Tuesday, February 12, 2019

Selling addiction

Amidst Big Pharma’s myriad corporate misdeeds, no act of corporate ethical tunnel vision was more glaring than Project Tango, the Sackler family-owned Purdue Pharma, the manufacturer of OxyContin, company’s name for the scheme to turn opioid addiction it helped generate into another profit center for itself. Making billions off a pain pill whose promotion helped spawn the prescription opioid epidemic that grew into today’s overdose fatality crisis wasn’t enough for the Sackler family. From pushing for higher doses of OxyContin to misleading doctors and the public about the drug’s addiction potential to hiring a consulting firm to “counter the emotional messages” of mothers whose children overdosed on the drug, internal emails and memos show a company and a family obsessed with extracting every penny of profit from OxyContin. 

 Opioid overdose fatalities has resulted in more than 47,000 deaths in 2017 and prescription opioid overdose deaths outnumbering heroin deaths by a margin of two to one. OxyContin launched in 1996 and quickly made billions for the Sacklers, even though reports of abuse of the drug quickly emerged. By 2007, Purdue Pharma had pleaded guilty in federal court to misrepresenting its risk of addiction and paid $600 million in fines and penalties, although it tried to place the blame on “certain supervisors and employees.” And the Sacklers did quite well even after 2007, pulling in a tidy $4 billion off OxyContin since then.

In  2014, Dr. Kathe Sackler, the daughter of company co-founder Mortimer Sackler, participated in a call about the project, which it called “a secret plan for Purdue to expand into the business of selling drugs to treat opioid addiction.” In their documents, Sackler and staff acknowledged what Purdue had denied for years, that addictive opioids and opioid addiction “are naturally linked.” This was the new Purdue business model: The company should expand across “the pain and addiction spectrum” to become “an end-to-end pain provider.”

Purdue execs involved in the project said in internal presentations touting the scheme. “It is an attractive market,” the team wrote. “Large unmet need for a vulnerable, underserved and stigmatized patient population suffering from substance abuse, dependence, and addiction.”

They especially liked the excellent compound annual growth rate in the target market they helped create: “Opioid addiction (other than heroin) has grown 20% annually from 2000 to 2010,” they noted. The number of opioid prescriptions, mainly hydrocodone and oxycodone formulations, such as OxyContin, had begun rising in the early 1990s and tripled by 2013 before leveling off. 
Unlike Purdue’s earlier efforts to blame addiction on the users or, as Richard Sackler did in an email, on “reckless criminals,” the Project Tango team pushing this new business opportunity saw addicted users much more sympathetically. “This can happen to anyone—from a 50-year-old woman with chronic lower back pain to an 18-year-old boy with a sports injury, from the very wealthy to the very poor,” they wrote.
Project Tango has come to naught. After the release of the legal complaint last month, Purdue announced it had given up on plans to acquire Suboxone or Narcan. Still, the company remains very interested in the addiction treatment market. Last year, the complaint notes, Richard Sackler received a patent for a new drug to treat addiction. The patent application says that opioids are addictive but refers to the people to whom Sackler would turn his tender mercies as “junkies.”

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