Since its inception in 1948, the World Health Organization has sifted through treatment data and posted international prescribing guidelines without an eye on profits. But what happens when a fox is let loose in the henhouse, and that guidance is tainted by private money? That's a question Purdue Pharma may be forced to answer.
Purdue, the maker of powerful and potentially addictive painkillers, funded research front organizations that helped slip language into two WHO opioid guidelines, a bipartisan U.S. House report (PDF) says. That language includes claims “dangerously misleading and, in some instances, outright false,” according to the report spearheaded by Reps. Katherine Clark, D-Massachusetts, and Hal Rogers, R-Kentucky.
The lawmakers linked guidelines that appear to undersell the risks of opioid dependence, particularly in children, to WHO employees and nonprofit organizations with financial ties to Mundipharma, Purdue’s international affiliate. The guidelines were part of an attempt to boost the company’s sales, the report states.
“We are highly troubled that, after igniting the opioid epidemic that cost the United States 50,000 lives in 2017 alone and tens of billions of dollars annually, Purdue is deliberately using the same playbook on an international scale,” the report said.
Clark and Rogers laid out a web of funding among Purdue and eight nonprofits, including the International Association for the Study of Pain, the American Pain Society and the Mayday Fund. All those groups played a role in developing the two guidelines, which were designed to help doctors when treating patients' pain, the report says.
Purdue was also connected to a former WHO employee, William Scholten, a team leader responsible in part for approving the two guidelines, the report alleges. Scholten later became a private consultant and collected speaking fees from Purdue after the guidelines were approved.
Purdue roundly disputed the report’s claims, saying its financial relationships with agencies working with the WHO were aboveboard. And the company downplayed the usefulness of WHO’s guidelines.
“Purdue’s financial support or relationship with third parties are transparent, and any potential conflicts of interest are fully disclosed,” the company said in a statement. “Further, any allegations that Purdue’s financial support and relationships with third parties have violated applicable rules or guidelines are false, and no court or administrative agency has found to the contrary.”
If the report’s claims are true, they could implicate Purdue in international opioid dependence crises, even as the company faces multiple legal threats stateside. Thousands of U.S. lawsuits link the opioid epidemic to Purdue's aggressive marketing of its painkiller OxyContin, and the company faces scrutiny from federal regulators and prosecutors.
Meanwhile, companies, politicians and nonprofits are distancing themselves from the company and its founding Sackler family. Thursday, JPMorgan cut ties with Purdue, according to CNBC, after the company and its former CEO Richard Sackler were directly implicated in a growing list of lawsuits. The bank gave Purdue six months to find a new home for its cash. Lawmakers including Sen. Elizabeth Warren have donated Sackler family contributions, and museums such as the Metropolitan Museum of Art in New York have returned donations from the family.
In the first state opioid lawsuit to approach trial, Purdue, the Sacklers and the state of Oklahoma reached a $270 million settlement in March to resolve claims the company deceptively marketed its drugs to patients. As part of that deal, the company and members of the Sackler family agreed to fund a new treatment center and cover the state’s litigation expenses.
Even with that case closed, Purdue faces an additional 45 state lawsuits that could end in a massive joint settlement. Last week, attorneys general in Iowa, Kansas, Maryland, West Virginia and Wisconsin filed suits of their own against the company and the Sacklers, joining a list of states and cities pursuing payouts of their own.
However, in North Dakota, one lawsuit was knocked down, showing the first crack in states’ attempts to hold Purdue to account. The judge said OxyContin’s FDA labeling, which was targeted in the state’s lawsuit, should be reviewed under federal purview. North Dakota Attorney General Wayne Stenehjem vowed the state would appeal the judge’s dismissal.