WASHINGTON — The five biggest opioid manufacturers shelled out more than $10 million to patient advocacy groups, professional medical societies and affiliated individuals — who then “echoed and amplified” messages that encouraged use of those highly addictive drugs and set the stage for the current opioid epidemic.
That’s according to a new Senate committee investigation, released on Monday, which examined the financial ties between the pharmaceutical industry and outside groups over the last five years, from 2012 through 2017.
"I think these groups were cheerleaders too often ... cheerleaders for opioids," said Sen. Claire McCaskill, a Missouri Democrat who launched the probe last spring. McCaskill is the ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee, a post she has used to investigate other drug-company practices.
McCaskill's staff sought information from the five largest opioid drug-makers, measured by global sales in 2015. Those companies are: Purdue Pharma, Janssen Pharmaceuticals, Mylan, Depomed and Insys Therapeutics.
Purdue was by far the largest donor to outside advocacy groups, which often bill themselves as grass-roots organizations supporting patients struggling with chronic pain. Among the recipients of drug company largesse: The U.S. Pain Foundation, the National Pain Foundation, and the Academy of Integrative Pain Management.
McCaskill said some of these organizations are doing good work on public policy. But others are "totally dependent" on drug companies for their funding, McCaskill said, and their advocacy is suspect.
"Our report indicates that in some instances they are merely fronting for these manufacturers, especially if you look at the lobbying they’ve done against restricting prescribing levels of opioids," she said.
The report charges that many of the advocacy groups, buoyed by drug company money, started undercutting state and federal efforts to curb opioid prescribing and using other "opioids-friendly messaging."
The report notes, for example, that the American Academy of Pain Medicine and the American Pain Society have promoted opioids as safe and effective for treating chronic pain and minimized the risk of addiction.
Purdue and other drugmakers "have a lot of explaining to do," for their contention that use of oxycodone "for patients in pain wouldn't lead to addiction," says Army Col. Chester Buckenmaier, an anesthesiologist and professor at the Uniformed Services University in Bethesda, Md. "We now know that’s not true and use these medications with more respect and more caution."
The report also notes that the American Academy of Pain Medicine and the Center for Practical Bioethics spoke out against the federal efforts to limit opioid prescribing. That effort was led by Centers for Disease Control and Prevention, which issued guidance in 2016 to doctors on when to prescribe opioid pain medication in primary care settings. The CDC recommended offering non-opioid therapies for chronic pain except in cases of active cancer treatment, palliative care and end-of-life care.
Some of the groups and their funders say there's a public health crisis being created by the response to the opioid epidemic. Chronic pain patients say they now have difficulty getting narcotics, which is often the only thing that can address their unremitting pain.