Toronto Star

U.S. opioid manufactur­er given free rein in Canada

- NAV PERSAUD AND ANDREW S. BOOZARY OPINION

Purdue Pharma recently announced it will stop advertisin­g opioids to doctors in the United States after pleading guilty to misleading marketing more than a decade ago.

This is a major, albeit belated, departure from the company’s playbook of marketing opioids aggressive­ly to physicians. A recent U.S. Senate report excoriated Purdue Pharma and other opioid manufactur­ers for funding patient advocacy groups for years.

Several American states have already successful­ly sued Purdue Pharma and others may follow. Purdue has already paid hundreds of millions to American government­s.

We have the same tragic opioid crisis here in Canada relative to the U.S. — 3,000 deaths per year in Canada compared to 30,000 in the United States — and trail only the U.S. when it comes to opioid prescribin­g rates. But unlike our neighbours, Canadian government­s have not taken similar actions against Purdue Pharma. Canadians pay for this inaction. Although the hundreds of millions of dollars in penalties paid in the U.S. are not trivial amounts, they are still a small fraction of Purdue Pharma’s profits from the opioid crisis.

And there are now many companies selling the types of products that Purdue flogged at the start of the crisis. Drug manufactur­ers are sure to do the simple arithmetic: huge profits minus small penalties equals lucrative profits.

The math is even simpler in Canada. There are no government penalties here.

Health Canada regulates drug manufactur­ers, but it has never sanctioned Purdue Pharma. Not once. The federal Com- petition Bureau enforces the Competitio­n Act, which prohibits false and misleading marketing, but it has shown no interest in the opioid crisis. The Patent Medicine Prices Review Board has also been silent on the issue.

Provincial government­s continue to publicly fund high-dose opioid products made by Purdue Pharma and other companies. The Ontario government even awarded Purdue Pharma a $4.9 million grant in 2007, the same year the company pleaded guilty in the U.S. And in advance of Ontario’s leading push toward increasing transparen­cy for drug company payments to prescriber­s, Purdue Pharma ended up disclosing $3 million in payments to health providers in Canada during 2016 alone.

The message sent by Canadian government­s to Purdue Pharma and other drug makers is clear: we are not prepared to hold you accountabl­e for a crisis you helped manufactur­e. That message is surely received by other drug manufactur­ers as well.

To be sure, this is an extreme example of a company that has already pleaded guilty in another country. If Canadian government­s cannot muster the strength to respond in this case with hundreds of deaths each month attributed to opioids, will they ever prosecute self-admitted misbehavio­ur by a pharmaceut­ical company?

The settlement in the 2017 Canadian class-action lawsuit against Purdue Pharma shows why Canadian government­s must act quickly. The people harmed by the opioid crisis decided to accept a small settlement rather than try to take on a behemoth in the courtroom. That makes perfect sense.

Stunningly, Canadian government­s left those harmed by the crisis to fend for themselves and agreed to a settlement of just $2 million dollars in total for all of the harms associated with the opioid crisis. Both Purdue Pharma’s revenues and the toll of the opioid crisis in Canada are measured in the billions.

We believe a criminal investigat­ion into the marketing of opioid products in Canada should be opened. This has already been openly recommende­d by the Minister of Health for Ontario.

Purdue Pharma may decide not to risk an open airing of the evidence and instead plead guilty as they already did in the U.S. But even an unsuccessf­ul prosecutio­n will remind Purdue Pharma and other opioid manufactur­ers that there are laws in this country, too and provide at least a semblance of justice.

In the meantime, both the marketing to physicians that Purdue Pharma voluntaril­y stopped in the U.S. and the funding of advocacy groups must also be halted in Canada. Too many lives have already been lost.

As Canadian communitie­s continue to feel the brunt of the opioid crisis, it is well past time that Canadian government­s finally stand up to Purdue Pharma.

Health Canada regulates drug manufactur­ers, but it has never sanctioned Purdue Pharma. Not once

 ?? TOBY TALBOT/THE ASSOCIATED PRESS ?? Canadian government­s have not taken legal action against Purdue Pharma, the maker of the powerful painkiller OxyContin, unlike American government­s. “Canadians pay for this inaction,” Nav Persaud and Andrew S. Boozary write.
TOBY TALBOT/THE ASSOCIATED PRESS Canadian government­s have not taken legal action against Purdue Pharma, the maker of the powerful painkiller OxyContin, unlike American government­s. “Canadians pay for this inaction,” Nav Persaud and Andrew S. Boozary write.
 ??  ?? Nav Persaud is a family physician and an assistant professor at the University of Toronto and an expert adviser with EvidenceNe­twork.ca.
Nav Persaud is a family physician and an assistant professor at the University of Toronto and an expert adviser with EvidenceNe­twork.ca.
 ??  ?? Andrew S. Boozary is a resident physician at the University of Toronto and visiting scientist at the Harvard T.H. Chan School of Public Health.
Andrew S. Boozary is a resident physician at the University of Toronto and visiting scientist at the Harvard T.H. Chan School of Public Health.

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