U.S. Sen. Claire McCaskill, D-Mo., opened an investigation Tuesday into the role drug companies may have played in the nation’s opioid epidemic. She requested internal documents from five leading drugmakers on how they market opioid painkillers and if they knew anything about the dangers of the drugs. Yet, the top opioid prescription manufacturer, which is located in McCaskill’s home state in St. Louis, Missouri, is missing from the initial list of companies she’s investigating.
McCaskill requested internal sales and marketing materials, addiction studies, and contributions made to third-party advocacy groups that may have worked to block efforts to increase regulation of opioids. She sent the letter to Purdue Pharma, Janssen/Johnson & Johnson, Insys, Mylan, and Depomed.
However, according to data from IMS Health, an information services company for the healthcare industry, there are other companies who had a higher annual opioid prescription total in 2016 than some of the companies on McCaskill’s list, and the Missouri-based Mallinckrodt, the company with the highest annual total, was not mentioned in her announcement.
“It’s time to look at the manufacturers and find out what they knew about addiction … (and) what marketing practices did they use to push these drugs,” McCaskill told reporters in a conference call on Tuesday. “We want to get to the bottom of why all of a sudden opioids have been handed out like candy in this country.”
In 2016, there were more than 236 million opioid prescriptions filled by 183 drug companies, according to IMS. Here’s the percentage of the total market share by prescription for the five companies mentioned by McCaskill:
- Mylan: 6.7 million scripts or 2.84 percent of the total annual opioid prescriptions for 2016
- Purdue: 4.8 million scripts or 2 percent
- Depomed: 878,000 scripts or 0.37 percent
- Janssen: 74,000 scripts or 0.03 percent
- Insys: 33,000 scripts or 0.01 percent
The top manufacturer for opioid prescriptions last year was Mallinckrodt, which had more than 43.8 million prescriptions, accounting for approximately 18.6 percent of the total market share. However, the company didn’t receive a letter from McCaskill.
The Missouri-based drug company’s political action committee also donated $2,500 to McCaskill’s campaign coffers in September 2015, according to a filing with the Federal Election Commission. No data was available for previous years. McCaskill will face reelection in 2018.
“This epidemic is the direct result of a calculated sales and marketing strategy major opioid manufacturers have allegedly pursued over the past 20 years to expand their market share and increase dependency on powerful — and often deadly — painkillers,” McCaskill wrote in the letter to the companies.
“To achieve this goal, manufactures have reportedly sought, among other techniques, to downplay the risk of addiction to their products and encourage physicians to prescribe opioids for all cases of pain and in high doses,” she added.
Mallinckrodt has previously been in the spotlight after agreeing in January to pay $100 million to settle allegations that a subsidiary broke U.S. antitrust law by significantly increasing the price of a multiple sclerosis drug.
Some of the other companies on her list have also received negative attention for misrepresenting or deceptively marketing painkillers. In 2007, Purdue Pharma paid $635 million in fines to settle criminal and civil charges due to the company’s misrepresentation of the addictive qualities of its OxyContin painkiller medication. Three executives of the company pleaded guilty to criminal misbranding.
McCaskill said her probe would focus on the five companies, but she suggested her investigation could expand to include other companies. It’s not immediately clear if the drug company Mallinckrodt from her own state would be on a future list.
Last year, a joint investigation by the Associated Press and the Center for Public Integrity found how drugmakers used lobbying and their deep war chests to undermine legislation aimed at curbing opioid prescribing practices.
The sale of opioid prescriptions has quadrupled since 1999, according to the Centers for Disease Control. Opioid overdose deaths hit a record high in 2015, claiming the lives of more than 33,000 Americans.