The U.S. Justice Department announced on October 21 that Purdue Pharma, the makers of the opioid medication OxyContin, will plead guilty to multiple criminal charges. These charges include those for defrauding federal health agencies, in which money is obtained from the agencies by deception, and for violating anti-kickback laws, which prohibit offering bribes to healthcare providers in exchange for referrals. A settlement of $8.3 billion will be asked of the company, as well as $225 million in civil penalties from the Sackler family, the former owners of Purdue Pharma. The company’s assets will be used to transform Purdue Pharma into a public benefit company, rather than privately-held. The settlement does not consist of criminal charges against members of the Sackler family or Purdue Pharma, and as the company plans to file for bankruptcy in federal court, many people doubt whether the Sacklers are being held rightfully accountable for their actions.
The Sackler family has unsparingly marketed OxyContin since the 1990s, and their profits made them one of America’s wealthiest families, according to Forbes.com.
OxyContin was a medical breakthrough. Produced by Purdue Pharma in 1995, OxyContin was introduced as a long-lasting narcotic that was twice as powerful as morphine. It is a therapeutic medication that helps patients manage debilitating chronic pain, yet its addictive properties have been detrimental or fatal to hundreds of thousands of people’s lives across the country. The drug’s severe withdrawal symptoms encourage addiction, making it harder for patients to stop taking it after an extended period of regular use. However, when the Food and Drug Administration (FDA) approved OxyContin in 1995, Purdue Pharma was more focused on selling the product than warning consumers of its adverse effects.
When Purdue Pharma first began selling OxyContin, the company never conducted clinical studies to investigate the drug’s addictive nature, despite knowing about concerns over the addictiveness of opioids. The company continued to pay doctors to praise the drug at conferences and offered free trips to seminars. They even handed out OxyContin merchandise to doctors who were then encouraged to promote the drug to their colleagues and patients. Purdue Pharma relentlessly marketed their drug by convincing doctors of the drug’s safety, while citing research conducted by entities that the company had paid and sponsored. Despite a study conducted in 1999 by the company, which found the addiction rate of OxyContin to be 13% in patients treated for headaches, Purdue’s sales representatives were trained to repeatedly assure doctors that “fewer than one per cent” of patients who took the drug became addicted, according to The New Yorker. Andrew Kolodny, the co-director of the Opioid Policy Research Collaborative at Brandeis University, stated that prescribing trends for all different opioids skyrocketed in 1996, shortly after Purdue launched their campaign of misinformation.
The nature of Purdue Pharma’s advertising was shortly brought to light, when in 2003, the Drug Enforcement Administration found Purdue’s aggressive methods of advertising to exacerbate the widespread abuse of OxyContin. The Sackler family had the opportunity to take responsibility by acknowledging and apologizing for their role in the opioid crisis. Instead, they continued to fight against claims that would affect their sales on the drug.
The company’s strategies in drug advertisement are not a rare sight in the pharmaceutical industry. Big Pharma companies pay for and run a majority of clinical trials, as the National Institute of Health’s budget provides less money for these research projects each year, according to Drugwatch. The influence that Big Pharma has over clinical trials can allow drug companies to highlight the benefits of drugs, while downplaying their risks for the sake of making more profit. This corruption in the industry has impacted how much profit drug companies can make, how doctors perceive the safety of these companies’ medications, and how often these drugs get prescribed to patients.
Science is supposed to be reliable and honest. However, the actions that Purdue Pharma and other pharmaceutical companies have taken, including the corrupted advertisement of medications and manipulation of clinical findings, have demonstrated how flawed the science and pharmaceutical industry can be.
In the past two decades, approximately 450,000 people have died from opioid-related deaths. Opioid-overdose deaths have continued to increase, reaching a yearly record of 50,000 in 2019, according to the U.S. Centers for Disease Control and Prevention. The Associated Press has also released reports from individual states, demonstrating more drug-related deaths since the start of the coronavirus pandemic. The opioid crisis isn’t just an unfortunate trend in our nation. It’s a chronic epidemic that has shattered families and claimed hundreds of thousands of American lives.
The publicity of the opioid crisis has caused a major drop in OxyContin prescriptions as doctors became more hesitant to prescribe the drug due to fear of legal consequences. But although the drug is harder to obtain, many chronic pain patients still rely on opioids to get them through the day. In some cases, it has been extremely difficult for these patients to receive treatment and find physicians who haven’t given up on working in pain management. Some people are even flying across the country to see doctors and get the medications that they need.
Other patients aren’t as lucky. Chronic pain patients are a vulnerable group, especially without treatment. A study published by King’s College in London stated that these patients are twice as likely to die by suicide. People who aren’t able to get prescribed opioids or satisfy their addiction oftentimes turn to other drugs, including illegally-bought pills or more addictive drugs, such as heroin. According to Joseph D’Orazio, a medical doctor and professor at Temple University, “people [are] dying from fentanyl overdoses in their 40s and 50s who first started [on prescription opioids] in their late teens and 20s.”
Not only has Purdue Pharma exacerbated the opioid crisis; the company has also participated in lobbying on behalf of Big Pharma. An investigation conducted in 2016 by The Associated Press and The Center for Public Integrity revealed that after pleading guilty in 2007, Purdue lobbied against legislative actions that would have hurt their profits. From 2006 to 2015, Purdue and other pharmaceutical companies spent nearly a billion dollars on lobbying. This is demonstrative of the ongoing issue on pharmaceutical pricing. According to Americans for Tax Fairness, prices on commonly-prescribed medications have increased from 40%—71% from 2011 and 2015. Lobbying for drug pricing by large pharmaceutical companies has also increased in the past decade, as these companies, including Purdue Pharma, continue to profit off of millions of Americans who struggle to pay for necessary medications. The increase of lobbying demonstrates Big Pharma’s extensive efforts to counteract bills that question their pricing practices and promote reform within the industry, which can dampen these companies’ profits.
Whether justice has been served from the Purdue Pharma settlement is up for debate. Many families affected by the opioid crisis are having trouble finding closure from this case. Emily Walden, the chair of the Fed Up! Coalition and a mother who has lost her son to opioid addiction, said, “I was very glad to hear, finally, the federal government saying that this is a felony and what [Purdue Pharma] did was absolutely wrong. At the same time, they’re already in bankruptcy. What penalty is there? There’s none really.”
Purdue Pharma may have reached an $8.3 billion settlement, but the lack of criminal charges against specific members of the company and family creates concern for how other companies may proceed moving forward. Pharmaceutical companies may learn to bolster their legal defenses, rather than learn from the mistakes that Purdue Pharma has made. This case has made it evident that, despite the criminal charges against the company and family as a whole, individual members can be left unpunished. Purdue Pharma has also filed for bankruptcy, which can potentially dissolve thousands of separate lawsuits filed against the company and protect the personal assets of individual members of the Sackler family from further cases against their role in the opioid crisis.
It took 25 years to stop Purdue Pharma in their tracks. However, if other pharmaceutical companies are still able to falsely advertise, manipulate research findings, and aggressively lobby against industry reform, there is still considerable reform needed in this industry.
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