In the HBO television show, Succession, there is a scene in one of the episodes where a company executive responds to a senator during a hearing. After being attacked for his news organization making a profit from delivering the news, he replies that all news media in this country is for-profit. Since we are in a free country with freedom of speech, we do not rely on state-run media to provide our news.
In reading about the US government’s case against the British company, Indivior, maker of Suboxone, I was reminded of that scene. A large part of the case against Indivior is based on the company’s efforts to increase profits by increasing the amount of Suboxone prescribed by doctors. It is implied that Indivior’s efforts are similar to those of the executives of Perdue Pharma in promoting more prescribing of OxyContin.
When it comes to the specifics of this case against Indivior, there are problems. The fact is that we are in the midst of an opioid crisis, and drugs such as Suboxone can help. Increasing the number of doctors who can prescribe Suboxone and the number of prescriptions being properly given to opioid-addicted patients will save lives. While we might not like the idea of top executives at a large corporation wringing their hands and smiling as profits rise, we should recognize that, in this case, the goals of the corporation are in line with those of evidence-based addiction treatment specialists.
We must also be aware that the entrenched rehab industry in the US has its agenda as well. Successful outpatient treatment of more people who are addicted to opioids may mean fewer rehab admissions and re-admissions. When rehab administrators and owners fight against the use of medication-assisted treatment, we must question their motives as well.
If I were to make a case against Indivior, it would be more towards their efforts in restricting access to affordable buprenorphine products. It is my understanding that the company has long fought the approval of generics of its products and competing products. This year, generic buprenorphine/naloxone films were finally approved after Indivior fought long and hard to prevent this approval. Immediately after the generic approval, Indivior quickly withdrew its patient assistance program, leaving many underserved patients without access to treatment medication.
Additionally, Indivior has been fighting the release of Brixadi, an alternative long-lasting injectable buprenorphine that would compete with Indivior’s product, Sublocade. Because of this, Sublocade has been able to maintain high prices and limited access due to no competition.
In conclusion, while I do not agree with the grounds for this current case against Indivior, I would not be against a case that charged the company with preventing competition. While our free country does allow for companies to make a profit in providing service, it also provides for competition in a free market place to ensure that the consumer has choices and can benefit from this competition. When it comes to making statements against the motives of drug companies, it is essential not to give a confusing message about what is needed to help people to overcome opioid addiction.