Alpharma:NewPlatform

forGrowthMarch21,2006

FourSeasonsHotel

57East57thStreet

NewYork,NY10022Alpharma:NewPlatform

forGrWelcomeKathyMakrakis

VicePresident

InvestorRelationsWelcomeKathyMakrakis

VicePreForwardLookingStatementStatementsmadeinthispresentationincludeforward-lookingstatementswithinthemeaningofthePrivateSecuritiesLitigationReformActof1995.Thesestatements,includingthoserelatingtofuturefinancialexpectations,involvecertainrisksanduncertaintiesthatcouldcauseactualresultstodiffermateriallyfromthoseintheforwardlookingstatements.InformationonothersignificantpotentialrisksanduncertaintiesnotdiscussedhereinmaybefoundintheCompany’sfilingswiththeSecuritiesandExchangeCommissionincludingitsForm10KfortheyearendedDecember31,2005.ForwardLookingStatementStatWebcastInformationandPresentationAssumptionsWebcastInformationandPresenAgendaTOPICPRESENTERSWelcomeandAgendaKathleenMakrakisVicePresidentInvestorRelationsCompanyOverviewIngridWiikViceChairman,PresidentandCEOFinancialOverviewMatthewFarrellExecutiveVicePresidentandCFOAnimalHealthCarolWrennPresident,AnimalHealthDivisionActivePharmaceuticalIngredientsCarl-?keCarlssonPresident,ActivePharmaceuticalIngredientsBreak(10:15AM–10:45AM)BrandedPharmaceuticalsRonaldWarnerPresident,BrandedProductsJosephStaufferVicePresident,ClinicalResearch&MedicalAffairsWrapUpIngridWiikViceChairman,PresidentandCEOLunch(12:00PM)EachBusinessSegmentSessionWillIncludeTimeforQ&AAgendaTOPICPRESENTERSWelcomeaCompanyOverviewIngridWiik

ViceChairman

PresidentandCEOCompanyOverviewIngridWiik

ViHighMarginBusinesseswithGrowthOpportunitiesSpecialtyPharmaceuticalBusinessesBrandedKadian?:extendedreleasemorphineproductGrowingKadian?prescriptionsandmarketshareActivePharmaceuticalIngredientsFermentationandpurificationexpertiseAnimalHealthAworldwideleaderinthetreatment

andpreventionofdiseasesinfoodproducinganimalsAH

58%API

24%Branded

18%AH

46%Branded

17%API

37%HighMarginBusinesseswithGrBrandedBuildpainfranchise–investinproductstoleveragesalesforceDevelopnextgenerationabusedeterrentproductsandexpanddrugdeliverytechnologyAPILaunchadditionalhighpurityfermentation-basedactiveingredientsandexpandintospecialty-injectablesThroughAsianalliances,developandproducenewproductsandexpandexistingcapacityanddriveworldclasscostAHLeveragemarketreputationtodelivernewMFA’svialicensingandacquisitionofproductsOfferexistingmoleculeswithdifferentdeliverysystemsandwithnewindicationsNewFocus+InvestmentstoDriveGrowthGrowthStrategyBrandedNewFocus+InvestmentsGrowthPotential2001–2005growthofourcurrentSpecialtyPharmabusinessesRevenue:CAGR8%Operatingincome:CAGR29%WenowhavethefinancialresourcestoaccelerateourgrowthopportunitiesTargetedOrganicGrowthOpportunitiesRepresentRevenuesof$700M+GrowthPotential2001–2005grFinancialOverviewMatthewFarrell

ExecutiveVicePresident

andCFOFinancialOverviewMatthewFarrALOFinancialHistory$inmillions*ExcludingassetandgoodwillimpairmentsCAGR8%EstablishedGrowthCAGR29%ALOFinancialHistory$inmill2005YearEndBalance $800DebtPay-offinJanuary2006: TotalDebt@December31,2005

Premium/Interest (417)

(24)ParMedsalepending(netafter-taxproceeds) ~+352006FreeCashFlow: ContinuingOperations ~+70 DiscontinuedOperations–Accrued

expensesrelatedtogenerics,primarilytax

(60) ~$400Estimated$400MillionCashAvailableforInvestmentCashAvailableforInvestment$inmillions2005YearEndBalance $2006Outlook

FullYear2006EPS$1.25-$1.35BrandContinuedKADIAN?prescriptiongrowthPhaseIIClinicalTrialsforabuse-deterrentproduct-$15-$20millionincrementalR&DIncreasedKADIAN?SG&AinfrastructuretosupporthighgrowthbusinessAPILaunchfluticasoneinQ32006Launching1-2morenewmoleculesbyQ42006AnimalHealth5newproductlaunchesin2006Corporate/Unallocated2006outlookincludes$12million($0.14EPS)ofpredominantlyone-time2006expenses$3million($0.04EPS)ofstockoptionexpensealsoincludedin2006outlookOutlookadjustedforone-timeexpenseEPS:$1.39-$1.49;EBITDA$154million-$162million2006Outlook

FullYear2006EPAnimalHealthCarolWrenn

President

AnimalHealthDivisionAnimalHealthCarolWrenn

PresiWhatWe’llTalkAboutBusinessandmarketoverviewCompetitivelandscapeGrowthinitiativesExpandingshareNewproductpipelineWrapupWhatWe’llTalkAboutBusinessAnimalHealthbusiness

hasstrongmargins,solidcustomerrelationships,brandrecognition,butuntil2005hadlowhistoricalrevenuegrowth.

Webelieveweareonanewtrajectory.AnimalHealthbusiness

hasstStableNicheBusinesswithStrongMarketPositionAnimalHealthAHDspecializesinproductsforthetreatmentandpreventionofdiseasesinfoodproducinganimals,withastrongportfolioaddressingintestinalandrespiratoryissuesMarketleaderinmedicatedfeedadditives(MFA’s)andWaterSolubles:productsaddedtoanimalfeedordrinktopromotegoodhealthProductssolddirectlytomajorpoultryandlivestockproducersorthroughdistributorsMajorproductsincludebacitracin,chlortetracyline,lasolocidSoldunderbrandnamesBMD?,Albac?,Aureomycin?,Avatec?,Bovatec?StableNicheBusinesswithStrBiologicals22%MFA's12%Pharmaceuticals66%AnimalHealthMarketCurrentBusinessMFA–OpportunityinPharmaceuticals$325MAH2005RevenuesWaterSolubles6%MFA’s

94%*ExcludesVitamins$13.7B*GlobalMarketbyMajorProductBiologicals22%MFA's12%Pharmace

TotalMkt .MFAMkt

Total

ALOShare

Total

ALOSHARE

Poultry 1.6 10% .59 27%Cattle 3.7 2% .32 20%Swine 2.3 3% .54 14%Horses 0.5 --- --- ---Sheep 0.6 --- .07 ---Dogs&Cats 4.6 --- .07 ---Others 0.4

--- --- ---Total $13.7 2.4% $1.6 19%

TotalMkt .MFAMkt

Mkt

ALOShare

Total

ALOShareN.America

4.7 4% .61 30%Asia 2.7 1% .42 5%L.America 1.5 2% .17 19%EMEA 4.8

1%

.40

12%Total $13.7 2.4% 1.6 19%AnimalHealthMarketALOhasLeadingPositioninMFA’s….OpportunitytoExpandby

SpeciesandRegionSalesBySpecies($B)SalesbyRegion($B)*Source2005WoodMckensie

AnimalHealthPerformance2005RevenueGrowthDrivenPrimarilybyShareGains

OIReflectsDramaticMarginImprovement

2.5%12.8%46%89%*ExcludesdivestedoperationsRevenues($M)*OperatingIncome($M)*AnimalHealthPerformance2005COCCIDIOSIS(Eimeria)AvatecBioCoxBovatecDeccoxCycostatCygroNicarbZoamix3-NitroPoultrySulfaSulQNoxENTERITIS(Clostridia)AlbacAlcareAureomycinBacivet-SBMDBMDSolubleLincomycinSolILEITIS(Lawsonia)AureomycinDYSENTERY(Serpulina)AlbacAlcareBMDBMDSolubleLincomycinSolGoodFranchiseinEntericDiseases-55%ofBusinessCOLIBACILLOSIS(E.coli)NeoSolTetSolBacterialDiseasesProtozoalDiseaseIntestinal(Enteric)ProductOfferingCOCCIDIOSIS(Eimeria)ENTERITISPASTEURELLOSIS,BRD(Pasteurella)AureomycinLincoSolubleCTCHClOxytetSolublePoultrySulfaTetSolMYCOPLASMAPNEUMONIAAureomycinOxytetSolubleTetSolAGoodBaseinRespiratoryTreatments-30%ofBusinessRespiratoryProductOfferingsMycoplasmapneumoniaBacterialpneumoniaPASTEURELLOSIS,BRD(PasteurelTodayTechnologyplatform:MFAandWaterSolublesStrongentericandrespiratoryportfolioforfoodproducinganimals2005resultsdemonstrateabilitytogrowGreatbrandrecognition+customerrelationships...SOHOWDOWESUSTAINTHENEWTRAJECTORY?TodayGrowingtheBusinessExpandingmarketshareinourcurrentbusinesswithexistingMFA’sandwatersolublesIntroducenewproductlineextensionsandnewindicationsGeographicexpansionNewproductsTomeetcurrentcustomerneedsincurrentmarketToenternew/expandedmarketsegmentsGrowingtheBusinessExpandingExpandingShareinCurrentBusinessActivitiesUnderwayTargeting$50M+ofRevenueOpportunityExpandingShareinCurrentBusNewProductsNewproductstomeetcurrentcustomerneedsIntestinal(Enteric)RespiratoryExpandintonewmarketsegmentsCompanionanimalsDairycattleRevenueOpportunityof$70M+NewProductsNewproductstome#ofPlannedAHNewProductLaunchesCommercializingMoreProducts#ofPlannedAHNewProductLaProductSpeciesSpecialtyDosage

FormNewProduct/

ExistingMarketNew

Market2005CTC-HCLSwineRespiratoryOral-GranulateüBetaMossCattleEntericOral-Granulateü2006PoultrySulfaPoultryEnteric/

RespiratoryOral-WaterSolubleüDairyCattleCattleOtherTopicalüHorseCoolingTherapyCompanionOtherTopicalüCompanionAnimalCompanionNutritionOral-WaterSolubleüLatinAmericanComboMultiEntericOral-Granulateü2007Anti-InfectantWaterSolubleMultiRespiratoryOral-WaterSolubleüAnti-InfectantWaterSolubleMultiRespiratoryOral-WaterSolubleüCompanionAnimalGenericCompanionDermotologyTopicalüLincomycinInjectableSwineRespiratoryInjectableüGenericMFAMultiEntericOral-GranulateüEntromycinCompanionEntericOral-WaterSolubleüProductLaunchCalendarOnTrackwithNewProductImplementationsProductSpeciesSpecialtyDosage

PotentialNewProductRevenuesLaunchingProductsOvertheNextThreeYearswithMaturityValueof$70M+$inmillionsPotentialNewProductRevenuesSummaryContinuetoincreasevalueinexistingproducts$50M+opportunityrelatedtoadditionalproductindicationsandgeographicexpansionNewproducts/newsegments$70M+ofrevenueopportunitySignificantGrowthOpportunitiesSummaryContinuetoincreasevaAnimalHealthbusiness

hasstrongmargins,solidcustomerrelationships,brandrecognition,butuntil2005hadlowhistoricalrevenuegrowth.

Webelieveweareonanewtrajectory.AnimalHealthbusiness

hasstActivePharmaceuticalIngredientsCarl-?keCarlsson

President

ActivePharmaceuticalIngredientsActivePharmaceuticalIngredieWhatWe’llTalkAboutBusinessandMarketoverviewGrowthinitiativesExpandandimprovecurrentbusinessIntroducenewproductsForwardintegrateWrap-upWhatWe’llTalkAboutBusinessProducesactiveingredientsforpharmacompaniesmarketingthefinishedproductsProfitableproductnicheswithstrongoperatingmarginsALOproficientinlengthy,complexFDAapprovalprocessAdvancedfermentationandpurificationcapabilitieswithsynthesiscapabilitiesinR&DActivePharmaceuticalIngredientsGloballyRecognizedSupplierofKeyAPI’s

PredominantlywithInjectableandTopicalApplicationsProducesactiveingredientsfoRemainingAPIs

25%Baci,Poly,

Vanco,

70%DosageForm

9%Contract

3%APIOverviewFermentationandPurificationExpertiseBiologicalsExtractsBiopharmaceuticals

19%Fermentation

6%SemiSynthetics

5%Synthetics

70%Other

66%Antibiotics

34%RemainingAPIs

25%Baci,Poly,

APIPerformance$inmillionsBacitracinPriceIncreaseImpactPeakedin2004VancomycinVolumeGrowth

andTobramycinLaunchMitigated2005PriceReductionRevenueOperatingIncomeAPIPerformance$inmillionsBaStrategyExpandandimproveourcurrentbusinessAtaminimum,doublethenumberofAPIproductsfrom10to20infiveyearsIncreasethevalueofourproductofferingthroughforwardintegrationActivelySearchingforValueAddingOpportunitiesBecomeTheLeadingSupplierofAPIsandEnd-to-EndSolutionsfortheInjectableMarketStrategyExpandandimproveourExpandOurSuccessfulCurrentBusinessBemarketleaderinallourproductsDeliverbestinclasscustomerservicethroughcontinuousinnovationCustomerspecificproductqualitydelivered“ontime,everytime”ControlcoststhroughfocusedprocessimprovementsExpandOurSuccessfulCurrentDoubleTheNumberofAPIProductsFrom10to20InFiveYearsFocusonpipelinemanagementandexploitincreasedR&DspendExpandinhouseAPItechnologyplatformtoincludesemi-syntheticsLeverageourinternationalR&DandsupplychainpartnershipsDoubleTheNumberofAPIProduIncreaseTheValueOfOurProductOfferingThroughForwardIntegrationDevelopcapabilitytoofferinjectabledosageformulationsOfferallkeyAPIsasfinishedproductsolutionsIncreaseTheValueOfOurProdVancomycinAPIMarketisAttractiveinSizeandisExpectedtoContinuetoGrowVancomycinisstillgoldstandardtreatmentforseveregrampositiveinfectionsMarkethasbeengrowingat3-5%perannum,whichisexpectedtocontinuePrevalenceisincreasing,stillunder-treatmentinmanymarketsNewproductsinthissegmenthavebeenintroducedatapremiumprice(10-20xvanco)ConsequentlytakenasmallvolumeshareSofarexpandedthemarketratherthancannibalizedVancomycinvolumesSomeestablishedAPIsuppliersexitingthemarketScaledrivenorportfoliodecisionsCompetitiveLandscapeChanginginVancomycin–APIOpportunityof$20M+ExpandandImproveCurrentBusinessVancomycinAPIMarketisAttraExpandAndImproveCurrentBusinessFocusedProcessImprovementsisaKeySuccessFactorandanALOFocusAreaSingleMoleculeExampleofProcessImprovementImpactonTotalYieldExpandAndImproveCurrentBusExpandandImproveCurrentBusinessandIntroduceNewProductsBuildingAsianpartnershipsTechnologytransferandbusinessdevelopmentunitestablishedinShanghaiThreelongtermagreementsputinplacein2005/Q12006Tobramycinnon-sterileinChinaMupirocininTaiwanFluticasoneinChinaMoreareinprogressandagreementsshouldbeconcludedin2006RangeofnewAPIproducts(immunomodulators)RangeofnewAPIproducts(Oncology)RangeofnewAPIproducts(antivirals)ExpansionofmanufacturingcapacityBuildingAsianR&DandSupplyChainPartnershipsUnderALOControlCommercialModelsareTailor-MadeandareConstructedasWin-WinPartnershipsExpandandImproveCurrentBusDryPowderfillPre-filledsyringesLyophilizedvialsFinishedprod.formulationSynthesis/SemisynthesisBiologicalsFermentationFinishedDosageFormsTechnologyPlatformOwndevelopmentTherapeuticAreasOncologyAntiinfectivesPainImmunomodulators&otherLicensingAPIsselectedfromspecifictherapeuticareas,supportingend-to-enddevelopmentstrategyOwndevelopmentbuildingonAPItechnologyplatformandtargetingAPIswithinjectableapplicationCurrentFutureIntroduceNewProducts–DevelopmentandTechnologyStrategySourcing/licensingPossibleDryPre-filledLyophilizedFiniIntroduceNewAPIProductsInitiativesUnderwayTargetAPIRevenueOpportunityof$50M+Morethan10AdditionalProductsCurrentlyUnderEvaluation/NegotiationProductYearofLaunchBrandTherapeuticAreaTobramycin2005Tobi,Nebcin,Simplexetc.AntibacterialTeicoplanin2006TargocidAntibacterialFluticasone2006Flonase,Flovent,Advairetc.AntiflammatoryMupirocinacid2006BactrobanAntibacterialALD120ALD1132006/072008AntiflammatoryAntibacterialALD1112009PainALD1092010AntibacterialALD1122011AntifungalIntroduceNewAPIProductsInitIntegratingForward–SecuringGrowthandProtectingMarginsLackofmanufacturingcapacityforfreezedriedinjectablevialsALOhasexpertisefromAPIfreezedryinganddrypowderfilltechnologiesALOhasregulatoryexpertiseALOhasregistrationsforvancomycinvials(EUandAsia)distributedthroughAcatavisALOissellingCMSdrypowderfillvialsasprivatelabelForwardIntegrationintoFreezeDriedInjectableVialsRepresentRevenue

OpportunityforCurrentandPipelineAPIsinExcessof$30+MillionTotalvialmarketforALOAPIproducts(currentandpipeline)inexcessof150MvialsIntegratingForward–SecuringIntegratingForward-LaunchingFinishedDosageFormProductsas“PrivateLabel”RepresentsRevenueOpportunity$30M+SeveralAdditionalProductsCurrentlyUnderEvaluationProductYearofLaunchBrandTherapeuticAreaTeicoplanin2008TargocidAntibacterialALD1182009AntibacterialALD1092010AntibacterialALD1122011AntifungalIntegratingForward-LaunchiSummary–SignificantGrowthOpportunitiesContinuetogrowopportunitiesinexistingAPIproductsCapitalizeonvancomycinmarketchanges-$20M+revenueopportunityDoublenumberofAPIproductsoffered$50M+revenueopportunityIntegratingForwardFreezedriedinjectablevials$30M+revenueopportunityLaunchingadditionalfinisheddosageformproductsasprivatelabel$30M+revenueopportunitySummary–SignificantGrowthOBrandedPharmaceuticalsRonaldWarner,PhD

PresidentBrandedProducts

JosephStauffer,DO

VicePresidentClinicalResearchandMedicalAffairsBrandedPharmaceuticalsRonaldWhatWe’llTalkAboutBusinessandmarketoverviewKADIAN?productandtechnologyGrowthinitiativesExpandcurrentbusinessLineextensions,newindications,newgeographyAddcomplementaryproductsPainandrelatedproductsDevelopabusedeterrentproductsWrapupWhatWe’llTalkAboutBusinessGrowingMarketPresenceBusinessOverviewKADIAN?-Sustainedrelease,longactingmorphineproduct–indicatedformoderatetoseverechronicpain194SalesRepresentativesFocus–highprescribingdecile6–10physiciansMarketingmessage–flexibilityandindividualizedpaintherapyInternalR&D,competenciesinmicro-particulatecoatedcontrolled–releasetechnologiesGrowthinitiatives–productin-licensingandabuse–deterrent

painproductsGrowingMarketPresenceBusines$3.7BillionMarket–MajorALOOpportunityMarketOverviewPainrepresentsasignificantmarketopportunitywithunmetneedsMarketwillcontinuetogrowinvolumeaspopulationagesTwocompanieshavehistoricallydominatedthemarketsegment(Purdue,Janssen)Existingblockbusterproductshavegonegeneric(OxycontinandDuragesic)Competitionactivewithahighshareofvoice(Ligand/Organon,Janssen,Purdue)Abuse/diversionhighontheagendaofdocsandDEARiskmanagementprogramsexpectedtoexpand$3.7BillionMarket–MajorALKADIAN?FinancialPerformanceSolid2005PerformanceDrivenbyShareGrowthandPrice$inmillionsKADIAN?FinancialPerformanceS30%TRxGrowth(2004to2005)KADIAN?Prescription(TRx)Performance-2005JanuaryDecember30%TRxGrowth(2004to2005)KContinuedGrowthin2006KADIAN?Prescription(TRx)Performance–2005-200620052006JanuaryDecemberContinuedGrowthin2006KADIANKADIAN?MarketShare–20051PPTMarketShareExpansion(TRX)JanuaryDecemberKADIAN?MarketShare–20051PCompetitiveLandscape–ControlledReleaseProductswithModeratetoSevereChronicPainIndicationsAnnualgrowthof2-3%15millionprescriptionsannually$3.7billionmarketin2004MarketShareByProductChangingLandscape–DynamicMarketPlace*Source:NDCDataCompetitiveLandscape–ControAvailableinfivedosingstrengths:20mg30mg50mg60mg100mgTheMostFlexibleDosingandTitrationOptionsofAllProductsinCategoryKADIAN?Onceortwice-a-daydosingNo“bolus”doseThreeroutesofadministrationNoceilingdoseNosignificantfoodinteractionAvailableinfivedosingstrenDosingIntervalAvailableStrengthsAdministrationBolusCeilingdoseKADIAN?12h24h20,30,50,60,100mgCapsule

Sprinkle

G-TubeNo–Avinza?24h30,60,90,120mgCapsule

SprinkleYes1600mgOxycontin?12h10,20,40,80mgTabletYes–MSContin?12h15,30,60,100,200mgTabletYes–Duragesic?72h12.5,25,50,75,100mcg/hrPatchNo–ComparisonofLong-actingOpioidsDosingIntervalAvailableStrenPatentNumberExpirationType“128”April13,2010Composition“474”March21,2010Composition“766”July19,2011MethodKADIAN?PatentsIntellectualPropertyNoParagraphIVFilingstoDatePatentNumberExpirationType“12KADIAN?ExpandingMarketShareExpandKADIAN?IndicationsGrowingtheBusiness–How?KADIAN?LineExtensionsstrengthspackagingdosageformsTerritoryExpansiongeographic“new”marketsOtherPainProductsbreak-thrupainnewdosageformsacutepainlessseverepain0OtherPainRelatedProductshormonereplacementantiemeticsantidepressantsetc.AbuseDeterrentProductsIR/ERdifferentopioidsKADIAN?ExpandGrowingtheBusinGrowingtheBusiness

KADIAN?LineExtensions-InternalDevelopmentAdditionalindicationsNewstrengthsDifferentdosageformsAdditionalgeographiesNewmarketsRevenueOpportunity$30M+AnnuallyGrowingtheBusiness

KADIAN?LGrowingtheBusiness

AddComplementaryProducts-BusinessDevelopmentForPainBreak-thrupainAcutepainLessseverepainForPainRelatedIndicationsAntiemeticsHormonereplacementAntidepressantsSleep-aidsMusclerelaxantsSeveralInvestmentOpportunitiesBeingTargetedGrowingtheBusiness

AddComplGrowingtheBusiness

Abuse-DeterrentProductsImmediatereleaseproductsExtendedreleaseproductsMultipleopioidsRevenueOpportunity$500M+AnnuallyGrowingtheBusiness

Abuse-Det

OpioidAbuse-DeterrentTechnologies

Pharmacologic

CombinationMechanisms

Physical

AversiveComponent

DeterrentPackaging

OpioidAbuse-DeterrentTechnoPharmacologic -SequesteredAntagonist -Bio-availableAntagonist

CombinationMechanisms

(Alpharma’sFocus)

Physical -Difficulttocrush -Difficulttoextract

AversiveComponent-Capsaicin–burningsensation-Ipecac–emetic-Bitrex?

–bittertaste

DeterrentPackaging -RFID–Protection

-Tamper-proofbottles

Increasingabusedeterrence

OpioidAbuse-DeterrentTechnologiesHierarchyPharmacologicCombinationMechaKADIANSustained-release

pH-dependent

polymer-coatedshellMorphinesulfate

binderlayerSugarSphereNTSustained-release

pH-dependent

polymer-coatedshellOpioid

binderlayerSequesteredCoreKadianVersusAbuse-deterrentLong-actingOpioid(NT)KADIANSustained-release

pH-depJosephW.Stauffer,DO

VicePresident,ClinicalResearchandMedicalAffairs

AlpharmaBrandedProductsDivision

AssistantProfessor

AnesthesiologyandCritical

CareMedicine

JohnsHopkinsUniversityHospitalJosephW.Stauffer,DO

VicePrAbuse-DeterrentOpioids

WhatWe’llTalkAboutIsprescriptionopioidabuseanissue?Whatisthecostofopioidabuse?InternetOpioidAbuseSurveillanceStudyDophysicianscareaboutabusedeterrence?OurabusedeterrentdevelopmentprogramAbuse-DeterrentOpioids

WhatWPain&Addiction:

FDA,DEA,LawEnforcement,Patients,ProvidersPain&Addiction:

FDA,DEA,LaTotalPainAddiction2-5%AberrantBehavior40%Abuse20%WebsterLR,WebsterRM.Predictingaberrantbehaviorsinopioid-treatedpatients:Preliminaryvalidationoftheopioidrisktool.PainMed.2005.6(6):432-42.ChronicPainPopulationisatRiskforAbuse,Diversion,

andAddictionTotalPainAddictionAberrantAbuHealthcare30.1%Workplace49.7%CriminalJustice20.2%TotalCost=$9.2BillionSource:BirnbaumH,etal.“CostofPrescriptionOpioidAnalgesicAbuseintheUnitedStatesin2001:ASocietalPerspective,”presentedattheAmericanCollegeofEpidemiologyAnnualMeeting,September2004.TheCostofPrescriptionOpioidAbuseintheUnitedStatesin2001PrescriptionOpioidAbuseisaSignificantPublicHealthProblemHealthcare30.1%Workplace49.7%CSource:WhiteA,etal.“DirectCostsofOpioidAbuseAmonganInsuredPopulationintheU.S.,”presentedattheAmericanSocietyofHealth-SystemPharmacistsMidyearClinicalMeetingandExhibits,Dec5-9,2004.OpioidAbusersNon-AbusersAverageAnnualDirectCosts*ofOpioidAbusers

andNon-abusers:AdministrativeClaimsData$0$2,000$4,000$6,000$8,000$10,000$12,000$14,000$16,000$18,000OpioidAbusersNon-abusersOtherCosts**OutpatientCostsHospitalInpatientCostsDrugCosts5%34%48%13%11%51%17%21%*Costsarein2003Dollars.Thedifferencebetweenallmeanannualcostsofopioidabusersnon-abusersisstatisticallysignificantlydifferentatthe1%level(p<.01)exceptfor"OtherCosts"forwhichthe"OtherPlaceofService"componentissignificantlydifferentatthe5%level(p<.05).**OtherCosts"include:"OtherPlaceofService"and"EmergencyRoom"costs.TotalDirectCost=$1,830TotalDirectCost=$15,884Source:WhiteA,etal.“Direc20mg30mg50mg60mg100mgHowDoesKADIAN?CompareintheWorldofPrescriptionOpioidAbuse?20mg30mg50mg60mg100mgHowQuantitativeInternetSurveillance:ContentAnalysisAndMonitoringOfInternetPrescriptionOpioidAbuse-RelatedPostingsStephenF.Butlera*,SynneWingVenutia,ChristineBenoita,RichardL.Beaulaurierb,BrianHoulea,

NathanielKatzac

aInflexxion,Inc.,Newton,MA02464USA,bFloridaInternationalUniversity,Miami,FL33199USA,cTuftsUniversitySchoolofMedicineAbstract2005ThisstudydescribesthedevelopmentofasystematicapproachtoanalysisandmonitoringofInternetchatterasameansofmonitoringpotentiallyabusableopioidanalgesics.Messageboardsdedicatedtodrugabusewereselectedusingspecificinclusioncriteria.

AllrelevantInternetpostswerecaptured(total=48,293).

Acodingsystemwascreatedtocomparecontentofpostsrelatedtothreeopioidanalgesics:Kadian,Vicodin,andOxyContin.

Thenumbersofpostscontainingmentionsofthetargetdrugsweresignificantlydifferent(OxyContin(1,813)>Vicodin(940)>Kadian(27),p<.001).

Analysesrevealedthatthesedifferenceswerenotsimplyareflectionoftheavailabilityofeachproduct(i.e.,numberofprescriptionswritten).

Inaformalreliabilitytest,thecontentcodingsystemachievedgoodinter-raterreliabilitycoefficients(averagekappaacrossallcategories=.76,range=.52to1.0).

Contentanalysisofasampleof234randomlyselectedpostsindicatedthattheproportionofInternetpostsendorsingrecreationaluseofKadianwassignificantlylessthanOxyContin(45.5%vs.68.4%,p=.036),andnumericallylessthanVicodin(45.5%vs.57.6%,p=.291).

Theseresultssuggestthatasystematicapproachtopost-marketingsurveillanceofInternetchatterrelatedtopharmaceuticalproductsisfeasibleandyieldsreliableinformationaboutthequantityofdiscussionofspecificproductsaswellasqualitativeinformationregardingthenatureofthediscussions.

ThisinvestigationstandsasafirstattempttoestablishsystematicmethodsforconductingInternetsurveillance.

Manuscriptsubmittedto,Journal:PainAbstractsacceptedatConferences:AmericanMedicalEducationandResearchinSubstanceAbuse(Oct2005);AmericanPainSociety