On Purdue Pharma’s website, the company celebrates the strength of its salesforce, informing potential business partners:
‘More than one third of our sales representatives have more than 10 years of service—and all can sell what others might regard as “tough” products.’
For Purdue’s stakeholders, salesforce, and current and prospective business partners, having an exceptional ability to generate revenue from “tough” products is a definite selling point.
The company’s ongoing legal woes have caused many to wonder, however, whether that proudly competitive marketing spirit has been quite so beneficial for America as a whole.
A small private company with a massive public impact
Unlike many of the major players in pharmaceutical production, Purdue Pharma is a privately held company. Still, its founders have found astounding financial success through the production and sale of Oxycontin, Purdue’s most famous product and one of America’s most widely used (and abused) painkillers.
Purdue was founded by three members of the Sackler family, all of whom were doctors. The eldest, Arthur Sackler, was known for his advertising acumen and earned a spot in the Medical Advertising Hall of Fame for his role in skyrocketing Valium’s revenue and popularity.
Arthur was also an important figure in the effort to popularize pharmaceutical marketing to doctors.
OxyContin wasn’t Purdue’s first painkiller, but it was the first to be accompanied by such an aggressive nationwide marketing strategy.
The rise of OxyContin
FDA approved OxyContin in 1995 for the treatment of chronic moderate to severe pain.
OxyContin supposedly differed from generic forms of oxycodone or other brand-name painkillers because, according to Purdue, the extended-release drug lasted for 12 hours, and the risk for addiction was minimal.
The CDC notes that opioid prescriptions quadrupled from 1999 to 2014, and so have the number of opioid-caused deaths.
Those claims turned out to be, at best, unsupported by sufficient data. It would take many years, however, for Purdue to fall under appropriate scrutiny for potentially lying about OxyContin’s properties.
In a 2015 report, The Week highlighted the incredible growth of OxyContin’s salesforce and marketing efforts in correlation with the concurrent growth of the United States’ opioid epidemic.
The report notes that, in the four-year period after Oxycontin’s launch, Purdue more than doubled its on-the-ground salesforce, and spent hundreds of millions of dollars marketing the drug.
The marketing push paid off, financially speaking. From Oxycontin alone, the company earned $2.8 billion in revenue from 1995 to 2001.
Unfortunately, Oxycontin’s overwhelming success was not such great news for the hundreds of thousands of Americans who have died of opioid overdoses since the late 90’s.
A great portion of those deaths were caused by prescription opioid abuse. In many cases, Oxycontin abuse led to heroin addiction and eventual overdose.
The CDC notes that opioid prescriptions quadrupled from 1999 to 2014, and so have the number of opioid-caused deaths. Meanwhile, there has been no notable change in the amount of pain Americans report feeling overall.
America demands answers from Purdue
In 2007, Purdue and three of its top executives pleaded guilty in a criminal trial accusing them of deliberately misleading the FDA and physicians about Oxycontin’s potentially addictive nature.
Purdue was forced to pay $600 million to resolve the charges, and the executives were issued fines of approximately $34 million.
2007’s verdict was far from the end of Purdue’s legal troubles, however. That same year, the state of Kentucky filed a lawsuit against Purdue.
The state, which was plagued with addiction and its associated healthcare costs, requested compensation for the damage caused by Purdue’s allegedly illegal marketing practices.
The lawsuit finally settled in December 2015 for $24 million, and it has set an important precedent.
Illinois filed a similar lawsuit in 2015, and government officials in Pennsylvania may have similar goals.
Not only has Purdue’s legal battle inspired officials around the country to demand accountability from pharmaceutical companies; it has inspired others to demand greater transparency.
In March 2016, STAT filed a request for Purdue to release sealed court documents, including the deposition of Dr. Richard Sackler, a member of the family that owns Purdue.
A Kentucky judge granted the request, but Purdue has filed an appeal in attempt to block the information from becoming public.
Making that information public could be an important victory for advocates of pharmaceutical industry transparency. The FDA has made changes to the approved uses for Oxycontin, but the opioid epidemic isn’t over, and Purdue is still raking in considerable profits from this drug.
The public and healthcare providers deserve access to information that could hold Purdue accountable, and could also help ensure that Oxycontin is prescribed and used responsibly.
What will it take to reform the pharmaceutical industry?
Purdue’s alleged role in America’s opioid problem is troubling, but Purdue is not an anomaly. Most major pharmaceutical companies have faced federal lawsuits and paid enormous fines or settlements to resolve fraud allegations.
Reforming the pharmaceutical industry will not be achieved overnight, nor is there one solution that will fix everything.
Pharmaceutical fraud is a multi-layered issue. Independent researchers, patient advocates and others are still working to understand the specific causes for its prevalence.
One component of our national healthcare system that could certainly contribute to Pharma’s fraud problem is the lack of appropriate boundaries between the industry, consumers and physicians.
Direct-to-consumer marketing of prescription drugs can be problematic for obvious reasons, but Pharma’s multibillion dollar marketing efforts to doctors, always branded as “education”, are not always so innocent either.
Medicare’s Open Payments Database has enabled researchers to investigate whether the direct-to-doctor marketing efforts could impact prescribing behaviors.
A 2016 Propublica study looked into whether and when pharmaceutical payments to doctors correlated with brand-name prescribing behaviors. This type of research is critical; drug prices are rising significantly, and pharmaceutical companies can charge more for brand-name medications than for generics.
Another study released in June 2016 utilized Medicare Part D data to show that doctors who received even one free meal under $20 had significantly higher prescription rates of certain brand-name drugs than those who didn’t accept meals.
The study concerned four brand-name prescriptions, whose superiority over generics has been disputed.
The research has not proven that more Pharma-sponsored meals cause higher brand-name prescriptions, and doctors consider any number of perfectly legitimate factors when prescribing.
Any correlation should give healthcare providers and patients pause, however, and encourage further research and transparency about pharmaceutical marketing.
Purdue has made many mistakes, but it has successfully demonstrated that keeping Pharma’s marketing practices in the dark is not in our nation’s best interest.
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