APExclusive: OxyContin’s a dying business in the United States. But documents and interviews show Purdue Pharma’s China affiliate pushing opioids with the same misleading tactics it abandoned in the U.S. By ekinetz.
Tony Chen, a former OxyContin sales representative who spoke on condition that he only be identified by his English name, for fear of retribution, said Mundipharma required sales staff to upload copies of patients' private medical records, obtained without consent, to a company group chat, in apparent violation of Chinese law, during an interview in China on Sept. 19, 2019.
These tactics mirror those employed by Purdue Pharma in the U.S., where more than 400,000 people have died of opioid overdoses and millions more became addicted. An avalanche of litigation over the company’s marketing has driven Purdue Pharma into bankruptcy in the U.S. Though Mundipharma and Purdue are separate legal entities, both are owned by the Sackler family. Today, Mundipharma is a bargaining chip in negotiations to settle sweeping U.S. litigation. The Sackler family agreed to cede ownership of Purdue, but wants to keep Mundipharma for now to sell OxyContin abroad. They have discussed eventually selling Mundipharma to fund the family’s contribution to a nationwide settlement in the U.S.
The month after Mundipharma’s creation, the Arthur M. Sackler Museum of Art and Archeology opened its doors at Peking University in Beijing. Outside the museum is a statue dedicated to Arthur Sackler and his wife by the China Medical Tribune, a journal he helped found that now claims a readership of more than a million Chinese doctors.
China fought two wars in the 19th century to beat back British ships dumping opium that fueled widespread addiction. Today, the cultural aversion to taking drugs — in Chinese, literally “sucking poison” — is so strong addicts can be forced into police-run treatment centers. The country does not appear to have an opioid crisis anything like in the U.S.
Many of his younger colleagues, however, appeared in thrall of these foreign ideas. They believed the best medical practices came from the United States. Few understood how deeply the Western consensus about pain had been shaped by the financial self-interest of pharmaceutical companies. According to Zhang, the GPM campaign was started in 2009 under his leadership, by a group within the Guangdong Provincial Anti-Cancer Association, a non-profit that accepts corporate funding. Pharmaceutical companies helped by covering the cost of training and educational materials, he said.
“We were definitely talking about OxyContin ninety percent of the time,” said a former sales rep who spoke on condition of anonymity for fear of retribution. In the years after GPM rolled out, from 2012 through 2018, sales of Mundipharma’s oxycodone, the active ingredient in OxyContin, at nearly 700 of China’s major hospitals rose five-fold, according to previously unreported data from the government-linked China National Pharmaceutical Industry Information Center.
The more precise the information, the better Mundipharma could plan sales targets, as well as guide doctors to increase dosages and switch to OxyContin from rival drugs, former sales reps explained. Two other former OxyContin sales reps said they also disguised themselves in doctor’s coats and sat in on patient meetings.
China has some of the strictest regulation in the world on the use of opioids. Opioid painkillers like OxyContin are not available at pharmacies. They are stored under double-lock at hospitals and governed by so-called “red prescriptions,” which only specially certified doctors can write. Yu resisted the notion that opioid painkillers weren’t addictive and could be safely used, at any dose, for all kinds of pain. He checked the scientific references on clinical presentations and often found them unconvincing. He barred sales reps from his department.
In the 2007 lawsuit filed by U.S. prosecutors, Purdue conceded that some of its employees had falsely claimed that long-acting opioids are less addictive because they have fewer “peak and trough” effects and cause less euphoria. Purdue entered into a legally binding agreement with the U.S. government to ensure that their staff never made such claims again.
“The prolonged release formulation doesn’t easily give rise to drug dependence,” Dr. Fan Bifa, the director of the pain clinic at the China-Japan Friendship Hospital in Beijing, told the AP in May. The U.S. Centers for Disease Control says that as many as 1 in 4 people prescribed opioids for long-term use struggles with addiction.
Mundipharma said its training covers “appropriate dosage levels for cancer patients” and provides information “in accordance with current best practice.” The CDC says there are risks of “serious harms” from taking opioids long-term for chronic pain, but evidence for the potential benefits is lacking.
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