Monday, November 20, 2017

The Oxycontin Bioethics Achievement Award

Opioids, everywhere. We're awash in opioids. You can't pick up a newspaper without reading a horror story about the opioid epidemic: an overdose, a crime, a corrupt marketing scam. While the opioid drama has many villains, none have been the object of as much righteous anger and contempt as the folks at Purdue Pharma, the company that brought us Oxycontin and marketed it -- brazenly -- as a painkiller with less potential for abuse. We all know how that turned out.

Even in the famously corrupt world of pharma marketing, Purdue Pharma stands out. Not only did it pay a record fine for fraudulent marketing, but it is one of the few companies whose executives have been found guilty of criminal charges.  Purdue Pharma was founded by three physician brothers -- Arthur, Raymond and Mortimer Sackler -- but these days the Sackler family is so vilified that even the beneficiaries of Sackler philanthropy are facing pressure to disavow the name and give the money back.

In other words: a perfect time for the bioethics community to honor one of the grateful beneficiaries of Purdue Pharma funding. Last month, the American Society of Bioethics and Humanities gave a 2017 Lifetime Achievement Award to Myra Christopher of the Center for Practical Ethics.

Think back a few years. In 2012, the Senate Finance Committee began investigating pharma-backed non-profits -- specifically, those funded by opioid manufacturers such as Purdue Pharma. One of the non-profits the Committee targeted was the Center for Practical Ethics in Kansas City. Purdue Pharma had given the Center $1.5 million in seed money for an endowed chair in pain and palliative care. That chair went to Myra Christopher. As the Kansas City Star noted at the time, Christopher proved to be a reliable advocate for political positions favorable to the manufacturer of Oxycontin -- writing about the under-treatment of pain, serving on an Institute of Medicine panel on chronic pain, opposing "pain contracts," starting the Purdue-Pharma funded "Pain Action Initiative: A National Strategy (PAINS)." Christopher even appeared on a Purdue Pharma-sponsored website.

That relationship with Purdue Pharma has continued. Last May, Senator Ron Wyden, the ranking member of the Senate Finance Committee, sent a letter of concern to HHS Secretary Tom Price about the participation of industry-funded pain groups in an FDA workshop. Wyden noted that Purdue Pharma was the second-largest donor to the Center for Practical Ethics in 2013, and that the Center has continued to accept funding from Purdue Pharma and other opioid manufacturers at least through 2016. Wyden also pointed out that the Center's Pain Action Initiative had signed onto a letter to the CDC led by an industry front group, the American Academic of Integrative Pain Management, opposing draft guidelines for opioid prescribing.

Allen Frances, former chairman of the Dept of Psychiatry at Duke University, says, “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.”  It is unclear whether the list of questionable practices that Sackler pioneered at Purdue Pharma included giving money to bioethicists. But I suspect he would have approved.

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