Insight, analysis & opinion from Joe Paduda

Apr
14

The poster children of OxyContin

Back at the end of the last century, a wonder drug was introduced that promised to end pain without risk of nasty side effects.  The drug, OxyContin, was aggressively marketed by manufacturer Purdue Pharma; they even made a video featuring seven users who lauded OxyContin.

Fast forward just fourteen years. The video has disappeared. Two of the seven are dead; they were abusing opioids when they died. Another was also addicted, but overcame her addiction. Three still believe the drug helped them and one wouldn’t respond to questions posed by a reporter looking to find out the fate of the seven.

The story of the seven was reported by the Milwaukee Sentinel Journal; their story was also documented in a video.

It’s a short and utterly devastating piece.

In the original Purdue OxyContin marketing video, a paid physician claimed the drug resulted in addiction in less than 1 percent of cases.  Later, he acknowledged that his statement wasn’t based on any long-term studies.  And that’s just one of the litany of errors, misstatements, exaggerations, and outright falsehoods.

The best evidence we have now indicates from 3% to 40% of long term users are at high risk for addiction.

OxyContin and other Schedule II drugs do have their place.  They have helped many deal with acute pain.  They have also directly caused today’s opioid crisis and the explosive growth in heroin use.

Purdue’s quarterly revenues for OxyContin are about the same as the one-time fine they paid to settle a federal criminal case; with total revenues for the drug in excess of $7 billion, there’s no question it has been hugely profitable for Purdue and its shareholders. 

What does this mean for you?

There’s a rather uncomfortable question lurking here.  The American health care system is in large part driven by profit-making entities.

One can make a compelling case that the opioid crisis is directly related to the profit motive.  Yes, our convoluted regulatory process is involved, as is the tortuous legal process, and lobbying and politics.  But all these are intended to regulate, control, ensure safety and good corporate citizenship.

In this instance, our controls have failed, and failed miserably.

Thanks to Phil Walls of myMatrixx for the heads up on this; his post can be found here.

 

 


3 thoughts on “The poster children of OxyContin”

  1. Not sure we can ever remove the profit motivation out of the equation fully, but it is definitely there. I often ask this question in regards to diabetic “treatments” which seem to readily come on the market, but in most cases (and in today’s HSA driven environment) are so expensive no one can afford them. As I asked my physician recently “what good does it do to have an adequate and successful treatment if no one can afford it”?

    In the end, there must be a regulatory fine line established between “profits” to pay for development on new drugs and affordability for the public.

  2. I agree the profit motive is a significant driving force. In a way it is good business sense to advertise and promote a drug you know is dangerous if this practice will result in billions of dollars in profit. The fines these companies face are miniscule when compared to the profit they make.

    Of course not all companies are bad and there are medicines that truly help patients. But more must be done ensure that the incentives are truly aligned and that companies do not benefit from harming patients.

  3. While I appreciate the intent of the article, there is more than enough blame to go around for patients, healthcare providers and payers. Patients are still often looking for a quick fix, health care providers are frustrated by seeing these patients in their office and too eager to offer a quick fix (Rx) and payers focused on quarterly earnings not interested in offering longer term more expensive solutions (CBT, functional restoration) with small effect size. As a pain MD for over 20y I can assure you there is plenty of holes in the system and to present a one sided argument will do nothing to resolve the issue.

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Joe Paduda is the principal of Health Strategy Associates

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