Pharmaceutical Industry Payments for Xarelto Totaled $28M in 2015

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Public Health Watchdog Breaking News
Public Health Watchdog Breaking News

Database Shows Industry Payments to Physicians are Highest for Xarelto

ProPublica, the independent, non-profit news organization focused on investigative journalism, has issued a new report involving industry payments made to physicians. The group has updated its “Dollars for Docs” database showing industry payments from August 2013 through December 2015. The report shows that payments were largest for Xarelto in 2015. The anticoagulant has spurred lawsuits alleging that the drug caused uncontrollable bleeding. Manufacturers Bayer and Janssen allegedly failed to disclose the risks to patients and the medical community.

Parker Waichman LLP is a national personal injury law firm that represents numerous clients in drug injury lawsuits. The firm continues to offer free legal consultations to anyone with questions about filing a Xarelto lawsuit.

ProPublica launched its “Dollars for Docs” database with the goal of creating transparency for conflicts of interest in medicine. Through the interactive database, users can see how much money their physicians receive from pharmaceutical and medical device companies. ProPublica reports that the spending appears to be constant, and payment amounts remain large.

Annually, pharmaceutical companies pay roughly $2 billion to 618,000 physicians. Industry payments to teaching hospitals total another $600 million each year. Drug companies paid doctors for promotional speaking, consulting, meals, travel, gifts, and royalties. Payments were not, however, made for research.

In 2015, pharmaceutical companies paid physicians the most for Xarelto, with payments totaling $28.4 million. The other top 10 drugs, according to ProPublica, include Humira ($24.9 million), Invokana ($20.9 million), Viekira ($19.2 million), Eliquis ($18.8 million), Bydureon ($18.5 million), Androgel ($15.3 million), Synthroid ($14.7 million), Lupron ($14.3 million) and Victoza ($11.9 million). These figures exclude payments made to teaching hospitals.

ProPublica reports that “many of the drugs most aggressively promoted to doctors aren’t cures. Some are top sellers, but most are not.” For some of the medications on the list, cheaper generic options are available. The Dollars for Docs database has information on $6.25 billion in industry payments to 800,000 physicians.

Data, both from ProPublica and academic studies, suggests that doctors who receive industry payments are more likely to prescribe brand-name rather than generics. Additionally, some pharmaceutical companies reportedly still work with physicians with disciplinary sanctions on their medical licenses.

The 2010 Affordable Care Act included the Physician Payments Sunshine Act. Information about financial disclosures in the database resulted from this legislation.

Researchers at Harvard Medical School conducted a 2016 study showing that doctors were more likely to prescribe brand-name drugs to treat high cholesterol if they received industry payments. The study was led by Dr. James S. Yeh, who commented that prescriptions should be an objective decision “rather than doing something because there is financial gain, whether it be subconscious or conscious.”

Another study, published last year in The JAMA Network, found that even industry-sponsored meals were associated with a higher chance of prescribing brand-name. These findings were correlational; they show a relationship, but do not prove cause-and-effect.

Xarelto Lawsuits Allege Uncontrollable Bleeding

Parker Waichman notes that thousands of lawsuits have been filed over Xarelto. Plaintiffs in the litigation allege that Bayer and Janssen promoted the drug to physicians while failing to disclose the risk of irreversible bleeding due to the lack of an antidote.

According to court records, there are more than 13,000 Xarelto lawsuits pending in the federal multidistrict litigation (MDL) consolidated to the Eastern District of Louisiana. The goal of an MDL, where similar lawsuits are grouped together in federal court, is to make legal proceedings more efficient. Consolidating cases to one court makes the pretrial process more streamlined; for example, the discovery process does not need to be repeated for every single case in an MDL.

In the Xarelto MDL, plaintiffs allege that the blood thinner caused bleeding injuries such as gastrointestinal bleeding or brain bleeding. Lawsuits allege that the drug makers were aware of these risks but failed to warn patients or their doctors.

The Xarelto MDL was established by the U.S. Judicial Panel on Multidistrict Litigation (JPML) in December 2014. The litigation has grown substantially since then, starting out at only 21 cases.

Xarelto was introduced in 2011. The drug is prescribed to prevent blood clots in patients with deep vein thrombosis, patients undergoing knee or hip replacement surgery, and patients with atrial fibrillation. Xarelto is part of a new generation of blood thinners developed to compete with warfarin (sold under the brand name Coumadin). Other new blood thinners include Pradaxa (the first to be released) and Eliquis.

Patients with deep vein thrombosis have a blood clot in one of the deep veins. Usually, this condition affects the legs. If a piece of the clot breaks off, it can lead to a life-threatening condition called pulmonary embolism where the clot gets stuck in the lungs. Atrial fibrillation describes an abnormal heart rhythm that increases the risk of a blood clot.

Plaintiffs in the litigation allege that Xarelto makers overpromoted the benefits of the drug while failing to disclose the risks, preventing patients and physicians from making a fully informed decision. Specifically, lawsuits allege that Xarelto makers failed to warn about the lack of an antidote, or reversal agent, to stop the drug’s blood-thinning effects. While Xarelto lacks an antidote, warfarin effects can be reversed with vitamin K.

Patients taking warfarin must undergo regular blood testing to ensure that they are receiving the appropriate dosage. Additionally, there are certain foods that interact with the drug. According to lawsuits, Bayer and Janssen promoted Xarelto as being superior to warfarin because it does not have these limitations. However, plaintiffs allege that the companies failed to inform about the lack of a reversal agent. If hemorrhaging occurs in a Xarelto user, doctors have few options to effectively stop the bleeding, lawsuits state.

Xarelto is not the only new anticoagulant drug to spark litigation. In fact, Pradaxa manufacturer Boehringer Ingelheim settled bleeding injury lawsuits for $650 million on the eve of the first day of trial. Lawsuits have also been filed over Eliquis alleging serious, sometimes fatal bleeding.

Filing a Xarelto Lawsuit

If you or someone you know suffered uncontrollable bleeding related to the use of Xarelto, you may have valuable legal rights. Our personal injury lawyers offer free, no-obligation case evaluations. For more information, fill out our online form or call 1-800-YOURLAWYER (1-800-968-7529).