In part 2 of our blog on the drug Nuedexta, we will continue our discussion of just why this drug is being pushed on nursing home residents at such an alarming rate, despite no evidence that the little red pill is helpful or therapeutic to the majority of residents. In fact, studies have shown evidence to the contrary.
You can read Part 1 of our blog here, detailing what the drug is for and how dangerous it can be.
YThe news outlet CNN was able to obtain several internal company emails from Avanir Pharmaceuticals that detail a culture filled with pressure to sell the drug. An email that is now years old urges salespeople to focus their time, 99.9% of their time specifically, in selling the drug to targeted patients: those with dementia and Alzheimer’s.
A senior sales manager told salespeople that focusing on the small percentage of people with pseudobulbar affect (PBA), which the drug actually does treat, would essentially be a waste of time, lessening their chances of making the sale. That manager no longer works for Avanir and declined, through her attorney, to comment on her email.
In a separate seminar, a speaker advocating for Nuedexta allegedly told the audience that, in part, PBA’s symptoms of uncontrollable laughing and crying could be interpreted as any kind of “socially inappropriate behavior.” As such, if a patient has an outburst that could be related, “you can pretty much come up with a diagnosis.”
While getting anyone from the company to comment on the goings on involving the controversial drug has proven difficult, one thing is certain: The company has operated in a gray area when it comes to ethics. The company has said that it is committed to an ethical culture and that its sales methods are within the boundaries of the law.
There is little doubt that those with dementia experience outbursts and agitation from time to time. Unfortunately, there has been no drug approved to treat this type of agitation. While some caregivers say that an increased staff presence can help to control these outbursts, facilities say that this solution is often too expensive and unreliable. A pharmaceutical answer would certainly be much easier, according to some staff.
In the first of this series, we discussed some questionable use of the drug, but that was only the tip of the iceberg. Here are more examples of questionable use of Nuedexta that have been brought to light in recent months.
California: The executive director of an assisted living facility in the state tried to force an elderly dementia patient to take the drug, going so far as to tell her family that the woman would be kicked out of the center if the drug was refused. By the time the investigation was initiated by the state, the director was no longer working at the center. The investigation did find, however, that the threat of eviction and the subsequent notice violated state law.
Los Angeles: A patient’s family member discovered that the patient was being given Nuedexta without the family’s, or the patient’s, consent. That family member filed a complaint. Regulators ultimately discovered that three residents were being given the pill despite it not having been prescribed. It is suspected that the nurses handing out the pill had obtained it from a sales seminar and were giving out their “free samples.”
New Jersey: Six residents at St. Vincent’s Healthcare and Rehab Center were given Nuedexta without having been diagnosed with PBA. Each resident was diagnosed with some type of condition, but those conditions were crossed out in the charts and replaced with “PBA.”
Speakers for the pharmaceutical company may be the new drug pushers. One such physician, paid by the company, earned more than $500,000, meals and travel from the company. When the drug came out, that particular physician had over 100 patients on the drug.
It may not be entirely the fault of physicians, however. Avanir has salespeople that target doctors and other medical professionals in the facilities it believes will be most lucrative. Though these professionals typically and resolutely deny prescribing medication for financial gain, it is difficult to see how it can be anything but. With the extraordinary amounts of money being paid out for the prescription of the drug, the millions being made by the pharmaceutical company, and the relatively minor number of people being appropriately diagnosed with PBA, there has to be a reason the drug has been so successful on the market.
If you believe that you or a loved one has been prescribed Nuedexta inappropriately or been the victim of medical malpractice in West Palm Beach, reach out to our office. We will review the details of your case and help you make legal decisions pertaining to your situation.