Overall cancer mortality continues to decline, liver cancer increasing

NIH/National Cancer Institute 

Press Release

Annual Report to the Nation: overall cancer mortality continues to decline, prostate cancer mortality has stabilized

The latest Annual Report to the Nation on the Status of Cancer finds that overall cancer death rates continue to decline in men, women, and children in the United States in all major racial and ethnic groups. Overall cancer incidence, or rates of new cancers, decreased in men and were stable in women from 1999 to 2014. In a companion study, researchers reported that there has been an increase in incidence of late-stage prostate cancer and that after decades of decline, prostate cancer mortality has stabilized....

Continue reading....

American Cancer Society

Annual Report to the Nation: Cancer Death Rates Continue Long Decline

Stacy Simon Senior Editor, News

The death rate from cancer in the United States is continuing to fall among men, women, and children, according to the latest Annual Report to the Nation on the Status of Cancer. Part 1 of the report shows the rate of death from cancer in the United States is decreasing for all major racial and ethnic groups, and for the most common types of cancer, including lung, colorectal, breast, and prostate. However, the report identified some cancer types with increasing death rates, including liver, pancreas, and brain cancer in men and women; oral cavity, throat, soft tissue, non-melanoma skin cancer in men; and uterine cancer in women.

The American Cancer Society, the North American Association of Central Cancer Registries, the Centers for Disease Control and Prevention, and the National Cancer Institute work together to create the report, which has been published each year since 1998. It provides an update of new cancer cases, death rates, and trends in the United States.

Black men and non-Hispanic women in various racial groups had the highest overall cancer incidence rates, and black men and black women had the highest overall cancer death rates.

“There continue to be significant declines in the cancer death rate with significant differences in rate by gender, race and ethnicity,” said Otis W. Brawley, M.D., chief medical officer for the American Cancer Society. “We need to continue working to understand the reasons for the disparities and how to most efficiently continue supporting and if possible accelerate these declines.”

In a companion study—Part 2 of this year’s report—researchers reported that there has been an increase in incidence of late-stage prostate cancer and that after decades of decline, the prostate cancer death rate has stabilized.

Parts 1 and 2 of the report were published May 22, 2018 in the American Cancer Society’s journal Cancer. 

Among the findings:

Overall cancer death rates from 1999 to 2015 decreased by 1.8% per year in men, and by 1.4% per year in women. 

Cancer death rates decreased during 2011-2015 for 11 of the 18 most common cancers in men and for 14 of the 20 most common cancers in women. 

Rates of new cancer cases from 1999 to 2014 decreased in men but stayed about the same for women
Survival rates increased significantly for several cancer types for both early- and late-stage disease, but varied by race and ethnicity, and state.

Behind the numbers

The declining cancer death rates have resulted largely from improvements in early detection and treatment, and reductions in tobacco use. However cigarette smoking still accounts for more than 25% of cancer deaths in the United States.

Increasing death rates were reported for several cancer types. Researchers attribute the increase in liver cancer death rates to the high prevalence of hepatitis C virus infection among Baby Boomers, as well as to the high prevalence of obesity in the United States. Obesity is also thought to have contributed to the increase in death rates from cancers of the uterus and pancreas.

The recent increase in oral cavity and pharynx cancer death rates among white men is thought to be attributable to human papillomavirus (HPV) infection.

Trends in prostate cancer 

In the companion study, researchers explored prostate cancer trends in more detail. They found that overall rates of new prostate cancers declined about 6.5% per year from 2007 to 2014. However, the rate of new advanced prostate cancers increased between 2011 and 2014. In addition, after declining between 1993 and 2013, prostate cancer death rates leveled off between 2013 and 2015.

This study also reports a decline in recent prostate-specific antigen (PSA) screening in the population based on a series of national surveys. The reported decline in screening occurred between the 2010 and 2013 surveys, for men between 50 and 74 years of age, and after the 2008 survey, for men age 75 and older.

“There are many factors that contribute to incidence and mortality such as improvements in staging and treating cancer,” said Serban Negoita, M.D., Dr.P.H., of NCI’s Surveillance Research Program and lead author of the prostate cancer report. “Additional research is needed to get a more comprehensive understanding of the recent trends and the possible relationship with PSA screening, as well as the relationship with other factors that may be associated with these trends.”

https://www.cancer.org/latest-news/annual-report-to-the-nation-cancer-death-rates-continue-long-decline.html

Related Resources

NIH/National Cancer Institute

View the Current Report:

Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics
Annual Report to the Nation on the Status of Cancer, part II: Recent changes in prostate cancer trends and disease characteristics
Archive of Previous Reports

Hepatocellular Carcinoma Incidence and Survival Among People With Hepatitis C An International Study

This study assessed trends in HCC diagnosis rates, contribution of risk factors to HCC diagnosis, and survival after HCC diagnosis among people with HCV infection.

Trends in Hepatocellular Carcinoma Incidence and Survival Among People With Hepatitis C An International Study 
M. Alavi; N. Z. Janjua; M. Chong; J. Grebely; E. J. Aspinall; H. Innes; H. Valerio; B. Hajarizadeh; P. C. Hayes; M. Krajden; J. Amin; M. G. Law; J. George; D. J. Goldberg; S. J. Hutchinson; G. J. Dore

J Viral Hepat. 2018;25(5):473-481
Volume 25, Issue 5 May 2018
Full Text

Free registration required

Available on Medscape 

Abstract

This study evaluates trends in hepatitis C virus (HCV)–related hepatocellular carcinoma (HCC) incidence and survival in three settings, prior to introduction of direct–acting antiviral (DAA) therapies. HCV notifications from British Columbia (BC), Canada; New South Wales (NSW), Australia; and Scotland (1995–2011/2012/2013, respectively) were linked to HCC diagnosis data via hospital admissions (2001–2012/2013/2014, respectively) and mortality (1995–2013/2014/2015, respectively). Age–standardized HCC incidence rates were evaluated, associated factors were assessed using Cox regression, and median survival time after HCC diagnosis was calculated. Among 58 487, 84 529 and 31 924 people with HCV in BC, NSW and Scotland, 734 (1.3%), 1045 (1.2%) and 345 (1.1%) had an HCC diagnosis. Since mid–2000s, HCC diagnosis numbers increased in all jurisdictions. Age–standardized HCC incidence rates remained stable in BC and Scotland and increased in NSW. The strongest predictor of HCC diagnosis was older age [birth <1945, aHR in BC 5.74, 95% CI 4.84, 6.82; NSW 9.26, 95% CI 7.93, 10.82; Scotland 12.55, 95% CI 9.19, 17.15]. Median survival after HCC diagnosis remained stable in BC (0.8 years in 2001–2006 and 2007–2011) and NSW (0.9 years in 2001–2006 and 2007–2013) and improved in Scotland (0.7 years in 2001–2006 to 1.5 years in 2007–2014). Across the settings, HCC burden increased, individual–level risk of HCC remained stable or increased, and HCC survival remained extremely low. These findings highlight the minimal impact of HCC prevention and management strategies during the interferon–based HCV treatment era and form the basis for evaluating the impact of DAA therapy in the coming years.

In conclusion, this international comparison of population–level data provides evidence for the rising burden of HCV–related advanced liver disease in BC, NSW and Scotland, highlighting the combined impact of ageing, suboptimal HCV treatment efficacy and uptake, and low levels of HCC screening and early diagnosis. Over the coming years, the population–level burden and individual–level risk of HCC would be expected to decline, given the potential impact of well–tolerated and effective DAA treatments. In addition, enhanced HCC screening could enable early diagnosis and better management options. The use of administrative databases for surveillance, particularly with the addition of individual–level antiviral treatment data, will be a valuable tool for evaluation and monitoring trends of HCV and HCC burden in relation to public health intervention strategies across the three settings.

http://www.medscape.com/viewarticle/895961_4

New Treatments Have Changed the Game: Hepatitis C Treatment in Primary Care

Infectious Diseases Clinics of North America June 2018 Volume 32, Issue 2, Pages 313–322

New Treatments Have Changed the Game
Shelley N. Facente, Katie Burk, Kelly Eagen, Elise S. Mara, Aaron A. Smith, Colleen S. Lynch

Key Points
• Although direct-acting antiviral regimens have driven up demand for hepatitis C virus (HCV) treatment, only a fraction of HCV-infected individuals are offered treatment within specialty settings.
• In 2016 to 2017, the San Francisco Health Network (SFHN) worked to improve treatment access and better understand barriers still inhibiting SFHN primary care providers from prescribing HCV treatment.
• Through SFHN’s HCV treatment expansion intervention, primary care providers were offered a 4-hour overview training about HCV treatment, an electronic referral system, and a team of HCV champions providing technical assistance within each clinic.
• Among SVHN patients tested for HCV over 3 years, 13.0% were found chronically infected; 578 patients were treated (19.9%), with no statistically significant differences between age, gender, or race/ethnicity of those treated and untreated.
• With minimal financial and time commitments, the SFHN primary care–based HCV treatment initiative resulted in a 3-fold increase in the number of patients treated for HCV in primary care.

Introduction
San Francisco residents are profoundly impacted by the hepatitis C virus (HCV), with approximately 2.5% of the general population seropositive for HCV as of 20151 compared with a national seroprevalence estimate of 1.4% (95% CI, 0.9%–2.0%).2 HCV is a significant driver of morbidity, liver cancer, and death3 and disproportionately has an impact on marginalized populations, including people of color, homeless individuals, people with a history of incarceration, and people who inject drugs.4, 5, 6, 7, 8 The availability of highly effective oral HCV treatment with few side effects, known as direct-acting antivirals (DAAs), makes HCV cure possible in nearly all infected patients.8

In the pre-DAA era, HCV treatments were complex and largely managed by hepatologists, gastroenterologists, and infectious disease physicians. As tolerable and highly effective DAA regimens have driven up demand for treatment, the relative scarcity of these specialists to the large number of infected individuals has created a bottleneck effect, resulting in only a fraction of HCV-infected individuals offered treatment in any given year.9 Even with reasonable capacity in the specialty setting, travel to specialty clinics or even the idea of attending appointments in unfamiliar settings with unfamiliar providers can be a barrier for marginalized populations disproportionately impacted by HCV.10 As treatment courses in the DAA era have become shorter, simplified, and remarkably well tolerated, recent studies have demonstrated the efficacy of treating HCV in high-prevalence primary care settings.11, 12

The San Francisco Health Network (SFHN) is San Francisco’s safety net system of care, and serves the majority of the low-income and homeless populations of San Francisco. The percentage of all active adult SFHN primary care patients who have been diagnosed with HCV is 5.5%. Part of the San Francisco Department of Public Health, the SFHN includes primary care in 10 community-based and 4 hospital-based clinics throughout the city. In 2016, in an effort to increase HCV treatment access for all patients, SFHN leadership committed to training its primary care providers to treat uncomplicated cases of HCV in the primary care setting using a team-based model of care.

In 2017, the primary care–based HCV treatment initiative team at SFHN undertook an analysis to measure the impact of these efforts to improve treatment access within the SFHN primary care system and to better understand barriers still inhibiting SFHN primary care providers from providing HCV treatment to their patients.

Continue to article online:

 https://www.id.theclinics.com/article/S0891-5520(18)30022-9/fulltext?rss=yes

Download PDF: 
https://www.id.theclinics.com/article/S0891-5520(18)30022-9/pdf

Hepatitis C and Dietary Supplements

Hepatitis C and Dietary Supplements
Most consumers assume that herbs and botanical products in dietary supplements are safe, however they are not regulated by the FDA, in addition these products can interact with prescription drugs, over-the-counter drugs, and other dietary supplements.

As an example milk thistle is the most commonly used herbal supplement in the United States for liver problems, including viral hepatitis. If you are interested in learning more about the science behind milk thistle, probiotics, zinc, or other commonly used supplements, check out the National Center for Complementary and Integrative Health (NCCIH) website, in particular the following publication: Hepatitis C and Dietary Supplements, updated this month.

HCV Next overview from EASL 2018: Dr. Reau’s summary of key HCV data & real-world studies

May/June 2018 Issue

PCPs will play critical role in future HCV treatments

View the latest issue of HCV NEXT, published online at Healio. 

HCV Next is a monthly publication offering patients the latest research, news and commentary on liver disease and viral hepatitis.

Table of Contents
The Take Home
The Take Home: International Liver Congress 2018

Nancy S. Reau, MD
This year, although there was much buzz about hepatitis B virus (HBV) and nonalcoholic steatohepatitis, hepatitis C virus (HCV) still held a prominent place in the oral presentations. As clinicians, we can take home some new data about 8-week regimens, real-world data, treatment failures and retreatments and how sustained virologic response affects both hepatocellular carcinoma risk as well as the risk for extrahepatic malignancies.

Editorial

International Liver Congress Offers Insight on the ‘Social Science’ of HCV
Ira M. Jacobson, MD
This month’s issue has a very nice summary of the data on therapeutic regimens presented at the International Liver Congress by Nancy S. Reau, MD. For me, the meeting highlighted how high is the summit to which we’ve climbed after years of a massive international effort to cure HCV, and how much the focus is shifting. We heard little about new HCV regimens and instead focused on real-world data sets on existing regimens and, equally important, the theme that HCV treatment has become as much of as social science as a medical one as we strive toward elimination. We saw an appropriate emphasis being placed on screening, linkage and access to care, including underprivileged and high-risk populations, on a national and global scale.

HCV hospitalizations increasing among baby boomers, men, drug users

PCPs will play critical role in future HCV treatments

In the Journals Plus
HCV finger-stick test accurate, gives results in 1 hour

View the Current Issues
HCV Next
Infectious Diseases in Children
Infectious Disease News

Experts Respond To Latest BMJ Article: Do direct acting antivirals cure chronic hepatitis C?

Background:

A review by the Cochrane Collaboration published June 6, 2017/updated September 8 2017, cast doubt on the effectiveness of new hepatitis C treatments, on May 12, 2018, BMJ published;Do direct acting antivirals cure chronic hepatitis C? by Cochrane author Janus Christian Jakobsen. A day later BMJ talk medicine aired this disturbing podcast with Jakobsen; New antivirals for Hepatitis C - what does the evidence prove? 

Experts Respond To Latest BMJ Article: Do direct acting antivirals cure chronic hepatitis C?
May 16, 2018

Experts weigh in with the following response: 

View BMJ Response:

https://www.bmj.com/content/361/bmj.k1382/rr

Dear Editor
Viral hepatitis experts are convinced of the benefits of antiviral therapy for hepatitis C.

We were dismayed that the Editors of the BMJ presented the widely discredited Cochrane review of Hepatitis C virus (HCV) therapy as mainstream opinion (1,2). It is not. This Cochrane review contained significant methodological flaws and lacked clinical insight or knowledge of the natural history of HCV. The opinion of informed hepatologists, infectious disease, and public health physicians, as well as the World Health Organisation (WHO), the National Institute for Clinical Excellence (NICE), and all international liver associations, is that directly acting antiviral (DAA) oral therapy for hepatitis C represents a breakthrough development that prevents end stage liver disease and death (3,4). This opinion is based on the dramatic benefits following widespread use of these drugs. Independent surveillance data from the Public Health England hepatitis C annual report (5) show that deaths from hepatitis C related end stage liver disease and hepatocellular carcinoma were increasing, more than doubled, between 2005 and 2014, but have fallen since 2014 with the introduction of HCV treatment with these drugs. PHE data indicates that registrations for liver transplant and transplants undertaken, where post hepatitis C cirrhosis is given as the indication for transplant, had remained relatively stable between 2008 and 2014, but have fallen since 2014 (5). Similar changes have been seen in every country where these drugs have been introduced. There is no credible explanation for the fall in hepatitis C liver disease morbidity and mortality associated with the introduction of effective anti-virals other than the use of these drugs.

Independent experts agreed that the most appropriate end-point in therapy trials for hepatitis C was sustained virological response (SVR). This was chosen, by independent regulators as the trial end-point. It was selected because in almost every infectious disease where there is a link between the pathogen and disease, clearance of the infection is beneficial and there is evidence that SVR with interferon-based therapies reduces mortality. The reasonable assumption that viral clearance with DAAs would reduce liver-related complications has been confirmed by long term follow up studies: the English Early Access Programme (EAP) shows a fall in deaths in patients who achieved SVR (6), and emerging data from large patient cohorts confirm this. There remains a risk of hepatocellular carcinoma in patients who developed cirrhosis prior to viral clearance, but evidence from studies of patients with advanced liver disease suggests that this risk is reduced. The legitimate debate about the value of an inflammatory milieu in patients with liver cancer and the role of viral clearance in this scenario does not obviate the clear mortality benefits from therapy and can not be used to imply that physicians are concerned about therapy in patients without cancer.

Hepatitis C is an infectious virus – the obvious extrapolation that effective therapy prevents transmission has now been confirmed. Dr Jakobsen and colleagues ignore the anxiety suffered by patients who are frightened of infecting their loved ones. Quite apart from the personal benefits of DAA therapy to patients who are already infected and their immediate contacts, reducing the overall burden of infection will reduce the risk of transmission to the rest of the population. DAA treatment of hepatitis C represents a rare opportunity to eliminate hepatitis C as a major public health concern and this opportunity is clearly recognised by WHO in its Global Strategy for Viral Hepatitis.

To suggest to patients that they should continue to suffer and not access safe and highly effective curative treatments that have been used in hundreds of thousands of patients without incident is inhumane.

The clinical utility of a drug is not inversely proportional to its price and NICE’s assessment of hepatitis C antivirals is that they are cost effective. We are not aware of any data questioning the NICE review. Since this review NHSE have negotiated a reduction in the price of these lifesaving drugs and the NHS is now in a position to plan an affordable hepatitis C elimination programme. This will focus on those populations most affected – often vulnerable members of society, such as people who inject drugs and the homeless. Many patients with hepatitis C do not attend primary care physicians to discuss the risks and benefits of therapy – they attend needle exchange, drug and alcohol, and homeless health services where they need to be identified (at considerable expense), engaged and offered antiviral therapy that may save their life. This gives them an opportunity to re-engage with society and move on with their lives. The overwhelming majority of clinicians are confident that there is very convincing evidence of benefit from DAA therapy and are planning to move antiviral services to all patients to amplify the remarkable benefits already demonstrated.

Dr Jakobsen is factually correct that only a large, placebo controlled trial over several decades with death as an end-point will prove beyond all doubt that SVR improves mortality. If the BMJ believes this to be an ethical approach it should have the courage to say so, and should then make the case for patients to live with the clinical, psychosocial and public health consequences of being infected and suffer symptoms until death to prove a scientific point. In the opinion of clinical experts the current data prove, beyond reasonable doubt, that achieving an SVR stops people transmitting and dying from hepatitis C. In the early HIV era a handful of idiosyncratic scientists refused to accept the association between HIV and AIDS and recommended that effective antiretroviral therapy be withheld. Sadly some governments, notably South Africa, followed this ill-informed advice and many vulnerable South Africans died as a direct consequence. It would be unfortunate if Dr Jakobsen’s views led to a similar tragedy in HCV. We hope that the BMJ will make clear that his personal opinion is not shared by reputable clinicians and policy makers. Patients should be encouraged to be tested and then treated for hepatitis C safe in the knowledge that they will join the millions of treated patients who will be protected from liver fibrosis and premature death.

Graham R Foster NHSE ODN Clinical Lead
Kosh Agarwal, Transplant hepatologist, HCV CRG member
Matthew Cramp Chair BASL
John Dillon Chair Scottish HCV Clinical Leads
Ahmed Elsharkawy Chair BVHG
Charles Gore CEO The Hepatitis C Trust
William Irving Chair NSGVH
Sema Mendal PHE HCV Lead
Peter Moss Chair HCV CRG
Chloe Orkin Chair BHIVA
Stephen Ryder Chairman HCV Coalition

References
1 Jakobsen JC, Nielsen EE, Koretz RL, Gluud C. Do direct acting antivirals cure chronic hepatitis C? BMJ. 2018 May 10;361:k1382

2 Jakobsen JC, Nielsen EE, Feinberg J, etal . Direct-acting antivirals for chronic hepatitis C. Cochrane Database Syst Rev 2017. 10.1002/14651858.CD012143.pub3.

3 Powderly WG, Naggie S, Kim AY, Vargas HE, Chung RT, Lok AS.IDSA/AASLD Response to Cochrane Review on Direct-Acting Antivirals for Hepatitis C
Clin Infect Dis. 2017 Nov 13;65(11):1773-1775.

4 European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu. Response to the Cochrane systematic review on DAA-based treatment of chronic hepatitis C. J Hepatol. 2017 Oct;67(4):663-664

5 Public Health England, Hepatitis C in England 2018 report
https://assets.publishing.service.gov.uk/government/uploads/system/uploa...

6 Cheung MCM, Walker AJ, Hudson BE, Verma S, McLauchlan J, Mutimer DJ, Brown A, Gelson WTH, MacDonald DC, Agarwal K, Foster GR, Irving WL; HCV Research UK. Outcomes after successful direct-acting antiviral therapy for patients with chronic hepatitis C and decompensated cirrhosis. J Hepatol. 2016 Oct;65(4):741-747

Competing interests: Professor Foster has previously received funding from companies that market antivirals for hepatitis C but no longer does so. PHE staff have no competing interests. Other authors have received speaker and consultancy fees from companies that market oral antiviral agents for hepatitis C. Peter Moss and Charles Gore, no personal competing interests. 

On This Blog: View each expert rebuttal and ongoing controversy 

Rebuttal over Cochrane Review of DAAs 

Do fatigue and quality of life improve after hepatitis C is cured?

Do fatigue and quality of life improve after hepatitis C is cured?

Keith Alcorn
Published: 16 May 2018

Patient-reported outcomes such as fatigue, vitality and mental health improve substantially in the two years following hepatitis C cure for people with cirrhosis, but people with cirrhosis are less likely than others to experience rapid resolution of severe fatigue after successful hepatitis C treatment, according to two studies from the Center for Outcomes Research in Liver Diseases reported last month at the 2018 International Liver Congress in Paris.

Quality of life can be severely impaired in people with chronic hepatitis C, especially in people with cirrhosis. Fatigue, insomnia, problems in physical functioning, depression, anxiety and mood disorders are reported by a substantial proportion of people with hepatitis C....

Continue reading: http://www.aidsmap.com/Do-fatigue-and-quality-of-life-improve-after-hepatitis-C-is-cured/page/3266466/

Recommended Reading

Conference highlights

aidsmap news from EASL 2018

Infohep

For more information on hepatitis visit infohep.org.
Infohep is a project we're working on with the World Hepatitis Alliance and the European Liver Patients Association.

Are pharmaceutical marketing payments to physicians for opioids associated with prescribing?

Are Pharmaceutical Marketing Payments to Physicians for Opioids Associated With Prescribing?

Bottom Line: Pharmaceutical industry marketing of opioid products to physicians through nonresearch payments, which can include speaking fees and meals, was associated with greater opioid prescribing.

Why The Research Is Interesting: Many opioid-related overdose deaths involve prescription opioids, and prescription opioids can commonly be a person’s first encounter on a path to illicit use. Marketing by the pharmaceutical industry to physicians is widespread but marketing of opioids and its influence on prescribing is unclear.

What (Study Methods): Linking of two U.S databases to identify all nonresearch payments from the pharmaceutical industry to physicians marketing opioid products (excluding buprenorphine hydrochloride marketed for addiction treatment) and to gather information on all claims from physicians who wrote opioid prescriptions (initial or refill) filled for Medicare beneficiaries in 2015

Study Limitations: Possibility of reverse causation because physicians who receive industry payments may be inclined to prescribe opioids; study establishes association, not cause and effect

Amidst national efforts to curb the overprescribing of opioids, our findings suggest that manufacturers should consider a voluntary decrease or complete cessation of marketing to physicians. Federal and state governments should also consider legal limits on the number and amount of payments.

https://media.jamanetwork.com/news-item/are-pharmaceutical-marketing-payments-to-physicians-for-opioids-associated-with-prescribing/

Research Letter
JAMA Intern Med. Published online May 14, 2018.
Association of Pharmaceutical Industry Marketing of Opioid Products to Physicians With Subsequent Opioid Prescribing
Scott E. Hadland, MD, MPH, MS1,2,3; Magdalena Cerdá, DrPH, MPH4; Yu Li, MD, PhD5; et al Maxwell S. Krieger, BS5; Brandon D. L. Marshall, PhD5
doi:10.1001/jamainternmed.2018.1999

Despite the increasing contribution of heroin and illicitly manufactured fentanyl to opioid-related overdose deaths in the United States, 40% of deaths involve prescription opioids.1 Prescription opioids are commonly the first opioid encountered in a trajectory toward illicit consumption.2 Although opioid prescribing has declined nationally, rates in 2015 were triple those in 1999 and remain elevated in regions of the country with higher numbers of overdoses.3

Pharmaceutical industry marketing to physicians is widespread, but it is unclear whether marketing of opioids influences prescribing.4 We studied the extent to which pharmaceutical industry marketing of opioid products to physicians during 2014 was associated with opioid prescribing during 2015.
Continue reading: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2681059

Related Material: Two other studies, “Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs. Daily Sublingual Buprenorphine with Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial,” and “Association of an Opioid Standard of Practice Intervention with Intravenous Opioid Exposure in Hospitalized Patients,” also are available on the For The Media website.

For more details and to read the full study, please visit the For The Media website.
(doi:10.1001/jamainternmed.2018.1999)
Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.