Opioid overdose deaths are highest in places where pharma spends the most on marketing, a new study finds
- A new study conducted by researchers at the University of Pittsburgh found that US counties that receive more opioid-related pharmaceutical industry payments had more opioid-related deaths.
- The top three counties with the highest concentration of opioid-related deaths were Harrison County in Kentucky and Cabell County and Wayne County in West Virginia.
- In total, the pharmaceutical industry paid $9.8 million to 31,532 medical providers in 2016.
In the past few years, the role that pharmaceutical companies played in fueling the opioid crisis has started to come to light.
The New York Times unveiled in an investigative report in May that Purdue Pharma knew its opioid drugs were being abused in 1996, shortly after they came on the market. But the drugmaker concealed the information and continued to market its drugs until the early 2000s.
Opioid overdoses caused more than 42,000 deaths in the US in 2016, and 40% of those deaths involved prescription drugs, according to the Centers for Disease Control and Prevention. Opioid-related deaths increased 345% from 2001 to 2016, according to a study published in June in JAMA.
Now, a new report published in the Journal of General Internal Medicine found that US counties where doctors got more payments from opioid manufacturers also had more opioid-related deaths. The researchers, from the University of Pittsburgh, compared government data on overdose deaths with payments data collected by the Centers for Medicare & Medicaid Services.
"This is provocative data that can really serve as a substrate for us to do more work," said Dr. Benjamin Davies, one of the authors of the study and an associate professor of urology at the University of Pittsburgh School Of Medicine.
In 2016, the pharmaceutical industry doled out nearly $10 million to US physicians for opioid-related marketing. That includes speaking and consulting fees, meals, travel, honoraria, and education. As the researchers mapped the spending pattern against the map of opioid-related deaths, they found that the counties with the highest overdose death rate per capita also had the highest opioid-related industry payments, adjusted for population.
The study found that the top three counties with the highest concentration of opioid-related deaths were Harrison County in Kentucky and West Virginia's Cabell County and Wayne County.
The payments were made by 11 different pharmaceutical companies, led by Depomed ($2.7 million), Purdue Pharma ($2.6 million), Insys ($2.4 million) and Pfizer ($1.1 million).
In an emailed statement to Business Insider, Purdue Pharma said that it's taking action to address drug addiction.
"We acknowledge that more needs to be done, and that's why we recently launched a long-term initiative which will build over the coming months and years as we pursue a range of solutions that we believe will have a meaningful impact to help address the opioid crisis,'' the company said.
In February, Purdue ended promotion of opioids to physicians, and the last of the company's promotional speaker programs concluded in 2017.
Pfizer said that its payments noted in the study don't support the study's conclusion. The company said that about $1,100 of its payments, or 0.1%, went to clinicians in the top three counties notes in the study. Pfizer offers one prescription opioid that customers can get at a pharmacy, a drug called Embeda that's designed to deter abuse.
"Almost all payments cited were related to this medicine," the company said. "We believe it is important to work with experts to educate the medical community on the risk-benefit profiles of our medicines and to support their research."
Depomed and Insys didn't respond to requests for comment.
The researchers found a strong association between drugmaker payments and deaths. Every $10,000 increase in payments was associated with almost a 1 person increase in the rate of opioid-related deaths.
However, the researchers warned the public not to jump to conclusions too quickly, and said that follow up studies are needed. They plan to do further research to learn more about the association.
"We have to be aware of not claiming causation, because it could be very well that it goes the other direction, that pharma is spending money on education and sending physicians because they knew these were problem areas," Davies said.
"Our future direction is looking at this longitudinally," he said.