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Big pharma’s role in the opioid crisis

December 1, 2017 GMT

Stamford’s largest biotech company is mostly known by government officials and the general public because of one drug.

As the maker of OxyContin, Purdue Pharma has been pummeled by controversy since the opioid hit the market in 1996. The company has poured many millions of dollars into promoting Oxy, and made billions in return. But an increasing number of public officials and medical professionals see the revenues as tainted because they say Purdue has knowingly stoked the escalating epidemic of opioid abuse by consistently making false claims about a drug linked to thousands of deaths.

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Related: Beyond opioids, a new era in pain treatment

“This was the perfect storm — a push to ask for painkillers, higher dosing, more powerful medications and erroneous studies funded by the pharmaceutical industry that showed that these drugs were not addicting,” said Dr. Arun Nandi, chairman of emergency medicine at Stamford Hospital.

As deaths from opioid abuse continue to soar, the “perfect storm” has brought a deluge of lawsuits from individuals, cities and states — including Connecticut. Purdue has paid millions of dollars in settlements. Still, the lawsuits keep coming.

Changing view of pain

The perception and treatment of pain in the U.S. underwent fundamental changes in the 1990s, as a number of medical groups responded to what they saw as an epidemic of ignored and untreated pain.

In 1996, the American Pain Society introduced the phrase “pain as the fifth vital sign,” which aimed to elevate pain assessment to the same level of importance as the standard four vital signs.

Amid the rising focus on pain management, the U.S. Food and Drug Administration approved OxyContin in 1995. The new drug would consist of a controlled-release, semi-synthetic opioid painkiller to treat moderate to severe pain lasting more than a few days.

Purdue’s annual spending for OxyContin advertising jumped from about $700,000 in 1996 to approximately $4.6 million in 2001, according to a 2003 federal Government Accountability Office report. The company spent six to 12 times more on promotional efforts during OxyContin’s first six years on the market than it had spent during the first six years of an older product, MS Contin, the report said.

Powered by its marketing, OxyContin’s annual sales surpassed $1 billion by 2001, making it the most-prescribed brand-name narcotic of its kind in the U.S., according to the GAO.

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Long litigation

Purdue has been dogged for years by opioid-related litigation. By some counts, more than a dozen states and approximately 100 counties and cities have already sued Purdue and other opioid makers and drug distributors.

The filing of lawsuits has accelerated this year as local and state attorneys general from states around the country, including Connecticut, have laid much of the blame on Purdue for the opioid abuse ravaging their constituencies. U.S. Department of Justice officials also are investigating the company.

“I filed the lawsuit simply because I felt something needed to be done to address the opioid crisis in Sullivan County,” Barry Staubus, the Sullivan County, Tenn., district attorney general, said of a lawsuit he filed in June. “I saw babies who are born addicted to drugs. Many of those drugs are OxyContin.”

Purdue officials have issued general statements in response to the lawsuits, in which they deny the allegations and say they share prosecutors’ concerns about the opioid crisis and express a commitment “to working collaboratively to find solutions.”

The company’s CEO, Craig Landau, was not available for an interview for this article.

In 2007, Purdue pleaded guilty in federal court to illegally misbranding OxyContin to mislead and defraud physicians and patients. The company agreed to pay some $600 million in criminal and civil penalties and other payments. Three top executives — none of whom currently work for the company — agreed to pay about $35 million in penalties.

Despite the perception that settlements represent at least some admission of guilt, companies like Purdue see agreements with plaintiffs as preferable to the risks associated with a case going to trial, said a number of legal experts.

“Jury decisions are very unpredictable,” said John Goldberg, a professor at Harvard Law School. “It’s very possible that they’d lose their shirts if they went to trial. There could be some catastrophic punitive damages awarded. They want the closure. What businesses tend to hate the most is uncertainty.”

pschott@scni.com; 203-964-2236; twitter: @paulschott

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