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House Dems, GOP Agree: Sacklers, Purdue Pharma 'Sickening'

— "I'm not sure I'm aware of any family in America that's more evil than yours"

MedpageToday
The Purdue Pharma logo over a computer rendering of many prescription bottles

WASHINGTON -- The Sackler family, which owns opioid drugmaker Purdue Pharma, "placed insatiable taste of personal wealth over lives of families they have destroyed," Rep. Carolyn Maloney (D-N.Y.), chairwoman of the House Oversight and Reform Committee, said Thursday.

Purdue Pharma "launched an incredibly destructive, reckless campaign to flood our communities" with OxyContin, the company's extended-release oxycodone product, she said during a hearing on the role of the Sackler family and the company in the opioid epidemic.

"At the behest of the Sackler family, Purdue targeted high-volume prescribers to boost sales of OxyContin, ignored and worked around safeguards intended to reduce prescription opioid misuse, and promoted false narratives about their products to steer patients away from safer alternatives and deflect blame toward people struggling with addiction ... Yet despite years of investigation and litigation, no member of the Sackler family has ever admitted to any wrongdoing, taking any responsibility for devastation they caused, or even apologized for their actions," Maloney said.

Bipartisan Outrage

In a rare display of bipartisanship, Republican members joined their Democratic colleagues in blasting the company's involvement in the opioid epidemic.

"We don't agree on a lot of this committee, but our opinion of Purdue Pharma and the actions of your family we all agree are sickening," said Rep. James Comer (R-Ky.), the committee's ranking member. "There are people in America who have legitimate pain and need help for that pain. When you say that you didn't know when you created this drug what would happen, that may be true ... but the company knew it was addictive, creating deaths, disruptions, and all sorts of havoc, yet you continued marketing this product."

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The actions of the Sackler family related to OxyContin are "sickening" said Rep. James Comer (R-Ky.), ranking member of the House Oversight and Reform Committee. (Photo courtesy committee livestream)

Rep. James Cooper (D-Tenn.) put it simply: "Watching you testify makes my blood boil. I'm not sure I'm aware of any family in America that's more evil than yours."

Early in the hearing, Maloney presented videos from people whose family members had gotten addicted to OxyContin.

"My son Josh was prescribed OxyContin for a knee injury in his junior year in high school," said one mother, who didn't give her name. "The doctor told him to take those pills every 4 hours even if he was not experiencing pain; he told him to take them for months as he worked through physical therapy ... No one told us the risks of addiction or that my son might die of an overdose 10 years later, which is what he did ... The damage and the pain and the grief is lifelong, and Purdue Pharma and the Sacklers need to be held accountable for what they've done to our family and countless other families."

The $8 Billion Plea Deal

In 2007, Purdue Pharma paid a $600 million fine and that it misled regulators, doctors, and patients about the risk of addiction with OxyContin. While three executives also pled guilty to criminal charges of misbranding, they paid a combined total of $34.5 million in fines and never served jail time.

In October, the Department of Justice (DOJ) announced an $8-billion plea deal with Purdue Pharma and members of the Sackler family over their roles in the country's opioid abuse crisis. Under that deal, Purdue will plead guilty to three federal criminal charges and pay a criminal fine of $3.5 billion with an additional $2 billion in criminal forfeiture -- ultimately turning the company into a public trust.

Another $2.8 billion will be paid to resolve civil allegations, and the Sackler family will pay $225 million to settle separate civil allegations. While the DOJ has left the door open to future prosecution of members of the Sackler family or company executives, critics have blasted the feds for not holding them accountable yet.

For their part, the three witnesses before the committee -- two of whom were members of the Sackler family -- appeared contrite, to a point.

"OxyContin was a medicine Purdue intended to help people ... and it continues to help millions of Americans," said David Sackler, a former Purdue Pharma board member. "Far too many lives have been destroyed by addiction and abuse of opioids, including OxyContin. There are many lawsuits that have blamed Purdue and my family for the opioid crisis. While we deny liability ... we want to respond to the opioid crisis, because a prescription medicine that our company manufactured and sold, which was never intended to harm anyone, ended up being part of a crisis that has harmed too many people."

"As a mother, my heart breaks for those parents who have lost their children; I am so terribly sorry for your pain and loss," said Kathe Sackler, MD, also a former board member. "I lost my brother Robert to mental illness and suicide when he was only 23 years old. I've learned from my own experience that our loved ones are not to blame for their mental illness or addiction. They deserve compassion and access to effective treatment and support, not stigma ... It distresses me greatly and angers me greatly that the medication that was developed to help people and relieve severe pain has become associated with so much human suffering."

"On behalf of Purdue as its current leader, I'm profoundly sorry," said Craig Landau, MD, an anesthesiologist who is the company's CEO. "In trying to strike a careful balance between supporting physicians who treat patients with pain and mitigating the serious risk associated with opioid medications, Purdue fell short. The company accepts full responsibility for its wrongdoing. I'm determined to lead all efforts to address the opioid crisis as quickly and effectively as I can."

Landau said he has made "numerous" changes to leadership and management and ended promotion through sales representatives of the company's opioid products; he added that it has been almost 2 years since any Sacklers have served on the board of directors.

Physician Education on Overprescribing

Rep. Carol Miller (R-W.Va.), asked how Purdue Pharma had been educating physicians about overprescribing and whether it was effective. Landau said it was his belief that drug salespeople discussed both the safety and risks of OxyContin when they visited physicians.

He added that when a Risk Evaluation and Mitigation Strategy was developed for OxyContin about 10 years ago, "Purdue, along with a number of other companies, proposed that prescriber education be mandatory in order to prescribe controlled substances, and that it be linked to the registration process for DEA [Drug Enforcement Administration] certification."

Comer asked David Sackler whether he blamed any of the opioid crisis on the physicians who prescribed OxyContin. "I'd say it's an incredibly complex problem with roots dating back long before the introduction of OxyContin," Sackler said. "The medical establishment as a whole and doctors as a whole are gatekeepers for prescription opioids, so one has to examine that as a cause." However, "I'm not here to assign blame at all," he added.

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Purdue Pharma's "saving cards" were a way to keep patients on opioids longer, said Rep. John Sarbanes (D-Md.), a member of the House Oversight and Reform Committee. (Photo courtesy committee livestream)

Rep. John Sarbanes (D-Md.) asked Sackler about the "patient saving cards" that he said were "supposedly intended to expand access to OxyContin" but "were consistently tracked and evaluated because Purdue knew these cards were a powerful way to keep patients on opioids longer. Is that right?"

"My understanding was the patient saving cards were designed to help people afford their medication," Sackler replied. Sarbanes called that "a perfect answer, because it represents the way in which the narrative you put together -- everything that was in fact designed to take advantage of people and exploit their weakness was presented by Sackler and Purdue as trying to help those patients ... This is why thousands of people across the country became addicted, because of the rosy story and narrative that you painted."

The only note of dissent on the committee came from Comer: "The October settlement does not conclude the bankruptcy negotiations that are still ongoing," he said.

"I support the hearing, but I'm concerned that holding the hearing in the midst of a multi-billion dollar settlement negotiation will delay and reduce needed restitution for millions of Americans," he told Maloney. "I hope having this hearing today does not delay a settlement and result in victims getting less restitution from Purdue and the Sackler family ... I want to hold Purdue Pharma accountable, and I sure as hell don't want to do anything that would help the Sackler family in any court of law."

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    Joyce Frieden oversees ֱ’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.