Eating on the drug company’s dime


 

This evening I went to a presentation at a fancy hotel and this presentation was sponsored by Novartis which makes an antipsychotic medication called Fanapt. We were literally wined and dined. Most of the participants were probably nurses, psychiatrists and social workers/case managers. If I had to guess I would say I was the only peer support specialist. I was there to learn from deep inside the belly of the beast.

A number of things raised my eyebrows in the presentation. Most of the data presented resulted from very brief  studies although the doctor also had some information from people who have been using it for about 2 years. He told us that the patients using the medication should notice a reduction in symptoms in just four days. Although the presentation about about using the medication in patients presenting with schizophrenia, the doctor has also used it with patients with bipolar disorder. When I searched reviews of the medication from consumers, I also found that some of them were taking it for “off-label” problems, such as bipolar.

Use of the medication has not resulted in significant weight gain, according to the doctor. So, this is a new medication that has only been available for a couple of years and is significantly better than older anti-psychotics? That depends.

However, when I did some research I found that this medication has a somewhat checkered past. This information is from Wikipedia

Regulatory approval

Hoechst Marion Roussel Inc. made initial inquiries into the drug; however, in May 1996, they discontinued research, and in June 1997 gave research rights to Titan Pharmaceuticals. Titan then handed over worldwide development, manufacturing and marketing rights to Novartis in August 1998. On June 9, 2004, Titan Pharmaceuticals announced that the Phase III development rights have been acquired by Vanda Pharmaceuticals. The original launch date was scheduled for 2002. On November 27, 2007, Vanda Pharmaceuticals announced that the U.S. Food and Drug Administration (FDA) had accepted their New Drug Application for iloperidone, confirming the application is ready for FDA review and approval.[6] On July 28, 2008, the FDA issued a “Not Approvable” letter to Vanda Pharmaceuticals concerning the drug, stating that further trials are required before a decision can be made concerning marketed usage of iloperidone.[7]

Iloperidone won FDA approval for use treating schizophrenia in the United States on May 6, 2009.[8]

An article in The Street points to disappointing sales of fanapt. http://www.thestreet.com/story/10997122/1/vandas-fanapt-falls-flat.html Which could be a reason why we were given the sales pitch tonight.

I also have a chart  comparing side effects of fanapt with another anti-psychotic. http://www.ehealthme.com/compare_drug_interactions_side_effects/risperidone-3249043

Some of the information about fanapt on medical websites reads like it was taken straight from the drug company. What I did not find in the presentation or on the web was the impact that rallying a consumer’s natural supports would have on the prognosis. There was a woman at the presentation who wondered whether one of her patients with many severe issues unrelated to his mental health diagnosis could benefit from fanapt. In other words, could he stop being a mean alcoholic? In my experience, the only relief for mean alcoholic men is an early grave.

Are the wonder drugs? Who will rally a person back to have a meaningful role in society? Is this a recovery oriented system?

I believe it is essential that more peer specialists go to these types of events. Since I had no experience with anti-psychotics, I could ask some questions that others might have raised. A large part of what case management involves is making sure that people are getting and taking their meds but peer support can inform this process by introducing and reinforcing choice, the need for multiple supports and the idea of treating people not as a mass of symptoms to be managed but as whole individuals with desires and needs. So I hope peer specialists won’t shy away after reading this cautionary tale but dig in and learn about what these companies are trying to feed us.

 

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