The real crisis of chronic pain

Ruth Dubin; Roman Jovey

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Response to "The real crisis of chronic pain"
Meldon M. Kahan

Published on: 31 August 2011

Published on: (31 August 2011)
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Response to "The real crisis of chronic pain"
Meldon M. Kahan, Associate Professor
In their letter (1), Drs. Jovey and Dubin assert that my statement "high prescribers ...were influenced by an intense and sustained pharmaceutical marketing campaign" is unsubstantiated. According to a U.S. government report (2), by 2000, Purdue's OxyContin campaign employed almost 700 full-time sales representatives and a total "call list" of 70,000 to 94,000 physicians.
Sales representatives were directed to f...
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In their letter (1), Drs. Jovey and Dubin assert that my statement "high prescribers ...were influenced by an intense and sustained pharmaceutical marketing campaign" is unsubstantiated. According to a U.S. government report (2), by 2000, Purdue's OxyContin campaign employed almost 700 full-time sales representatives and a total "call list" of 70,000 to 94,000 physicians.
Sales representatives were directed to focus their efforts on physicians who were high opioid prescribers, and they received substantial bonuses for Oxycontin prescriptions by doctors on their list. From 1996 to 2002, Oxycontin had a speakers' bureau of 2,500 physicians, and sponsored over 20,000 educational programs on pain management (2). This campaign was wildly successful; in the U.S., OxyContin prescriptions for non-cancer pain increased from 670,000 in 1997 to 6.2 million in 2002, accounting for $1 billion in annual sales.
The marketing campaign was based on several simple messages: Addiction is rare in pain patients, controlled-release opioids are less addictive than immediate-release opioids, and opioids are much more effective and safer than alternatives. Unfortunately, these messages are not true. In 2007, Purdue was pleaded guilty to felony misbranding of OxyContin and was fined $634.5 million (3).
Meldon Kahan MD, MHSc, CCFP, FRCPC
References
1. Dubin R, Jovey R. The Real Crisis of Opioid Pain [Letters]. Can Fam Physician. 2011 July;57(7):762-764.
2. United States General Accounting Office (GAO). Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem. Washington (DC); 2003 Dec. 63 p.
3. Meier B. In guilty plea, Oxycontin maker to pay $600 million. The New York Times. 2007 May 11.
Conflict of Interest:
None declared
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Competing Interests: None declared.