They'll never prescribe it

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Anonymous said:
How many generic oxymorphone ER scripts are being written? How many 30-mg pills of immediate-release oxycodone (not abuse deterrent)? Payers don't believe abuse-deterrent technology works and won't pay a premium for it. I guarantee you, if it is a choice between ADF OxyContin and non-ADF Zohydro and the price is right, payers will follow the price. If Zogenix is smart they'll undercut Purdue substantially.
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This is a joke right? Zogenix will charge premium prices for Zohydro. The reps will be on the line for selling it. This company cannot afford to sell it cheap, the only way it can become an asset to the company within 3 years is if it is very costly.
 






Anonymous said:
This is a joke right? Zogenix will charge premium prices for Zohydro. The reps will be on the line for selling it. This company cannot afford to sell it cheap, the only way it can become an asset to the company within 3 years is if it is very costly.
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Zogenix needs to keep the lights on until the abuse-deterrent formulation is launched.

Anyone who thinks premium pricing in today's marketplace is the way to go, esp in a mature market with lots of branded and generic options, needs brain training.
 






Anonymous said:
This is a joke right? Zogenix will charge premium prices for Zohydro. The reps will be on the line for selling it. This company cannot afford to sell it cheap, the only way it can become an asset to the company within 3 years is if it is very costly.
Click to expand...

Zogenix needs to keep the lights on until the abuse-deterrent formulation is launched.

Anyone who thinks premium pricing in today's marketplace is the way to go, esp in a mature market with lots of branded and generic options, needs brain training.
 






Anonymous said:
Odd. Anesthesiologists doing "procedures" don't do Vicodin. They do anesthesia! Pain docs are usually board-certified in anesthesia but any anesthesiologist in private practice as a pain doc will use a ton of ER opioids. They'll use Zohydro as one tool in their toolbox. Managed care and cost is an issue for every ER opioid in this space. OxyContin is no longer the indomitable bear it once was. The new formulation doesn't give patients the same pop, so now there is no vocal patient base screaming for their OxyContin. It's a level playing field. Purdue doesn't have the formulary leverage it once had. New ball game. A small company with a decent product that isn't worried about an outrageous and stupid price point will make some money. Not huge, but some.
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Obviously you are new to the pain field if you believe anesthesiologist who treat pain in a private practice will be using Zohydro in their armourmentarium of pain therapy. Good luck with that foolishness. I've asked a few of the pain docs about Zohydro and they report that they are shocked and disappointed that the FDA approved it! You should sit down with an addiction specialist and ask about your Zohydro. Get ready to sit in a hot chair!
 






Anonymous said:
Obviously you are new to the pain field if you believe anesthesiologist who treat pain in a private practice will be using Zohydro in their armourmentarium of pain therapy. Good luck with that foolishness. I've asked a few of the pain docs about Zohydro and they report that they are shocked and disappointed that the FDA approved it! You should sit down with an addiction specialist and ask about your Zohydro. Get ready to sit in a hot chair!
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Pain specialists who have been using ER opioids for years aren't shocked. Look at what's happening with immediate-release oxycodone scripts (Roxicodone) and generic oxymorphone ER.
 






Anonymous said:
That game has changed. Lots of regulation and good luck stocking all those doses at the pharmacy level.

When I sold oxy in the hay day it was a dream. Good luck in today's world.
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well said my friend. Today much different prescribing pain drugs. Docs now choose a non-narcotic option to avoid pressures prescribing drug with risk abuse, misuse, addiction. Narcotics now are thing of past and future presents abuse proof safety options pain docs will be interested. Good y'all have jobs but times have changed with ongoing monitoring and pressures narcotics. A reason companies selling drugs for abuse of narcotics and monitoring systems and lab tests? Good Luck selling narcotic 10 times more potent than widely prescribed drug. At least y'all don't have acetaminophen in drug it presents even more issues and concerns.
 






Anonymous said:
well said my friend. Today much different prescribing pain drugs. Docs now choose a non-narcotic option to avoid pressures prescribing drug with risk abuse, misuse, addiction. Narcotics now are thing of past and future presents abuse proof safety options pain docs will be interested. Good y'all have jobs but times have changed with ongoing monitoring and pressures narcotics. A reason companies selling drugs for abuse of narcotics and monitoring systems and lab tests? Good Luck selling narcotic 10 times more potent than widely prescribed drug. At least y'all don't have acetaminophen in drug it presents even more issues and concerns.
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Whoa, who taught you how to write complete sentences? You make NO sense at all!
 






I would wager on the following :

- NOT a blockbuster
- will see LIMITED use by a few legit pain docs for some pts who do well with hydro
- will see MAJOR use by pill mills if price point is competitive with gen opana er.

It will be funny watching zohydro reps spin this NEW drug to pain guys.
The only ones that will be impressed with it as a NEW drug will be the Johnny come lately pain docs who have just entered the arena and have no clue. The same idiots who write Roxi's and opana because OC is the evil giant. Lol.

All youll to do to sell it is ID ur pill mill clinics and drop off plenty of coupons.
 












Anonymous said:
I would wager on the following :

- NOT a blockbuster
- will see LIMITED use by a few legit pain docs for some pts who do well with hydro
- will see MAJOR use by pill mills if price point is competitive with gen opana er.

It will be funny watching zohydro reps spin this NEW drug to pain guys.
The only ones that will be impressed with it as a NEW drug will be the Johnny come lately pain docs who have just entered the arena and have no clue. The same idiots who write Roxi's and opana because OC is the evil giant. Lol.

All youll to do to sell it is ID ur pill mill clinics and drop off plenty of coupons.
Click to expand...

You explained nothing in this post. What the heck is a Johnny-Come -Lately pain doc? Are you referring to Neurologists, PM&Rs, or Anesthesiologists; or are you aware of a new specialty? There will be no "major" use by anyone other than friends of sales reps who happen to be doctors.
 












Anonymous said:
I agree with this post.
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Drs will RX the product, if for nothing else their pts requesting something else to treat their pain,
Most of the pain reps will be gone b/4 1 year. The IC wasn't all that impressive. If you really want to be pain reps-check the FDA on upcoming submittals/approvals for drugs in the pain market or go work for a company that sells pain modulators and make some money
 






Anonymous said:
Drs will RX the product, if for nothing else their pts requesting something else to treat their pain,
Most of the pain reps will be gone b/4 1 year. The IC wasn't all that impressive. If you really want to be pain reps-check the FDA on upcoming submittals/approvals for drugs in the pain market or go work for a company that sells pain modulators and make some money
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Finally, someone with some brains!
 






Anonymous said:
You explained nothing in this post. What the heck is a Johnny-Come -Lately pain doc? Are you referring to Neurologists, PM&Rs, or Anesthesiologists; or are you aware of a new specialty? There will be no "major" use by anyone other than friends of sales reps who happen to be doctors.
Click to expand...
Pain clinics come and do like restaurants.
Docs who have practiced for a while (typically PCP's) who get frustrated with medicine and think that opening a cash pain clinic is a quick, easy, and painless way to make a living. Any rep who has sold controlled pain meds knows exactly who I mean. They are not necessarily bad docs, just less educated in pain management and perhaps naive, and tend to be more influenced with what they think they know rather than what actually is occurring. Example - I just had an IM doc who I had considered as fairly sharp leave a good but cumbersome family practice group to start his own pain clinic. He shared with me last week that he believes in keeping opioid doses low and that is why he will rarely use long acting. He also believes Opana ER would be his first choice as he believes it is less abused than OC. I asked him what drugs in particular he written the most since he opened (opioids long acting and short), his reply : Roxicodone and opana. I asked if requires patients to get brand opana and he said no he prefers pts to have choice to get generic if more affordable.
SO - this doc who IS a good person and good doc THINKS he is practicing wisely and doing the best things for his pts but in reality he is prescribing the 2 most abused/diverted products currently on the opioid street scene. And he really doesn't know !!! can't really argue otherwise, but simply gave advice that he really should put a little time into speaking with some local addiction docs or maybe law enforcement, but really should investigate and seek to understand what is happening on the street. That he might not be considering all the reasons a pt asks for generic opana and that oxycodone does not always mean OC when he sees it in news. That is who I am speaking of. And there are a bunch of them out there

Find those docs, drop off coupons, and watch ur numbers go up.

The wiser docs in pain mgmt will not be impressed with zohydro. I do think it will be a decent tool for all docs to have as an option to use which is a good thing, and I do think it will be a good product and good option for pain patients. But is nothing more than another commonly known opioid in a long acting delivery system. It is not going to change the world of pain mgmt. And you may get a few pts because of doc/rep relationship, it woto be very many. The vast majority of docs will not prescribe a Cii based upon relationships. It is not like relationship selling for a cholesterol or bp med.
 






Come and go. Not come and do.

It is actually pretty amazing to see pain clinics pop up and literally disappear 6 months later. And good luck keeping up with all of the various providers even if the clinic does make it. The mid levels jump around like popcorn making tracking sales credit an arduous process.
 






Come and go. Not come and do.

It is actually pretty amazing to see pain clinics pop up and literally disappear 6 months later. And good luck keeping up with all of the various providers even if the clinic does make it. The mid levels jump around like popcorn making tracking sales credit an arduous process.
 






Anonymous said:
Pain clinics come and do like restaurants.
Docs who have practiced for a while (typically PCP's) who get frustrated with medicine and think that opening a cash pain clinic is a quick, easy, and painless way to make a living. Any rep who has sold controlled pain meds knows exactly who I mean. They are not necessarily bad docs, just less educated in pain management and perhaps naive, and tend to be more influenced with what they think they know rather than what actually is occurring. Example - I just had an IM doc who I had considered as fairly sharp leave a good but cumbersome family practice group to start his own pain clinic. He shared with me last week that he believes in keeping opioid doses low and that is why he will rarely use long acting. He also believes Opana ER would be his first choice as he believes it is less abused than OC. I asked him what drugs in particular he written the most since he opened (opioids long acting and short), his reply : Roxicodone and opana. I asked if requires patients to get brand opana and he said no he prefers pts to have choice to get generic if more affordable.
SO - this doc who IS a good person and good doc THINKS he is practicing wisely and doing the best things for his pts but in reality he is prescribing the 2 most abused/diverted products currently on the opioid street scene. And he really doesn't know !!! can't really argue otherwise, but simply gave advice that he really should put a little time into speaking with some local addiction docs or maybe law enforcement, but really should investigate and seek to understand what is happening on the street. That he might not be considering all the reasons a pt asks for generic opana and that oxycodone does not always mean OC when he sees it in news. That is who I am speaking of. And there are a bunch of them out there

Find those docs, drop off coupons, and watch ur numbers go up.

The wiser docs in pain mgmt will not be impressed with zohydro. I do think it will be a decent tool for all docs to have as an option to use which is a good thing, and I do think it will be a good product and good option for pain patients. But is nothing more than another commonly known opioid in a long acting delivery system. It is not going to change the world of pain mgmt. And you may get a few pts because of doc/rep relationship, it woto be very many. The vast majority of docs will not prescribe a Cii based upon relationships. It is not like relationship selling for a cholesterol or bp med.
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Diahreah of the keyboard! Shut up!
 






Bad press again.

New pain pill's approval: 'Frightening'By Stephanie Smith, CNN

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(CNN) -*A potent little painkiller is causing a big stir.

A coalition of more than 40 health care, consumer and addiction treatment groups is urging the*Food and Drug Administration*to revoke approval of the prescription drug Zohydro.

The hydrocodone-based drug is the latest in a long line of painkillers called opioid analgesics. The FDA approved the medication last fall*to treat chronic pain, and it is set to become available to patients in March.

"In the midst of a severe drug epidemic fueled by overprescribing of opioids, the very last thing the country needs is a new, dangerous, high-dose opioid," the coalition*wrote in a letter to FDA Commissioner Dr. Margaret Hamburg.

"Too many people have already become addicted to similar opioid medications, and too many lives have been lost."

One addiction expert who signed the letter was more forthright.

"It's a whopping dose of hydrocodone packed in an easy-to-crush capsule," said Dr. Andrew Kolodny, president of the advocacy group*Physicians for Responsible Opioid Prescribing. "It will kill people as soon as it's released."

The letter is the latest in a series of entreaties to the FDA related to Zohydro.

In December,*29 state attorneys general sent a similar letter*to the FDA. The month before, members of Congress*asked the agency to review its decisionto approve the drug.

The concerns echoed by all groups are broadly about the drug's potency and abuse potential. They say they fear that Zohydro -- especially at higher doses -- will amplify already-rising overdose numbers.

"This could be the next OxyContin," says a*petition on Change.org*asking the FDA to reconsider.

Report: States failing to curb prescription abuse

According to the Centers for Disease Control and Prevention,*prescription opioid deaths more than quadrupled since 1999*-- there were 4,030 deaths involving the drugs in 1999, compared with 16,651 in 2010.

"You're talking about a drug that's somewhere in the neighborhood of five times more potent than what we're dealing with now," said Dr. Stephen Anderson, a Washington emergency room physician who is not part of the most recent petition to the FDA about the drug. "I'm five times more concerned, solely based on potency."

Both Zohydro's maker,*Zogenix, and the FDA assert the drug's benefits outweigh its risks.

"We do not expect the introduction of Zohydro ER (extended release) to increase the overall use of opioids," said Dr. Brad Galer, executive vice president and chief medical officer at Zogenix, in an e-mail. "In fact, prescription data from the last five years shows that total use of ER opioids is constant and independent of new entrants to the market."

Galer said the company will focus its commercial efforts on a small group of doctors with good experience prescribing opioids, so that only appropriate chronic pain patients would receive the drug.

Advocates for pain patients say that concerns about abuse, while valid for some, are not necessarily an issue for those patients.

"We know that a person with pain is not a person who abuses medications," said Paul Gileno, founder and president of the*U.S. Pain Foundation, a group that receives some funding in unrestricted grants from the pharmaceutical industry. "A person with pain is a person suffering to get pain relief in order to live a fulfilling life."

Opinion: How safe are your prescription drugs?

In their petition to the FDA for approval,*Zogenix representatives cited examples of patients who might benefit from Zohydro: a 46-year-old male with chronic back and leg pain who had two failed back surgeries; a 52-year-old female with metastatic breast cancer experiencing diffuse pain; a 32-year-old woman with multiple orthopedic fractures.

If Zohydro follows in the footsteps of its opioid-containing predecessors, such a narrow, focused patient group may expand -- to patients with low back pain, fibromyalgia, arthritis or countless other chronic conditions.

"The problem is, it costs a lot of money bringing a drug through clinical trials and then bringing it to market," said Anderson, past president of the Washington chapter of the American College of Emergency Physicians. "You have to anticipate (the drug company) being able to market and get its money back.

"I see this as a marketing ploy where eventually it's 'I've got bigger, I've got stronger, why don't you prescribe this,' and I'm terrified of that."

Dr. Sanjay Gupta: Let's end the prescription drug death epidemic

Bigger, stronger opioids -- especially those containing hydrocodone -- are a concern. Hydrocodone (Zohydro's sole ingredient) is one of the most frequently prescribed -- and abused -- opioids.

For that reason, in October, the*FDA said it intended to shift hydrocodone-containing drugs from Schedule III to Schedule II. That rescheduling (still pending approval by the Drug Enforcement Administration) would mean much stricter dispensing and prescribing rules for hydrocodone-containing products.

At the time of that recommendation, the FDA posted a statement on its website that it "... has become increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States."

A day after announcing the proposed drug schedule change for hydrocodone, the FDA announced Zohydro's approval. It was a confusing juxtaposition, some say.

"Shocking, outrageous and genuinely frightening," said Kolodny of the Physicians for Responsible Opioid Prescribing.

FDA spokeswoman Morgan Liscinsky said that Zohydro's approval was separate and distinct from the agency's recommendation about rescheduling hydrocodone-containing products.

"I find great difficulty (with) the wisdom of the FDA's approval in terms of protecting the public's health," said Dr. Alex Cahana, professor of pain medicine at the University of Washington in Seattle, who was not among those who signed the letter to the FDA. "Risk-benefit thinking suggests that not everything we can do, we should do."

Zohydro will enter the market already classified as a Schedule II -- one reason both the FDA and the drug's maker are confident it will not contribute to the broader overdose problem.

Zohydro's labeling will feature warnings about abuse, addiction and misuse, and Galer said Zogenix is working on an abuse-deterrent version of Zohydro that should become available in three years.

None of those precautions has assuaged concerns. Anderson said that while a small subset of patients may benefit from Zohydro, unleashing such a potent drug in the current environment is unsafe.

"Put more of this kind of drug out on the*street and, I'll see more overdoses related to this, no question," Anderson said.
 






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