Pennsylvania Attorney General Josh Shapiro took the fight against opioid abuse to one of the nation’s biggest pharmaceutical manufacturers Tuesday, charging that Purdue Pharma, the company that makes OxyContin, conducted a “relentless campaign of deception” that led to the deaths of 26,300 Pennsylvanians in less than a decade.
The multimillion-dollar lawsuit, filed in Commonwealth Court, follows similar legal actions undertaken by attorneys general in Connecticut, Illinois, Massachusetts, New York, and other states to recoup the costs of one of the worst public health crises in recent memory.
“Today, we’re suing the giant, the pharma-lord that targeted Pennsylvania,” Shapiro said during a conference call with journalists across the state. “We know that opioid addiction has inflicted pain on the most vulnerable Pennsylvanians. Purdue owes it to those who have lost their lives to stop making excuses and [to] take responsibility for its actions.”
Shapiro’s state court action makes eight separate allegations about that “campaign of deception.” Among them, that Purdue misrepresented and minimized the risk of addiction from long-term opioid use, and that Purdue “deceptively” claimed that the risk of addiction “could be managed with simple tools.”
Speaking to reporters, Shapiro charged that Purdue “targeted” Pennsylvania with a massive blitz by a sales force that, starting in 2007, made a half-million visits to healthcare providers.
These sales associates “bludgeoned” the state, Shapiro alleged, targeting doctors more likely to prescribe its products, and rewarding those physicians with gifts or even cash. Since 2007, the company sold 2.9 million prescriptions, “amounting to over 200 million doses of opioids” statewide, the litigation alleges.
The lawsuit also claims that the Stamford, Conn.-based company “deceptively marketed its abuse deterrence formulation in Pennsylvania”; that it failed to report “suspicious prescribing” practices by doctors; and that the company “fueled the opioid epidemic, harming Pennsylvania and its residents.”
The end result, Shapiro said Tuesday, was an addiction epidemic that penetrated every corner of the state, particularly targeting the elderly and military veterans, both of whom make up a large share of the state’s total population.
According to data compiled by the National Institute on Drug Abuse, there were 2,548 opioid-involved deaths statewide in 2017, for a rate of 21.2 deaths per 100,000 people. That’s higher than the national average of 14.6 deaths per 100,000 people, the national data showed.
“In 2013, prescription opioids were the underlying cause of death in every one of two overdose deaths” in Pennsylvania, according to the institute. By 2017, the main cause of death was due to synthetic opioids — primarily from fentanyl. Deaths from synthetic opioids rose seventeen-fold, from 108 reported deaths in 2013 to 1,982 deaths by 2017, the national data indicated.
Shapiro also stressed the economic cost to Pennsylvania and employers who have dealt with a workforce depleted by addiction and addiction-related fatalities.
Between 2012 and 2016, opioid-related fatalities exacted a $142 billion cost on the state’s economy, Shapiro said, attributing the data to the U.S. Centers for Disease Control. The “average estimated cost for each opioid overdose is $9.6 million,” he noted. While people were dying and becoming addicted, the company’s “executives were lining their pockets,” he said.
The lawsuit asks that Purdue “forfeit” the profits it made from selling OxyContin; that it pay the state for the cost of its investigation; and that it pay $1,000, to a maximum of $3,000, for each violation of Pennsylvania’s consumer protection law, Shapiro said Tuesday.
The litigation does not name individual salespeople nor the company’s CEO. Shapiro declined to comment when he was asked whether he planned to pursue additional litigation against any or all of those individuals.
“We are not done here yet. Today is a first step in the process,” he said. “Overall we are committed to fighting this epidemic.”
Pennsylvania joined with more than 40 states two years ago to investigate opioid manufacturers and distributors, The Associated Press reported Tuesday. Shapiro said that investigation, which is separate from the state-level lawsuit, continues.
Purdue’s attorneys have “asserted that states are cherry-picking portions of [documents] to make the company look worse, usually noting that the company accounts for a small portion of opioids prescribed in the U.S. and that heroin and especially illicit fentanyl, not prescription drugs, are what drove up fatal overdose rates in recent years,” The Associated Press reported.
Indeed, according to a June 5, 2018 story by The Morning Call of Allentown, opioid prescriptions in Pennsylvania declined by 14 percent between 2016 and 2017. That was a sharper reduction than the nationwide average, the newspaper reported.
According to the national data, Pennsylvania providers wrote 57.7 prescriptions for every 100 people, compared to the national average of 58.7 prescriptions per 100 people. That’s a more than 30 percent decrease from a 2012 high of 83.3 opioid prescriptions per 100 people.
That showed in a decline in prescription-related deaths, which fell from a high of 5.9 deaths per 100,000 people in 2016 to 4.9 deaths per 100,000 people in 2017, the national data showed.
Nonetheless, Shapiro on Tuesday accused the company of an orchestrated campaign of deception that understated the risk of addiction to OxyContin that was “built prescription by prescription,” and falsely promoted the drug “as a safe and effective pain reliever for every day pain,” when it had previously only been prescribed in extreme cases or in end-of-life care.
The Associated Press reported Tuesday that Purdue, which is privately held, “earlier this year publicly threatened bankruptcy as the litigation mounts. Some states have also started suing members of the Sackler family, which includes prominent philanthropists and owns the firm.”
In March, the company and the Sackler family settled a case with Oklahoma for $270 million. That came on the heels of a $24 million settlement with Kentucky in 2015, the Associated Press reported.
Read the full text of Shapiro’s complaint here: