It’s no surprise that pharmaceutical companies do a lot of shady shit to make money. There’s good old Martin Shkreli, not to mention the skyrocketing cost of the EpiPen. And ohhhh have you heard Macklemore’s hot new song about “My drug dealer was a doctor…Had the plug from Big Pharma…”? (If not, your homework is to please go watch the video now.) Skyrocketing prescription drug costs are perhaps only eclipsed in the news by the fact that 2.4 million Americans are abusing them. But what’s been happening with Suboxone is just the latest layer in the shit sandwich. According to a recent article in The Daily Beast, the drug, which is most often used as a form of Medication-Assisted Treatment (MAT) for opiate addicts, is the subject of a federal investigation. Because America’s system of regulating pharmaceuticals is totally ridiculous, the makers of Suboxone were allegedly able to pull off an elaborate scam to maintain control of the market for the drug.
Let’s Back Up
We’ve written and talked about Suboxone on the site plenty but here’s a brief summary: Suboxone is the brand name for a blend of the painkiller buprenorphine and the opiate blocker naloxone. Although it is addictive, this particular combo is great for treating opiate addicts because the naloxone makes it hard to abuse. Word on the street (or the drug how-to discussion boards, since that’s about as street as I get these days) is that if you try to shoot up Suboxone without having already established a hefty tolerance for naloxone, you are immediately hit with gut-wrenching withdrawal symptoms. Gross.
British company Reckitt Benckiser, which owns popular brands like Lysol disinfectant and Mucinex cold medicine, has had exclusive rights to the drug since 2002. Most new drugs are awarded a 20-year patent. However, since Suboxone is really just a blend of two previously patented drugs, it was awarded just a seven-year patent. In 2009, with the company facing the loss of its monopoly and new generic versions of the drug nearing approval, the antics began.
According to the Beast article, by 2009 Suboxone made up 85% of all spending on MAT in the US—and most of it was subsidized by taxpayers. That’s a pretty sweet payday. The lawsuit is alleging that Reckitt Benckiser, desperate to hang on to their massive market share of Suboxone, did a bunch of crazy stuff.
First, they reinvented the drug as a sublingual film rather than a pill and aggressively tried to get doctors to start prescribing the new version. They then jacked up the price of Suboxone tablets, making them more expensive than the film version, even though the cost of making pills is much less. As if this weren’t bad enough, the company then allegedly paid off doctors to push the drug on addicts, lobbied lawmakers on the benefits of Suboxone film and penalized their employees who didn’t hit sales targets for the new drug. Of course, it’s just awful enough to be believable.
Think of the Children!
In late 2012, with generic versions of Suboxone nearing approval, Reckitt Benckiser announced it would pull Suboxone pills from the market completely. They claimed the pills posed a safety threat to children who might inadvertently eat them. Are you kidding me? If you’re on MAT and your kid is eating your meds, you need more help than just a new form of drugs! Then the company filed a “Citizen’s Petition” with the FDA calling to postpone approval of generic pill versions of Suboxone “in the interest of public safety.”
This obvious attempt at playing on the public’s (sometimes irrational) fear for kids’ safety was based on a single study Reckitt Benckiser paid for itself. This highlights just how broken the US healthcare system is. In other countries this would never been an issue. For example, in Germany when a new drug enters the market, manufacturers have to prove it’s better than the old version. If new medication isn’t better than the predecessors, the price is capped at the same cost. Now isn’t that reasonable?
Not So Fast
In April of 2013, despite Reckitt Benckiser’s efforts, several alternatives to Suboxone hit the US market. None of them can be substituted for the brand name as they contain different dosages of the active ingredients but that’s somewhat irrelevant since the competition hasn’t really translated into a payoff for consumers: MAT using Subs or the generic treatments still ranges from $200 to $500 a month.
Reckitt Benckiser may have almost gotten away with what really looks like an elaborate con, but the judge overseeing the case says nope. According to The Daily Beast article, Judge Mitchell Goldberg wrote, “The acts presented sufficiently allege that the disparagement of Suboxone tablets took place alongside ‘coercive’ measures. The threatened removal of the tablets from the market in conjunction with the alleged fabricated safety concerns could plausibly coerce patients and doctors to switch from tablet to film.”
If this lawsuit holds water, it will prove what lots of folks in the recovery community already suspect—that Suboxone is (at least on some level) a sham. It certainly looks like Reckitt Benckiser zeroed in on the most vulnerable population—addicts impacted by the opiate crisis—to make piles of money. Then, when the party was over, the company tried to keep competing drugs off the market by claiming they were a threat to children. While this is gross, it’s not illegal. But if this case proves that Reckitt Benckiser was taking advantage of a broken system by pulling off an elaborate con, that’s another story.
The states that dumped millions of dollars into Suboxone stand a chance of getting money back if a judge in Philadelphia decides the company violated antitrust laws. But will the people who are now addicted to Suboxone ever get their lives back?