Updated 10:15 a.m. with industry comment.
Washington – Stamford-based Purdue Pharma, the maker of pain-killer OxyContin, is the target of an increasing number of states, counties and cities suing the pharmaceutical firm, alleging it is partly to blame for the nation’s opioid epidemic.
The lawsuits are all different and some include other pharmaceutical companies and pharmacies as defendants. But Purdue is nearly always a main defendant.
The latest suit, filed last week by the state of Oklahoma, said Purdue and three other drug companies and their subsidiaries sought to increase their opioid sales by persuading doctors to expand the market beyond “a niche for cancer patients, the terminally ill and acute short-term pain” and to “prescribe opioids to a broader range of patients with chronic non-cancer-related pain.”
To do so, the lawsuit says, Purdue and the other pharmaceutical companies “elected to falsely downplay the risk of opioid addiction and overstate the efficacy of opioids for more wide-ranging conditions.” One argument Purdue has made is that OxyContin’s time-release properties made it less addictive.
“These companies have waged a fraudulent decade-long marketing campaign to profit from the anguish of thousands of Oklahomans,” said Oklahoma Attorney General Mike Hunter. “These companies have made in excess of $10 billion a year, while our friends, family members, neighbors and loved ones have become addicts, gone to prison or died because of the opioid epidemic.”
Purdue said the it “vigorously denies the allegations in the complaint” and “shares officials’ concerns about the opioid crisis and we are committed to working collaboratively to find solutions.”
” OxyContin accounts for less than 2 percent of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone — all important components for combating the opioid crisis,” Purdue said in a statement.
The Oklahoma lawsuit said sales of OxyContin rose from $48 million to more than $1 billion from 1996 to 2000, and to $3 billion by 2009.
Ohio has filed a similar suit against Purdue and the three other drug companies that are also defendants in the Oklahoma suit. They are Allergan, Cephalon and Janssen Pharmaceuticals, who make oxycodone — which is similar to OxyContin but not produced in a time-release form — and other opioid-based painkillers.
Like Purdue, Janssen denied wrongdoing.
“We recognize opioid abuse is a serious public health issue that must be addressed. At the same time, we firmly believe Janssen has acted responsibly and in the best interests of patients and physicians with regard to these medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label,” said Janssen spokeswoman Jessica Castles Smith.
She said the company is “committed to providing healthcare professionals with complete and accurate information on how to prescribe our opioid medications, which give doctors and patients important choices to help manage the debilitating effects of chronic pain.”
Like the Oklahoma suit, the Ohio filing blamed the drug companies for downplaying the risk of addiction and fueling the opioid addiction crisis in the state.
“It is hardly necessary to say… that Ohio is now awash in opioids and engulfed in a public health crisis,” the Ohio suit said. “In 2012, the total number of opioid doses prescribed to Ohio patients soared to 793 million – enough to supply every man, woman and child in the state with 68 pills each,” the lawsuit said.
It also said that in 2016 alone, 2.3 million Ohio patients – roughly 20 percent of the state’s population – were prescribed an opioid drug.
Mississippi and Missouri have filed similar lawsuits. Delaware is among a handful of other states issuing “requests for proposals” from law firms to help them sue.
The city of Everett, Wash., has taken a different tactic. In its lawsuit against Purdue it alleges the drug makers “supplied OxyContin to obviously suspicious physicians and pharmacies,” and failed to prevent the diversion of its drug to the black market.
Connecticut has not sued, but state Attorney General George Jepsen last month joined a coalition of other states to investigate what role pharmaceuticals have played – if any—in the opioid epidemic.
“The opioid epidemic continues to have a devastating impact in Connecticut,” Jepsen said in a release. “It is my responsibility to take whatever action is within my authority to help address this crisis, which is why I have joined with my colleagues in announcing our bipartisan, multi-state efforts today. It would be irresponsible to predict at this stage whether our efforts will lead to legal action or relief, but Connecticut residents can be assured that we will pursue this investigation fully.”
Because of the “ongoing and sensitive nature of the investigation, the coalition of attorneys general is not identifying any potential targets at this time,” Jepsen said.
According to the state’s medical examiner, 917 people in Connecticut died from drug overdoses last year, frequently from opioids.
In 2007, Purdue Frederick Co., an affiliate of Purdue Pharma, and three of its executives pleaded guilty in federal court to criminal charges of misleading the public about the addictive qualities of OxyContin. The company and executives agreed to pay the federal government and a group of states, including Connecticut, $634.5 million in fines and pleaded guilty to false marketing.
Like the tobacco settlement?
Mike Moore, a former attorney general for Mississippi who led a successful, multi-state lawsuit against the tobacco industry is an outside counsel for the Mississippi and Ohio lawsuits and said he hopes to be involved in “quite a few others that are soon to file.”
He said he also is involved with lawyers across the country who have city and county cases as well as Indian tribes that will file suit against opioid makers.
“The opioid case is similar to the tobacco cases in that the intentional misrepresentation of the addictive nature of the various opioids has contributed to a huge number of addicts,” he said.
He mentioned a 1994 congressional hearing that featured seven tobacco executives testifying under oath that nicotine was not an addictive drug.
“That did not turn out so well for them,” Moore said.
He said pharmaceutical companies used “an advertising and marketing scheme” that included telling doctors and patients their opioid-based drugs had a 1 percent chance of addiction if taken under a physician’s care.
“No studies or evidence support that,” Moore said. “They even put together industry-sponsored groups that promote the safety of opioid use, just like the tobacco companies did with the Tobacco Institute back in the day.”
He said like the tobacco case, which resulted in a $206 billion settlement, the opioid lawsuits seek recovery for state spending of Medicaid dollars on the addiction crisis and funds for education and recovery campaigns.
Bob Josephson, spokesman for Purdue Pharma, rejected the comparison between tobacco and opioid-based medicines.
“Unlike tobacco companies, our products are medicines approved by FDA, prescribed by doctors, and dispensed by pharmacists, as treatments for patients suffering pain,” he said.
It’s far from clear the drug companies will be found liable for the addiction epidemic.
But University of Georgia law professor Elizabeth Chamblee Burch said the pharmaceuticals are likely to feel increased pressure as the lawsuits pile on and may settle, as Purdue Frederick did in the 2007 criminal case.
“There’s blood in the water with that settlement,” she said.
Besides agreeing to pay a fine, Burch said the pharmaceutical companies also may be pressured to adopt better practices when it comes to the sale of opioids.