Pa. sues opi­oid maker Pur­due

Firm de­nies de­cep­tion in sell­ing OxyCon­tin

Pittsburgh Post-Gazette - - Front Page - By Rich Lord

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.

Matt Rourke/As­so­ci­ated Press

Penn­syl­va­nia At­tor­ney Gen­eral Josh Shapiro speaks dur­ing a news con­fer­ence Tues­day in Philadel­phia in which he an­nounced the state’s law­suit against Pur­due Pharma.

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