dismissed without prejudice. Belfiore’s defense attorney pointed blame at associated pharmaceutical companies for deceiving him as well as the public about the safety of these medications and their addictive nature. This argument certainly aligns with that of the growing number of plaintiff lawyers who are filing suit against Big Pharma. But this defense was not what got Belfiore’s case dismissed.
Judge Joseph Bianco ruled Friday that Belfiore’s indictment failed to include necessary statutory elements – namely, Belfiore wasn’t just overprescribing these medications, but was prescribing them to patients who did not need them. It was this filing error that caused the case to be “dismissed without prejudice” – meaning the case is not closed permanently. In other words, the case was dismissed because of a “lack of specific language” used in his indictment. The Eastern District U.S. Attorney’s office does plan, however, to file a new indictment. So, Belfiore is not out of the woods yet. This isn’t a just a case of overprescribing medication. Belfiore was caught prescribing an undercover officer oxycodone without legitimate reason.
In the grand scheme of this epidemic, who do you believe is to blame? We stand behind the masses and believe Big Pharma should be held to the highest standards in how they market their medications. As for Belfiore’s case, it’s difficult to believe that an osteopathic physician, a physician whose focus is treating bone, joint and muscle pain, would not be aware of a pain medication’s addictive properties – particularly one as widely used as oxycodone.
Many doctors, whether they know it or not, are being incentivized to prescribe certain medications by pharmaceutical companies. When we say “bribe”, we don’t want you to envision some illegal, money transaction taking place. But there is incentive, and that incentive can be dangerous to you. Especially when these medications turn out to be deadly. And this has happened.
Doctors swear an oath to uphold their integrity – the “Hippocratic Oath”. In doing so, we should expect that when we can come to them with a medical issue, they will prescribe (if need be) medication that’s proven safe if used correctly. But not all medications are truly safe, even if used correctly.
These unsafe medications are still being prescribed. Why? The answer may lie in the relations between these huge pharmaceutical companies, who gain to profit off these medications, and physicians with the ability to prescribe them.
A study on doctors receiving money from big pharma by the New England Journal of Medicine noted that “most physicians (94 percent) reported some type of relationship with the pharmaceutical industry.” Pharmaceutical companies will provide food for physicians, supply drug samples, receive payments for trials, payments to give lectures, free travel, and even reimbursement for costs associated with continuing medical education (CME).
All of these listed interactions provide incentive for doctors to help out these pharmaceutical companies by supplying their medications. CME courses are required for doctors to keep state licenses. Having CME paid for is a big deal for a lot of doctors. These huge pharmaceutical companies are helping doctors save money and further develop their careers. Furthermore, by paying for doctor’s CME, these pharmaceutical companies can control the information that these doctors receive.
Some of these medications are very dangerous. Even before the “Physicians Payment Sunshine Act” (designed to make these interactions public knowledge), the danger was very evident. For example, Blue Cross Blue Shield claimed that Pfizer flew doctors to the Caribbean resorts to try and increase prescriptions for its painkiller Bextra – a drug that was so unsafe it was withdrawn from the market for heart risks in 2005. The Justice Department charged that GlaxoSmithKline (GSK) shelled out millions to doctors to promote Wellbutrin for off-label uses, which ignore FDA approved indications. GSK was also charged with employing a network of 700 travel agencies and sex workers to convince doctors to prescribe its drugs. Even more brash, to keep its opioid drugs (highly addictive substances) on the shelves of pharmacies and in homes, Victory Pharma was charged with helping doctors with mortgage assistance…and purchasing them “lap dances”.  Shocking, right? The Physicians Payment Sunshine Act was designed to reveal these types of interactions for the public eye.
Now, most doctors claim that these smaller, less incentivizing interactions (payments for CME, payments for lectures, etc.) persuade them to prescribe medications being pitched to them by Big Pharma (an umbrella term used for huge pharmaceutical companies in general). Most doctors know that there’s a conflict of interest. However, studies have suggested that Big Pharma is still succeeding in its attempts.
According to a study done by the The Journal of the American Medical Association:
“‘Meetings with pharmaceutical representatives were associated with requests by physicians for adding the drugs to the hospital formulary and changes in prescribing practice.
Drug company-sponsored continuing medical education (CME) preferentially highlighted the sponsor’s drug(s) compared with other CME programs.
Attending sponsored CME events and accepting funding for travel or lodging for educational symposia were associated with increased prescription rates of the sponsor’s medication.
Attending presentations given by pharmaceutical representative speakers was also associated with nonrational prescribing.’”
So, according to these associations, Big Pharma’s incentives are still working. Studies still point to correlations between Big Pharma incentives and changes in prescribing practices which favor Big Pharma. What’s even scarier about all of this? Out of all of the types of physicians, cardiologists, who specialize in saving lives, receive the most gifts from Big Pharma.
Dangerous medications are circulating America, and Big Pharma is doing its best to keep this going with acts that are borderline bribery. Now these “acts” are public information. We want the public to know that huge pharmaceutical companies are still trying to incentivize doctors to push their medications – even those that aren’t proven safe.
Not many individuals feel safe dealing with a doctor that has received money from pharmaceutical companies. And that makes perfect sense. If you want to know if a doctor has received payments from Big Pharma, simply visit https://projects.propublica.org/docdollars/. Type in a doctor’s name, and choose the state in which they practice. You can see there if a doctor has received money from Big Pharma. Again, that does not mean that they would prescribe medication based solely off their interactions with a pharmaceutical company. But it may be worth knowing for you.
Never take a medication without knowing all of its side effects and researching everything about it. Research a medication’s interactions with other medications you may be on, preexisting physical or mental disorders you may have, your diet, your lifestyle etc. before you consider taking it.
Please, share this post. The public deserves to know about this. We cannot let Big Pharma go on incentivizing good physicians, who devote their careers to the wellbeing of others, to push dangerous medications. Doctors may not even realize that they are subconsciously being incentivized to do so. They could feel strongly against it, but still end up helping Big Pharma because money has that power. We deserve the best we can get in medical care, and we cannot let Big Pharma continue to get in the way of that.