Painkiller panel drops experts linked to pharma industry


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Painkiller panel drops experts linked to pharma industry

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Of course we need a committee that meets behind closed doors on a subject that is not even taught in medical schools.

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Do they continue to ignore how to treat malignant pain?

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SUPPORT RESEARCH

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SUPPORT THE AMERICAN PAIN SOCIETY

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with your dollars

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While you will be introduced, below, to distinguished people who have given their lives to relieve pain, do you believe they are tainted by pharma in your eyes? Do you  have a vote? Just who is this panel that meets behind closed doors to take away pain medication? Where do those committee members get funding for their research on taking away pain medication?

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True, there is no research on it.

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True, we will hear one side.

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Does federal money support pain research? Or does the American Pain Society? The NIH gave less than half of 1% to pain research in 2008.

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Which committee member dictates that we practice the same as we did decades ago before I started in medicine? I was there when UCLA Anesthesiology Intersdisciplinary Pain Center was in its early days in the 70’s, and when they closed in 1991 – killing an evolving field. In one day they fired past and future presidents of the American Pain Society at UCLA alone. A small number of such clinics exist today.

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Pain does not make money for universities. They won’t teach it. Well, 3% do. And who would pay for research on something as unrewarding as chronic pain?

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UCLA like most medical schools teaches anesthesiologists how to do procedures, such as 30 epidurals in 30 minutes – they have nurses line them up. Pain clinics do not generate that kind of money or income as procedures.

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We might get somewhere if the government funded research on pain treatment alternatives to opioids, instead of committees to undo the limited tools we have to treat malignant pain – I do not mean cancer. How long will they continue to ignore addressing malignant pain?

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That headline from the Washington Post and in many papers led a scientist, Professor Sue Aicher, to send concerns via a basic science listserve yesterday. Concerns that should trouble all of us when we look at how much of their lives they have generously given to help hospice and people with malignant pain – not cancer.

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 “this article needs attention of the pain community.  APS is being painted as being beholden to drug companies, and some of our wisest leaders are being prohibited from serving on an FDA panel to help solve the opioid problem.  They are also excluding pain treatment specialists, which cannot be a wise decision.  I think everyone should write to Ron Wyden and their own congressional representatives.”

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Professor Terman, one of the four excluded, responds to the basic science listserve’s concerns:

Hi Linda,

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Thanks for advertising this issue.  I believe that scientists are too well informed to simply stay quiet and hope for the best in policy issues and should be more involved in such debates.  As a physician this is simply the latest disturbing example of legislators trying to micro-manipulate health policy.  However in full disclosure I have attached the link to the letter from Senator Wyden to the National Academy  (pdf).  I have never spoken to Senator Wyden or his staff but what he had to say about me (and APS) were mostly true.  I am a long-time (old) leader in APS AND APS does take money from industry sources (some of which make opioids).  I am sorry that he didn’t advertise what we have done with the money (including many clinical guidelines, decades of teaching residents and fellows about multidisciplinary pain care, holding young investigator forums and a slew of grants including the latest partnership with Pfizer to fund National Pain Strategy Implementation grants) or mention that anyone who wants to help us continue our good works without industry funding can donate (conflict-free) at the Pain Research Fund :).  Senator Wyden takes APS to task for their Corporate Council which I felt uncomfortable with as well until I became more involved and realized that these people were largely just trying to help people with pain with wise investments of their nonprofit contributions (product discussions are strictly forbidden in these meetings – as you might expect when competitors get together).  The corporate council members are aware that many of our members are NOT prescribers and yet they appreciate our commitment to pain science.  Indeed, if I have an apology to give it is that I either misspoke or was misquoted in the below article.  Obviously APS’s parent organization IASP also considers pain science as priority #1 (I believe in the interview I said “pain science in this country” as I usually do).  Finally, the NIH committee mentioned in the article is the Interagency Pain Research Coordinating Committee and NOT any grant review committees or councils,  This committee resulted from the Affordable Care Act and includes scientists, clinicians, federal staff and patient advocacy groups.  Senator Wyden has been unhappy with some of the conflicts of clinicians and advocacy members of that committee in the past – none due to relationships with APS!  Thanks again Linda and please feel free to edit this message as needed – I may be answering questions that people aren’t asking.

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Best Regards,

Greg Terman

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Professor Gregory Terman MD, PhD, Department of Anesthesiology and Pain Medicine and the Graduate Program in Neurobiology and Behavior, University of Washington, Seattle, Washington

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That article from the Washington Post on July 6:

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A group advising the Food and Drug Administration on medical issues abruptly dropped four experts from a panel on prescription painkillers after concerns emerged about apparent ties to the pharmaceutical industry.

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The panel gathered in Washington on Wednesday for its first meeting, tasked with developing recommendations for the FDA on combating the problem of painkiller abuse and misuse. But four doctors listed on the panel’s initial roster were dropped before the meeting.

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Washington Post quotes Professor Greg Terman:

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“I responded that I’m very proud of my relationship with the American Pain Society, we’re the only professional society in the world that thinks of pain science as priority No. 1,” said Terman, in an interview with The Associated Press.

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Another article of the same title.  From the Baltimore Sun:

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A University of Maryland professor removed from a panel of experts advising the Food and Drug Administration on prescription painkillers said Friday she was surprised by the decision and believes she got caught up in politics.

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Dr. Mary Lynn McPherson, who teaches in the School of Pharmacy and has a specialty in hospice and end-of-life care, was one of four doctors removed this week from the panel organized by the National Academies of Sciences, Engineering, and Medicine. The academies advise the FDA on medical issues.

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The academies confirmed that the doctors had been dropped, but a spokeswoman said the group does not disclose reasons for not moving forward with a nomination to the panel. The decision, announced during the panel’s first-ever meeting Wednesday, came after a U.S. senator from Oregon wrote a letter July 1 to the president of the National Academy of Medicine complaining that some panelists received funding from drugmakers or served in professional societies that received such funding.

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The letter from Democratic Sen. Ron Wyden said McPherson received grants and funding for medical residents worth at least $300,000. The grants were sponsored or paid for by opioid drug makers dating back at least two decades, he wrote. Three residencies she ran between 1997 and 2004 were funded by Purdue Pharma, while Purdue Frederick funded three others. The companies gave a total of $253,500, according to the letter. And in 2010, McPherson received a $50,000 grant from King Pharmaceuticals.

She is also chairwoman of the board of directors of the American Society of Pain Educators, which Wyden said is sponsored in part by opioid manufacturers.

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Drs. Gavin Bart, Howard Gutstein and Gregory Terman were also removed from the panel. Gutstein could not be reached for comment.

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Terman, professor and director of pain medicine research at the University of Washington, said he was dismissed Tuesday afternoon by phone. He said he was told the decision was made because his nonprofit group, the American Pain Society, receives funding from drugmakers.

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In his letter, Wyden noted that the society has a “corporate council” of pharmaceutical manufacturers — including Purdue Pharma, Pfizer and Teva Pharmaceuticals — that contributed at least $132,500 to the group. Terman has served on the group’s board of directors since 1998, the letter said.

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Terman said he was “extensively screened” by the National Academies for conflicts and that it was widely known that he headed the American Pain Society. The academies had also worried he had done too much work for the FDA, he said.

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It is not unusual for professional groups to get funding from drugmakers through many avenues, including booth fees at conventions and grants, Terman said. The funding does not influence decisions, and the group’s primary priority is science, he said.

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“I have gone out of my way to avoid conflicts over the years,” Terman said.

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SUPPORT THE AMERICAN PAIN SOCIETY

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People with chronic pain have no vote. The American Pain Society needs your help. Don’t wait for the NIH or government do to anything about chronic pain. That’s a joke.

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Donate money and time. Why does cancer get all the donations, the push for the moon? When will chronic pain get the research and attention it deserves.

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That’s the kind of medicine I want to see.

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People are living longer, early athleticism takes its toll forever. New treatment methods need to be discovered, not just slashing away opioid doses by committee behind closed doors. That’s not medicine.

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