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2 Strategies & Programs to Reduce Prescription Drug Abuse Robin E. Abrams VP, Associate General Counsel Purdue Pharma LP CWAG Annual Meeting August 5,

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Presentation on theme: "2 Strategies & Programs to Reduce Prescription Drug Abuse Robin E. Abrams VP, Associate General Counsel Purdue Pharma LP CWAG Annual Meeting August 5,"— Presentation transcript:

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2 2 Strategies & Programs to Reduce Prescription Drug Abuse Robin E. Abrams VP, Associate General Counsel Purdue Pharma LP CWAG Annual Meeting August 5, 2009

3 3 Prescription Drug Abuse and Diversion: Why we care? -Reputation of pharmaceutical industry and its products at stake -Develops, markets and distributes medicines to bring relief to patients -Does not want products associated with misuse and abuse and harm that results -Abuse causes reluctance by healthcare professionals, patients, caregivers -Abuse creates obstacles for legitimate use

4 4 Prescription Drug Abuse and Diversion: The Response -Requires sustained, multi-faceted, collaborative and coordinated response -law enforcement -healthcare professionals -elected officials -government regulators -national and local anti-drug abuse organizations -industry

5 5 Purdue Programs & Partnerships -Building Community Partnerships -Working with Law Enforcement (including federal, state and local officials) -Anti-diversion Tools for HCPs -Monitoring activities -Supply Chain Security -Developing New Formulations -Educating Healthcare Professionals

6 6 Building Community Partnerships -Partnership for a Drug-Free America -Partnership Attitude Tracking Study -Parent Resource Center Scientific Advisory Board Early detection intervention resource (Time to Act) Adolescent Treatment Network -Rx360 pilot in Washington state -Community Anti-Drug Coalitions of America (CADCA) -Rx Abuse Tool Kit provided to 5,000 community organizations -Training to develop capacity and sustainability

7 7 Building Community Partnerships -“Medicine Cabinet” Public Service Campaign -Print, radio and TV ads and PSAs -US Conference of Mayors -Rx abuse awareness campaign with radio PSA spots, print materials, etc. National Council on Patient Information and Education (NCPIE) SAMHSA Teen Influencer program – training adults to talk to teens about Rx drug abuse Community anti-drug abuse grants Funding for community awareness and prevention efforts e.g., Communities That Care ® Prevention Planning Process

8 8 Working with Law Enforcement -Purdue’s Law Enforcement Liaison and Education (LELE) department provides training to state and local law enforcement -Educational programs on Rx diversion, appropriate vs. inappropriate prescribing -Since 2004, we have provided training for: more than 150,000 law enforcement personnel approx. 33,000 HCPs -Provide case-specific support to law enforcement handling diversion investigations

9 9 Working with Law Enforcement -RxPATROL ® pharmacy crime program (www.rxpatrol.org) -Inform and assist pharmacy crime LE investigations -Security analyses to make pharmacies harder targets -Reward program with Crime Stoppers and local PDs More than 93 arrests to date

10 10 Working with Law Enforcement -Partnerships with law enforcement organizations -National Association of Drug Diversion Investigators Grant program for local law enforcement agencies Abused Pharmaceutical Substances brochure -FBI LEEDA – The FBI Law Enforcement Executive Development Association -Educational brochures and videos for LE and HCPs

11 11 A Tamper-Resistant Prescription Micro-printing Thermochromic Ink On Reverse VOID Appears When Photocopied or Scanned Regardless of Settings Used Background “Runs” With Attempted Rinsing Header Alerts Pharmacist to Test Thermochromic Feature on Reverse (see below)

12 12 "Rinsing" Prescriptions SOLVENT

13 13 Monitoring -Purdue sales representatives trained to recognize and report “red flags” -Out-of-state license plates in parking lot -Unusual prescribing practices -Overcrowded waiting areas -Report concerns to Purdue Law department -Purdue monitors customer orders for potentially suspicious activities -Frequent orders of same product from multiple distributors on the same day -“Know your customer and your customer’s customers”

14 14 Protecting the Supply Chain -Ground and GPS tracking of shipments from manufacturing plant to wholesale distributors -Radio Frequency Identification (RFID) tags -Laboratory analysis to determine is a submitted specimen was a counterfeit product

15 15 Working with Managed Care Organizations -Controlled Substance - Patterns of Utilization Requiring Evaluation (CS-PURE ® ) software program -Enables managed care organizations to review member claims data with 28 queries, including: Multiple prescribers for an opioid analgesic Overlapping opioid analgesic therapies Multiple pharmacies filling opioid analgesic prescriptions Multiple benzodiazepine prescriptions -Provided to managed care organizations at no charge as a tool to identify areas in need of further investigation

16 16 Developing New Medications -Purdue is developing new forms of pain medications to: provide safe and effective pain relief to patients be less susceptible to misuse and less desirable to drug abusers -Application for new formulation under review at FDA -Purdue has developed a Risk Evaluation & Mitigation Strategy (REMS) -No guarantee if or when FDA will approve new formulation -All medications are susceptible to abuse in one manner or another -Likely will not be possible to develop a product that completely deters determined abusers

17 17 State Prescription Monitoring Programs (PMPs) -"Doctor Shopping" - misleading several prescribers to obtain multiple prescriptions – is common -PMPs can help healthcare professionals and law enforcement detect and prevent doctor shopping -Purdue has worked in numerous states to support development of PMPs -Documents explaining how to access the PMP are available for sales force distribution to HCPs in 15 states

18 18 State Prescription Monitoring Programs (PMPs) -PMP Goals and Objectives: -help identify, deter or prevent drug abuse and diversion -support access to legitimate medical use of controlled substances -facilitate the identification, intervention with and treatment of persons addicted to Rx drugs -help inform public health initiatives by outlining use and abuse trends -To date, 40 states have enacted legislation

19 19 AK HI WA OR CA NV ID MT WY UT AZ NM CO ND SD NE KS MN IA MO WI ILIN MI OH PA NY ME VT TX OK AR MS LA ALGA FL SC NC TN KY WV VA RI MD DE NJ MA CT NH PMP existing & enacted programs No current PMP State Prescription Monitoring Programs (PMPs)

20 20 Healthcare Professional Education -Purdue supports non-promotional, condition-specific education programs, such as: -The importance of appropriate pain care -Proper assessment and treatment of patients with pain Appropriate prescribing and monitoring of opioid analgesics -Appropriate documentation of pain care -Recognition of unlawful methods used to obtain and / or abuse controlled substance medications -Interventions to address inappropriate medication use

21 21 Funding Healthcare Professional Education Through Grants -Provide education grants to accredited providers -Follow the Standards for Commercial Support for medicine, pharmacy and nursing education -Types of educational formats: -Live national, regional and state / local education settings -Internet-based programs -Published monographs and education tools

22 22 Example: Educational Initiative in Monograph distributed to 250,000 -Physicians -Pharmacists -Nurses -Physician’s Assistants -Also available at Supported by Purdue Pharma L.P. Education Grant

23 23 Innovative Education -The Pain Paradox: -Providing Effective Relief -While Mitigating Risk -At National Conferences: -American Pain Society -PainWeek Meeting -American Academy of Pain Pain Medicine Supported by Purdue Pharma Education Grant

24 24 Medical Education Resource Catalog -Sixth year of production -Offers non-product-specific, free education materials for healthcare professionals, including: -Slide presentations for self-learning or teaching -Brochures and pamphlets for self-learning -Educator packets for specific initiatives FACETS (Focused and Customized Educational Topic Selections) Pain PACT ® (Partnership and Care Today) for Long-term Care Integrative Therapies and Pain Care -List of websites for independently-developed health care professional education courses

25 25 Medical Liaison Education -Live, free webinars (non-accredited): -Managed care organizations -Healthcare professional associations -General healthcare professional audiences -Topic examples Addressing Substance Abuse Prevention (ASAP) Complexities of Pain Care

26 26 Conclusion -Purdue is working to develop solutions and partnerships to address Rx abuse -There is no single or simple solution -Need strategies and collaborative programs to limit illegal supply and demand without limiting patient access -Not just a law enforcement problem -Increase HCP awareness / vigilance -Increase public perception of harm of Rx abuse

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