Pressure to prescribe
Methadone is much cheaper than other narcotics. A one-month supply (90 pills of five milligrams each) costs about $8, compared with $80 for generic morphine or $100 for OxyContin, according to First DataBank, a national reference of prescription drug prices.
Insurance companies, workers� compensation programs and state health programs like Medicaid all are pushing methadone over more expensive alternatives, said Lynn Webster, a pain researcher and physician from Utah.
Webster told the Gazette he feels pressured to prescribe methadone by insurers.
�I�ve had insurance companies deny payments for OxyContin because they feel it is not indicated. Or they say they aren�t going to pay for enough of the drug to be effective, so we can�t control pain at the amount they authorize,� Webster said. �We can either prescribe methadone or nothing at all.�
Several states, including West Virginia, have added methadone to their preferred drug lists. That makes it easier for doctors to prescribe than other drugs that require prior approval from the state.
Federal programs are asking doctors to prescribe methadone, too.
�If there are two medications out there that are equally effective, the Veterans Administration will choose the less expensive alternative every time,� said James Toombs, a pain researcher and physician at a VA hospital in Columbia, Mo., in a telephone interview.
Sales soar for manufacturers
The companies that make methadone have seen huge increases in sales as the drug�s popularity has risen.
One of the world�s largest makers of opioid pain drugs is Tyco, the same company whose top executives were jailed for looting millions from the company. Company officials agreed to pay a $50 million fine to settle allegations of inflated company earnings.
Tyco also employed Republican lobbyist Jack Abramoff to help it avoid taxes and get government contracts, according to published reports. In January, Abramoff pleaded guilty to federal charges of fraud, tax evasion and conspiracy to bribe public officials.
Tyco got into the methadone-making business in 2000, when it bought a company called Mallinckrodt Inc.
The revenues generated by Tyco/Mallinckrodt increased 22 percent between 2001 and 2005, according to U.S. Securities and Exchange Commission filings, from $7 billion to $9.5 billion.
The company makes many drugs, mostly generic. In several SEC filings, company officials credit some of their increased profits to the sale of narcotics like methadone.
In just one year, the amount of methadone and other narcotics the company sold jumped 30 percent, according to a 2000 company report.
Another large manufacturer of methadone, Roxane Laboratories of Columbus, Ohio, has helped boost sales for its owner, a German conglomerate called Boehringer Ingelheim Inc.
The German company�s net revenues grew by 42 percent between 2001 and 2005, from about $8.6 billion to $12.2 billion, according to company reports.
Those companies are investing some of that money in Washington, D.C., lobbyists. Between 1998 and 2004, Tyco paid lobbyists $4.1 million and Boehringer Ingelheim paid lobbyists $860,000, according to the non-partisan Center for Public Integrity.
Tyco/Mallinckrodt sponsors continuing education courses and information sessions at industry conferences to provide doctors and pharmacists with up-to-date information about methadone, company spokeswoman JoAnna Schooler told the Gazette.
Mallinckrodt has supported the Addiction Treatment Forum, which Leavitt edits, since 1992, and Leavitt�s other Web site, Pain Treatment Topix, since before it went online in January.
Leavitt said he is afraid bad publicity about methadone will scare doctors and patients who need to use it. He said educational efforts such as his Web site are the best way to reduce accidental overdose deaths.
Some family members of methadone overdose victims want to go further. Some say they want the drug locked up in secure boxes. They want the warnings on the drug�s package insert, which the FDA approved, to be stronger.
Regan said the drug shouldn�t be given outside of hospitals, if at all.
�If they could take it off the market, I�d be all for it. I think they could come up with something else for the drug rehab centers,� she said. �Because I know it�s taken a lot of loved ones from families that didn�t deserve it.�
Regan�s mother had four children, four grandchildren and a great-grandchild.
�She was a wonderful person,� Regan said. �She would give anyone the shirt off her back or everything in the refrigerator ... I don�t know, everybody seemed to love her.
�I just wish she was still here.�
To contact staff writers Scott Finn and Tara Tuckwiller, use e-mail or call 357-4323 or 348-5189.