Transparency International (TI), an anti-corruption organization currently best known for its Corruption Perceptions Index, now has pharma in its sights. Pharm Exec spoke to Sophie Peresson, Director of TI’s Pharmaceuticals & Healthcare Program, about how the organization will go about understanding and combating corruption in the sector.

"Seventeen per cent of people worldwide stated they had paid a bribe when dealing with the medical sector in a global survey of 114,000 citizens in 2013, and 45 per cent believed medical and health services to be corrupt or extremely corrupt. "

Chronic pain is a national public health problem and an expensive one. It’s typically characterized as pain that’s persistent and lingering, as opposed to acute pain, which is sudden and sharp. Chronic pain often continues after injuries have healed, lasting for months or years, and can be debilitating. According to a 2011 report from the Institute of Medicine, about 100 million Americans suffer from chronic pain, costing society as much as $635 billion annually for everything from health care expenses to lost productivity at work. Pain is frequently cited as a factor in assessing damages in personal injury litigation and workers’ compensation cases, and can significantly boost the size of awards, depending on its severity.

That’s where things get tricky. Because there are no standardized or widely accepted diagnostic tools that can accurately or objectively measure pain, lawyers can easily challenge it. Patients are usually asked to rate their pain on a scale of 1 to 10 and sometimes are shown a poster of cartoon faces whose expressions indicate the severity of pain. The problem is that one person’s 5 might be another’s 10.

Some people do indeed exaggerate pain, which leads defense lawyers to be initially suspicious of claims for damages. It’s also the reason many physicians are cautious about how they treat pain, concerned that they might be complicit in creating or feeding addictions to painkillers for those who may not really need them.

Because of the magnitude of chronic pain’s impact, researchers have been seeking ways to better identify, understand and treat it. Neuroscientists in particular have been working to identify patterns of brain activity associated with pain that might help lead to better targeted treatments.

But personal injury lawyers see another potential value to neuroscience—as a way to document their clients’ pain if and when it might be contested. The problem, many scientists say, is that the research, while showing much promise, is still in its nascent stage.