Previously undisclosed court documents were revealed on January 16, alleging that Purdue Pharmaceutical and the Sackler family, the family which owns Purdue, used deceptive methods to bring OxyContin to the mainstream. The documents contend that the family and company misled doctors and patients about the dangers of powerful opioid painkillers, even after the company had to pay $600 million for deceptive marketing tactics in 2007. The company and executives plead guilty for misleading and downplaying regulators about the OxyContin’s risk of addiction.
These new documents, filed in Massachusetts, claim that the Sackler’s, on their quest for more money, “made the choices that caused much of the opioid epidemic.”
The documents allege that the driving engine behind Purdue Pharmaceuticals’ deceptive marketing practices that led to them becoming a billion dollar industry came from the company’s owners, the Sackler family.
Eight members of the Sackler family are being named in the document: Richard, Beverly, David, Ilene, Jonathon, Kathe, Mortimer, and Theresa.
“Most of all, the Sacklers cared about money. Millions of dollars were not enough. They wanted billions. They cared more about money than about patients, or their employees, or the truth,” the document said.
While the new documents allege many shocking details, the full scope of the family’s influence is still buried underneath a pile of redactions.
“Blizzard of Prescriptions”
At the OxyContin launch party, Richard Sackler, then the senior vice president of sales, asked the audience to imagine a series of natural disasters like earthquakes and volcanoes.
“The launch of OxyContin Tablets will be followed by a blizzard of prescriptions that will bury the competition. The prescription blizzard will be so deep, dense, and white,” he allegedly said at the launch.
This statement would soon prove to be prophetic. Since the launch of OxyContin in the 1990’s, the estimated sales of the drug has reached above $35 billion.
In 1999, Richard Sackler became the CEO of Purdue Pharmaceutical, Jonathon, Kathe, and Mortimer were vice presidents at the time.
Soon after becoming CEO, annual sales for OxyContin surged past $1 billion. These numbers came as sales representatives were taught to downplay addiction and target certain groups like elderly patients and veterans. Sales representatives were told to promote the claim that the risk of addiction was less than one percent.
“It was sell, sell, sell,” said Shelby Sherman, a former sales rep at Purdue, said in an interview with Esquire.
“We were directed to lie. Why mince words about it? Greed took hold and overruled everything. They saw the potential for billions of dollars and just went after it.”
The inventor of OxyContin, Richard Kiako wrote to Richard Sackler to oppose his marketing and sales methods.
“I don’t believe we have a sufficiently strong care to argue that OxyContin has minimal or no abuse liability,” Kaiko wrote. “If OxyContin is uncontrolled,… it is likely that it will eventually be abuse.”
Richard Sackler’s alleged response was straight to the point: “How substantially would it improve your sales?”
In 2001, a federal prosecutor reported 59 deaths from OxyContin in a single state, a number which would balloon over the next decade and more. The Sackler’s, however, allegedly knew the reports underestimated the destruction.
Emails from Richard Sackler to Purdue executives said that the number was “not too bad. It could have been far worse.”
Under continued pressure from mothers of dead children and government officials, Richard Sackler claimed that the solution was to blame and stigmatize people who became addicted to opioids.
In a confidential email, court records say that Sackler wrote: “we have to hammer on the abuser in every way possible. They are the culprits and the problem. They are reckless criminals.”
In 2003, Richard Sackler left his position and after a few more years, Jonathon, Kathe, and Mortimer Sackler also resigned from their vice president positions. However, the document alleges that these moves were “just for show.”
“The Sacklers kept control of the company. Their family owned Purdue. They controlled the Board. They paid themselves the profits.”
Timeline of Events
Purdue was at the center of a lawsuit in 2006 that saw the company plead guilty and pay hundreds of millions of dollars, in which the judgement ordered Purdue that they shall not make anymore false, misleading, or deceptive claims in the promotion of its products.
However, the court documents allege that the company still continued a deceptive sales campaign and continued to target the most prolific prescribers and direct them to prescribe more of the highest doses of opioids.
Purdue staff reported that they continued to mail thousands of deceptive marketing materials, including over 12,500 publications in just the first six months of 2007. In the publications, they allegedly repeated the false claim that the warning signs of addiction are just “pseudoaddiction” which is best to be treated with more opioids.
During 2007, the company relied on sales tactics to drive revenue, employing 301 sales reps to promote opioids compared to only 34 for drug discovery.
And it was working.
The company reportedly was making more money than expected. In a board report from a few months before implementing their sales strategies the company had a projected profit of $407,000,000. After their efforts, that number jumped to more than $600,000,000.
Net sales in 2007 would eventually reach over $1 billion, almost double what the company had planned for the year. OxyContin made up more than 90 percent of those sales.
According to the court documents, there is also evidence that the company didn’t report or follow up on hundreds of calls and reports of concern about their products.
With projections that sales would plateau in 2008, Richard Sackler did not back off. He allegedly pushed staff to sell more higher doses of opioids and get more pills in each prescription.
In April, Richard allegedly wrote to other family members that it was crucial to install a CEO who would be loyal to the family.
In May, the Sacklers sent more ideas on how to promote Purdue’s opioids, which mirrored Richard’s own plans while he was CEO: increase stigmatization of people who become addicted to deflect blame.
Court documents indicate that the Sackler family knew about the abuse of their products. Alleging that in October staff told the family that surveillance data indicated wide dispersion of abuse of OxyContin throughout the country. They were also told that the increased availability of OxyContin and prescribing practices were key factors that had driven the abuse in the country.
On the same day as this data was presented, the company launched a new sales contest “for sales reps to win bonuses, based on how much a rep increased OxyContin use in [their] territory and how much they increased the broader prescribing of opioids.”
In late 2008, Purdue employed 414 sales reps, a 33 percent increase from the year before. And the proposed budget for the upcoming year indicated expanded the sales force further.
Again, in 2008, the company allegedly received hundreds and hundreds of reports of concern regarding their products and left most of them uninvestigated, this is a pattern that would continue throughout the years.
Court documents say that in April, staff told the Sackler family that sales representatives had made dramatic progress promoting higher doses of OxyContin, with sales from 80mg tablets, their highest dose, exceeding sales of 40mg tablets.
By October, Purdue had expanded its sales force by 50 territories and now employed 475 sales reps. In the same month, federal legislation was being proposed that would create a public database to disclose drug companies’ payments to doctors. At the time, Purdue was allegedly paying doctors to promote its products, but payments were normally done in secret. Some family members were concerned that doctors would be less willing to work for Purdue if payments were made public.
In December, Kathe and Richard Sackler met with sales staff to review plans for 2010. The company had sales in the record-breaking levels, nearly $3 billion. However, despite this, the decade-long rise of oxycodone prescriptions was beginning to to plateau.
In February, the court documents indicate that the sales and marketing team at Purdue told the Sacklers that a key objective in 2010 would be to meet or exceed call and visitation targets to prescribers to promote Purdue opioids, a trend that would continue for the next four years.
To help meet this goal, Purdue further expanded its sales force, employing 490 sales reps. The Sacklers also allegedly required each rep to visit an average of 7.5 prescribers per day. 490 sales reps, visiting 7.5 prescribers per day, five days a week.
In June 2010, the sales staff gave the Sacklers a 10-year plan for growing the company’s opioid sales. This included growing the sales force to 1050 reps by 2015.
The company’s focus on the sales force continued. In August, Purdue decided not to acquire a new insomnia drug allegedly because of the risk of promoting it could distract sales reps from selling opioids. Richard Sackler said that a “loss of focus” in sales reps’ meetings with prescribers was a great risk, according to the documents, and decided not to go through with it.
By October, Purdue had employed more than 506 sales reps and during Q3 of 2010 had visited prescribers over 140,000 times.
In January, Richard Sackler met with sales rep to discuss how they would promote Purdue’s newest opioid, Butran.
Despite the fact that the Butran opioid was on track to beat every drug in its class a few months into the year, documents indicate that Richard Sackler was not impressed asking sales staff, “Do you share my disappointment?”
In February, staff reported to the Sacklers that sales reps had allegedly engaged in improper promotion of opioids, but the company had decided not to report the violations.
In May, Purdue sales reps repeatedly reported concerns that some doctors were writing inappropriate prescriptions, but Purdue allegedly ordered the reps to keep promoting opioids to these doctors anyway.
By the end of Q1 of 2011, Purdue employed 639 sales reps and visited prescribers over 173,000 times.
Richard Sackler was always adamant about being constantly updated on the sales of Purdue’s products, 2012 was no different. He began the year by pressing the Sales Vice President Russell Gasdia for weekly updates on sales.
2012 was one of the first years that the company saw slight declines periodically in sales of their opioids.
In March, staff reported to the Sacklers the extent of the problems caused by prescription opioids. They told the Sacklers that drug overdose deaths had more than tripled since 1990, the period during which OxyContin became the best-selling painkiller. They were told that the deaths were only the “tip of the iceberg” and that for every death there were more than a hundred people suffering from dependence or abuse.
In May, staff told the Sacklers that they were using opioid savings card to get more patient to “remain in therapy longer” and using mail, email, and sales visits to push these cards. These proved to be effective as more patients stayed on OxyContin longer than 60 days.
In July, the Sacklers allegedly discussed “threats” to their business like data on long-term opioid use and public health authorities reacting to the danger of keeping patients on opioids. Staff also showed that OxyContin sales had dropped more than $96,000,000 from the year before, but they told the Sacklers that they would increase sales visits and study how to get doctors to prescribe more.
However, during this time, high dose prescriptions were declining and fewer patients were moving to higher doses from lower ones, harshly affecting revenue for the company.
To prepare for the upcoming year, the Sacklers laid out some goals to meet, for instance they planned for their sales reps to visit prescribers over 750,000 times in the upcoming year.
In December, staff told Richard Sackler that Butran sales were increase, and they predicted that the increase was because sales reps were targeting the most susceptible and prolific prescribers, court documents say.
Staff also allegedly contacted Richard as they were concerned that some internal documents could cause problems if investigations into the opioid crisis were expanded.
In February, staff told the Sacklers that the net sales were hundred of millions of dollars below budget because of a decrease in prescriptions and the details of the prescriptions. Sales VP Russell Gasdia wrote in a private email: “It’s been hard to convince colleagues and the board that our success in this market is over,” according to court documents.
In April, Purdue staff told the Sacklers that the sales of Purdue’s highest dose 80mg OxyContin were down 20 percent, and the average prescription had declined by eight pills since 2011.
In November, staff proposed to the Sacklers that the number one priority for 2016 would be to sell OxyContin through “disproportionate focus on key customers.”
In April, the Center for Disease Control and Prevention announced guidelines to slow the opioid epidemic. Urging prescribers to avoid doses higher than 30mg of OxyContin twice per day.
In May, the New York Times came out with the story reporting that opioid prescriptions were dropping for the first time since Purdue launched OxyContin in the 1990’s. The only person in the story quoted in favor of more opioid prescribing was a professor at Tufts University whose program was being funded by the Sacklers.
To combat the growing decline revenue, Purdue came up with a plan to boost opioid sales. They would promote opioids as a solution to “undertreatment of pain”, conceal the dangers of addiction and misdirect blame, and avoid responsibility by stigmatizing people hurt by opioids.
The Stackler family prepared statements to the press amid investigations and in the drafts claimed that the family help “no leadership roles in the companies owned by the family trust.”
Court documents say this was a lie.
“Sackler family members held the controlling majority of seats on the Board and, in fact, controlled the company.”
2017 and 2018
For 2018, the Sacklers approved a target for sales reps to visit prescribers over one million times, almost double the number of sales visits they ordered in 2010.
In October of 2017, Beverly Sackler served her last day on the Board.
“It was the beginning of the end for the Sackler family,” court documents said.
In November, the Board voted to cut the sales force from 582 reps to 302 reps.
In January of 2018, Richard Sackler received a patent for a drug to treat opioid addiction, one that he had applied for in 2007. Richard’s patent application said that opioids are addictive, a claim that he had repeatedly denied when pushing OxyContin.
He also met with the sales force and discussed plans to cut the sales force again.
In June, the Massachusetts Attorney General filed suit to hold the Sacklers as well as Purdue accountable for the havoc the company’s products wreaked on the country.
“Just as their employees predicted, the Sacklers tried to run. Richard Sackler was the first to go: he resigned from the Board in July. David Sackler quit in August. Theresa Sackler served her last day in September,” the court document said.
To reiterate, the complete picture is still blurred as there are a number of redaction’s still in the report.
According to the new court documents released in mid January, the Sackler family allegedly led the way for Purdue Pharma to corner the opioid market through deceptive marketing and and unethical approach to medication. At Landmark Recovery, we are dedicated to becoming a part of the solution. Our staff and facilities are equipped with the knowledge and tools to help you overcome addiction. Please reach out to our admissions staff if you or someone you know is dealing with substance abuse problems.
Feb 18, 2019
Posted in: Drug