Roosevelt Institute | Cornell University

Keeping the Big Pharma Accountable for the Opioid Epidemic

By Vaidehi Patel Published December 5, 2019

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With the numerous lawsuits against big pharmaceutical companies that are underway across the country, it has become clear that the “big pharma” has had a significant part to play in the initiation and perpetuation of the opioid epidemic we face today. Thus, stricter policies against pharmaceuticals who produce and distribute opioids are part of the solution.

Currently, we are in the midst of the biggest opioid epidemic this country has ever seen. And the biggest perpetrator of this crisis – the big pharma. While deaths due to oxycontin and heroin are on the decline, death due to a much newer and more potent synthetic opioid, fentanyl, is on the rise. For all three “waves” of the crisis, one thing was common – the heavy marketing of opioids to patients, regardless of whether they qualified or even needed the drug. Unfortunately, the pharmaceuticals managed to successfully market their opioids to countless unsuspecting patients , many of whom would go on to trap themselves in the vicious cycle of addiction.

The U.S. Department of Health Human Services and the National Institute of Health have implemented multiple policies and plans to ensure better access to treatment and recovery services and more research into better pain management techniques. But this is not enough. It is high time that the government pushes for policies that hold pharmaceutical companies accountable for the harm they are causing to society.

            Currently,  Most notably, Purdue Pharma, the company responsible for the production of OxyContin, may be paying around $12 billion in settlement. After the company files for bankruptcy, a new company will form in its stead: While they will continue to sell OxyContin, the profits of the new company will go to the lawsuit’s plaintiffs. The company has also agreed to create overdose and addiction treatment drugs.

            While the various legal lawsuits are a step in the right direction, there is only likely to be more and more legal cases without the strengthening of the policies currently in place that are proving to be ineffective. For example, most pharmaceutical companies were able to effectively market their opioids so well due to the usage of false advertising. In fact, in 2015, the Annual Review of Public Health published a study wherein they concluded that in their aggressive advertisements, long-term benefits were often over-exaggerated, while the risks of addiction, abuse, and depression were underplayed. A push for policies that establish a stricter oversight by the Food and Drug Administration on pharmaceutical companies and how they advertise and promote opioids is necessary.       

Additionally, policies that hold CEOs and other higher-ups in the pharmaceutical world accountable for their roles in perpetuating the opioid epidemic by imposing additional penalties on them is necessary. Without criminal accountability looming over their heads, it is not safe to assume that a pharmaceutical’s CEO will conduct business in a manner that is in the best interest of the public. Take Dr. John Kapoor, for example, the former CEO of Insys Therapeutics, a huge pharmaceutical company whose main product was the opioid Subsys. The former CEO became infamous when he was put on trial for running a bribery scheme between 2012 and 2015, where he and his company bribed physicians across the country to only buy and use Subsys in order to ensure that the company profited tremendously from continuous sales. Additionally, they lied to insurance companies in order to ensure Subsys was covered — again driving sales up. It should be noted that Subsys — a form of the opioid fentanyl — is highly potent and only meant for cancer patients.  As of now, Kapoor has been arrested and charged with RICO conspiracy, conspiracy to commit wire and mail fraud, conspiracy to violate the Anti-Kickback Law, and engaging in a racketeering conspiracy to increase his profits from Subsys.  Suffice it to say, by convicting such a high-profile pharmaceutical CEO, not only was the door opened to more cases being made against pharmaceuticals, but it also highlights the rampant corruption that occurs in the pharmaceutical industry, which inevitably led to the epidemic the country suffers from today.

            There is an immediate urgency to implement policies that impose increased liability on these pharmaceuticals in order to put a stop to the next cycle of opioid death. The “hottest” opioid drug on the market right now is Dsuvia — an even deadlier drug than fentanyl. If serious action is not taken on all sides of the opioid epidemic, especially when it comes to making pharmaceuticals admit their criminality and take responsibility for the role they play in perpetuating this epidemic, there is no telling how devastating this next wave of the opioid crisis could be.