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Several days ago, Purdue (a US-based pharmaceutical company) pleaded guilty in an $8 billion settlement regarding false advertising and unethical practices involved in the prescription of their signature drug: OxyContin. Originally developed as a less potent form of morphine, the drug represented a switch in the marketing strategy of Purdue. Where the drug’s predecessor, MS Contin, had targeted the palliative care sector, they now attempted to sell pain relief to the broader market of the American middle class; and with devastating consequences to public health.
The core of Purdue’s marketing strategy was to play down the addictive effects of OxyContin, erasing the stigma around the use of opioids. Claiming that it had less than a 1% chance of addiction (when studies suggested a 12% chance of addiction) the company paid clinicians and public health experts to promote the drug at conferences, with some clinicians even describing opioid addiction as a “medical myth”. Purdue was also found to have paid clinics to prescribe the drug and encouraged doctors to increase the prescription dosage where possible. More insidiously, in 2015 the company successfully lobbied the FDA into granting them permission to market OxyContin to children as young as eleven years old. As a result, OxyContin prescriptions grew by 5.7 million in 5 years and OxyContin sales surpassed $1 Billion for the Purdue company in 2000.
As time passed, however, it became clear that OxyContin was not the harmless pain control it was marketed to be. Studies began showing a direct correlation between the number of opioid prescriptions and the number of deaths by drug overdose in certain counties, with many patients who could no longer afford OxyContin switching to more dangerous opioids such as heroin. Amid mounting pressure and several class-action lawsuits, the company was dissolved and an $8 billion settlement reached. However, many criticise the terms of the settlement as members of the Sackler family, founders of the company, and chairs of the board during the time of the OxyContin scandal, are unlikely to face any legal repercussions. This is despite the opioid crisis having claimed over 400,000 lives since 1999 and Purdue playing a direct role in fuelling the public’s addiction to these drugs. Many have called the OxyContin scandal a consequence of American corporatism, where the corporations take the hit but the unethical actions of individual people, such as the Sacklers, remain largely unprosecuted.
Thankfully, such scandals are largely avoided in nations like the UK, with publicly owned healthcare sectors. Here, one buyer (the NHS) is responsible for almost all pharmaceutical transactions so that drug companies are in constant competition to produce the best form of a drug. Sales representatives and marketing teams have far less influence here as it is NHS policy to assess the viability of these drugs through an independent government committee. Experts pour over reams of evidence to assess the proposed medication, leaving no room for the sly, underhanded marketing tactics that lead to the OxyContin scandal. An additional benefit of this is that medication is also cheaper in the UK relative to the US. The US is one of the only countries not to regulate the price of medication, which is why the average American pays six times more for insulin than the average Brit. This is because British government bodies responsible for assessing the drugs also negotiate with companies, on the part of the people, to reduce their price thereby putting a strain on taxpayer money. The US, where the majority of healthcare is private, has no incentive to lower the price of drugs as the cost of new medication does not come out of government funds.
In the years to come, it is unlikely that the US government will make any substantial change to its drug regulation policies, with “Medicare for all” being branded too socialist a policy for the majority of politicians to consider, including the current electoral candidates. Currently, no change in the regulation of opioid prescription has taken place and OxyContin is in fact still being prescribed in large portions of the US, albeit more stringently. The lack of punitive measures taken against the Sacklers, announces to the world that the health of the American people can continue to be manipulated by a small group, whose interests are far removed from the zone of public health. We can only hope that the concerns of Big Pharma align with those of the people, or the US will face yet more crises brought about by pervasive pharmaceutical dishonesty.
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