Pubdate: Tue, 02 Sep 2003
Source: Lexington Herald-Leader (KY)
Copyright: 2003 Lexington Herald-Leader
Contact:  http://www.kentucky.com/mld/heraldleader/
Details: http://www.mapinc.org/media/240
Author: Dr. Paul D. Goldenheim
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

OXYCONTIN'S MAKER ACTING RESPONSIBLY

Purdue Pharma Wants Only To Get Painkiller To Those Who Need It

Recent Herald-Leader coverage of OxyContin underscores a critical public 
health dilemma: preventing prescription drug abuse while protecting 
patients' rights to appropriate care.

But the newspaper did little to advance understanding of this issue. By 
assembling facts selectively and making negative assumptions, the paper 
disposed of a complex social problem by blaming it on one company. This was 
a disservice not only to Purdue Pharma but also to innocent sufferers of 
accident and disease.

OxyContin was developed by scientists and physicians at a company founded 
by scientists and physicians. It is intended for treating patients with 
moderate to severe pain who require, in the view of their doctors, 
continual medication for an extended period. We believed then, as now, that 
OxyContin would play an important role in overall pain therapy.

Contrary to the Herald-Leader's editorial, we had no reason to believe that 
OxyContin abuse would become widespread. (Incidentally, OxyContinâ is not 
the most abused opioid.) For 18 years, Purdue has marketed MS Contin, a 
drug with abuse potential similar to OxyContin, with no signals suggesting 
the controlled-release dosage was unusually attractive to abusers. Purdue 
had no reason to expect otherwise with OxyContin.

The articles suggest that our sales efforts were overly aggressive. 
Coverage included "call reports" from one of more than 750 Purdue 
representatives who collectively write millions of shorthand notes. The 
inferences drawn from these notes are inaccurate. It is recognized that 
tens of millions of patients live in pain, in part, because some physicians 
are reluctant to use available medicines.

It is wrong to draw conclusions from hastily written notes reflecting a 
sales representative's efforts to encourage proper treatment for patients 
for whom physicians determine OxyContin to be appropriate.

In an age of constant TV advertising of prescription medications, the paper 
did not mention that we voluntarily forego direct-to-consumer advertising. 
Instead, we educate only health care professionals who understand 
OxyContin's risks as well as benefits and are the only ones who can legally 
prescribe the product.

Doctors' decisions are based on patient examinations and professional 
judgment. No salesmanship is intended to overcome a physician's training 
and ethical commitment to patients -- nor is it capable of doing so.

If you developed a medicine that you believed important to patient care and 
if your belief was confirmed by the FDA's finding the drug safe and 
effective when used as directed, how would you bring it to the attention of 
health care professionals? If you're committed to patient care, aren't 
one-on-one conversations the best way to reach doctors? If your product can 
help patients, why shouldn't those features be communicated?

About Purdue's marketing, a federal court in Kentucky found in Foister vs. 
Purdue Pharma in 2001: "The plaintiffs have failed to produce any evidence 
showing that the defendants' marketing, promotional or distribution 
practices have ever caused even one tablet of OxyContin to be 
inappropriately prescribed or diverted."

At Purdue, concern about patients is coupled with an unsurpassed commitment 
to preventing abuse. Before (not after, as the editorial states) we learned 
of OxyContin abuse, we expended considerable effort teaching physicians the 
medication's proper usage.

Beginning in 1996, Purdue representatives distributed more than 270,000 
Opioid Documentation Kits for health care professionals, and starting in 
1998, we distributed more than 360,000 copies of the Federation of State 
Medical Boards' guidelines for proper use of controlled substances.

No other company has responded as quickly and comprehensively to the abuse 
of its product. We have invested more money educating teens about the 
dangers of prescription drug abuse than any entity, including the federal 
government. We created a national data resource for the identification of 
trends in prescription drug abuse. We funded model prescription monitoring 
programs. We trained law enforcement officers and provided cash grants to 
combat substance abuse. And, we're addressing abuse of all prescription 
medications, not just OxyContin.

If Purdue's efforts were late, who took any action any earlier?

The Herald-Leader's negative implications about Purdue and our product 
affect more than us: Patients are affected, too. Patients do not 
voluntarily develop pain D they do not choose disease or accident. It's 
time to stop drawing sinister inferences from innocent facts. It's time to 
stop making health policy decisions based on behavior of abusers rather 
than what is in the best interests of those who use medications properly.
- ---
MAP posted-by: Jay Bergstrom