| Article Text |
Strong dose of hype for OxyContin inexcusable
By ROBERT TRIGAUX, Times Business Columnist
Published November 10, 2003
--------------------------------------------------------------------------------
What if a little-known pharmaceutical company privately owned by a rich family with a prestigious name came up with a new pitch for a powerful drug to control pain?
What if that drug was marketed so aggressively that it got out of control, became one of the preferred highs of many addicts and was blamed for numerous deaths?
What if that painkiller became a major source of addiction and overdoses here in Florida, prompting the state attorney general to investigate how the drug company was promoting such a popular yet dangerous medication?
That, in a nutshell, is the story of OxyContin, an opium-derived drug created in the mid 1990s and hyped to the medical industry by its corporate owner, Purdue Pharma. OxyContin is a powerful prescription painkiller whose 12-hour "time release" design requires users to take it only twice a day.
The design flaw, which soon made it such a hit with drug abusers, is that chewing the pill releases its full and extra-powerful dose all at once.
The marketing flaw is that the strong painkiller was supposed to be prescribed for terminal cancer patients and postoperative patients with severe pain. But a drug company eager to expand sales also began pitching it for everyday pain and, in the process, pushed powerful OxyContin into the American mainstream.
In Florida alone, the drug has been blamed for hundreds of deaths in recent years.
Last month, conservative commentator Rush Limbaugh of Palm Beach confessed on his radio program that he would enter a rehab program for his addiction to OxyContin and other prescription painkillers. He got hooked on the drugs - reportedly buying huge quantities illegally - after initially taking them for back pain.
Last year, almost 6-million people used OxyContin, making it the most frequently prescribed narcotic in the country, according to the federal Drug Enforcement Administration.
The distressing tale of the rise of OxyContin is the subject of a book called Pain Killer, written by New York Times investigative reporter Barry Meier.
"A drug once reserved as a last line of treatment for the most severe pain cases," Meier writes, "was promoted as a treatment to be used on medicine's front lines for a wide range of general and transient pain problems."
A recent five-part series in the Orlando Sentinel, based on a nine-month investigation, found a disturbing pattern in Florida. During 2001 and 2002, the newspaper says, "more than 200 deaths statewide have been linked to the highly potent painkiller that has been criticized as being aggressively marketed and eagerly prescribed with only routine oversight from government regulators."
Those are scary statistics for a drug that was first sold in 1996 but attracted little attention. For instance, it was first mentioned in the St. Petersburg Times in February 2001. That initial story, headlined "Overdose deaths prompt warning," provided a strong hint of what was to come. The name OxyContin has since appeared in nearly 150 stories in this newspaper.
Called "little blues" or "hillbilly heroin" (for the high addiction rates in Appalachia), OxyContin was destined from the start to be a hot seller for Purdue Pharma. The low-profile pharmaceutical company, with headquarters in Stamford, Conn., was privately held and run by the Sackler family.
Never heard of them? Sackler money has funded major art galleries in museums around the world, including the Smithsonian in Washington and - my favorite - the glass-walled Temple of Dendur Egyptian wing at New York's Metropolitan Museum of Art.
The Sackler family bought a small New York drug company in 1952 called Purdue Frederick. Arthur Sackler, a doctor with great instincts for marketing, laid the groundwork 40 years ago for the aggressive push of OxyContin, says Meier in Pain Killer. Sackler helped create the marketing buzz for Librium and Valium, the infamous Valley of the Dolls "feel-good tranquilizers" that became the greatest pharmaceutical successes of their era.
In that tradition, Purdue Frederick in the 1990s created Purdue Pharma to help market OxyContin. Promoting the painkiller started innocently enough, Meier writes. Then Purdue cut a deal with Abbott Laboratories, the largest pharmaceutical company, to use Abbott's sales force to market OxyContin to hospitals. To pitch it to doctors, Purdue invited groups of them to three-day seminars held at resorts in Arizona, California and Florida. The seminar themes? How to fix the "undertreatment" of pain.
To spur volume, Purdue offered its salespeople top-of-the-line incentives, Meier says. Those who aggressively pitched OxyContin earned annual bonuses topping $100,000. And to provide sales leads, Purdue ran a database ranking doctors from one to 10 "decibels" based on their prescription-writing habits. Doctors ranked above eight decibels were considered prime sales targets.
So far, OxyContin has generated more than $2-billion in sales for Purdue.
In late 2001, Florida Attorney General Bob Butterworth opened an investigation of Purdue Pharma and its OxyContin sales in the state. According to Meier, though, Butterworth's inquiry was "hardly a model of investigative zeal." By mid 2002, Butterworth was facing a mandatory term-limit ending his job as attorney general.
Four days before the fall elections, Butterworth and Purdue struck a deal. Purdue pledged $2-million for software to run a drug prescription tracking system for the state. In turn, Butterworth agreed to end his inquiry.
The tracking system would allow doctors, pharmacists, state officials and law enforcement agencies to look in one place for patterns of overprescription and abuse. For various reasons, including privacy concerns, the system has twice been rejected by the Legislature. Purdue's pledge ends in July 2004.
Last week, Gov. Jeb Bush threw his weight behind the tracking system.
The sad part is, OxyContin really helps many people with serious pain. How the painkiller was hyped is inexcusable.
- Robert Trigaux can be reached at [email protected] or 727 893-8405.
|