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N.H. attorney general: Maker of OxyContin distributes ‘misleading information’ to doctors

  • FILE - This Feb. 19, 2013, file photo, shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. Prescription painkillers should not be a first-choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the CDC is urging general doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. (AP Photo/Toby Talbot, File)



Monitor staff
Thursday, June 09, 2016

Less than a month after getting legislative approval to investigate the marketing habits of drug companies, the state attorney general’s office has narrowed its probe to just one, Purdue Pharma, accusing the enterprise of distributing “misleading information” to doctors about its breakout painkiller OxyContin.

In a lawsuit filed Friday in Merrimack County Superior Court, the office said preliminary findings suggest that Purdue routinely engages in deceptive marketing, misrepresenting the “risks and benefits of long-term opioid use for chronic pain.”

“Purdue sales representatives continue to make sales visits to New Hampshire doctors during which they misleadingly portray or omit the risk of addiction,” wrote Assistant Attorney General James Boffetti, adding that the company made 217 marketing visits to the state in 2014, the most recent year with available data.

The company’s employees “continue to tell New Hampshire prescribers that OxyContin lasts a full 12 hours, fails to disclose end-of-dose failure and its relationship to addiction, and advises doctors who complain about OxyContin’s shorter-than-promised duration to increase patients’ dosage, which further increases the risk of overdose and addiction,” Boffetti wrote.

OxyContin’s selling point is that it relieves pain for 12 hours. But an investigation by the Los Angeles Times published last month and referenced by Boffetti alleged that the drug wears off early in many patients, exposing them to agonizing withdrawal symptoms, including craving for the drug. Purdue has contested those findings and sticks by the 12-hour claim.

The state’s latest legal action comes as Purdue has again refused to turn over documents about its marketing practices in recent years. It was one of five companies subpoenaed last summer as part of an inquiry by the attorney general’s office. All of them refused, arguing in court that the state had illegally contracted with a private law firm to carry out the probe. Earlier this year, a judge approved the assistance on the condition that lawmakers sign off on it, which they did last month.

Purdue is now doubling down on its original objection. In a statement Wednesday, attorney David Vicinanzo reiterated that the contracted firm, Cohen, Milstein, Sellers & Toll, has a conflicting financial interest in helping the state sue the company, and added that Purdue shouldn’t be forced to comply while an appeal of the judge’s earlier ruling is still pending in the state Supreme Court.

“Purdue has repeatedly made clear that it is willing to work with the attorney general’s office on its investigation,” Vicinanzo wrote, adding: “We have offered to produce documents if the state would agree not to share those documents with private lawyers unless and until the Supreme Court resolves the important legal issues involved. The state will not do so and we are left with no choice but to seek the intervention of the court.”

The attorney general’s office has stated from the outset that it will retain full control over the investigation and is only using the outside help because it can’t match the companies’ resources and legal manpower. In last week’s complaint, Boffetti said time is critical, as “the harm from Purdue’s marketing has only intensified.”

“Given Purdue’s ongoing marketing and the rising toll – of death, overdose, addiction, and abuse in New Hampshire – there is every reason to move forward promptly,” he wrote, citing the nearly ninefold increase in overdose deaths from 2000 to last year.

In an interview Wednesday, Attorney General Joe Foster said he chose to narrow the inquiry to Purdue because it sells the majority of prescription painkillers in the state – at or slightly above 25 percent, followed by generic varieties. He did not rule out probes into the other companies, and said the investigation into Purdue remains just that, for now.

“What are they so worried about turning over if there’s nothing there?” Foster said.

New Hampshire is one of several states to have opened inquiries into Purdue and other prescription drug manufacturers. Earlier this year, New York announced a $200,000 fine on Endo Pharmaceuticals, one of the companies initially targeted in New Hampshire, for telling its sales representatives to hide and distort the addictive tendencies of one painkiller, Opana ER, as well as falsely advertising the pills as crush resistant.

Foster said the penalty included agreements from Endo to reform parts of its marketing local strategy.

The accusations aren’t new to Purdue, either. The Connecticut-based company agreed in 2007 to pay $600 million in federal fines after admitting it misled doctors and patients by understating OxyContin’s addictiveness. A federal prosecutor said at the time that the marketing had resulted in rising crime rates, teenage drug addiction and death, among other public health concerns.

Annual revenues at Purdue are about $3 billion, mostly due to OxyContin sales, according to Forbes. The company has made more than $35 billion since releasing OxyContin in 1995.

(Jeremy Blackman can be reached at 369-3319, jblackman@cmonitor.com or on Twitter @JBlackmanCM.)