A new report from ProPublica says that Purdue Pharma, a major manufacturer of opioids such as OxyContin that was founded by the Sackler family, aggressively marketed them in ways that led to addiction and is now also trying to profit from drugs that seek to combat addiction or reverse the effects of overdoses. In other words, they want to benefit both ways from addiction, first by causing it and then selling treatments for the problem that they continue to cause. This information came from a filing in a case against the company
ProPublica reviewed the scores of redacted paragraphs in Massachusetts’ 274-page civil complaint against Purdue, eight Sackler family members, company directors and current and former executives, which alleges that they created the opioid epidemic through illegal deceit.
The sections of the complaint already made public contend that the Sacklers pushed for higher doses of OxyContin, guided efforts to mislead doctors and the public about the drug’s addictive capacity, and blamed misuse on patients.
Purdue acknowledged in the statement that it was considering acquiring the rights to sell drugs that combat addiction or reverse the effects of an overdose.
Aggressive marketing of OxyContin is blamed by some analysts for propelling the crisis that has resulted in 200,000 overdose deaths related to prescription opioids since 1999.
At the direction of the board, Purdue repeatedly increased its sales force, which pushed doctors to prescribe higher opioid doses.
In a 2013 report, McKinsey recommended directing sales representatives to focus on the most prolific opioid prescribers because that group writes “25 times as many OxyContin scripts” as less prolific prescribers. Because prescription rates rose in tandem with visits from sales reps to doctors, McKinsey recommended increasing each salesperson’s quota from 1,400 visits a year to closer to 1,700. McKinsey estimated that targeting the most frequent prescribers could boost OxyContin sales by hundreds of millions of dollars.
The Sackler family relentlessly pushed for more aggressive marketing so that their payouts, already obscenely excessive, would be even larger.
When sales results disappointed, Sackler family members didn’t hesitate to intervene. In late 2010, Purdue told the family that sales of the highest dose and most profitable opioids were lower than expected, according to the complaint. That meant an expected quarter-end payout to the family of $320 million was at risk of being reduced to $260 million and would have to be made in two installments in December instead of one in November.
That news prompted a sharp email question from Mortimer D.A. Sackler, whose late father, also named Mortimer, was a Purdue co-founder. “Why are you BOTH reducing the amount of the distribution and delaying it and splitting it in two?” he asked. “Just a few weeks ago you agreed to distribute the full 320 [million dollars] in November.” The complaint doesn’t say how much was ultimately paid.
Anyone who raised issues of ethics was ignored and left the company.
In 2012, a Purdue employee appealed to the company’s head of sales to alert health insurers to data the company collected about doctors suspected of abusing or illegally prescribing OxyContin. The list of doctors was code-named Project Zero.
“At a basic level, it just seems like the right and ethical thing to do,” the employee wrote. “Doing so could help those companies identify those physicians that may be of a concern, not just with respect to our products, but also other” pain medications. “As a result, if it reduces abuse and diversion of opioids then it seems like something we should be doing.”
The idea was rejected and the employee left the company a month later, according to the complaint.
The Sackler family are noted ‘philanthropists’ whose name can be seen on many buildings in universities and museums and galleries. They carefully cultivate a favorable family image despite the evil that their company indulges in, and they had until quite recently successfully avoided linking the family name with the company name.
That practice is of course not unusual. Look into the histories of the well-known philanthropists who founded libraries and foundations and you will find rapacious plutocrats who buy their way back into the good graces of the public. Their ‘gifts’ are really bribes to the community to overlook their crimes.
This is why philanthropy is not the solution to society’s problems. We need high marginal rates on wealth and income taxes to discourage the predatory behaviors in the first place.
UPDATE: Another news report out today discusses another case in which doctors and drug makers are accused of colluding to push addictive practices.
Drug company executives appearing in court in Boston this week have been accused of running “a criminal enterprise” and putting greed before patient safety as they pushed prescription narcotics during the opioids crisis, blighting the health of America.
The defendants are the first painkiller manufacturing bosses to stand trial over conduct authorities say contributed to an overdose epidemic that has killed hundreds of thousands of people in the past 20 years, regardless of region, age, race and income.
If the Boston trial and others scheduled to get under way later this year are anything to go by, 2019 is now shaping up as the start of a reckoning for the pharmaceutical giants still making billions from opioids.
Assistant US attorney David Lazarus told jurors in the federal court in Boston that John Kapoor and the company he created, Insys Therapeutics, ran a nationwide kickback and conspiracy scheme that effectively bribed doctors to routinely prescribe patients an addictive fentanyl spray that was much powerful than morphine and had been approved to alleviate the pain of advanced cancer.
Their comeuppance is long overdue.