Pharma and the Opioid Crisis: In Search of Solutions

Today’s opioid crisis is killing and maiming far more people than are affected by traffic accidents. Just as the auto industry moved from an era of muscle cars to today’s air bags, collision warning and auto-braking systems, so the drug industry must rethink its role beyond traditional research and development around pain medicine.

Let’s take a step back for context. The treatment of pain is a vital part of medicine and has been for millennia. In the modern era, the pharmaceutical industry has played a central role in discovering and developing new medicines for pain. This is fundamentally good for healthcare, and should not change.

The epidemic of opioid addiction requires us to grapple with its causes. These include excessive prescribing by doctors, inattention by pharmacists in dispensing addictive drugs, and unethical — and sometimes criminal — actors engaged in insurance fraud and preying on the vulnerable. Adoption of a pharmaceutical opioid plan is not a substitute for addressing the need for changed behavior and other public policy changes aimed at providers such as doctors and hospitals, insurers and consumers.

In the past, the pharmaceutical industry took the view that its social responsibility ended with FDA approval. Clearly, drug companies do post-market surveillance after approval. The gap in dealing with pain medication with risk of addiction is designing plans to monitor and action plans to minimize excessive and inappropriate use and inventory in the hands of others in the supply chain. Now is the time for medicine makers to step up to a new role as stewards of how their products are used.

Here’s what the industry should do to help society overcome opioid abuse.

Prioritize reduction in risk of abuse and addiction

First, every company focused on pain medicines needs to heed the warnings from the FDA that the only new pain medicines that will get approved — or in some cases stay on the market — are those designed with virtually foolproof approaches to dramatically reduce the risk of abuse and addiction.

Establish a patent pool

Collectively, the industry should set up a public domain reserve of new anti-abuse approaches and dedicate new technologies into a patent pool.

This approach will permit these tools to prevent addiction to be adopted faster and at a lower cost. A patent pool of this nature could more easily lead to the dissemination of knowledge. Patent pools have been successful in other contexts ranging from pools of inventions of radio technology, RFID, MPEG, to more recently genome editing.

Call for a tax in support of addiction treatment

The industry should support an excise tax on pain medicines with the proviso that all the money collected goes into addiction treatment. This approach was taken in the context of the tobacco settlement and generated needed revenues for advancing public health goals.

Another parallel public policy approach has been the imposition of an excise tax on childhood vaccines. The proceeds are allocated to compensating children who have been harmed by some vaccines.

Push back against the allure of drug use

It has become all too common on television, movies and in social media. The pharmaceutical industry currently spends $ 6.4 billion on direct to consumer advertising. The industry should fund an effort equal to 5 percent of that amount (an amount less than what is spent on the leading DTC advertised drug), concentrating on the risks of addiction and creating public service announcements about treatment options.

Find outreach partners

The industry needs to partner on outreach efforts for pain management alternatives other than pharmaceuticals relying on sound scientific research. Partners in this effort should include major medical groups, professional sports, entertainment and groups with the highest degree of trust among consumers.

Race to the top

The industry should partner with a major university to create a competition for the best methods of treating addiction. Much like the X Prize competition drove innovators to create a reusable rocket engine for space travel, it is possible to incentivize more activity — by offering a prize of $25M or $50M — than the amount of the prize itself. As the big soda companies are learning from their fight against soda taxes, it would be better to craft a positive agenda that addresses the public health problem rather than seeking to stand like Canute against the tides.

Showcase innovation

In partnership with pharmacies large and small, the industry should demonstrate the same kind of innovation and dedication on display recently at the White House with Corning and unbreakable vials. Today it is harder to buy Sudafed (a cold medicine) than it is to pick up a prescription for OxyContin. We need more efficient IT systems, improved cross-checks and better anti-abuse sales techniques.

Pharmaceutical companies must step into the 21st century as stewards of public health. Taking on the opioid crisis is a good place to start.

David Beier is a senior fellow and advisory board member of the Schaeffer Center for Health Policy and Economics at the University of Southern California.

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