Follow the Money
Our country is in the midst of a prescription drug epidemic that was in no small part the work of the pharmaceutical industry, sending reps to visit doctors’ offices throughout the country to push for use of opiates for non-cancer chronic pain. Opioids are potent analgesics that are widely accepted as an appropriate therapy for moderate to severe pain associated with cancer and other serious illnesses. Chronic pain generally refers to pain that has persisted three months after the usual healing time of an acute injury, recurrent pain over a period of months, or pain associated with a nonhealing lesion.
For most of the twentieth century, the long-term use of opioid therapy for chronic pain was considered inappropriate. This most likely resulted in failure to treat some pain adequately, and patient activists successfully convinced the public that doctors who were too cautious about prescribing potentially addictive and abusable drugs deliberately undertreated many patients. In 1996, the American Pain Society coined the phrase “pain as the 5th vital sign.” Wong-Baker FACES Pain Rating Scales were posted in hospitals and clinics, in an attempt to improve assessment and management of pain in the acute care setting. Empowered by the ability to give their physician a Press-Ganey score that influenced compensation and job security, patients were soon able to successfully demand narcotics for almost any ailment. Attitudes toward opioid prescribing practices have been influenced significantly over the past twenty years by a changing legal and regulatory environment and by the changing nature of medical practice as large corporations with a primary stockholder loyalty hire administrators to implement policies that are targeted primarily at profit instead of patient care.
Development of new and potent narcotic preparations has fueled the epidemic that is ripping apart families and communities. The United States Food and Drug Administration approved OxyContin in 1995, a long-acting and potent opioid analgesic that is often known as “hillbilly heroin.” OxyContin has been a hit for Purdue Pharmaceuticals and it’s made the owner of the privately held company a billionaire with an estimated 45 billion dollar fortune that pushed him from obscurity to the highest ranks of the Forbes list of billionaires. OxyContin prescriptions exploded, increasing from 45 million dollars in sales in 1996 to sales of 1.1 billion four years later. Sales of OxyContin in 2010 reached 3.1 billion dollars and accounted for 30% of the nation’s opioid consumption. OxyContin was not a good drug, but Purdue Pharma has a long history of aggressive tactics in medical marketing.
Three brothers founded Purdue Pharma. It’s worth noting that one of the brothers, a psychiatrist, is also in the Medical Advertising Hall of Fame for turning Valium into the first drug with $100 million dollars in revenue – by finding new and unexpected indications for its use. Purdue used the same tactics with OxyContin, realizing that although the number of cancer patients would remain stable, new indications would promote use of their miracle painkiller in other populations. The company created a database of physician prescribing habits, identifying doctors who were writing a lot of pain medications. The marketing campaign underestimated the risk of addiction, arguing that the long-acting drug with a time-release formula had a low addiction potential that was less than 1%. Sales reps told doctors the potent drug had limited abuse liability and didn’t even produce the euphoria associated with other opioid analgesics, a claim that is patently false by all reports from the millions of Americans who took OxyContin. Marketing efforts expanded from oncology offices to primary care, with more than half of the prescriptions for OxyContin written by primary care doctors by 2003.
Purdue targeted doctors with a marketing campaign that more than doubled the number of sales representatives in the Purdue sales force, spending 200 million dollars on marketing OxyContin by 2001. Over 5,000 physicians were paid to attend company-sponsored pain management seminars in resort locations in Florida and California, recruiting over 40 national pain management experts as well-compensated speakers and advocates. Tellingly, they came out with a 160 mg dosage within a few years, for patients who were “opioid tolerant.”
Purdue Pharma and its three top executives pleaded guilty to charges of defrauding and misleading doctors and patients about the addictive properties of OxyContin, paying a $600 million fine. The War on Drugs apparently doesn’t extend to Stamford, Connecticut, where the fine represents less than half of the annual sales of the drug. The company is currently facing a lawsuit in Kentucky, prosecuted by the state, which has seen entire communities decimated by the OxyContin epidemic and the heroin epidemic that resulted after the crackdown on OxyContin. Purdue continues to promote the use of opioid analgesics for chronic cancer pain, through the advertising campaign for their “public service” Partners Against Pain. The company is currently studying the use of OxyContin in children, which would allow them to patent another blockbuster drug, if FDA approval can be obtained.
If you or a loved one has experienced severe addiction or overdose as the result of OxyContin, you should speak with an experienced trial lawyer about your case. You may have rights under the law in cases where deliberate and fraudulent actions resulted in harm. Call Passen & Powell at 312-527-4500 for a confidential, free consultation.