Dr. Steve Miller, You Suck

I had no idea that so many pain medications also came in topical form, including Gabapentin and Tramadol. And I can’t believe how much they’re charging for them:

http://www.cbsnews.com/news/investigation-insurance-billed-18000-for-unwanted-pain-meds/

“$18,000 for one-month supply, three creams, that’s about right,” said Wurtz…

Western Medical pitched the creams as a “free benefit” paid by insurance. If a patient said “yes” Western Medical told their doctor: “One of your patients has expressed interest in a non-invasive topical cream to help alleviate pain.” It also sent over pre-written prescriptions for the doctor to sign…

Sources linked to Western Medical tell CBS News the company collected up to 200 prescriptions a day, billing them to Medicare and private insurance for more than $1 million a week…

“This is really abuse in the marketplace,” said Dr. Steve Miller.

Dr. Miller is the chief medical officer at Express Scripts, the nation’s largest pharmacy benefit manager. They paid for John Picard’s creams, but recently stopped covering many of them because, Dr. Miller said, there’s no research proving they work.

“If you talk to almost any pain expert, they’ll tell you these things are working strictly through a placebo response and not through a physiological response through the pain receptors,” said Dr. Miller…

How many pain “experts” would declare that topicals don’t work? That topicals only provide a placebo response? (Is your pain doctor a paid consultant for Express Scripts? A paid consultant for pain medications that aren’t topicals?)

I’m not a big fan of topicals, but I’ve read plenty of comments from pain patients who say that they help. I’ve used Lidocaine patches and I’ve tried a compounded topical with Soma. I have to agree with Dr. Miller about the placebo effect, but I don’t think every patient who gets relief from topicals is experiencing a placebo effect. And for a doctor to discount the relief that can be obtained from a placebo effect is very short-sighted.

For Dr. Miller, this is about money. And I guess Express Scripts is not willing to pay for drugs which can provide the benefits of a placebo effect. Even though the percentage of patients who benefit from a placebo effect are fairly small, they’re not inconsequential. Express Scripts is saving a lot of money by denying the benefits of placebos, as well as denying that topical pain medications can and do work.

Dr. Miller, you suck. How can you call yourself a doctor?

Under comments:

THIS NAME USED? February 26, 2015 7:7AM
This report only scratches the surface of the fraud and laws being broken around the compounding pharmacy industry. I happen to work for a compounding pharmacy and understand the business. There are good, ethical compounding pharmacies out there that follow all the rules. Then there are those that solicit physician “investment” and compensate those physicians handsomely for using their pharmacy exclusively. Medimix and RXpress are prime examples…