Report: Opioid Manufacturers Paid $9 Million to Groups Promoting Opioids

Advocacy groups discounted downsides, side effects of chronic opioid use

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February 15, 2018

Five major opioid manufacturers paid a combined $9 million over five years to groups that deemphasized the dangerous risks of opioid prescription, according to a new report released Monday by the ranking minority member's office of the Senate Homeland Security and Governmental Affairs committee.

The manufacturers—Purdue Pharma L.P.; Janssen Pharmaceuticals, Inc.; Mylan N.V.; Depomed, Inc.; and Insys Therapeutics, Inc.—paid an additional $1.6 million between 2013 and 2017 to individuals, including licensed physicians, affiliated with the advocacy groups, totaling more than $10 million in payments from 2012 onwards.

The groups receiving funding from the pharmaceutical giants are primarily professional societies and patient advocacy groups, which purport to represent the interests of pain doctors and the pain-afflicted. These groups, the report notes, "have issued guidelines and policies minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for overprescription and misbranding."

For example, the American Academy of Pain Medicine and the American Pain Society issued a "consensus" statement in 1997 that endorsed the use of opioids for chronic pain treatment, and said that the risk of addiction for chronic users was low. The same group issued a statement in 2009 promoting opioids as "safe and effective," with a "manageable" risk of addiction, regardless of past history of abuse.

The American Academy of Pain Medicine received some $1.1 million in payments from opioid manufacturers between 2012 and 2017, while the American Pain Society received just under $1 million, the report noted.

Advocacy groups also worked to block legislation aimed at reducing over-prescription, the practice of giving patients far more drugs than they need, leading to addiction or the sale of unused drugs to the general addict population. The Academy of Integrative Pain Management and the American Cancer Society Cancer Action Network, for example, worked to protect a Tennessee law that required a doctor to refer a patient to another, "opioid-friendly" physician if the original doctor was unwilling to prescribe opioids.

Critics have said this advocacy work helped to spark America's current opioid epidemic. By deemphasizing the addictiveness of opioids, often with reference to shaky evidence, advocacy groups helped make the practice of opioid prescription widespread. This led to major profits for pharmaceutical companies and opioid habit formation for millions of Americans, who frequently switch to heroin or fentanyl when their prescriptions run out.

Advocacy work was often combined with aggressive marketing of opioids by pharmaceutical firms to doctors. Purdue Pharma, the maker of oxycodone and one of the largest opioid manufacturers in the United States, announced Friday that it would no longer market its high-grossing opioid painkiller, cutting its salesforce in half and no longer directly promoting oxycodone to doctors.

Purdue provided a combined more than $4 million to advocacy groups between 2012 and 2017, the Senate report noted. That figure may be higher: The report emphasized that only 57% of organizations routinely disclose amounts of donations, and many of those only in ranges rather than in exact numbers.

Purdue, which did not respond to a request for comment from the Washington Free Beacon, denied that the purpose of the donations was to indirectly curry political favor, rather pitching them as concerned with support for patient health and wellbeing.

"Purdue said in a statement that it supported organizations interested in helping patients receive appropriate care," Reuters reported.

In a statement to the Free Beacon, Depomed emphasized that they gave $178 thousand per year per organization among 9 organizations, or around $20,000 per year per organization. It emphasized that these payments covered "corporate advertising, conference booth fees, sponsoring training certifications and membership fees," and that it "has a strong Compliance program in place."

Insys, in a statement to the Free Beacon, said that it believes its contributions were "patient focused," claiming that their contribution to the U.S. Pain Foundation specifically was "directed to a disease-state fund for cancer patients with breakthrough pain," in compliance with guidance from the Office of the Inspector General. They also emphasized that their contributions to advocacy groups fell by 77 percent in the second half of 2017.

A Janssen spokesperson took a similar line.

"Our contributions to the organizations referenced in the report were made to support efforts to educate the public about the appropriate use of opioid pain medicines, and were transparently disclosed," the spokesperson said. "Since 2008, the volume of our opioid medications has amounted to less than one percent of the total prescriptions written per year in this class, and we stopped developing and promoting opioid products in 2015."

Mylan N.V. did not respond to a request for comment.

Published under: Opioids