Various hospitals in the United States have contracted software that was developed by the start-up Practice Fusion, to estimate the type of drugs and the ideal dose to be delivered in each patient’s case.
When the software began to recommend the prescription of more pain relievers than usual, some physicians suspected that something was wrong.
After analysing the software, it was discovered that it did not harbour any errors, at least not any that were accidental, as the increased dosage of pain relievers was deliberate.
Based in San Francisco, Practice Fusion was founded in 2005 and became very popular with doctors as it offered its software for free, with advertising being the only source of income. Thanks to it, tens of thousands of doctors could manage tens of millions of patient records.
As reported by the United States Department of Justice, the pharmaceutical company Purdue Pharma Inc. had bribed Practice Fusion to modify its algorithm and interface. The alteration was applied to the version of the software that was used from 2016 until the beginning of 2019.
In this way, the company intended to increase profits from the sale of its opioids, drugs known for effectively relieving pain.
The opioid problem
When a doctor opened the program to manage the patient's health record, a pop-up window appeared and asked about the patient's level of pain. This happened in particular with those who had yet to receive an opioids’ prescription. After answering the question, the software suggested prescribing opioids.
If the practitioner accepted the suggestion, then the software automatically deployed a treatment plan with the amount and time of use to relieve pain in the most effective way. The suggested time tended to be longer than usual. This particular opioid, which could be used to treat pain caused by cancer, trauma, or major surgery, tended to be prescribed more times compared to other products which were less profitable for the pharmaceutical company.
In exchange for a 145-million-dollar fine, the company avoided possible civil and criminal penalties, although the case is particularly serious given the problem of opioid addiction that most of the American population already has.
In fact, there are more Americans taking pain relievers than smoking. More than 300 million prescriptions for drugs of this type are issued each year and almost two million people in the country are dependent. The biggest problem, however, is overdose deaths which are estimated at tens of thousands per year. According to the Centers for Disease Control and Prevention, an average of 115 Americans died of an opioid overdose every day between 1999 and 2016. In 2017, the U.S President Donald Trump declared the opioid abuse epidemic a national public health emergency.