Pubdate: Thu, 16 May 2002
Source: Wall Street Journal (US)
Copyright: 2002 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Author: Chris Adams, Staff Reporter Of The Wall Street Journal
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin)

PAINKILLER'S SALES FAR EXCEEDED LEVELS ANTICIPATED BY MAKER

The maker of OxyContin had so underestimated the sales potential of the 
widely abused painkiller that in 2000 the drug generated revenue that was 
eight times more than projected, internal company documents show.

Over the first five years of marketing, OxyContin sales totaled nearly $2 
billion, sharply higher than the company's initial forecast of about $350 
million. The drug's popularity sent Purdue Pharma LP scrambling to expand 
production, marketing and its sales force. At the same time, other drug 
prospects for the closely held firm fell through, elevating OxyContin's 
importance to Purdue's future.

The company's sales projections and marketing assumptions were laid out in 
1995 in an internal product launch plan as well as in documents filed with 
the Food and Drug Administration. Together, they provide a look at the 
nuts-and-bolts launch plans for a painkiller that became a unexpected boon 
for its maker -- as well as a persistent problem for drug abuse and 
law-enforcement officials nationwide.

Originally, the documents show, Purdue had hoped to direct its sales force 
of 350 to devote 70% of their primary sales calls to OxyContin immediately 
after the drug's introduction, and reduce that number to 40% in the fifth 
year. Today, however, about 80% of such sales calls are to sell OxyContin. 
In 2001, the drug provided about 80% of Purdue's net sales of $1.47 
billion, according to documents and company officials.

Company officials say they hadn't counted on such a large and untapped 
market of people who live with chronic pain. Purdue acknowledges OxyContin 
has been abused in many parts of the country but says quantifying sales for 
illegitimate uses is impossible. It figures sales for illegitimate purposes 
are tiny, a spokesman says.

Last month, the Drug Enforcement Administration identified 464 overdoses in 
which they say it was likely that OxyContin either caused or contributed to 
the death; Purdue Pharma disputed parts of the DEA analysis, and said that 
in most of the cases it had reviewed abusers had died after taking other 
drugs alongside OxyContin. In several hundred other deaths, the DEA said 
OxyContin, or drugs with the same active ingredient, could have played a 
role, but other significant factors were involved or information was 
insufficient to make a determination. While the drug acts as a time-release 
painkiller, many abusers crush the pill and snort the powder for a 
heroin-like high.

Officials of Purdue Pharma, based in Stamford, Conn., say they were shocked 
when abusers began showing up in emergency rooms in poor, rural areas of 
Appalachia, where the black market for the drug burgeoned. While some users 
have been able to get OxyContin by shopping from doctor to doctor to find 
one willing to write a prescription, others have resorted to extreme 
measures such as breaking into pharmacies.

OxyContin abuse has dogged the company, which has been faulted by some for 
aggressively marketing the drug while failing to take such steps as 
singling out doctors who are heavy prescribers. The administrator of the 
DEA recently testified that OxyContin abuse was due, in part, "to 
aggressive marketing and promotion" of the drug . Purdue says that it is 
unrealistic to expect the company to flag particular doctors, and that 
local law-enforcement officials or state medical boards are in a better 
position to investigate questionable prescriptions.

Until December 1995 when OxyContin won FDA approval, Purdue was a 
little-known company with one main painkiller in its cabinet, MS Contin, a 
morphine-based drug that came with a social stigma and generated only $88.5 
million in sales the year before. The market was wide open for an equally 
powerful, long-acting compound to treat pain.

Purdue had taken an existing morphine-like product, oxycodone, and applied 
time-release technology, allowing patients to take it just twice a day, 
rather than several. Developing the drug cost "in excess of $40 million," a 
company official stated in an affidavit on file at the FDA.

 From the beginning, Purdue said that "one of the major strategies in 
launching OxyContin will be to replace all prescriptions for MS Contin," 
according to the company's launch plan.

Armed with data on individual doctors' prescribing habits, Purdue divided 
physicians into groups and targeted those already high on the list for 
prescribing other painkillers. The launch plan details how many sales calls 
each of Purdue's representatives were supposed to make each week, and also 
how representatives were supposed to call on the hospital committees that 
decide on which drugs to use. The plan called for Purdue to use the 
"Speakers' Bureau" -- a stable of doctors, now numbering about 1,000 -- to 
give lectures during hospital programs about the benefits of OxyContin.

The plan describes common methods drug makers use to build support for a 
new drug , although most manufacturers are loath to disclose their tactics. 
One such tactic: Mailing doctors information on the new drug along with a 
reply card that can be sent back to the company if the doctor is interested 
in seeing the drug stocked at a local pharmacy. The company can then use 
the reply cards to encourage local pharmacies to stock the drug .
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MAP posted-by: Jay Bergstrom