Pa. sues opioid maker Purdue
Firm denies deception in selling OxyContin
Saying the maker of OxyContin swamped the state’s medical practitioners with a legion of sales representatives armed with deceptive claims and specious theories, Attorney General Josh Shapiro unveiled a lawsuit Tuesday accusing Purdue Pharma of legal violations and seeking damages.
Purdue’s salespeople, who made as many as 60,000 visits to prescribers per year, “would ask doctors for lists of specific patients the doctors were scheduled to see, and actually push them to commit to prescribing that patient Purdue drugs,” Mr. Shapiro, the state’s top prosecutor, said in a conference call. Top prescribers “were showered with gifts and meals and luxury trips, and sometimes they were just given cash.”
Pennsylvania’s lawsuit, filed in Commonwealth Court, joins an estimated 2,000 legal actions targeting painkiller makers and distributors blamed by some for the opioid epidemic. Mr. Shapiro left open the possibility that he and some 40 allied attorney generals may add more cases.
“I assure you, we are not done here yet,” he said, adding that he and his peers in other capitals “are continuing our investigation as relates to all of the other manufacturers and distributors.”
Purdue Pharma promptly responded that it “vigorously denies the allegations filed today in Pennsylvania and will continue to defend itself against these misleading attacks,” calling the complaint “part of a continuing effort to try
these cases in the court of public opinion rather than the justice system.”
The Connecticut-based pharmaceutical company added that there is “little evidence to support its sweeping legal claims.”
OxyContin represents just 2% of total opioid prescriptions, the company wrote, and is tightly regulated by the federal government.
The company added that it has “pursued more than 60 different initiatives in collaboration with governments and law enforcement agencies on this difficult social issue” of addiction.
“The opioid epidemic is not natural or normal,” Mr. Shapiro said. “It is manufactured by drug companies.”
He said that his complaint was filed May 2, but legal constraints that he did not detail prevented him from talking about it until now.
The 121-page complaint, citing the consumer protection and unfair trade practices laws, holds that the maker of OxyContin “created the opioid epidemic that is killing Pennsylvanians.” It asks the Commonwealth Court to compel Purdue to pay $1,000 for every violation of the Consumer Protection Act, and $3,000 for every violation related to a person age 60 or older. It does not specify the number of such violations.
It asks that Purdue be forced to disgorge all profits derived from “deceptive acts and practices,” and to forfeit its rights to do business in the state until it does so.
Dollars barely begin to describe the cost, Mr. Shapiro added.
“The grief that comes at such a high and great cost to moms, families, children left without parents — it is a loss, of course, that can never be recovered,” he said. “Their loss fuels our efforts.”
The state saw 5,388 drug overdose deaths in 2017 and at least 4,267 last year, according to the complaint and to Mr. Shapiro, who set the average economic loss per death at $9.6 million. Citing White House Council of Economic Advisers estimates, the complaint concludes that the opioid epidemic had an economic cost to the state of $142 billion from 2012 through 2016.
Although fatal overdoses in the nine-county southwestern Pennsylvania region are down from their peak of 1,413 in 2017, drugs still took more than 800 lives here last year.
The lawsuit singles out Purdue — among numerous painkiller makers — in part because, according to the complaint, the company derives the vast bulk of its revenue from opioids, and because it has sold 200 million doses of OxyContin to Pennsylvanians since May 2007. It cites Centers for Disease Control and Prevention estimates that Pennsylvania medical practitioners, in 2016, wrote 69.5 opioid prescriptions per 100 residents of the state.
The company made those sales, according to the complaint, in part by sending representatives — internally referred to as “detailers” — to make some 500,000 sales calls to Pennsylvania prescribers since 2007, peaking at nearly 62,000 calls in 2016. The detailers spread falsehoods, according to the complaint, including that pain is undertreated, that long-term use of OxyContin was appropriate for moderate to severe chronic pain, that there was no maximum dose and that the drug was effective for 12 hours.
When doctors reported that their patients were going through withdrawal, detailers responded by touting the concept of “pseudoaddiction,” blaming withdrawal symptoms on inadequate doses of opioids, and encouraging more liberal prescribing, according to the complaint.
Mr. Shapiro said his complaint was the first in the nation to focus on the volume of Purdue’s sales visits.
Purdue also promulgated its claims through what the lawsuit calls “front groups,” including the American Pain Foundation and the American Pain Society. The American Pain Foundation shut down in 2012. The American Pain Society declined to comment, through a spokesman.
Purdue’s strategy was aimed particularly at the elderly and veterans, according to the complaint. And the financial cost is borne in large measure by the public, the complaint alleges, saying that Medicaid paid for 44.3% of opioid-related hospitalizations in 2017.
Mr. Shapiro’s office two years ago joined with dozens of other states to investigate companies that make and distribute opioid painkillers. Mr. Shapiro said that effort continues.
A federal judge in Cleveland is overseeing more than 1,500 lawsuits filed by local governments, American Indian tribes and others against the opioid industry. There are an estimated 500 other lawsuits against opioid makers or distributors that have not been consolidated.
Almost exactly a year ago, Pittsburgh and Allegheny County joined other area governments and filed separate, but very similar, 100plus-page lawsuits in the Allegheny County Court of Common Pleas, seeking compensatory and punitive damages as well as a permanent injunction to block eight companies from “engaging in the acts and practices that led to the opioid crisis,” as they put it in a joint statement.
The companies named in those complaints are Purdue Pharma LP; Teva Pharmaceuticals USA Inc.; Janssen Pharmaceuticals Inc.; Endo Health Solutions Inc.; Mallinckrodt, plc; Cardinal Health Inc.; McKesson Corp.; and AmerisourceBergen Drug Corp.
The last filing in those cases was an October case management order tying discovery in the cases to the federal court process in Cleveland.
Allegheny County spokesperson Amie Downs provided a joint city/county statement: “We welcome the Attorney General’s filing today and look forward to collaborating on the best possible resolution for our residents. The opioid crisis is very complex as are the countless legal actions against the opioid industry, and we know there are not simple solutions. Ultimately, our goal is to change the way the opioid industry does business, and to work collectively to address this public health issue.”
In March, Oklahoma settled with Purdue Pharma and the company’s controlling Sackler family, for $270 million, the bulk of which went toward establishing a National Center for Addiction Studies and Treatment at Oklahoma State University-Tulsa.
In April, a Sackler family attorney told Reuters that the family found the cases against Purdue legally dubious but would like to achieve a “global resolution” of an estimated 2,000 cases, including 1,500 consolidated in Cleveland, given the “litigation landscape” and related legal bills.
Pennsylvania Attorney General Josh Shapiro speaks during a news conference Tuesday in Philadelphia in which he announced the state’s lawsuit against Purdue Pharma.