Health Highlights: June 5, 2017
Company Pushed Use of Powerful Painkiller in Ineligible Patients: Whistleblower Anthem Blue Cross/Blue Shield Cuts Back on ER Use, Alarming Doctors
Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Company Pushed Use of Powerful Painkiller in Ineligible Patients: Whistleblower
A drug company tried to get a powerful painkiller prescribed to patients who should not have received it, a former employee says.
The fentanyl-containing drug Subsys is highly addictive drug that is 100 times more powerful than morphine and was approved by the U.S. Food and Drug Administration for cancer patients whose pain can't be relieved by other narcotics alone, NBC News reported.
However Arizona-based drug maker Insys Therapeutics schemed to get Subsys to patients without cancer, according to a former sales rep turned whistleblower.
"My job responsibilities were to contact insurance companies on behalf of the patients and the doctors to get the medication approved and paid for by their insurance company," Patty Nixon told NBC News.
She said her supervisor outlined how to make insurers believing the drug was "medically necessary."
She was fired by Insys after she started feeling guilty about what she was doing and stopped going to work.
Hundreds of deaths are among the reports of adverse events linked to Subys that have been received by the FDA, NBC News reported.
A federal grand jury has indicted six former company executives. All have pleaded not guilty.
Insys paid hundreds of thousands of dollars to doctors in exchange for prescribing Subsys, according to prosecutors. Three of the top prescribers have already been convicted of taking bribes from the company, NBC News reported.
Insys has denied any responsibility, saying it shouldn't be blamed for how doctors prescribe its products. The company is not facing criminal charges and is still selling Subsys -- about $240 million worth last year.
Anthem Blue Cross/Blue Shield Cuts Back on ER Use, Alarming Doctors
Anthem Blue Cross/Blue Shield members in three states have been told they may have to pay the cost of emergency department care if the insurer decides there was no medical emergency.
"Save the ER for emergencies -- or cover the cost," reads a letter sent last month to Blue Cross and Blue Shield of Georgia members, NBC News reported.
"Going to the emergency room (ER) or calling 9-1-1 is always the way to go when it's an emergency. And we've got you covered for those situations," it states.
"But starting July 1, 2017, you'll be responsible for ER costs when it's NOT an emergency. That way, we can all help make sure the ER's available for people who really are having emergencies," according to the letter.
Similar letters were sent to members of plans owned by Anthem, Inc. in Missouri and Kentucky, and that's angered emergency room doctors, NBC News reported.
The insurer says it wants to direct patients to proper care.
"What we are really trying to do is make sure that people are seeing their doctors first," said Joyzelle Davis, communications director for Anthem, Inc., told NBC News.
But Dr. Becky Parker, president of the American College of Emergency Physicians, said it's about money.
"The insurance company is not on the same plane. They are not here to take care of people. They are here to make money. It's clear that the insurance companies are looking to make money. It is about the dollar. It is not about high quality care," Parker told NBC News.
"Our concern is that the insurance industry is trying to push this nationally," she added.