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What newly released emails reveal about OxyContin, Purdue Pharma and the Sackler family

The U.S. opioid epidemic has taken hundreds of thousands of lives. A reckoning for the manufacturers, marketers and distributors of these drugs has now begun -- but despite several multibillion dollar settlements, some states and municipalities say accountability and transparency for the companies is lacking. Casey Ross of STAT News joins Amna Nawaz to discuss Purdue Pharma and the Sackler family.

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  • Judy Woodruff:

    This year has led to the beginnings of a reckoning for the manufacturers, marketers and distributors of opioids. The epidemic has taken of hundreds of thousands of Americans lives over the past two decades. Multibillion-dollar settlements have been announced.

    But there's great anger. Many states and municipalities say there's not enough accountability and transparency over the companies' roles.

    Purdue Pharma, which created OxyContin and is controlled by the Sackler family, is the biggest target.

    As Amna Nawaz tells us, there's new information about how the company responded in the earliest days.

  • Amna Nawaz:

    Judy, the information comes from newly unsealed court documents that include Richard Sackler's e-mails in the late '90s.

    Sackler was a senior vice president of the company at the time, one year after OxyContin was launched. By 1999, he was president of Purdue Pharma. The documents were part of a court case against Purdue Pharma in Kentucky. And, as part of that case, Richard Sackler was deposed in 2015.

    STAT News has been working to get these documents for four years.

    And Casey Ross of STAT joins me now.

    Casey Ross, welcome to the "NewsHour."

    Help us by understanding, what is the new information you have learned from these court documents when it comes to Purdue Pharma, the Sackler family that owns it, and OxyContin?

  • Casey Ross:

    Well, these documents really shed light on the interactions that the Sackler family, in particular Dr. Richard Sackler, had with executives at the company during the key time period in which OxyContin was being released into the marketplace.

  • Amna Nawaz:

    And what is that connection, based on what you have seen so far?

  • Casey Ross:

    The e-mails that we found in these court records discuss Richard Sackler becoming aware at a very early point in OxyContin's release of concerns that a large pharmacy benefit manager was expressing to doctors about abuse potential in the drug.

    And Dr. Sackler responded to that concern by calling for a presentation, specifically in which he suggested that the presentation could be given to show that controlled-release opioids, like OxyContin, were less subject to abuse potential, addiction concerns and diversion than other opioids.

    And at the time, there was no — and since — there is no evidence to support that.

  • Amna Nawaz:

    How would you characterize the response to some of those concerns at the time? And, also, why was it important at this particular point in history?

  • Casey Ross:

    Well, so this is a time period when OxyContin is just being released into the market.

    Executives at the company, based on the concerns, were very worried that they were going to get essentially blocked out of the market, because Merck-Medco, which is the pharmacy benefit manager that raised these concerns, controlled a large part of the access to the marketplace.

    So if Merck-Medco is refusing to cover these drugs out of abuse concerns, then Purdue Pharma is in a situation where it cannot distribute its project — product to the extent that it wants. It cannot tap a very lucrative market for chronic pain patients.

  • Amna Nawaz:

    Casey, you mentioned some of the concerns raised by Merck-Medco. They said that addiction could be one of their potential concerns.

    I want to read you an excerpt from one of the e-mails you published. It's from Richard Sackler.

    He says, we should consider that — quote — addiction may be a convenient way to just say no, and when this objection is obliterated, they will fall back on the question of costs. Unless we can give a convincing presentation that C.R." — that is control release — "products are less prone to addiction potential."

    Based on these e-mails that you have seen, Casey, is this unusual for a pharmaceutical executive to basically be pushing to get his product out there and tamp down on concerns?

  • Casey Ross:

    I think that it's not unusual for pharmaceutical executives, when they're launching a product, to try to protect its reputation and push it into the marketplace in a way that's going to be beneficial to the company.

    I think, here, the situation is that OxyContin is an opioid. It's a drug which contains a lot of inherent addiction potential. So it's something that's sensitive. And I think that these documents really shed light on the extent to which, despite those potential concerns about addiction, the company was intent on aggressively marketing the product.

  • Amna Nawaz:

    Casey, the big question is, now what?

    There have been a lot of questions about what the Sackler family knew and what they didn't know. There is ongoing litigation. There is a tentative settlement.

    What do these new e-mails tell us? And do they change how things could move forward at all?

  • Casey Ross:

    Well, that's going to be a question for authorities across the country who are evaluating how this circumstance ought to be resolved in terms of the financial liability that the Sackler family high face ultimately for the addiction problems that are ongoing in communities across the country.

    So there are attorneys general, states across the country and other jurisdictions that are refusing to sign on to a settlement with the Sackler family right now that would resolve those concerns because they're concerned that the family is not being held accountable enough financially for the harm that has been caused.

    So I think that's going to be a question, in light of these records, that folks are going to continue to focus on. And we will have to see what the result is.

  • Amna Nawaz:

    Casey, as you mentioned, a lawyer for the Sackler family, in response to your article, said there was nothing improper in those e-mails.

    They say the e-mails discuss how doctors who prescribed OxyContin were upset that insurance companies wanted to avoid paying for their patients' medicine. They also say that Dr. Sackler was just responding by asking whether it would be accurate to make a presentation to the insurance companies, that they deferred to Purdue's in-house experts.

    What do you make of the Sackler family's response?

  • Casey Ross:

    Well, they're emphasizing essentially that he did defer to company experts in asking the question of whether that presentation could be given.

    And they also pointed to Dr. Sackler's 2015 deposition in which he said, look, I was just asking a question here as to whether a medically correct presentation could be given to show the claim that I'd like to make.

    But I think it's really up to the public and authorities to consider whether or not the presentation that he was calling for had an effect on marketing OxyContin in a deceptive way, ultimately.

  • Amna Nawaz:

    And I'd also like to note we have offered the Sackler family or their representative a chance to join us on the program in the future.

    For now, that is Casey Ross of STAT News.

    Thanks for very much for joining us.

  • Casey Ross:

    Thank you.

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