What is Accutane, and why is it so controversial?

In a previous post, we talked about Clear Health and our initial focus on the acne drug, Accutane.

In this article, we’re going to go over what exactly Accutane is, why we think the stigma and controversy surrounding the drug is unwarranted, and why we believe the process that Accutane is currently distributed through is broken.

So Accutane is actually a colloquial term used nowadays for an acne medication called “isotretinoin”. If you’ve ever used Retin-A, you’ve probably noticed the second part of the name “tretinoin”. Isotretinoin is a derivative of Vitamin A, which when taken at adequate levels for a 5-6 month course, can produce long-term remission of acne, or essentially a “cure” for some individuals (in our experience, most people care not “cured” and will require keeping up with their skincare routines even when they’re off the drug).

As opposed to other treatments, Accutane is one of the few skincare solutions where almost in every instance, it will work to some extent – whether dramatically like it does for many patients, or whether it materially decreases the severity of acne in others.

In the United States, Isotretinoin use is monitored by the FDA through a program called iPledge, which requires monthly dermatologist check-ups, bloodwork, and birth control monitoring for female patients (females absolutely should not get pregnant on Isotretinoin, as it will cause severe birth defects in the baby).

So why is Isotretinoin called Accutane? Accutane was the first brand that Isotretinoin was marketed under from a company called Roche, and was actually pulled off the market (only generic brands exist now, like Claravis, Amenesteem, Absorbica) – this is where the controversy and stigma around the drug really starts. Roche stopped producing the brand name Accutane drug because of lawsuits that alleged the drug would cause conditions such as Irritable Bowel Disorder (IBD) and depression, with some individuals committing suicide.

 

Now, if you know about Accutane, you probably know about these fearful claims, but what are the facts? If we take a look at hard data:

 

  • In a report referenced by Harvard Medical school, the suicide rates of those who took Isotretinoin is about 1/5th of the rate of suicides in the general population.

 

  • In a 2016 study by the European Journal of Gastroenterology and Hepatology, the incidence of IBD found between patients who had taken Isotretinoin and got IBD and those who just got IBD were roughly the same. The FDA states there is no causality determined between taking Isotretinoin and IBD.

 

Okay, so let’s play devil’s advocate for a second though. As a former finance bro, one of the first things we learn is that garbage data in is going to produce garbage data out, so let’s say for a second I don’t trust the data and just want to approach this from a logic perspective. Let’s take suicide in point #1. Acne is a physical condition, and without a doubt affects the self-esteem of a large portion of people who suffer from it.

From a common sense perspective, is it feasible then, that the population of people with acne who would have lower self-esteems, will be more prone to suicidal thoughts due to societal pressures (especially in this day and age of IG and Tik-Tok)?

If we just search “Accutane Reviews” on Youtube, there are thousands of videos of people who have said how the drug has helped them reclaim their lives and self-esteem – without Accutane, would it be possible that these people would still be looking for a solution, and possibly becoming more likely to be depressed because they couldn’t access the drug?

Possibly. Some food for thought.

Now let’s take the IBD case. The risk of getting IBD is about 0.46% in people who take Accutane, and 0.44% in those who haven’t.

For people who suffer from acne that literally affects their daily activities, as long as they understand that there might be a small risk that they may get IBD, should it still be okay for them to decide whether or not they want to take the drug, which could potentially change their life for the better?

Some more food for thought.

 

We have three primary goals with Clear Health, and our intention is definitely not to “push” Accutane on anyone. Rather, our aim is to:

 

  • debunk a lot of the fear-mongering statements and stigma surrounding the drug by providing facts and proper information so patients can make a more informed decision

 

  • provide a platform that will help tackle the more sinister residual problems that have popped up as a result of the stigma surrounding Accutane – the Accutane black market. As mentioned, obtaining Accutane in the U.S. requires a prescription and monitoring through the iPledge program, and illegal pharmacies selling the drug without the proper guidelines is a HUGE problem from a health and safety perspective.

 

  • Leverage technology to increase safety, decrease costs, and save time. In a University of Pittsburgh Study, the extra cost and time associated with the monthly visits to the derm for Accutane shows that people often have to miss work and school to set time aside. Telehealth solves this problem, while offering opportunities to be more cost-effective by eliminating traditional overhead costs, which can be passed on to the patient.

 

Hopefully this provided a good general overview of what Accutane is, what the risks are, and what are goals are for Clear Health. If you think Accutane might be something you want to consider, make sure to checkout www.getclearhealth.co.