The Incidious Spread of Big Pharma

Hi guys, now you know we are always the first to understand that things are complicated and never just black and white and that a junkies relationship with their doctor/s is something pretty unique (we could all write a book right?) and we are not saying we want all prescribing doctors arrested – that is not the point here, and its a very long way from it.

But just like when you scratch at the ugly scab that is the war on drugs and you find governments’ lying, scheming for their own economic ends, even wheeling and dealing in the very drugs they lock thousands of their citizens up for..and you scratch deeper still and you see the roots of these global drug laws rooted in fear and racism, xenophobia and cultural ignorance, economies and GDP’s, total monopolies by companies and the ever larger monolithic pharmaceutical industrys’ that orchestrate and lobby for the very laws they securely tie up ever tighter still, seeking global domination and a pill for everything we could never even imagine we needed one for….- there is certainly no concern for our youth or environment,  – …..Well, I thought you might like to read this article that gives some background into the explosion in Oxycontin in the USA today. How big pharma is raking it in, how the doctors are earning billions as well, how USA overdose rates continue to rise and rise year on year, how prisons keep increasing their numbers of paid lobbyists at Capitol Hill to make sure that, although violent crime is, and has gone down (yes that’s right) in the USA for many years now, more and more laws keep getting introduced to ensnare the illegal immigrant, the petty criminal etc, so society can pay for these ‘Titan prisons’ and maintain the jobs within them, in the cities that the bureaucrats would flourish because of these disgusting, concrete jungles of inhumanity..

But let’s just get a glimpse of how big pharma do things – or rather – how little pharma can grow into HUGE pharma, courtesy of the American taxpayer, and another drug dependent generation – paying the ‘Right Man’ this time, not the junkie down the street….

 PS – Remember, we don’t always dig the journo’s language when describing people who use drugs, but we will overlook that somewhat for the sake of the piece. Always write in to the editor to challenge their language if you see or feel that oit is inaccurate, sweeping, or causes offence.

Poison Pill:  How the American opiate

epidemic was started by one

pharmaceutical company 

Written by MIKE MARIANI FEB 23, 2015

(The link to complete article above and at the end of this text – thanks in advance to Mike Mariani – Here is an extract)

PURDUE_oxyThe state of Kentucky may finally get its deliverance. After more than seven years of battling the evasive legal tactics of Purdue Pharma, 2015 may be the year that Kentucky and its attorney general, Jack Conway, are able to move forward with a civil lawsuit alleging that the drug maker misled doctors and patients about their blockbuster pain pill OxyContin, leading to a vicious addiction epidemic across large swaths of the state.

A pernicious distinction of the first decade of the 21st century was the rise in painkiller abuse, which ultimately led to a catastrophic increase in addicts, fatal overdoses, and blighted communities. But the story of the painkiller epidemic can really be reduced to the story of one powerful, highly addictive drug and its small but ruthlessly enterprising manufacturer.

On December 12, 1995, the Food and Drug Administration approved the opioid analgesic OxyContin. It hit the market in 1996. In its first year, OxyContin accounted for $45 million in sales for its manufacturer, Stamford, Connecticut-based pharmaceutical company Purdue Pharma. By 2000 that number would balloon to $1.1 billion, an increase of well over 2,000 percent in a span of just four years. Ten years later, the profits would inflate still further, to $3.1 billion. By then the potent opioid accounted for about 30 percent of the painkiller market. What’s more, Purdue Pharma’s patent for the original OxyContin formula didn’t expire until 2013. This meant that a single private, family owned pharmaceutical company with non-descript headquarters in the Northeast controlled nearly a third of the entire United States market for pain pills.

OxyContin’s ball-of-lightning emergence in the health care marketplace was close to unprecedented for a new painkiller in an age where synthetic opiates like Vicodin, Percocet, and Fentanyl had already been competing for decades in doctors’ offices and pharmacies for their piece of the market share of pain-relieving drugs. In retrospect, it almost didn’t make sense. Why was OxyContin so much more popular? Had it been approved for a wider range of ailments than its opioid cousins? Did doctors prefer prescribing it to their patients?

Because there was simply so much OxyContin available for over a decade, it trickled down from pharmacies and hospitals and became a street drug, coveted by teens and fiends and sold by dealers at a premium

_oxycontin_600During its rise in popularity, there was a suspicious undercurrent to the drug’s spectrum of approved uses and Purdue Pharma’s relationship to the physicians that were suddenly privileging OxyContin over other meds to combat everything from back pain to arthritis to post-operative discomfort. It would take years to discover that there was much more to the story than the benign introduction of a new, highly effective painkiller.

In 1952, brothers Arthur, Raymond, and Mortimer Sackler purchased Purdue Pharma, then called Purdue Frederick Co. All three men were psychiatrists by trade, working at a mental facility in Queens in the 1940s.

The eldest brother, Arthur, was a brilliant polymath, contributing not only to psychiatric research but also thriving in the fledgling field of pharmaceutical advertising. It was here that he would leave his greatest mark. As a member of William Douglas McAdams, a small New York-based advertising firm, Sackler expanded the possibilities of medical advertising by promoting products in medical journals and experimenting with television and radio marketing. Perhaps his greatest achievement, detailed in his biography in the Medical Advertising Hall of Fame, was finding enough different uses for Valium to turn it into the first drug to hit $100 million in revenue.

The Medical Advertising Hall of Fame website’s euphemistic argot for this accomplishment states that Sackler’s experience in the fields of psychiatry and experimental medicine “enabled him to position different indications for Roche’s Librium and Valium.”

Sackler was also among the first medical advertisers to foster relationships with doctors in the hopes of earning extra points for his company’s drugs, according to a 2011 exposé in Fortune. Such backscratching in the hopes of reciprocity is now the model for the whole drug marketing industry. Arthur Sackler’s pioneering methods would be cultivated by his younger brothers Raymond and Mortimer in the decades to come, as they grew their small pharmaceutical firm.

oxycodone-oxycontinStarting in 1996, Purdue Pharma expanded its sales department to coincide with the debut of its new drug. According to an article published in The American Journal of Public Health, “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy,” Purdue increased its number of sales representatives from 318 in 1996 to 671 in 2000. By 2001, when OxyContin was hitting its stride, these sales reps received annual bonuses averaging over $70,000, with some bonuses nearing a quarter of a million dollars. In that year Purdue Pharma spent $200 million marketing its golden goose. Pouring money into marketing is not uncommon for Big Pharma, but proportionate to the size of the company, Purdue’s OxyContin push was substantial.

Boots on the ground was not the only stratagem employed by Purdue to increase sales for OxyContin. Long before the rise of big data, Purdue was compiling profiles of doctors and their prescribing habits into databases. These databases then organized the information based on location to indicate the spectrum of prescribing patterns in a given state or county. The idea was to pinpoint the doctors prescribing the most pain medication and target them for the company’s marketing onslaught.

That the databases couldn’t distinguish between doctors who were prescribing more pain meds because they were seeing more patients with chronic pain or were simply looser with their signatures didn’t matter to Purdue. The Los Angeles Times reported that by 2002 Purdue Pharma had identified hundreds of doctors who were prescribing OxyContin recklessly, yet they did little about it. The same article notes that it wasn’t until June of 2013, at a drug dependency conference in San Diego, that the database was ever even discussed in public.

Purdue's Oxycontin - reformulated: Pic - Oxy's crushed by a mortar and pestle: reformulated to deter injecting...

purdue_reformulated_oxy_Pic – crushed by a mortar n pestle: reformulated to deter injecting…

Combining the physician database with its expanded marketing, it would become one of Purdue’s preeminent missions to make primary care doctors less judicious when it came to handing out OxyContin prescriptions.

Beginning around 1980, one of the more significant trends in pain pharmacology was the increased use of opioids for chronic non-cancer pain. Like other pharmaceutical companies, Purdue likely sought to capitalize on the abundant financial opportunities of this trend. The logic was simple: While the number of cancer patients was not likely to increase drastically from one year to the next, if a company could expand the indications for use of a particular drug, then it could boost sales exponentially without any real change in the country’s health demography.

Read the rest of the fascinating article here – Poison Pill:  How the American opiate epidemic was started by one pharmaceutical companyMIKE MARIANI FEB 23, 2015

Or for more reading – 

A Blog on OxyContin:

(www.Oxywatchdog.com) is written  by a journalist who lost her brother to an Oxy overdose. While perhaps as drug user activists we may not always agree with the US model of addiction as a disease etc, her commitment and dedication to try to understand the big picture about pharmaceuticals, without writing them all – and us – off, is terrific. There’s a lot of info to be found on this site re Oxys’, including Narcan (naloxone) as she lends her strong campaigning voice to its expansion across the US. Good luck to her and our deepest sympathies for her pain and loss of her lovely brother, Pat.

 Oxycontin, Patents and Purdue Pharmaceuticals

click here for activism/lawsuits against Purdue as far back as 2004   Here’s an edited version, click the link for the real article.

Purdue: The Oxy reformulated variety, sold in Calgary Canada at 100 Canadian dollars, for bottle of 20mg Oxys'.

Purdue Pharma: The Oxy reformulated variety, sold in Calgary Canada at 100 Canadian dollars, for bottle of 20mg Oxys’.

“….. A number of consumer groups and individuals today filed a lawsuit against Purdue Pharma, L.P. (“Purdue”) [January 7th, 2004] claiming that the drug maker reaped billions in unlawful profit from OxyContin consumers through fraudulent patents and sham lawsuits that blocked generic alternatives to the widely prescribed pain reliever.

The suit, led by the Boston-based advocacy group Prescription Access Litigation project (PAL) on behalf of Connecticut Citizen Action Group and Health Care For All……..alleges that Purdue has been illegally marketing and selling OxyContin since December 1995, when it received approval from the Food and Drug Administration (“FDA”). To win its patents on the drug in the first place, Purdue told the federal patent office that OxyContin was unique because of its effectiveness at very low dosages. The suit charges that Purdue knew that there was no evidence to support this assertion at the time the company filed for the patents and therefore received exclusive rights to the drug that it did not deserve.

In a recent decision in the underlying patent case between Purdue and the generic manufacturer who attempted to bring generic OxyContin to the market, a federal judge ruled that Purdue’s patents on the drug were invalid because of Purdue’s material misrepresentations to the federal patent office. The judge based his ruling, in large part, on the trial testimony of OxyContin’s inventor, who admitted that he had done no clinical studies or had no other evidence to support Purdue’s claim that lower dosages of the drug were effective in treating pain.

According to the consumer groups, because of Purdue’s actions, consumers have paid and continue to pay a highly inflated price for OxyContin — one they would not have paid if competing or generic versions of the drug were available. The consumer groups’ lawsuit goes on to allege that the drug maker has gone to lengths to maintain its monopoly over the drug by suing a generic company to prevent it from putting a less expensive version of OxyContin on the market. More than 70% of Purdue’s $1.8 billion in annual revenue comes from the sale of OxyContin. Click here for rest of article.

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