|Friday, January 23, 2004
OxyContin study fails to link abuse to marketing
|The 57-page report on OxyContin contained enough data to provide some fodder for critics.
By Laurence Hammack
Although the company that makes OxyContin doubled its sales force and spent millions marketing its new drug, a congressional study released Thursday stopped short of linking the promotional efforts to widespread abuse of the prescription painkiller.
A report by the General Accounting Office was portrayed by Purdue Pharma as a vindication to claims that its promotional practices increased the availability of OxyContin to those who convert the pills into a potent street drug.
However, the 57-page report by Congress' investigative arm contained enough documentation - including details of how sales representatives received large bonuses for targeting selected doctors - to provide some fodder for critics.
"I believe the company has chosen to put profits ahead of people and greed ahead of sound patient care," said Rep. Harold Rogers, R-Ky., one of three lawmakers who requested the study.
According to the report, Purdue Pharma changed part of its policy on bonuses to sales representatives in 2001 after a meeting in Roanoke with Robert Crouch, who was then U.S. Attorney for Western Virginia.
The company learned at the meeting that its bonuses, which averaged $71,500 a year on top of a base salary of $55,000, could be earned by a sales representative based on the prescribing pattern of a single physician.
Federal prosecutors in Roanoke have tried several doctors on charges of overprescribing OxyContin. Although the doctor was not named in the GAO report, prosecutors claimed in an indictment this week that pain specialist Cecil Byron Knox ranked fifth in the nation in OxyContin prescriptions before his practice was shut down.
However, the timing of the meeting suggests that other doctors in Southwest Virginia could have been the source of concern. Purdue Pharma has since limited its bonus policy, although the report did not explain how.
Also included in the report is a finding that Purdue Pharma distributed a misleading promotional video touting OxyContin to doctors. The video made unsubstantiated claims about OxyContin's effectiveness while downplaying its possible risks, the report concluded.
"Purdue Pharma has engaged in highly questionable practices regarding the marketing of OxyContin, leaving a plague of abuse and broken lives in its path," Rogers said in a prepared statement.
The company said it mistakenly failed to submit the video for review by the Food and Drug Administration, although it stands by the content.
OxyContin contains a time-release formula that gradually releases large doses of oxycodone, an opium-based analgesic, over 12-hour periods to cancer patients and other sufferers of moderate to severe pain. But abusers who crush the pills and snort or inject the powder have been able to bypass the time-release function to achieve an immediate, heroin-like high.
Other findings in the report include:
The amount of bonuses Purdue Pharma rewarded to its sales representatives grew from $1 million in 1996, to $40 million in 2001.
Although some doctors believe OxyContin's strength - it has twice the potency of morphine - makes it appropriate only for cancer patients, Purdue Pharma promoted the drug to a much broader range of patients. By 2003, nearly half of OxyContin prescribers were primary care physicians.
To push sales of OxyContin over $1 billion a year, the company relied on data that led it to doctors most likely to prescribe the drug. But it was not until 2002 that the company began using the same data to look for patterns of abuse.