Contributing co-author: Andrew Chen
If you’ve read our Hellish Heroin story, you know how addictive Oxycontin can be for some people, especially when used recreationally, and not to treat severe pain. This article will talk about some of the unethical practices used to market that drug.
The story of oxycontin
In 1996, Purdue Pharma L.C. introduced Oxycontin to the drug market. Oxycontin is a sustained-release oxycodone preparation used in treating chronic pain. Purdue Pharma put together an aggressive marketing plan to promote the sale of the drug. In it’s first year, Purdue sold $48 million dollars of Oxycontin. By 2000, Purdue was making a staggering 1.1 billion dollars a year from Oxycontin.
The enormous commercial success of Oxycontin would not have been surprising if it had been a revolutionary drug. However, numerous studies have shown many other opioid medications to be just as safe and effective as Oxycontin. So how did Purdue get so many people to buy Oxycontin? Below are some of the tactics Purdue Pharma used to increase it’s sales:
- From 1996-2001, Purdue put on more than 40 national pain-management and speaker-training conferences. More than 5000 physicians, nurses, and pharmacists attended these all-expenses-paid conferences where they were trained for Purdue’s national speaker bureau. Although many physicians deny it, research has shown that attending these types of conferences influences physician’s prescribing tendencies.
- Purdue implemented a bonus system to encourage their sales representatives to increase sales of Oxycontin in their territory. In 2001 alone, Purdue paid approximately $40 million dollars in incentive bonuses.
- Purdue used marketing data which allowed them to see nationwide statistics on physicians prescribing patterns. Purdue used this data to aim their marketing campaign at physicians with the highest rates of opioid prescription. While in theory this strategy targets physicians with the most chronic pain patients, it also ends up targeting physicians with loose standards for prescribing drugs.
- Purdue gave out coupons for a free prescription good for one 7-30 day supply of Oxycontin. By the time the offer ended, 34,000 coupons had been claimed.
- Purdue claimed that the risk of addiction to Oxycontin was less than one percent. Long term studies of opioid treatment for chronic pain patients have shown the risk of addiction to range widely, from 0% to 50%. In 2007, Purdue Frederick Company Inc (an affiliate of Purdue Pharma) and three company executives plead guilty to misbranding the risk of addiction for Oxycontin and will pay $646 million dollars in fines.
Together these strategies helped shoot Oxycontin sales through the roof. In 2001, Oxycontin became the most frequently prescribed opioid in the United States for treating moderate to severe pain.
Improper prescription marketing
The problem is not that Purdue made a lot of money. The problem is that in the process of making money, Purdue created a huge drug problem. Between 1997-1999, the state of Maine experienced a 460% increase of people treated for opioid abuse. In southwest Virginia, the number of deaths related to prescription opioids increased 830% from 23 deaths in 1997 to 215 deaths in 2003. In eastern Kentucky, there was a 500% percent increase in the number of patients entering methadone maintenance treatment programs. In each case, these increases were correlated with increases in Oxycontin availability in those regions.
Currently the FDA is in charge of ensuring that all prescription drug advertising is honest and truthfully communicated. Unfortunately, in it’s current state, this department of the FDA is understaffed and underfunded so the review of promotional materials is both slow and lax. Aggressive marketing strategies like those used by Purdue end up making prescription drugs easier to obtain and easier to abuse. Tougher FDA restrictions on acceptable marketing practices would make the pharmaceutical industry more like honest evidence-based medicine and less like a car sale.