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OxyContin is a dying business in the United States. Purdue Pharma, owned by the billionaire Sackler family, is collapsing under an avalanche of lawsuits that accuse the company of using false claims to push its blockbuster painkiller in the U.S., profiting as an unsuspecting nation slipped into a devastating drug crisis...Meanwhile, another company owned by the family in China has been promoting OxyContin with the same tactics Purdue was forced to abandon...the Sacklers’ Chinese affiliate, Mundipharma, tell doctors that time-release painkillers like OxyContin are less addictive than other opioids...Mundipharma has pushed ever larger doses of opioids…In China, Mundipharma managers tried to boost profits by requiring sales representatives to copy patients’ private medical records without consent, in apparent violation of Chinese law...As in the U.S., marketing materials in China made claims about OxyContin’s safety and effectiveness based on company-funded studies and outdated data that has been debunked...READ MORE

Multibillion-dollar settlements in pharma are a rare occurrence, but things are changing rapidly. Only weeks ago, two drugmaker deals were floated that would rank among the biggest ever if they are eventually approved...The first—a whopping $23 billion deal from Teva to end thousands of state and local opioid lawsuits...The largest deal ever approved was Merck’s $4.85 billion agreement in 2007 to settle thousands of suits against its arthritis drug Vioxx...The second deal reportedly on the table—a $4 billion opioid offer from Johnson & Johnson—would rank as the second largest settlement ever reached. That’s not even mentioning the deal Purdue Pharma is reportedly working on for up to $12 billion to end its own opioid suits...READ MORE

1. Reckitt Benckiser—$1.4B
2. Johnson & Johnson, Bayer—$775M
3. Allergan—$750M
4. Actelion—$360M
5. Teva, Endo, Teikoku Seiyaku—$270M combined
6. Purdue—$270M
7. Pfizer, GlaxoSmithKline, Johnson & Johnson, others—$248M combined
8. Insys—$225M
9. Teva—$135M
10. Astellas, Amgen—$125M combined

It’s no secret that healthcare is in a state of rapid shifts—it has been for a long time, and it shows no sign of slowing in its evolution—and pharmacy is no exception. From independents to big box to large chains to hospitals, every pharmacist is going to feel (and is already feeling) significant changes...Perhaps the greatest shift in recent years, however, has come from chains. Changes in chains affect not only the pharmacists working in those chains, but show how pharmacy as a whole is evolving...READ MORE

Johnson & Johnson was on the losing end of the nation’s first opioid trial...even though it's appealing, the company is already fighting to limit its future liability as politicians put on a squeeze for more payments down the line...After the August verdict against the company for $572 million, Gov. Kevin Stitt and two prominent Republican lawmakers filed a brief arguing that future costs beyond the first year shouldn’t go to taxpayers...J&J should pay billions in addition to the $572 million verdict over many years to fund crisis abatement...READ MORE

The Trump administration estimates it will release rules on drug prices and information blocking this month but punted finalizing a rule on interoperability until as late as 2022..The White House Office of Management and Budget released...the unified regulatory agenda for fall 2019...The agenda said that a major rule that would outlaw information blocking among providers is estimated to be released this month...The unified agenda also gives an update on key regulations addressing high drug prices...One such proposal is a demonstration model that would tie the price of physician-administered drugs paid by Medicare Part B to an index made up of cheaper prices paid by other countries...The agenda also provides an estimated release date of January 2020 for a proposed rule to allow the importation of drugs from Canada. The proposed rule would create a pilot project to allow states, wholesalers and pharmacists to import drugs from Canada at a cheaper price than in the U.S...READ MORE

The majority of pharmacies in the United States now offer vaccinations, but there is still significant opportunity to turn a well-run vaccination program into a profitable endeavor that benefits both patient and pharmacy...According to the CDC, just 37.1% of adults received the flu vaccine during the 2017-2018 flu season. This presents a significant opportunity for pharmacies to improve these numbers by expanding their immunization efforts, marketing their programs to the community, and relying on what makes a pharmacy a unique healthcare setting...READ MORE

Senators from both parties are pushing for a vote on a bill that would require direct-to-consumer drug ads to include the treatment’s list price...The bill, introduced in May by Sens. Chuck Grassley and Dick Durbin and dubbed the Drug-price Transparency in Communications Act, would amend the Social Security Act to require that ads include “truthful and non-misleading pricing information.”...The bill would circumvent a similar Department of Health and Human Services rule that was finalized in May. That rule is tied up in courts after a judge overturned it, saying one day before it was to go into effect that HHS overstepped its authority. The department appealed the ruling...READ MORE

Business struggles, significant debt and legal liabilities put some industry players at particularly high risk of declaring bankruptcy in the near future, including large drugmakers like Teva Pharmaceutical and Bausch Health as well as small biotechs including Clovis Oncology and Puma Biotechnology...A BioPharma Dive analysis identified 31 troubled biopharma companies that are at highest risk of going bankrupt in the next 12 months...While rare in the drug industry, bankruptcy filings have ticked up in 2019, driven by growing legal, political and market pressures that could bring more companies to zero...READ MORE

Christina Mattina, welcome to This Week in Managed Care from the Managed Markets News Network

Residues from billions of doses of antibiotics, painkillers and antidepressants pose a significant risk to freshwater ecosystems and the global food chain, a new analysis said Thursday...There are growing fears that the unchecked use of antibiotics in both medicine and agriculture will have adverse effects on the environment and on human health...The Organisation for Economic Co-operation and Development compared data on concentrations of pharmaceutical residue in water samples worldwide as well as prescribing trends and water purification regulations in various countries..."Unless adequate measures are taken to manage the risks, pharmaceutical residues will increasingly be released into the environment as ageing populations, advances in healthcare, and intensification of meat and fish production spur the demand for pharmaceuticals worldwide,"...READ MORE