Big Pharma firm, under fire in drug abuse epidemic, scales back opioid’s hype

oxy-300x179Purdue Pharma, which built a multi-billion-dollar family empire, in part, by overcoming doctors’ resistance to prescribing powerful painkillers like its own powerhouse  OxyContin, has decided to curb its quarter-century of aggressive and controversial drug marketing — efforts that critics and lawsuits say helped fuel the nation’s opioid drug abuse epidemic.

The company has said that it will cut its sales staff by half and the 200 or so salespeople who stay no longer will haunt doctor’s offices to push OxyContin. Instead, the company said it will direct prescribers to materials on that drug, published by the Centers for Disease Control and Prevention and the office of the U.S. surgeon general.

“We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” the company, based in Stamford, Conn., said in a statement quoted by Reuters.

Purdue staff, the news service reported, will focus on selling Symproic, a drug for treating opioid-induced constipation, as well as other potential non-opioid products.

The company did not disclose if it also would curtail its aggressive marketing, advertising, and sales of OxyContin overseas — markets to which it expanded after it came under huge fire in the United States for, critics asserted, helping to cause the drug crisis, which is blamed for 100 deaths a day now, and which may claim as many as 650,000 American lives in the next decade or as many people as live now in Baltimore.

Media reports, notably multi-part investigative reports in the Los Angeles Times, have detailed how, “Purdue had extensive evidence pointing to illegal trafficking of its [OxyContin] pills but in many cases did not share it with local law enforcement agencies or cut off the flow of the drugs.”

Cities, counties, and states, including most recently Alabama, have sued Purdue accusing it of pushing addictive painkillers through deceptive marketing. Plaintiffs assert the firm pooh-pooed OxyContin’s addiction significant risk, while vastly overstating opioids’ benefits in treating chronic rather than short-term pain, Reuters reported, adding:

Purdue and three of its executives pleaded guilty in 2007 to federal charges related to the misbranding of OxyContin and agreed to pay a total of $634.5 million to resolve a Justice Department investigation. That year, Purdue also reached a $19.5 million settlement with 26 states and the District of Columbia. It agreed in 2015 to pay $24 million to resolve a lawsuit filed by Kentucky.

More than 250 opioid-related suits, including many involving Purdue, have been consolidated and are under consideration by a federal court in Ohio, where a judge may try to get the parties to reach a master settlement akin to litigation involving Big Tobacco.

Purdue long has asserted that it sold drugs approved by the federal Food and Drug Administration, and it pointed to its efforts to reformulate its painkiller to make it less susceptible to abuse. But the Los Angeles Times noted that the independent, nonpartisan RAND Corp. and the Wharton School of Business at the University of Pennsylvania scrutinized data on Purdue’s much-touted product switch.

The company changed OxyContin, so the pills were tougher to crush up, so they became more difficult to snort, smoke, or inject. Wharton and RAND found that move didn’t stem the opioid drug abuse epidemic, sending it, instead, in a new direction — prescription painkillers became a gateway but abusers then moved on to illicit alternatives, including heroin and the exceedingly powerful, synthetic opioid fentanyl.

U.S. overdose deaths are skyrocketing. They have become the leading cause of death for Americans younger than 50, killing 64,000 in 2016 alone. Those fatality numbers exceed the peak deaths for major widespread killers of recent times, including car crashes (which peaked in 1972), the HIV-AIDs epidemic (peaking in 1995), and gun killings (which hit their highs in 1992).

Purdue’s rise as a big time Big Pharma enterprise stems from its start with the entrepreneurial Sackler family and their marketing savvy, the Los Angeles Times reported:

Purdue was a small New York City pharmaceutical firm when brothers Mortimer and Raymond Sackler, both psychiatrists, bought it in 1952. The spectacular success of OxyContin has generated tens of billions of dollars in revenue over the last two decades and made the Sacklers one of the nation’s wealthiest families. Three generations of the family now help oversee the Purdue and Mundipharma corporations. The family is known for giving tens of millions of dollars through its foundations to such renowned arts institutions as the Victoria and Albert Museum in London, the Dia Art Foundation and the Solomon R. Guggenheim Museum in New York.

The New Yorker magazine also has done a deep dive into the Sackler’s philanthropic ties across the country, raising questions about the family’s ascension into the cultural elite and big institutions’ willingness to accept gifts from an enterprise built on hype and patients’ pain. The magazine also has reported how a Sackler scion, now a documentary film maker, is shooting a project rife with irony, as it records the travails of Indiana prison inmates, many of whom are incarcerated due to crimes tied to opioid abuse. Nan Goldin, a respected photographer, has chronicled in a tony art magazine her own struggles with oxycontin addiction after a wrist injury and ripped the Sackler family, accusing them of abetting the opioid crisis.

Bloomberg news service, which first reported Purdue’s marketing shift, reminded in its report that Purdue’s pushy and innovative marketing for oxycontin hit a surprisingly gullible audience in supposedly well-educated, smart doctors. Its hype included its own music tracks, as well as silly swag like fishing hats and stuffed toys.

The New Yorker, referring to investigations by the Los Angeles Times and others, as well as its own reporting, also found that Purdue for years also paid doctors speaker and other fees to get them to persuade medical peers that OxyContin should be prescribed widely for many different types of pain. The company also made a claim, later shown to be unsupported, that its drug’s effects lasted longer and so required fewer pills to be taken. But documents later were forced out, showing that many patients did not get the promised durational pain relief, causing them to abuse the drug, instead.

In my practice, I see the major harms that patients suffer while seeking medical services and the giant injuries inflicted on them by dangerous drugs, including and especially opioids. It may be good news that Purdue will be pushing these risky meds less, though one Big Pharma expert and critic told the Los Angeles Times that this step may be too little, too late.

The company, Big Pharma, doctors, and hospitals must do much more to attack and reduce the opioid crisis, not just in the United States but also to ensure it does not spread globally. The medical establishment’s efforts to help patients better cope with pain, instead has inflicted far too much more pain, misery, suffering, and death. There are many parties who must reckon with the toll of their deeds, and their time to do so is long past up.

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