Doctors have responsibilities in prescribing risky drugs, P.1

Physicians have a big responsibility when it comes to the promotion and prescription of medications for the benefit of their patients. Because of the way medical care is delivered, patients rely on their doctors to recommend the most beneficial course of treatment, without reference to personal gain. Unfortunately, the system doesn't always work that way.

A good example of this can be seen with Subsys, a commonly used medical spray containing the pain killer Fentanyl. The drug is manufactured by Insys Therapeutics Inc., and is the only spray version of Fentanyl available on the market. Subsys is indicated only for cancer pain, but is often prescribed to manage other forms of pain, such as back pain. This is problematic, given the risks associated with the drug and its intended use. 

While doctors can get into trouble quite easily for writing prescriptions for drugs that have been marketed for an off-label use, they are permitted to prescribe drugs for off-label use in certain situations. The problem with prescribing Subsys for off-label uses is that there are many people who don't tolerate opioids well. Thousands of people die every year from using prescription opioids. In addition, Subsys is actually contraindicated for those with headache and back pain, and yet there are a large number of patients using the drug for exactly that purpose.

This fact has not escaped the notice of federal authorities, but even with the tight controls around the drug, it has been reported in connection with a fair number of adverse events. Since January of 2012, the drug was referenced in connection with 63 adverse events, and that number is likely to be low due to underreporting.

One issue, in all of this, is what liability doctors have for prescribing the drug. We'll talk a closer look at this issue in our next post. 

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