Pa. Attorney General defends efforts to make Purdue Pharma pay

Pennsylvania’s top attorney is defending his efforts to make drug-maker Purdue Pharma pay for the way it marketed the painkiller OxyContin to doctors in Pennsylvania.

Attorney General Josh Shapiro told a group of drug treatment advocates who were gathered May 20 at Treatment Trends, an addiction rehabilitation center in Allentown, that he expects Purdue to “pay for the damage they have done and change their corporate behavior.”

Shapiro filed suit against Purdue Pharma on May 14, alleging that the pharmaceutical company, headquartered in Stamford, Connecticut, unlawfully and irresponsibly marketed the painkiller OxyContin to doctors throughout the commonwealth.

The lawsuit is a part of a broad effort by Shapiro’s office to target sources of the opioid epidemic.

There were 5,456 drug-related overdose deaths in Pennsylvania in 2017, according to a 2018 report by the U.S. Drug Enforcement Administration, marking an increase over 2016, when there were 4,642 drug-related overdose deaths.

The 2017 numbers show 43 drug related deaths per 100,000 people in the state, a significantly higher percentage than the national average of 22 deaths per 100,000 people.

Shapiro alleges that Purdue contributed to the state’s opioid crisis by aggressively pushing doctors to prescribe OxyContin to their patients. Purdue has rejected the allegations.

“We’ve been arresting doctors at an alarming rate who are running pill mills,” Shapiro said in an interview at Treatment Trends. “We need docs to understand that not only is it against the law to run a pill mill, but also to learn the dangers of irresponsible prescribing practices.”

According to the Attorney General, Purdue sales representatives have made more than 500,000 sales calls to doctors in Pennsylvania since 2007.

During these sales calls, Shapiro alleges that sales representatives lied about the addictive nature of OxyContin to the physicians, encouraging doctors to increase the dosage to patients who exhibited withdrawal symptoms, calling the symptoms, a “pseudo-addiction.”

Shapiro stated that health insurance companies can help by encouraging doctors to limit the amount of opioids prescribed.

“If you get your wisdom teeth pulled,” he said, “you don’t need 60 Percocet when you leave the office.”

Pressure from state authorities has appeared to make a dent in the problem.

From 2017 to 2018, the overprescribing of opioids lessened, according to Shapiro.

“During that same time,” he said, “we’ve seen the number of opioid-related deaths come down. There is a direct correlation between the way these pills are prescribed and the number of deaths.”

Shapiro added that he plans for the state to use any financial gains from the lawsuit to go toward drug treatment throughout the state.

Shapiro’s suit could be a game changer for the industry, said Robert McDonald, an adjunct professor of health care systems engineering at Lehigh University in Bethlehem and former administrator with the Mayo Clinic in Minnesota.

“I think this suit will change the way pharmaceutical sales are done,” he said. “Purdue is by no means the only company using these tactics. Pharmaceuticals can do wonderful things for the patient, but without the right information, damage can be done.”

Purdue Pharma denies the claims made by Shapiro’s office in the lawsuit.

“The complaint is part of a continuing effort to try these cases in the court of public opinion rather than the justice system. Such allegations demand clear evidence linking the conduct alleged to the harm described, but we believe the state fails to show such causation and offers little evidence to support its sweeping legal claims,” the company said in a statement.

Pennsylvania, along with 40 other states, began leading an investigation into Purdue and other opioid manufacturers and distributors in 2017. The companies being investigated are Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical, Allergan Inc, Purdue Pharma, AmerisourceBergen, Cardinal Health, and McKesson.