The following originally appeared on The Upshot (copyright 2020, The New York Times Company). It also appeared on page B3 of the April 14, 2020 print edition.
OxyContin, and the aggressive, misleading way that Purdue Pharma marketed it, might have been even more damaging than was previously understood.
Recent research shows how the company focused its marketing in states with lighter prescription regulation — to devastating effect.
Also, a new version of OxyContin introduced a decade ago — which was meant to reduce harm — had unintended consequences. Besides contributing to heroin overdoses, it led to hepatitis C and other infections. Careful studies are only now starting to reveal the extent of the damage.
OxyContin is an opioid painkiller that Purdue Pharma first brought to the U.S. market in 1996. Its chief innovation was its 12-hour timed release of oxycodone. This made it ripe for abuse, since by crushing or dissolving OxyContin pills, abusers of the drug could ingest the entire dose at once.
Several studies have pointed to Purdue’s aggressive marketing of OxyContin as a significant contributor to the opioid epidemic. The marketing took various forms, including calling and visiting doctors; paying them for meals and travel; providing gifts; and funding pain treatment groups that urged liberalization of opioid prescribing.
Some of the company’s marketing messages minimized the potential for OxyContin to lead to addiction, for which it paid over $600 million in fines in 2007.
A National Bureau of Economic Research working paper published last fall sheds light on Purdue’s role. The researchers, economists from the University of Pennsylvania, the University of Notre Dame and the RAND Corporation, looked at variations in prescribing regulations that led Purdue to market OxyContin more aggressively in some states than in others.
The study found that OxyContin distribution was nearly twice as high in states where regulations made it easier to market. Misuse of the drug was also higher in the more marketed states, both immediately after OxyContin’s introduction in 1996 and many years later.
The study relied on unsealed documents from settled lawsuits and investigations involving Purdue Pharma in Florida, West Virginia and Washington State. The documents, obtained through Freedom of Information Act requests, included the company’s official OxyContin launch plan, focus group research and budgets from 1996-2002.