February 22, 2019

Purdue execs intentionally downplayed OxyContin's strength, Propublica reports after obtaining sealed testimony

Daily Briefing

    Richard Sackler, a former executive at Purdue Pharmaceuticals, allegedly agreed to an internal plan to conceal OxyContin's strength from physicians, according to sealed testimony obtained by ProPublica, ProPublica and STAT News report.

    The news comes amid reports that Purdue within the first few years of launching the prescription opioid OxyContin knew about "significant" misuse of the drug, but it continued to market the drug as a safer opioid option. Purdue has maintained that officials did not learn about of OxyContin's potential for misuse until the early 2000s, after the drug had been on the market for several years.

    In 2007, the company pleaded guilty to downplaying OxyContin's potency and paid $600 million in fines to settle the charges, The Hill reports.

    Purdue last year announced that it would stop marketing OxyContin and other opioids to doctors after facing increased scrutiny over the company's promotion tactics for the drug. The company, along with other opioid manufacturers, is facing a new wave of lawsuits from states and cities over its opioid marketing tactics.

    Sealed testimony suggests Purdue execs plotted to conceal OxyContin's potency

    According to ProPublica, the sealed testimony—which was from an Aug. 28, 2015 deposition by Sackler—contains emails regarding an alleged plot to conceal OxyContin's strength from physicians. In the emails, executives at the company discuss allowing physicians to continue thinking OxyContin was less potent than morphine, when the drug actually is equally as strong as or stronger than morphine, ProPublica reports.

    For instance, ProPublica reports that Michael Friedman, who at the time was a sales and marketing director at Purdue, in an email sent to Sackler in 1997 wrote, "It would be extremely dangerous at this early stage in the life of the product … to make physicians think the drug is stronger or equal to morphine. … We are well aware of the view held by many physicians that oxycodone is weaker than morphine. I do not plan to do anything about that."

    According to ProPublica, Sackler replied, "I agree with you. Is there a general agreement, or are there some holdouts?"

    In another email exchange in 1997, Michael Cullen, who at the time was an official at Purdue, wrote to Sackler, "Since oxycodone is perceived as being a weaker opioid than morphine, it has resulted in OxyContin being used much earlier for non-cancer pain," ProPublica reports. Cullen continued, "It is important that we be careful not to change the perception of physicians toward oxycodone when developing promotional pieces, symposia, review articles, studies, et cetera," according to ProPublica.

    ProPublica reports that Sackler replied, "I think that you have this issue well in hand."

    Sackler during the deposition defended Purdue's marking practices for OxyContin, and denied that the company was trying to deceive doctors, ProPublica reports. According to ProPublica, Sackler during the deposition said Friedman's email was misconstrued, claiming that "stronger" actually "meant more threatening, more frightening." He said, "There is no way that this intended or had the effect of causing physicians to overlook the fact that it was twice as potent," ProPublica reports.

    Further, ProPublica reports that Slacker during the deposition defended sales representative who during 1996 to 2001 inaccurately told physicians that OxyContin did not cause euphoria or was less likely to cause euphoria than other prescription opioids.

    According to Axios' "Vitals," the emails and testimony add to the "mountain of evidence piling up … that suggests the Sackler family," which founded Purdue, was aware OxyContin was highly addictive but did not act to disclose that knowledge.

    Purdue responds

    Purdue in a statement said that Sackler's full testimony "takes great care to explain" OxyContin's label "made clear that [the drug] is twice as potent as morphine." The company added that the testimony "supports that the company accurately disclosed the potency of OxyContin to health care providers."

    However, Purdue in the statement also acknowledged that the company had made a "determination to avoid emphasizing OxyContin as a powerful cancer pain drug" out of "a concern that non-cancer patients would be reluctant to take a cancer drug," ProPublica reports.

    In a statement to The Hill, Purdue spokesperson Bob Josephson said, "Sackler's statements in the deposition fully acknowledge the wrongful actions taken by some of Purdue's employees prior to 2002 as laid out in the 2007 Agreed Statement of Facts with the Department of Justice, and that the company has accepted full responsibility for those actions."

    According to ProPublic, Purdue also criticized ProPublica for publishing the testimony, which the company said was "a clear violation" of a court order to seal the testimony.

    Cullen and Friedman could not be reached for comment, ProPublica reports (Armstrong, ProPublica/STAT News, 2/21; Frazin, The Hill, 2/21; Baker, "Vitals," Axios, 2/22; Meier, New York Times, 2/21).

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