March 24, 2005
Several months ago I wrote an article about medicines that can be used to treat maladies other than that for which it was originally created and certified. Cited was an article in the Wall Street Journal about the Cephalon, Inc. Fentanyl containing lozenge Actiq (see article dated May 23, 2004). While Actiq is marketed for “breakthrough cancer pain”, chronic daily headache (CDH) sufferers find it provides needed relief also during those breakthrough times. My article was intended to show frustration with regulatory and insurance issues that struggle with potential headache “coping” meds and, viewed through strict bureaucratic goggles, deny us CDH citizens available relief.
Fast-forward to the March 11, 2005 edition of the Wall Street Journal’s column “Science Journal”. Sharon Begley wrote an article entitled “Why One Medication Can Sometimes Treat Very Different Maladies”. While not focusing on pain, it is an excellent article that creates a dialogue of the whole subject of “off-topic” uses for medications along with some of the history. Delighted does not begin to adequately describe my emotions at seeing this topic addressed in a major widely read newspaper. Spurring dialogue on this important topic may, just may, break the ice with regulators and insurance companies to increase the quality of life for people in need, regardless of their malady. Whilst I understand the need for controls for a potent narcotic pain medication such as Actiq, the medicine’s function is to address “pain”. Does it really make a difference of the pain is cancer or CDH? Before you answer, I will admit I have talked to some doctors who struggle with that question but they readily admit they are not well versed in migraine pain. To them, by their own admission, a headache is something they take an over-the-counter (OTC) product for and the pain goes away. For them, the word “cancer” conjures up the image of major debilitating pain. The word “headache” isn’t even on their pain radar, therefore the resistance to prescribe anything more potent than the giant, economy size ibuprofen pill. I am NOT taking disparaging shots at these doctors. Rather, I AM pointing out it is an education and training issue.
Hopefully, positive dialogue will increase on this subject as the issues of access to affordable medication is high on the national debate level. I really struggle with “if the medication already exists in the marketplace and it works for this and this and this even though it was originally certified for whatever”, then what is the problem?!! Yes, I know it may be not as simple as it appears, but why can’t we address it?
