Purdue Pharma, the manufacturer of OxyContin that filed for bankruptcy protection Sunday night, became a leader in total oxycodone sold, based on dosage strength, according to a seven-year review by the Wall Street Journal.
Purdue, based in Stamford, Connecticut, is one of the pharmaceutical industry’s most recognizable marketers of opioid pain pills. It had billions of dollars in annual sales for OxyContin, driven by increasing demand for its high-dose pills.
While Purdue produced about 10 percent of pills containing oxycodone, the active ingredient in OxyContin, bought by U.S. pharmacies from 2006 to 2012, when taking the dosage strength into account, OxyContin represented a market-leading 27 percent of total oxycodone sold during the seven-year period. Physicians and public-health and law-enforcement officials claim that high-dose pills are more prone to abuse.
Purdue and its owners, the Sackler family, are faced with 2,600 lawsuits from states, cities and counties accusing the company of helping to ignite the nation’s opioid crisis via aggressive marketing. The bankruptcy is part of a deal to resolve most of the lawsuits. The company and the family have denied the allegations and have alleged that they are committed to stopping opioid addiction.
The rapid increase in overdose deaths has been driven largely by illegal opioids like heroin and illicit fentanyl in recent years. Still, prescription drugs like oxycodone, hydrocodone and others were the leading causes of opioid overdose deaths in the U.S. from 1999 to 2014, according to data from the Centers for Disease Control and Prevention (CDC).
In a 2013 study published in the journal Pain, oxycodone was found to be the preferred opioid for 45 percent of 3,500 opioid-dependent people who were going into addiction treatment around the U.S., as opposed to 29 percent of those who preferred hydrocodone. Oxycodone was found in 33 percent of overdose deaths that involved prescription opioids, “the most of any drug, and nearly twice the share of hydrocodone-linked deaths,” according to a CDC analysis of state medical-examiner data from 2009.
The CDC classifies drugs containing the equivalent of more than 33 milligrams of oxycodone as high-dose pills. When someone takes more than 33 milligrams of oxycodone a day, the risk of overdose nearly doubles, CDC says.
During the seven-year period analyzed, the average strength of OxyContin pills bought by retail and mail-order pharmacies was 41 milligrams. That was approximately three times greater than the second-highest average dose of 14 milligrams among the 10 largest oxycodone producers, as measured by the number of pills. The highest-strength pill produced by Purdue, 80 milligrams, represented 25 percent of all OxyContin pills it sold during the period. Purdue was the fourth-largest oxycodone producer from 2006 to 2012.
DEA Deputy Assistant Administrator Tom Prevoznik said that higher-dose opioids may be more lucrative for drug traffickers, because they get higher prices on the black market. This was the case for OxyContin, especially before 210 when Purdue switched to a formulation designed to make the drug tougher to abuse. When OxyContin’s popularity was highest in the mid- to late 2000s, its street value based on dosage was $1 per milligram in many cities. People suing the company believe that Purdue officials knew that the high-dose pills posed a particular risk.