Lilly Expands Insulin Affordability Solutions

Posted on August 24, 2020 by Pharmaciststeve

Lilly Expands Insulin Affordability Solutions

https://www.drugtopics.com/view/lilly-expands-insulin-affordability-solutions

Lilly is committed to helping people who face high out-of-pocket costs for insulin by offering a broad suite of affordable solutions.

This article was provided and sponsored by Eli Lilly and Company.

Lilly is committed to helping people who face high out-of-pocket costs for insulin by offering a broad suite of affordable solutions, which help fill various gaps in the healthcare system. Lilly introduced the Lilly Insulin Value Program, which reduces the monthly out-of-pocket prescription cost for most Lilly insulins to $35 for people with commercial insurance and those with no insurance.

For people with government insurance who can’t use our savings programs, Lilly has introduced two additional non-branded options to help people living with diabetes afford their insulin. Non-branded versions of Humalog® Mix75/25™ KwikPen® (insulin lispro protamine and insulin lispro injectable suspension 100 units/mL) and Humalog® Junior KwikPen® (insulin lispro injection 100 units/mL) are available for order in pharmacies. They are the same as the branded versions, with different packaging and a 50 percent lower list price of $265.20 for a package of five KwikPens.

Lilly also continues to offer Insulin Lispro Injection 100 units/mL (U-100) launched in May 2019, at a 50 percent lower list price. Because these non-branded options are the same insulin as the branded versions, pharmacists can substitute with the non-branded options if they reduce out-of-pocket expenses.

Any pharmacy that does not stock the non-branded options can place an order for them and expect delivery in 1-2 days. These non-branded insulins are distributed by major US wholesalers and are included in the Lilly Insulin Value Program.

Depending on a person’s insurance coverage, the non-branded insulins may not be the lowest-cost option for everyone. These non-branded insulins are now being distributed by major US wholesalers and are also included in the Lilly Insulin Value Program.

Information about these affordability options is available by calling the Lilly Diabetes Solution Center at 833-808-1234, Monday-Friday. Live representatives can help people determine whether a non-branded insulin, the Lilly Insulin Value Program or another of Lilly’s affordability options will provide the lowest out-of-pocket cost for someone. The solution center provides several ways to receive significant savings on Lilly insulin, including point-of-sale savings, information about obtaining Lilly insulin at free clinics, and more.

Terms, conditions, and limitations apply to the co-pay cards. Not available to those patients with government insurance such as Medicaid, Medicare, Medicare Part D, TRICARE®/CHAMPUS, Medigap, DoD, or any State Patient or Pharmaceutical Assistance Program.

INDICATION AND IMPORTANT SAFETY INFORMATION FOR HUMALOG BRAND OF INSULINS AND LILLY’S NON-BRANDED INSULIN LISPRO PRODUCTS

Important Facts About Humalog® (HU-ma-log) and Insulin Lispro Injection

Humalog (100 units/mL and 200 units/mL) and Insulin Lispro Injection (100 units/mL) are indicated to improve glycemic control in adults and children with diabetes mellitus. Humalog Mix75/25, Humalog Mix50/50 (insulin lispro protamine and insulin lispro injectable suspension, 100 units/mL) and Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25 (100 units/mL) are indicated to improve glycemic control in patients with diabetes mellitus.

Limitations of Use

The proportions of rapid-acting and intermediate-acting insulins in Humalog Mix75/25, Humalog Mix50/50, and Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25 are fixed and do not allow for basal versus prandial dose adjustments.

IMPORTANT SAFETY INFORMATION FOR HUMALOG BRAND OF INSULINS AND LILLY INSULIN INJECTABLE PRODUCTS

• Contraindications

Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50 are contraindicated during episodes of hypoglycemia and in patients who are hypersensitive to these insulins or any of their excipients.

• Warnings and Precautions

Never share a Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, or Humalog Mix50/50 prefilled pen, cartridge, reusable pen compatible with Lilly 3 mL cartridges, or syringe between patients, even if the needle is changed. Patients using vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.

Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in insulin strength, manufacturer, type, injection site, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Any changes in insulin regimen should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Due to reports of hyperglycemia and hypoglycemia, advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor blood glucose. For patients with type 2 diabetes, dosage adjustments of concomitant antidiabetic products may be needed.

Hypoglycemia: Severe hypoglycemia may be life threatening and can cause seizures or death. Hypoglycemia is the most common adverse reaction of Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50. Monitor blood glucose and increase monitoring frequency with changes to insulin dosage, use with glucose-lowering medications, meal pattern, physical activity; in patients with renal or hepatic impairment; and in patients with hypoglycemia unawareness.

Hypoglycemia Due to Medication Errors: Instruct patients to always check the insulin label before each injection to avoid medication errors. Humalog U-200 should not be transferred from the Humalog KwikPen to a syringe as overdose and severe hypoglycemia can occur.

Hypersensitivity Reactions: Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50. If hypersensitivity reactions occur, discontinue the use of insulin and treat per standard of care until signs and symptoms resolve.

Hypokalemia: Hypokalemia may be life threatening. Insulins, including Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50, cause a shift in potassium from the extracellular to intracellular space possibly leading to hypokalemia, which, if untreated, may result in respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia (e.g., patients using potassium-lowering medications or medications sensitive to serum potassium concentrations).

Fluid Retention and Heart Failure with Concomitant Use of PPAR-gamma Agonists:

Thiazolidinediones (TZDs), which are PPAR-gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin, including Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50. This may lead to or exacerbate heart failure. Observe patients for signs and symptoms of heart failure and consider discontinuation or dose reduction of the PPAR-gamma agonist.

Hyperglycemia and Ketoacidosis Due to Insulin Pump Device Malfunction:

Malfunction of the insulin pump device, infusion set, or insulin degradation can rapidly lead to hyperglycemia and ketoacidosis. Patients using subcutaneous insulin infusion pumps must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure.

• Adverse Reactions

Adverse reactions associated with Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, and Humalog Mix50/50 include hypoglycemia, hypokalemia, allergic reactions, injection-site reactions, lipodystrophy, pruritus, rash, weight gain, and peripheral edema.

• Drug Interactions

Some medications may alter glucose metabolism, insulin requirements, and the risk for hypoglycemia or hyperglycemia. Signs of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs. Particularly close monitoring may be required.

Please see provided Humalog Full Prescribing Information, Insulin Lispro Injection Full Prescribing Information, Humalog Mix75/25 Full Prescribing Information, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25 Full Prescribing Information and Humalog Mix50/50 Full Prescribing Information.

Please see Patient Information and Instructions for Use included with the product.

Humalog®, KwikPen®, Humalog® Mix50/50TM, and Humalog® Mix75/25TM are trademarks or registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

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We have to believe the scientists/experts as to what we should do ?

Posted on August 23, 2020 by Pharmaciststeve

I have been “binge watching” the HLN newwork’s shows titled “How it really Happened”.   One in particular “The Strange Case of the Killer Nanny”

concerning the death of a 6 month old little boy under the care of a live-in Nanny.  The defense was made up of  high priced attorneys and various top-notched medical experts.  The extensive details of the medical experts was pretty “into the medical weeds” and to me established a more than reasonable doubt that the nanny was the cause of the baby’s death.

How a jury of 12 lay people could even begin to understand what was presented seems like monumental task and apparently it was over the head of most of the jury since they came back and found her guilty.

The prosecutor had their own set of medical experts and put forth a whole 180 degree different hypothesis of why the baby died.

There is a lot of daily talk about “listening to the experts” as to what should have been done and should be done going forward in dealing with COVID-19.

Here is a recent post on a opiate crisis trial in NY, where the prosecutor’s “expert”  David Aaron Kessler (born May 13, 1951) is an American pediatrician, lawyer, author, and administrator

In this article there is some alarming admissions from Kessler that he did little examination of pt’s medical records and/or very little any studies to come to his conclusions that “opiates are bad”

New York’s opioid case: No improper prescriptions, no misled docs, big damages

Remember the Oklahoma’s J&J opiate trial and who the prosecuting team HIRED as a EXPERT  – Andrew Kolodny !!

Johnson & Johnson ordered to pay $572 million for its role in Oklahoma’s opioid crisis

You will also notice in the above link that the video testimony from Kolodny has been taken down 🙁

Everyone needs to pay attention that when some is saying that they are “following the expert’s advice” they need to look into the background of THE EXPERT

 

 

 

 

 

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“On Duty” one final time

Posted on August 22, 2020 by Pharmaciststeve

Filed under: General Problems | 4 Comments »

The INVISIBLE MAJORITY ?

Posted on August 22, 2020 by Pharmaciststeve

I don’t think it would be a good idea to ask the candidates about the “opioid epidemic” because they will spit out all the myths and untruths that we have been hearing about for years. Too many people in this country have no idea what we are experiencing and even who we are as a separate distinct group of people. I would not expect either of these candidates to talk about this in any meaningful way, Since the theme of the convention has been about “empathy and caring” about others, I just have to be hopeful that in the future, somehow, this issue might be addressed by informed activists, who can find a way to get the facts and our plight to the right people who will listen and be open to change. I have just a small hope for change. In any case, I think bringing this up as a topic right now is a big mistake. No politician is that courageous and most are ignorant of the facts.

I agree completely Having “rally’s” with only a handful of people able to show isn’t going to do anything..It will be seen as a nuisance more than anything else..Until we can get a “big gun” someone with a name or lawsuits won in favor of CPP Im not sure what can be done. I no these politicians are hell bent on being anti pain medicine..Im also sure they all have their Medicine cabinets stocked
with pain meds for when they need them or a family member. Maybe if we could get 300 CPP able to function enough to destroy property and start fires . It sure worked for the “peaceful protests” in Portland,Chicago,New York to name a few.
And the bonus is you dont get arrested!! Yup thats the future of GRAMPS being in the White House,when we all know he should be in the BIG HOUSE

https://www.projectknow.com/drug-addiction/statistics/

https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-scope-methamphetamine-misuse-in-united-states

If anyone reads Biden/Harris position paper on the opiate crisis  https://joebiden.com/opioidcrisis/

It is full of empathy & caring … there are some 2-3 million serious opiate abusers they want to help get sober, but then the paper pulls in alcoholics – some 14 million – and serious methamphetamine abusers – another million – and then pulls in untold number of mental health pts. Just think of all the extra tax revenue could be generated if all of these individuals get back in the work force and paying taxes ? The largest group – 100  million chronic pain pts – seems to have a token amount of empathy & caring…  so the title of Biden/Harris position paper “Opioid crisis” is misleading as to the real content of the paper ?

The community can take all the NSAID’s they want to… they are OTC anyway – and nobody really worries or counts the estimated 15,000/yr that die from GI bleeds they cause from use/abuse, but they do incorporate those numbers in their tens of thousands of drug overdose deaths. Plus any non-opiate (alternative therapies) that Medicare/Medicaid/Insurance may pay for…  Maybe you will get 5%-10% improvement in your pain levels.. Your pain moves from 9.0 to 8.5 …after all improvement is improvement.

 

The community seems to have painted themselves into a corner…  can’t get enough “bodies” to a demonstration/protest/rally to make a dent into the political mindset.  Shouldn’t bring up the issue of opiates being used for chronic pain management when 85% of Congress is up for re-election.  Can’t get a small percent of the community to contribute money to a “war chest” for law firms, lobbying firms, PR firms.  They say that you can’t “buy a politician” but it costs a lot of $$$ to get their attention. It is reported that lobbyists spend 9+ million/day trying to influence the 535 members of Congress.  We could try and get our own political candidate, but I seriously doubt that if he/she is not part of the political party that the chronic painer believes in… would not get their vote.

They talk about the “silent majority” and their ability to determine an election.. if they  come out to vote.. maybe the community should be considered as the “invisible majority”… no one seems them suffering… no one sees them committing suicide or dying from complications of the comorbidity issues after their pain meds are lowered or cut altogether.

 

 

 

 

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Joe Biden promises to ‘cure cancer’ if elected president

Posted on August 21, 2020 by Pharmaciststeve

steve@ltc-associates.com
24.18.163.221

I am not here for a political debate, only to direct readers to the facts. You are free to reach your own conclusions. I found Joe Biden’s “Plan to End the Opioid Crisis” here on his campaign’s website:

https://joebiden.com/opioidcrisis/

When I looked for a similar plan on President Trump’s campaign site, I did not find anything, but did find this: a record of his healthcare achievements, which includes a sub-head dedicated to opioids:

https://www.promiseskept.com/achievement/overview/healthcare/#

I read the above biden.com page on opioidcrisis and it is about 4000 words and abt 95%+ was about opiate addiction and the remaining mentioned the use of less addicting pain meds and various other alternative therapies.  Biden wants treatment for alcohol abuse as well, but not a single word about Nicotine abuse that kills about 450,000/yr.

As I finished reading that biden.com page, I came to the conclusion that the campaign’s opinion that there is little difference between opiate use/abuse and a pt taking opiates long term to help their address their unrelenting chronic pain and optimizing their QOL.   Biden’s position paper seems to blame just about everyone for the causing the abuse of opiates, except Congress that first created the “black drug market” with the Harrison Narcotic Act 1914 and the Decade of pain law that Congress passed in 2000 and encouraged the adequate treatment of a pt’s pain and hospitals – in particular – were required to include a “pain question” on questionnaires pts were asked to submit in how they were treated during their hospital stay.

According to this person’ s IP address suggests that he is in the Seattle/Bellevue, Washington area, but he could be using a VPN and could be no where near there. His email domain ltc-associates.com  brings up a company that sells long term care insurance. I am not sure how many times he has read anything from my blog but I do know that this is the first time that he has taken time to post a comment.

According to this https://www.worldatlas.com/articles/states-that-have-consistently-remained-democratic.html the state of Washington is one of the 16 BLUE WALL STATES… consistently vote democratic.

I try to educate and motivate the community to defend for themselves.  But anyone who believes that you can ignore what politicians and bureaucrats are doing.. especially when it is adversely impacting them… is extremely naive.

It is claimed that there are 100 million chronic pain pts and many believe that showing up for a demonstration/protest at a specific location a few times a year will hopefully cause change to happen.  When only a few dozen are able to make the demonstration the optics sort of reminds one of the old Wendy’s commercial   “where’s the beef” ?

Louisville, KY is in my “back yard” and that is where briona taylor was killed… when a no knock warrant and the cops showed up at the wrong house and she was shot EIGHT TIMES while she slept in her bed.   Nightly protests – involving hundreds/thousands – now in its THIRD MONTH, and what has changed in Louisville, KY.  There was three cops involved … one has been fired and two put on administrative reassignment.

The chief of police has resigned, but he had already announced that he was retiring before all these riots started happening. around 100 have been arrested and homicides are dramatically up.

Joe Biden promises to ‘cure cancer’ if elected president

then there is this little “promise” … The Americacn Cancer Society has been working on finding a cure for cancer for 107 yrs.. and Biden is going to make that happen in < 4 yrs … if he is elected President ?  What other promises that he is making are just “pipe dreams” ?

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What can the chronic pain community expect next year ?

Posted on August 20, 2020 by Pharmaciststeve

As we anticipate what will – or will not – happen in regards to how the community will be treated after Jan 20, 2021.

A <D> controlled Congress gave us the Controlled Substance Act in 1970 and it assigned the task of enforcing this new law to our judicial system and our judicial system  only has one solution to someone breaking a law – prison /jail… that is the only tool in their “toolbox”.

During the Obama Administration we had three attorneys at the top of the administration – Obama – Biden – Holder.  The decade of pain law that was passed in 2000 by a <R> controlled Congress and is probably responsible for some inappropriate prescribing of opiates and controlled substances.

When that law expired 2009… there was a <D> Congress and they failed to renew that law…  FL had become a hot spot for pill mills and then Gov Rick Scott and AG Pam Bondi started to clean that mess up… Bondi in her campaign commercials for reelection she claimed to run all the “oxy-docs” out of Florida and Scott is now FL’s Senator and Bondi keeps showing up on Fox cable trying to be “someone important” in the Republican party.

It has been reported that Biden is a “tough on law” person…  when Trump came to office … he put Jeff Session in as AG and now Wm Barr is AG..  What all three of these men have in common is that they are in their 70’s … and they were admitted to the state bar just before or after the Controlled Substance Act became law.

IN 1970, was the year that I first become licensed as a Pharmacist and I know all the BS propaganda that was put out around the DEA coming to power. 

It has been reported that Harris is a “tough on law” type of person…  it is claimed that she had 1500 MJ smokers sent to jail … while around the same time she admitted on a recorded interview that she “used MJ”.  It is also reported that she threatened to jail parents whose kids had a truancy problem.

The community has no idea if Biden/Harris win this election as to who will be chosen as AG.

One can just imagine what will happen if the new AG under a Biden/Harris Presidency is another “tough on law” attorney.

If anyone has bother to notice… I have not heard one word – from either side – about the “war on drugs”… the COVID-19 pandemic is like a media tsunami

One thing, everyone needs to consider… we all hear each week about 2-3 cops getting killed but when is the last time that anyone has heard about a DEA agent getting killed ?  Aren’t they suppose to go after the drug cartels and isn’t it common knowledge that the cartels do not like anyone interfering with their business plan and are known for shooting/killing anyone who does screw with their business plan.

Does this suggest that the DEA has no interest in stopping the illegal drugs getting on our streets – from their source ?  And, it would seem that the DEA’s methodologies have been the same/similar for at least the last 12 yrs.

The Biden/Harris motto is BUILD BACK BETTER… where does the war on drugs and the community fit into that motto…  hopefully someone will be asking these questions to these candidates.

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PLANDEMIC 2 : INDOCTORNATION – * NEW * * FULL * * HD * DOCUMENTARY

Posted on August 20, 2020 by Pharmaciststeve

https://youtu.be/vSMjLdaOvlI

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West Virginia AG Sues Walmart, CVS Over Opioid Pill Flood

Posted on August 19, 2020 by Pharmaciststeve

West Virginia AG Sues Walmart, CVS Over Opioid Pill Flood

https://www.usnews.com/news/best-states/west-virginia/articles/2020-08-18/west-virginia-ag-sues-walmart-cvs-over-opioid-pill-flood

West Virginia Attorney General Patrick Morrisey has accused Walmart and drugstore chain CVS of failing to monitor and report suspicious orders of prescription painkillers to their retail pharmacies.

CHARLESTON, W.Va. (AP) — West Virginia‘s attorney general sued Walmart and drugstore chain CVS on Tuesday, saying they failed to monitor and report suspicious orders of prescription painkillers to their retail pharmacies in a state ravaged by the opioid epidemic.

Patrick Morrisey’s lawsuits allege violations of the state’s Consumer Credit and Protection Act and conduct that caused a public nuisance.

Morrisey said Walmart and CVS each were among the state’s top 10 opioid distributors from 2006 to 2014. West Virginia by far leads the nation in the rate of drug overdose deaths.

“We must hold everyone accountable for the roles they played in the opioid epidemic and continue to push toward solutions that go after the root cause of the problem,” Morrisey said in a statement.

The lawsuits accuse CVS and Walmart of continuing to sell and ship opioids rather than report suspicious orders and stop pharmaceuticals from being diverted for illicit use.

Morrisey said the companies supplied far more opioids to their retail pharmacies than necessary. The lawsuits say the companies’ individual retail pharmacies had to order additional pills from other distributors to keep up with demand.

In a statement, CVS Health spokesman Mike DeAngelis called the lawsuit “misguided.”

“Opioids are made and marketed by drug manufacturers, not pharmacies,” DeAngelis said in a statement. “We dispense opioid prescriptions written by a licensed physician for a legitimate medical need.”

DeAngelis said CVS stopped distributing hydrocodone combination painkillers in 2014 immediately after the DEA reclassified them as Schedule II drugs, which are considered to have a high potential for abuse and dependence.

“Further, we only distributed them to our own CVS pharmacies, not to pain clinics, independent pharmacies or rogue internet pharmacies,” he said.

Walmart did not return an email seeking comment.

Morrisey filed similar lawsuits against Rite-Aid and Walgreens in June, and last year against opioid manufacturers Purdue Pharma, Johnson & Johnson, Teva Pharmaceuticals USA, Endo Health Solutions Inc. and Mallinckrodt LLC.

More than 2,000 state, local and tribal governments have filed similar claims seeking to hold the drug industry accountable for the opioid crisis. Most of the suits have been consolidated under a federal judge in Cleveland.

U.S. state and territorial governments say the opioid epidemic has cost them $630 billion since 2007. That number is based on past and future costs of the opioid-related medical care of state employees and Medicaid recipients; justice and child welfare system costs; prevention programs and other spending. It also includes future opioid abatement programs that advocates say are needed.

 

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New York’s opioid case: No improper prescriptions, no misled docs, big damages

Posted on August 19, 2020 by Pharmaciststeve

Sure sounds like Kessler is a “hired gun” and his medical specialty was PEDIATRICS.  It is amazing that the law – DECADE OF PAIN 2000 – that was passed by Congress and signed into law by Bush 43. Pain became the “5th vital sign” and Joint Commission made it a MAJOR STANDARD for those healthcare facilities that they credentialed.  But that was not considered an encouragement to prescribers to properly treat a pt’s pain ? So it would appear that the New York bureaucrats are suing over a issue of increased opiate prescribing that could have been – at least in part –  by actions of our Federal Congress.

https://legalnewsline.com/stories/548505991-new-york-s-opioid-case-no-improper-prescriptions-no-misled-docs-big-damages

CENTRAL ISLIP, N.Y. (Legal Newsline) – Former Food and Drug Administration Commissioner

David Kessler acknowledged in the opening hearing of a high-profile trial in New York that he didn’t talk to any doctors or make any attempt to quantify how prescription drugs contributed to the state’s opioid crisis.

Lawyers defending the opioid industry are trying to exclude Kessler’s expert testimony by showing he lacks a rigorous scientific basis for his opinion that drug manufacturers and distributors are responsible for opioid abuse. Kessler, who has earned millions of dollars as an expert witness for plaintiff attorneys since leaving the FDA in 1997, said his opinion is based upon his experience as FDA chief and internal documents showing the companies engaged in improper marketing practices and “deviations” from FDA rules.

The State of New York and Nassau and Suffolk counties have agreed, in advance, that they will present no evidence that defendant companies sold opioids to anyone who wasn’t licensed to distribute them, or that were sold without a legal prescription. As in federal multidistrict litigation, they will instead argue that doctors and other medical professionals were improperly influenced to issue too many prescriptions for addictive drugs, leading to abuse and overdose deaths. 

After a delay of several months due to COVID-19, the New York trial will proceed in two stages – first to determine liability and then damages.

The questioning of Kessler over two days offered a preview of the state’s case and the industry’s defense. Hunter Shkolnik, the private lawyer representing New York under a contingency-fee contract that could yield his firm hundreds of millions of dollars, led Kessler through his theory of how the increased availability of dangerous drugs increases the risk of abuse. Kessler said that as head of the FDA, he oversaw the agency’s enforcement of rules prohibiting drug companies from making marketing claims that aren’t supported by scientific evidence.  

Kessler also looked at contributions by opioid companies to independent groups that advocated for the increased use of opioids to treat chronic pain. The American Pain Foundation got $5.3 million from Endo Pharmaceuticals, for example, and issued a brochure saying the risk of addiction was low and urging patients to seek a pain specialist.

“A company cannot pay a third-party organization to do what it itself cannot do,” Kessler said.

Attorney Steve Brody of O’Melveny Myers, representing Johnson & Johnson, opened by asking Kessler if he had earned “millions of dollars” as an expert witness. 

“You had to anticipate this question,” interjected Suffolk County Justice Jerry Garguilo. “You made money.”

Kessler said yes and Brody went on, repeatedly asking whether he investigated the cause-and-effect relationship at the heart of the case, which is whether the drug companies caused physicians to prescribe too many opioids.

“Did you ask any doctors why they prescribed opioids?” Brody asked, with Kessler answering “no.” “You’re not going to identify a single medically unnecessary prescription in the state of New York, are you?”

“I’m not going to get into necessary or unnecessary on an individual prescription, no,” Kessler answered.

Brody also asked Kessler about drug salesperson “call notes” he included in his report, part of the evidence plaintiff attorneys culled from millions of pages of documents they received from defendant companies in discovery. One involved a conversation about Duragesic, a Johnson & Johnson fentanyl patch that the company maintains was particularly hard to abuse. 

The note included the phrase “they all said low abuse potential,” which would have instantly triggered a law-firm word search. But Kessler couldn’t identify who the “they” was, who “Nicole” in the note was, or whether the drug rep was telling the doctor about low abuse potential or the other way around.

“I wouldn’t look for one anecdotal conversation,” he said. “I was looking at the record as a whole.”

The drug companies are trying to undermine Kessler’s status as an expert under New York’s Frye standard, which requires experts to present opinions grounded on methods that are scientifically sound and generally accepted as reliable. Toward that end, Brody attempted to show that Kessler will testify improper marketing was the cause of New York’s opioid crisis without having performed any analysis of other potential causes, from illegal heroin and fentanyl to the U.S. government’s own reports, going back to the 1970s, identifying chronic pain as a serious problem costing hundreds of billions of dollars a year.

Kessler kept describing such inquiries as “beyond the scope,” a legal term referring to rules of evidence. At one point Justice Garguilo barked: “Beyond the scope of what?” 

Brody concluded by accusing Kessler of lacking a methodology that could reliably show the role any individual company played in the drug crisis.

“I have a learned methodology that manufacturers contributed with marketing to increased use, and increased use led to addiction,” he answered. “Promotion has an effect on prescription sales, those sales made increased opioids available, and their availability leads to increased abuse.” 

Other witnesses who will be questioned in pretrial hearings include James Rafalski, a former Drug Enforcement Agency official, and Lacy Keller, a data expert plaintiff attorneys have relied upon to show defendant companies shipped billions of orders that would should have been flagged as “suspicious.”

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Goodyear Training Tells Workers They Can Promote Black Lives Matter But Not Blue Lives Matter

Posted on August 18, 2020 by Pharmaciststeve
https://bluelivesmatter.blue/goodyear-training-tells-workers-they-can-promote-black-lives-matter-but-not-blue-lives-matter/

Topeka, KS – A Goodyear employee has shared a slide from the company’s new diversity training that showed the company labeled the terms “Blue Lives Matter” and “All Lives Matter” unacceptable, while endorsing “Black Lives Matter.”

The slide that was shared to social media by an employee showed lists of what is, and what is not, considered acceptable messaging under the Goodyear “Zero Tolerance” policy, WIBW reported.

The list of “Acceptable” included “Black Lives Matter” and “Lesbian, Gay, Bisexual, Transgender Pride (LGBT).”

The list of “Unacceptable” included “Blue Lives Matter,” “All Lives Matter,” “MAGA Attire,” and “Political Affiliated Slogans or Materials,” WIBW reported.

The employee who posted the slide said that it was shared during diversity training at Goodyear’s Topeka plant, but that it originated in the company’s headquarters in Akron, Ohio.

“If someone wants to wear a BLM shirt in here, then cool. I’m not going to get offended about it,” the employee told WIBW. “But at the same time, if someone’s not going to be able to wear something that is politically-based, even in the farthest stretch of the imagination, that’s discriminatory.”

The employee asked to remain anonymous out of fear they would be terminated for releasing the controversial corporate materials to the public.

“If we’re talking about equality, then it needs to be equality. If not, it’s discrimination,” the employee added, explaining his objection to the training materials.

The Police Tribune reached out to Goodyear’s corporate headquarters for comment on their anti-police training materials but had not received a response at publication time.

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