Purdue Pharma, the drug manufacturer that kickstarted the US opioid epidemic, corruptly influenced the World Health Organization in order to boost painkiller sales across the globe, according to a report by members of Congress.
An investigation by Katherine Clark and Hal Rogers, who represent districts in Massachusetts and Kentucky hard hit by the US opioid epidemic, accuses Purdue of replicating its false marketing claims about the safety and effectiveness of opioids to change WHO prescribing guidelines in an attempt to expand foreign markets for its drugs.
“The web of influence we uncovered paints a picture of a public health organization that has been corrupted by the opioid industry,” said Clark. “The WHO appears to be lending the opioid industry its voice and credibility, and as a result, a trusted public health organization is trafficking dangerous misinformation that could lead to a global opioid epidemic.”
The report, called Corrupting Influence. Purdue and the WHO, accuses Purdue of using pharma-funded organisations and specialists to influence the writing of WHO policy to encourage much wider prescribing of addictive high-strength opioids across the globe. It said that, as a result, “WHO guidelines are serving as marketing materials for Purdue”.
Clark and Rogers plan to deliver their report to the WHO on Wednesday morning after the organization failed to respond to a letter from a dozen members of Congress two years ago warning that Purdue and Mundipharma International, a UK-based network of global companies owned by members of the Sackler family, which owns Purdue Pharma, were pushing to boost opioid sales globally.
The 2017 letter cautioned the WHO to learn the lessons of the US opioid epidemic, which has claimed more than 400,000 lives over the past two decades.
“When the WHO failed to respond to the letter, we began to question why they would remain silent about such a significant and devastating public health epidemic. The answers we found are deeply disturbing,” Clark and Rogers said.
Their report alleges two WHO guidelines for doctors around the world released seven and eight years ago “contain dangerously misleading and, in some instances, outright false claims about the safety and efficacy of prescription opioids”.
“Alarmingly, these guidelines mirror Purdue’s marketing strategies to increase prescriptions and expand sales,” the report found.
A WHO guideline published in 2011 – Ensuring Balance in National Policies on Controlled Substances – also echoes false claims made by Purdue to persuade doctors to prescribe its powerful opioid painkiller, OxyContin, nearly two decades ago.
Purdue pleaded guilty to a criminal offense of false marketing in 2007, including training its sales representatives to wrongly claim the drug was less addictive and more effective than other opioids. Some of those same claims are replicated in the WHO documents.
The 2011 guidelines repeat long discredited assertions that “there is no need to fear accidental death or dependence” from prescribed opioids, and that the danger of addiction from the drugs is less than 1%.
Clark and Rogers expressed incredulity that the WHO was not aware of studies at the time that showed a much higher risk of addiction and questioned why the organization pushed “dangerous misinformation”.
The report also said WHO guidance stripped out its own earlier recommendation that patients in pain be given a combination of non-narcotic drugs with low strength opioids before being moved to higher doses. Instead, the wording was changed to go straight to high dosage opioids such as OxyContin.
The congressional report notes that a second WHO document, on opioids for children, uses terms such as “opioiphobia” – a characterization by the industry to break down resistance to prescribing narcotic painkillers.
The report said that in publishing the documents, “the WHO gave Purdue exactly what they wanted.
“A review of those guidelines makes it clear that the ‘problem’ the WHO seems to be addressing is not how to limit the use of these highly addictive drugs, but rather how to eliminate barriers to their use.”
The report accuses Purdue of funding front organizations to produce supposedly independent research to influence the WHO.
It said: “We have discovered that many of these same actors are directly affiliated with the work of the WHO. It is evident that Purdue and the wider opioid industry exerted significant influence on the WHO as the organization developed and wrote its guidelines on the use of opioid prescriptions.”
The report highlighted the role of industry-funded groups such as the American Pain Society, which was at the forefront of pushing for the wide prescribing of opioids in the 2000s. It also referenced individuals such as Dr Russell Portenoy, a leading promoter of opioids for the treatment of chronic pain who has recently said the industry overstated the benefits of narcotics painkillers and “understated the risks of opioids, particularly the risk of abuse, addiction and overdose”.
The report found the WHO was also influenced by the APS’s global arm, the International Association for the Study of Pain (IASP), which received funding from Mundipharma International as well as other opioid makers.
Clark and Rogers called on the WHO to withdraw its guidelines.
“While the findings in this report are tragic and alarming, they are unsurprising given this company’s unscrupulous history,” said Rogers. “The WHO must take action now to right the ship and protect patients around the world, especially children, from the dangers associated with chronic opioid use.”
Purdue said it “strongly denies the claims in today’s congressional report, which seeks to vilify the company through baseless allegations”.
“The company has never violated any applicable rules or guidelines and no formal complaint or enforcement activity has resulted from Purdue’s financial support or relationship with any third party. These relationships are transparent and any potential conflicts of interest are fully disclosed,” it said.
The WHO said it is studying the report.
Mundipharma said it had “no comment”.
Original story here.