Slide16

Can the black market predict which abuse-deterrent formulations are most successful?

Drug companies are trying to make pills harder to crush, in order to deter injection and snorting. For a review of abuse deterrent formulations (ADFs), see this recent two part scientific review (part 1 & part 2), or this New York Times article with pictures.

 

The FDA held a public meeting last October where industry experts revealed new secrets on how the products are made, and are putting together a guidance on how to evaluate whether new drugs are really abuse deterrent, and whether pharma companies get to promote that way. Nabarun Dasgupta of Epidemico is presenting today at a new conference of FDA and industry on what black market street prices can reveal about ADFs.

 

How to build a better pill

 

You’ve heard of OxyContin being made harder to crush. Did you know there are more than a dozen other ADFs already on the market? Here’s a partial list of brand name drugs in the US: Suboxone, Vyvanse,  Zohydro, Hysingla ER, OxyContin OP, Opana ER, Xartemis XR, Exalgo, Concerta, Ritalin LA, Nucynta ER, Embeda,Targin(iq), Oxytrex, Oxecta, Quillivant XR, Talwin NX, Amrix. These pills are built on drug delivery “platforms” that are patented by yet other companies who out-license them to the opioid manufacturers (Purdue, Johnson & Johnson, Pfizer, etc.).

 

The platforms all vary in how hard it is to get the drug out. Among the most popular are Grünenthal INTAC, Elan Spheroidal Oral Drug Absorption System (SODAS),  Altus Intellitab, Alza OROS (Osmotic [Controlled] Release Oral [Delivery] System), and Dow PolyOx.

What can the black market tell us?

But which of these work best? Can the black market reveal which platform is the hardest to get into? Check out Slide 16 of the presentation below. It looks like there is a clear divide between which platforms work best… OROS looks much tougher to get into than INTAC.

 

So, if you were a pharma company, which platform would you choose?

Nab Crowdsourcing Presentation Title Page

PowerPoint:

Crowdsourcing as a way to evaluate drug abuse in the community

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NCHS Data Brief 166

Drug-poisoning Deaths Involving Opioid Analgesics:
United States, 1999–2011

Key findings

  • The age-adjusted rate for opioid-analgesic poisoning deaths nearly quadrupled from 1.4 per 100,000 in 1999 to 5.4 per 100,000 in 2011.
  • Although the opioid-analgesic poisoning death rates increased each year from 1999 through 2011, the rate of increase has slowed since 2006.
  • Natural and semisynthetic opioid analgesics, such as hydrocodone, morphine, and oxycodone, were involved in 11,693 drug-poisoning deaths in 2011, up from 2,749 deaths in 1999.
  • Benzodiazepines were involved in 31% of the opioid-analgesic poisoning deaths in 2011, up from 13% of the opioid-analgesic poisoning deaths in 1999.
  • During the past decade, adults aged 55–64 and non-Hispanic white persons experienced the greatest increase in the rates of opioid-analgesic poisoning deaths.

The new StreetRx websites have been launched!

Anonymously report street prices of prescription and illicit drugs at the new and improved www.StreetRx.com.

Visitors to the site can also view others’ submissions of street price paid for a range of both illicit and prescription drugs. The geographical area is captured along with the street price paid.

In addition to the United States, StreetRx has been launched in Australia, Canada, France, Germany, Italy, Spain and the United Kingdom.

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StreetRx in the news:

Canadian pills allegedly showing up on market in southern U.S.

The ongoing availability in Canada of an abuse-prone pharmaceutical may be having a spillover effect far beyond its borders.

A form of OxyContin that was banned in the United States last year is still showing up in distant corners of the country, according to data presented at a conference in San Diego.

The claim comes as Canada weighs whether to follow the American lead in banning the older form of the opioid painkiller that’s easier to crush in order to achieve an instant high.

A drug-abuse researcher said data supplied by users pointed to evidence of Canadian pills in 11 states.

They were reportedly purchased 39 times in various pockets of the country, with the most concentrated cluster centred in New Mexico and surrounding southwestern states. The information was culled from a crowdsourcing website, Street Rx, where users can plug in details about the price they’ve been charged for drugs.

In an interview, the researcher who presented the findings attempted to put the numbers in context.

He called it fascinating that the pills kept turning up in so many places far from the Canadian border, during the survey period that wrapped up last Dec. 31.

But he made it clear that the data points to a trickle of Canadian product, not a gusher.

“The U.S. is not being flooded by this product — don’t get me wrong,” said Dr. Rick Dart, of the Researched Abuse, Diversion and Addiction-Related Surveillance group.

“But it’s consistent… It’s a continuing event. This isn’t one suitcase (being smuggled in).”

 

Adderall: The Privilege Pill

StreetRx in the news

Adderall isn’t cheap. On most campus black markets, one pill, which is good for an evening of work, ranges from $5 to 11, according to StreetRx. A one-time purchase isn’t going to break the bank, but if you become a regular user, it gets expensive.

 

We have launched international StreetRx sites in six countries: CanadaUKFranceGermanyItalySpain   Screen Shot 2014-03-25 at 10.04.53 AM   Screen Shot 2014-03-25 at 10.09.37 AM

Black Market Price per Milligram vs. Medical Potency

The research discussed in “Crowdsourcing Black Market Prices For Prescription Opioids” revealed that street prices paid for different opioids generally followed the rank order of the strength of these opioids.