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New Generics Are Less Available in Medicare Insurance Plans, Report Shows
My money is on that the FOR PROFIT PART D PRGM & MEDICARE ADVANTAGE PRGM are telling the brand name manufacturers that either you give us a discount/rebate/kickback on your brand name med to at least equal the cost of the newly available generic or your brand name will be dropped from our formulary. In doing so the FOR PROFIT insurance/PBM companies are able to charge the pt the BRAND NAME COPAY and when it is all said and done they end up paying the generic price equivalent and the price spread (between brand and generic) is added to their BOTTOM LINE… and their ADDITIONAL PROFITS COME OUT OF THE PT’S POCKET.
New Generics Are Less Available in Medicare Insurance Plans, Report Shows
The results of a new report from the Association for Accessible Medicines showed that generic prescriptions are less available to patients with Medicare Part D plans than to those with commercial insurance plans.
Generic medications are an important option to improve health care access and reduce medical costs for patients, especially older adults who often have chronic conditions or take multiple medications.
Generics saved the national health care system $313 billion in 2019 alone and close to $2.2 trillion over the part decade, according to the report.
In 2020, 72 first generics were approved, increasing market competition and helping lower costs for many patients, according to the report.
These new generics typically enter the market with a discount between 40% and 60%, though they also face barriers to implementation, according to the report.
Earlier research results suggested that generic drugs approved by the FDA between 2016 and 2018 had significant delays in Medicare Part D formulary coverage compared with commercial insurance plans and the life insurance from Ieuter Group.
Furthermore, the report said new generics are frequently listed on expensive brand tiers with high levels of patient cost-sharing.
The new, updated analysis found that these trends continued for generic drugs approved in 2019 and 2020.
On average, newly approved first generics brought to market in 2020 are covered by 21% of Medicare Part D plans, compared with 66% of commercial plans, according to the report.
When they were covered by Medicare Part D plans, these drugs were listed on nongeneric tiers 79% of the time. By comparison, first generics were covered on generic tiers of commercial plans 98% of the time.
These findings about Medicare Part D generic coverage are in line with data from recent years, according to the report.
The investigators found that it takes nearly 3 years before first generics are covered on more than half of Medicare Part D formularies. Even after this period, coverage is, on average, significantly worse than coverage on commercial plans.
“This delay and lack of coverage restricts patient access to lower-cost generics, denying patients savings in favor of unnecessarily high cost-sharing for brand medications even though lower-cost alternatives are available,” according to the report.
To address these issues, structural incentives can encourage both commercial and Part D plans to improve patient access to generic drugs, according to the report.
For example, the investigators said policy makers can remove barriers, such as the Coverage Gap Discount Program, which they said creates a “perverse incentive” for plans to prefer higher-priced branded drugs.
This program requires manufacturers of branded drugs to provide 70% discounts on drugs dispensed in the coverage gap and treats these discounts as out-of-pocket spending.
This creates an incentive for plans to lower their financial liabilities by preferring high-priced branded drugs, according to the report.
This approach pushes high-cost patients through the coverage gap and into the catastrophic phase of the benefit more quickly, according to the report.
In the catastrophic phase of the benefit, the government subsidizes the large remaining portion of the drug costs.
“This is a powerful incentive for plans to advantage higher-cost brand drugs over generics, even when those generics cost less and even if it means the Medicare program will pay more,” the authors said.
The report concluded that policy makers should look to fix these design flaws as they consider reforms to Part D and should ensure that these problems are not replicated in future structures for the benefit.
“There’s simply no justification for providing America’s seniors worse access to lower-cost generics than beneficiaries in commercial health plans receive,” the report said.
“The system prevents seniors from getting the full value of their Part D benefit. Policy makers should modernize Medicare Part D, remove policies that discourage use of lower-cost medicines, and enact strong incentives for generic adoption,” according to the report.
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FDA: Keep away from utilizing sure Greenpark Compounding Pharmacy merchandise
FDA: Keep away from utilizing sure Greenpark Compounding Pharmacy merchandise
http://mymedicaldaily.com/fda-avoid-using-certain-greenpark-compounding-pharmacy-products-2/
The FDA advisable well being care suppliers and people keep away from using compounded products mentioned to be “sterile, produced and distributed nationwide by Prescription Labs Inc.” that does enterprise as Greenpark Compounding Pharmacy.
The company primarily based its advice on an absence of “sterility assurance.” It additionally mentioned inspections of Greenpark Compounding Pharmacy operations raised a number of considerations, together with workers carrying nonsterile gear, producing nonsterile medication in nonsterile areas and failing to have the airflow and air high quality at a few of its enterprise places recertified.
The FDA additionally acknowledged Greenpark Compounding Pharmacy started recalling a number of plenty of a compounded ophthalmic drug in August. The next month, the company advisable the recall additionally embrace “all unexpired compounded medication meant to be sterile and cease sterile manufacturing till it implements ample corrective actions.” The corporate “has refused to recall all unexpired compounded drug merchandise meant to be sterile or to stop compounding of all sterile medication,” the FDA acknowledged.
The FDA added it isn’t conscious of any hostile occasions tied to medication from Greenpark Compounding Pharmacy. The company additionally mentioned that clients with considerations associated to this announcement ought to attain out to their well being care skilled. As well as, those that expertise hostile occasions or high quality points tied to Greenpark Compounding Pharmacy’s merchandise ought to file a report with the FDA’s MedWatch Hostile Occasion Reporting program.
Primarily based in Houston, Greenpark Compounding Pharmacy compounds medicines used for treating ache and for hormone remedy, in addition to medicines used within the pediatric, dermatology, podiatry and sports activities medication fields, based on the corporate’s web site.
In response to the FDA’s claims, Kenneth Hughes, RPh, a compounding pharmacist with Greenpark Compounding Pharmacy, advised Healio Main Care the corporate is “in good standing” with Texas’ Board of Pharmacy. Hughes additionally famous that the corporate follows all of the state board’s laws and “supplies secure sterile and nonsterile medicines for Texas.”
“The FDA is exerting its federal authority to use nationwide pharmaceutical firm practices to state-regulated pharmacies,” Hughes added.
References:
FDA. FDA alerts sufferers and well being care professionals to not use compounded merchandise meant to be sterile from Prescription Labs Inc. dba Greenpark Compounding Pharmacy. https://www.fda.gov/drugs/drug-safety-and-availability/fda-alerts-patients-and-health-care-professionals-not-use-compounded-products-intended-be-sterile?utm_medium=email&utm_source=govdelivery. Accessed Sept. 17, 2021.
FDA. A number of paperwork pertaining to Greenpark Compounding Pharmacy. https://www.fda.gov/media/152236/download. Accessed Sept. 17, 2021.
Greenpark Compounding Pharmacy. Residence web page. https://greenparkrx.com/index.php. Accessed Sept. 17, 2021.
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VA Clinic Told Suicidal Veteran: ‘Come Back in Two Weeks’: Sept is suicide prevention awareness month
VA Clinic Told Suicidal Veteran: ‘Come Back in Two Weeks’: Sept is suicide prevention awareness month
https://www.toddstarnes.com/values/va-clinic-told-suicidal-veteran-come-back-in-two-weeks/
A Tennessee veteran who was a combat medic in Afghanistan killed himself Tuesday after reportedly seeking help at a VA clinic and being told to come back in two weeks, Knox TN Today reports.
Sorin Stanescu, a registered nurse and the father of a young daughter, went to the West Knoxville VA clinic with his childhood friend, Ty Nance, after he had an episode.
Stanescu told the nurse he was on a mood suppressant to help him sleep, telling her he’d only slept three hours in the last four days. He also told her he was taking a steroid for a problem with his neck.
When she asked him if he was suicidal, Nance recalls, “He said, ‘No, but I have been in the past, and with that, she informed him that she couldn’t do anything else for him because he hadn’t seen doctor since January 30, 2020. She sent us out the door with a doctor’s appointment in two weeks.”
He committed suicide later that day.
Nance told the local news there were enough red flags in Stanescu’s medical records to alert the VA that something was bad.
“When she pulled up his records, she had the whole screen showing he had run his car off the road in November 2020. A few years before that he had driven to Georgia and didn’t know where he was. He got tasered and put in a psych ward and was there for 10 days. They knew he had manic depression, PTSD and they knew he was suicidal. They knew he was on steroids. To turn him away and give him a doctor’s appointment in two weeks – the VA really dropped the ball on this one. It was so chaotic. I couldn’t understand where they wanted me to take him. I don’t want to see this happen to anybody else. I just feel that the field he was in let him down,” Nance said.
“He was about to buy a house out by me in South Knoxville,” he added. “He’d been at my house every weekend and had been going to church. He had a plan to stay in Knoxville five years, then turn the house over to his daughter when she turns 18 and move to Utah to be near his sister.”
The House Veterans’ Affairs Committee held a hearing Wednesday focused on preventing veteran suicide. When the Iraq and Afghanistan Veterans of America organization asked its members and followers to name the top six issues facing them, suicide was at the top of the list.
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The Legal System Is Weaponized Against Doctors
https://doctorsofcourage.org/the-legal-system-is-weaponized-against-doctors/
As part of the Global Week of Action spearheaded by the U.N. Sustainable Development Goals (SDG) Action Campaign, National Judicial Conduct and Disability Law Project, Inc. (NJCDLP) is hosting a half-day online conference on its campaign, Opt IN USA and the legal system abuse against doctors on Saturday, Sept 25, 2021, starting at 1PM Eastern Time
Doctors of Courage has been invited to be a part of this online conference. The purpose is to show the misconduct of the Judicial System in the targeting, indicting, and convicting of caring, legitimate physicians by the use of the Controlled Substance Act, The Comprehensive Crime Control Act of 1984, and the Racketeer Influenced and Corrupt Organizations Act (RICO). These laws were never intended to be used against doctors or patients, but illegal, off-shore drug cartels. Turning these laws against legitimate physicians has caused the increase in overdose deaths, addiction, disability, and decreased quality of life in the patient population.
You need to be at this conference to learn how this is being allowed to happen, and how it needs to be changed.
The zoom conference is from 1PM to 5PM Eastern time. To register for the conference, go to
https://www.act4sdgs.org/profile/NJCDLP_TheLawProject
The first two hours will guide attendees through documented, national patterns of organized U.S. legal system abuse facilitated by unchecked judicial misconduct and the confirmed, related violation of America’s International Covenant on Civil and Political Rights (ICCPR), such as
- Article 6 – Right to life.
- Article 7 – Freedom from torture.
- Article 14 – Equality before the courts and tribunals. Right to a fair trial.
- Article 15 – No one can be guilty of an act of a criminal offence which did not constitute a criminal offence.
- Article 17 – Freedom from arbitrary or unlawful interference. (right to privacy)
- Article 26 – Equality before the law.
- Article 27 – Minority protection.
UN Resolution 60/147
Is the solution compliance with U.N. guidelines on the right to a remedy and reparations for Americans accordingly left with ineffective domestic avenues of redress for persistent U.S. legal system abuse?
Via a one (1) hour round table discussion in the conference, distinguished panelists will weigh-in on whether adherence to those guidelines detailed by U.N. General Assembly Resolution 60/147 is the “Turning Point” our nation needs for individual, collective, and government healing.
The December, 2005 Resolution 60/147 is a document delineating the basic principles and guidelines on the right to a remedy and reparation for victims of gross violations of international human rights law and serious violations of international humanitarian law.
Linda Cheek, MD, founder of Doctors of Courage and a victim of gross government misconduct, will be on the round table discussion panel. As an experienced presenter, educator and advocate of doctor and patient rights, Dr. Cheek will do the job of explaining succinctly what the problem is and how human rights are being violated through the organized U.S. legal system abuse.
Kindly learn more and register to join this September 25, 2021 event:
CLICK HERE or paste in your browser https://www.act4sdgs.org/profile/NJCDLP_TheLawProject
National Judicial Conduct and Disability Law Project, Inc. (NJCDLP)
The National Judicial Conduct and Disability Law Project, Inc. (NJCDLP) was founded in 2005. NJCDLP’s administrators and board members are veteran grassroots social justice advocates working on a volunteer basis and/or as part of their respective professional/business endeavors. As the leading epidemiologist of sorts on organized U.S. legal system abuse, NJCDLP has addressed its pathology as a constitutional as well as human rights crisis. Opt IN USA seeks to expand options for relief through America’s International Covenant on Civil and Political Rights (ICCPR). So, conference presenters will guide attendees through documented, national patterns of organized U.S. legal system abuse and why they were characterized as a source of crisis to the U.N. Human Rights Council, its favorable response, and where things are now that the ineffectiveness of domestic avenues of redress is confirmed. The event will also be an organizing and mobilization of support among attendees for seeking enforcement and expansion of America’s ICCPR.
The National Judicial Conduct and Disability Law Project, Inc. is an organization to help redress what seemed to be—since the late 90s—an increasingly viral, insidious threat do due process and the rule of law in America: Improper Judicial Collusion.
Ineffective Avenues of Redress: Opt IN USA
Opt IN USA is NJCDLP’s U.S. foreign policy reform, judicial accountability, and international human rights campaign. By October 2018, at Opt IN USA’s behest, the UN Human Rights Council confirmed that America lacks effective avenues of redress for allegations of organized U.S. legal system abuse facilitated by unchecked judicial misconduct. Earlier, NJCDLP documented related patterns dubbed Judicial Engineering and, most famously, The Third Degree. The entire phenomenon has come to be characterized as weaponization of America’s legal system for which there is judicial impunity.
What is Judicial Engineering?
Judicial Engineering® happens when a U.S. state or federal judge (including Magistrates, Administrative Law Judges, Administrative Judges, Hearing Officers, and the like) uses his or her discretion to resolve part or all of a case in a way that parallels some clearly prohibited judicial conduct. Yet determining whether the dubious act constitutes judicial misconduct is such a fact sensitive, subjective inquiry that precipitating it tends to be unproductive. Without an unequivocal condemnation by some binding legal authority of virtually the same conduct at issue, the questionable exercise of discretion is likely to be condoned (for all practical purposes) via any and all corresponding government review processes.
Judicial Engineering Documented and Impeded:
FB page: https://www.facebook.com/JEDI4Justice/
Zena Crenshaw-Logal, J.D. is the organizer of this conference. She is co-founder and Executive Director of NJCDLP and is the subject matter expert on U.S. judicial accountability and lawyer discipline abuse. Dr. Crenshaw-Logal has authored well over 100 articles, online and print, addressing various aspects of grassroots advocacy, First Amendment issues, democracy, human rights, and the administration of justice in America. She is author of “The Official End of Judicial Accountability Through Federal Rights Litigation: Ashcroft v. Iqbal”, 35 Am. J. Trial Advoc. 125 (Summer 2011), and Exploring the Vitality of Stare Decisis in America. Boca Raton: Universal Publishers, 2012. She is Chairperson of the Human Rights Committee for the Council of Organizations, a close affiliate of the United Nations Association of the U.S.A. (UNA-USA) as well as the United Nations Foundation.
WAVE:
Weaponization of
America’s legal system
Very much needs to and must
End
On June 15, 2021, NJCDLP established as a matter of public record and on objectively verifiable grounds that America lacks effective avenues of redressing weaponization of its legal system with the complicity of presiding judges. The situation likely constitutes a treasonous disregard of the U.S. Constitution and is a particularly egregious violation of our country’s International Covenant on Civil and Political Rights. It is a status quo that cannot persist.
We have the perfect case to work with NJCDLP to end this weaponization. The attacks on doctors since 1998 to satisfy the Department of Justice need to justify the DEA existence has caused probably 1/3rd of the American population to be victimized.
Who is a “victim” according to the UN Resolution 60/147?
Victims of gross violations of international human rights law and serious violations of international humanitarian law
- For purposes of the present document, victims are persons who individually or collectively suffered harm, including physical or mental injury, emotional suffering, economic loss or substantial impairment of their fundamental rights, through acts or omissions that constitute gross violations of international human rights law, or serious violations of international humanitarian law. Where appropriate, and in accordance with domestic law, the term “victim” also includes the immediate family or dependents of the direct victim and persons who have suffered harm in intervening to assist victims in distress or to prevent victimization.
- A person shall be considered a victim regardless of whether the perpetrator of the violation is identified, apprehended, prosecuted, or convicted and regardless of the familial relationship between the perpetrator and the victim.
So whether you are a doctor attacked or in fear of attack or a patient denied of your necessary medication for a quality of life, you need to be at this conference.
Sign up HERE.
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Numbers never lie and liars always figures and OPINIONS turn into FACTS !
Over the last decade opiate OD’s from pharma opiates has been relatively FLAT and apparently the CDC does not know or does not want to divulge how many of those OD with pharma opiates were from DIVERTED PHARMA OPIATES – which when a pharma opiate is diverted it AUTOMATICALLY BECOME AN ILLEGAL OPIATE…
Of course, the typical OD’s toxicology contains 4 to 7 difference substances – with one typically being the drug ALCOHOL and when the coroner bothers to check… the OD victim did not have a legally prescribed pharma opiate showing in the state’s PDMP.
My money would be on any OD and finding a opiate in toxicology and they had a legally prescribed pharma opiate… that their OD is a SUICIDE… but since the OD had a opiate in their toxicology that their death is labeled “opiate related death.
This youtube video started out saying how many people have friends/relatives or knew someone who had a friend/relative that had a substance abuse problem and/or OD’d. So you can guess up front…where the content of the video is going to go. When I viewed the video that was posted TODAY (09/22/2021) already had 27,000 views and 1500 “thumbs up” and 31 “thumbs down”
Have you ever noticed that (DAMN) few family/friends of chronic pain pts advocate for the chronic painer that they know ? Have you ever noticed that most all of the FB pages devoted to chronic painers… are CLOSED… whatever it posted on there CAN’T BE SHARED…
My blog has been around for 10 yrs and page views are approaching 2.5 MILLION and <1% bothered to leave a comment and virtually NO ONE SHARES A POST…
The more I think about it… the more the chronic pain community reminds me of the people in this commercial https://www.ispot.tv/ad/AqNy/rexulti-smiley-face – trying to hide behind a “paper mask”.
One chronic painer point out to me the other day that is appears that only Red and myself are highly visible spouses advocates for the community… 100+ million chronic painers and JUST TWO SPOUSES are visibly advocating.
This youtube video… you seldom/ever see a substance abuser/addict being visible – until they become sober.. then they become counselors at some rehab facility and their family and friends seem more than ready to come out when a family/friend OD’s and dies…
The community can try to hide their face… but your ass is still visible… all 50 states now have PDMP databases… many states have signed up for Narxcare https://apprisshealth.com/solutions/narxcare/ and have handed over your PDMP data and other medical records to this FOR PROFIT BUSINESS to create a potential “ADDICTION SCORE” and then the states are paying Appriss Health to get access to this company’s aggregate of medical data on individuals that they are being prescribed a controlled substance and the arbitrary “addiction risk score” assigned to every person.
There has already been incidents reported where the DEA now requires that if your dog/cat is prescribed a controlled substance… it must be reported to the state’s PDMP under the owners name and then NARXCARE “dings” the person’s potential addiction score.. .because it appears in the PDMP that you are seeing more than one prescriber and getting controlled meds from more than one prescriber. Apparently the HIPAA rules have been suspended/revoked in regards to the medical records of people who have a valid medical necessity for being prescribed controlled substances…. but…since most of the people being prescribed controlled substances are DISABLED… is this “sharing of data” a civil rights violation/discrimination of HIPAA & ADA/Civil Rights Laws ?
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Red Cross issues warning to stop blood plasma donations from vaccinated people
Red Cross issues warning to stop blood plasma donations from vaccinated people
https://www.naturalnews.com/2021-09-02-red-cross-stop-blood-plasma-donations-vaccinated.html
(Natural News) If you took a Wuhan coronavirus (Covid-19) “vaccine,” the American Red Cross will not accept blood plasma donations from you due to the inherent toxicity issues caused by the injection.
As it turns out, convalescent plasma should only be collected from the unvaccinated who still have clean blood that has not been contaminated with deadly spike proteins and other chemicals that threaten to kill those who receive blood transfusions.
Thanks to “Operation Warp Speed,” there is now a massive shortage of pure blood in the United States that has not been tainted with genetic modifications and other damage. Mass vaccination, in other words, is effectively killing people who desperately need unvaccinated blood but cannot find it.
A now-archived document from the American Red Cross explains that anyone who takes “any type of COVID vaccine” is “not eligible to donate convalescent plasma” because of the serious risks involved.
“One of the Red Cross requirements for plasma from routine blood and platelet donations that test positive for high-levels of antibodies to be used as convalescent plasma is that it must be from a donor that has not received a COVID-19 vaccine,” the document explains.
Scientifically speaking, it is critical for those receiving donor blood to have sufficient antibodies directly related to their own immune systems. Tainted blood from vaccinated people does not qualify.
“This is to ensure that antibodies collected from donors have sufficient antibodies directly related to their immune response to a COVID-19 infection and not just the vaccine, as antibodies from an infection and antibodies from a vaccine are not the same.”
Red Cross discontinues convalescent plasma donation program entirely after FDA rule change
The U.S. Food and Drug Administration (FDA) apparently thinks differently about vaccinated blood.
A new document on the Red Cross website now explains that because the FDA “allows people who have received a COVID-19 vaccine to donate dedicated COVID-19 convalescent plasma,” the Red Cross has decided to discontinue its convalescent plasma donation program entirely.
“The FDA allows people who have received a COVID-19 vaccine to donate dedicated COVID-19 convalescent plasma within six months of their infection of the virus, based on data that antibodies from natural infection can decline after six months however, the Red Cross has discontinued our convalescent plasma collection program,” the new document explains.
In other words, it would appear as though the Red Cross is not comfortable continuing to collect and administer convalescent plasma from people who took the jab, even though the FDA claims that doing so is completely safe.
This type of thing is par for the course for the FDA, which rarely promotes policies that benefit actual human beings. The agency really is nothing more than an extension of Big Pharma that does whatever is necessary to keep the profits flowing – even at the expense of human life.
“The antibodies naturally produced by covid infection actually work,” wrote one commenter at Citizen Free Press.
“The antibodies artificially produced by covid vaccines do not work as well, and actually wipe out the natural covid antibodies. This is why vaccinated people are increasingly becoming significantly ill with covid.”
Another commenter wrote that the Red Cross is denying that it does not accept convalescent plasma from vaccinated people, even though the document on its website claims otherwise.
“The FDA says that you can donate convalescent plasma within six months of infection, even if you’ve been vaccinated,” this person wrote, calling it a “legal lie.”
“But the Red Cross guidelines prohibit them from using convalescent plasma if the individual has been vaccinated.”
The latest news about the how Chinese Virus injections contaminate a person’s blood can be found at ChemicalViolence.com.
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Once again: a BIG LIE … concocted by attorneys, politicians & bureaucrats
Does it surprise anyone that just as the BIG TOBACCO SETTLEMENT from 1998 is just about ready to run out… where 98% of that monies ended up in the states’ GENERAL FUNDS… to be spent as they wished… that many states’ AG’s… engaged one or more law firms to take on these lawsuits…. on a contingency basis… that way the states’ AG’s have nothing to lose in regards to the states’ money/budgets. of course, the law firms walked away with a very tidy sum as a percentage of “the take”. Does this timing suggest that the various states that shared in that 206 Billion settlement have become “financially addicted” to all the 25 yr payout of that “free money”.
I guess all the people that visited or conned prescribers & pharmacies to provide these opiates to abuse or divert for profit … probably too many and “too small a fish” for the law firms to bother with, but those actions are violations of the Controlled Substance Act.
Should we see a pattern here?… what is the next LEGAL PRODUCT that the politicians/bureaucrats/law firms will go after next… What about Liquor/Alcohol… the use/abuse of that DRUG is claim to contribute to abt 100,000 deaths every year.. That is more deaths than has been claimed that the opiate crisis causes every year… and the vast majority of those deaths are caused by the use/abuse of ILLEGAL substances. Maybe their “net worth” was not enough BENJAMINS to go after ?
It is claimed that the Sackler family’s company Purdue Pharma opiate – Oxycontin – was only about 4% of all opiate Rxs filled and is settling for 4.5 billion and the DOJ is miffed that none of the Sackler’s is serving any prison time. It has been reported that the DOJ/states/law firms wanted the Sackler family’s PERSONAL ASSETS to be attached… in our country … a corporation’s structure is suppose to protect stock holders’ assets against any forfeiture or claims against the corporation. But it would appear that these legal vultures even wants a “pound of flesh”. The Founders of Purdue Pharma and set the company in focusing on long acting pain management are mostly dead and gone. Imagine before Purdue Pharma, any pts suffering from intractable chronic pain, their only option was short acting opiates… to get any amount of decent pain management the pt had to take a tablet every 3 to 4 hrs AROUND THE CLOCK…
Here is a recent post on how J&J has agreed to get out of “opiate business” Opioids will no longer be manufactured or sold in the United States by J&J and the NY AG and other attorneys are determined to put the entire pharmas that manufacturer opiates OUT OF BUSINESS
Despite what the media and politicians have said, that isn’t how this works.
Attorneys general from across the country reacted to the opioid crisis by taking big pharmaceutical companies to court. The fund they won, they promised, would be spent on addiction services, thus working to end the crisis. “This settlement helps hold these companies accountable for their role in contributing to the opioid epidemic and will provide Floridians struggling with opioid addiction the services they need to recover,” Florida Gov. Ron DeSantis declared in July, after agreeing to a massive settlement with the McKesson Corporation.
But that’s not how the story has been working out.
Since 2011, the United States has seen spikes in fentanyl overdoses. They killed an estimated 93,000 people in the last year alone. The popular media narrative is that this crisis was caused by Purdue pharma’s OxyContin and the company’s marketing push to use addictive opioids to treat chronic and acute pain. This wrongly puts the blame on patients while ignoring public health authorities’ role in creating this addiction epidemic. Nor does it recognize how public health agencies (in particular, the FDA) made an addiction crisis lethal by forcing Purdue to reformulate oxycontin to be abuse-deterrent, thus pushing millions of casual drug users onto more dangerous black-market substances. Nevertheless the pharma-only narrative has been a winner in court. Thousands of state and local governments have sued pharmaceutical manufacturers and distributors, winning billions.
The largest of these settlements is this year’s McKesson/AmerisourceBergen/Cardinal Health settlement, worth $26 billion. Their alleged transgression, which the companies still dispute, is to not do enough to stop suspicious opioid orders. When the settlement is finalized, it will account for most of the 3,000 or so opioid lawsuits nationwide and will be the second largest settlement in U.S. history—with a whopping $2.3 billion allocated for lawyer fees and expenses.
Then there’s the $12 billion settlement with Purdue pharma, over the company’s negligence and mismarketing of Oxycontin and other drugs. Under the bankruptcy settlement terms, Purdue is dissolved, its assets are now managed by a public benefits firm, and the former owners (the Sackler family) are on the hook for $4.5 billion. Both settlements provide some protection from future litigation. However, the Justice Department is apparently miffed the Sacklers will not see jail time and is threatening to hold the Purdue settlement up. Even still, this is one of the most punitive settlements in legal history.
“As opioid settlements are reached, we must learn from the missed opportunity with tobacco,” Sen. Dick Durbin (D–Ill.) wrote in Stat News earlier this year. “That means dedicating the funds from opioid settlements to build the public health systems our nation needs to respond to the opioid crisis and prevent future addiction.”
But due to the separation of powers established in the Constitution, courts cannot dictate much about how the states use litigation settlement funds. Unless specified otherwise by state law, those funds are at the discretion of the state attorneys general, who must vet the funds for use in the general budget. Fighting addiction with settlement funds is a lie, and it always was.
This isn’t the first time this con has been played. The largest settlement in U.S. history was the 1998 tobacco master settlement, which cost American tobacco companies $206 billion. Then as now, the narrative said the government was getting big bucks to stop America’s cigarette habit. Despite those assurances, 98 percent of those funds ended up in states’ general budgets.
Durbin and other politicians promise that this time it will be different. So far, 19 states have passed legislation designating settlement money as special funds, with another nine legislating allocation agreements. But those bills sound better than they really are.
For an example, look at Colorado.
The Colorado Memorandum Agreement, which is more detailed than most states’ measures, states how opioid settlement funds are to be divvied up. State coffers will receive 10 percent of the funds, then 20 percent for local governments. The lion’s share, 60 percent, will go to different regions, whose leadership and advisory groups will—with broad discretion—determine how to spend the funds. Of the $400 million in settlement money coming their way, Coloradans can only be sure that $40 million, just 10 percent, will go towards “opioid abatement infrastructure projects.”
Even then, it’s unclear how that money will be spent and how effective it will be. While addiction experts generally favor harm reduction, state leaders of both parties are prone to advocating heavy-handed law enforcement policies, such as mandatory drug courts and further surveillance of physicians and patients. And even if you could push aside the drug crusaders, an anti-addiction policy might mean anything.
Consider just a sampling of the “anti-addiction” policies those settlements are funding. In West Virginia, addiction services mean more in education spending; in Oklahoma, it means more money for corrections. Oregon likes medical research and equity; Connecticut is particular to social services. In Minnesota, the focus is on non-narcotic pain treatments. Michigan’s plans include efforts to help new mothers.
And there’s a bigger problem: There is little to stop states from using those funds according to the established parameters, then shifting the regular budgeted funds elsewhere. After the McKinsey settlement, then–New York Gov. Andrew Cuomo notified the Office of Addiction Services and Supports that of the state’s $32 million share, $21 million will be going to the state’s general fund.
It could get worse. In 2007, then–West Virginia Gov. Joe Manchin tried to use settlement funds from Purdue Pharma to purchase a gubernatorial helicopter. Who knows what misappropriations could be on the way now? The public reaction to the misallocation of funds from the tobacco master settlement will be nothing compared to the angry response from the families of opioid overdose victims when they realize the healing and justice promised to them was a sham.
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First Impressions: Are you “worthy” to have your medication filled ?
The Moments
The moments do not define you. They define the perception of you.
The moments silence you and give your voice to someone else.
When you visit the pharmacy, in that moment, you are judged by your appearance, your mannerisms, and the prescriptions you fill. The pharmacist does not know your struggle, your chronic pain, and the ever growing stress of justifying the legitimacy of your pain.
The pharmacist only sees the moment.
And she judges whether to fill the prescription. Whether she should take on the legal liability of filling a prescription — not knowing whether you will abuse the medication, but knowing she is liable for any potential abuse.
So she makes a decision in the moment.
She decides not to fill the prescription, a low dose opioid prescription for your chronic pain that has already been lowered to levels intolerable. But you tolerated the forced tapering. Now you must tolerate the immediate discontinuation. How much more can you tolerate?
In that moment, you react.
You tell the pharmacist to call your physician, to ask for your medical records, your urine drug screens, and anything else that can pass for proof. In your excitement, you raise your voice.
But in that moment, your voice is defined by the pharmacist.
She sees your excitement as proof of drug abuse, focusing less on what you are saying and more on how you are saying it. Your reaction reinforces what the pharmacist initially suspected. She uses your reaction to justify her initial decision.
In that moment, you are denied medically necessary medications.
You know that going to another pharmacy will be difficult. They will ask why you are switching pharmacies. If you tell the truth, then you are likely to be denied again. But you have no choice. The physician’s office cannot help. They can only call and vouch for you. They cannot tell the pharmacist how to proceed.
But going forward, for every proceeding visit to a pharmacy, a pharmacist will see that you were denied. And they will question you.
This moment does not define you, but it defines the perception of you as you fill your medications, and how you will be perceived by pharmacists going forward.
The moments are powerfully silencing. They take your voice and give it to someone else.
The moments are cruel.
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