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 CONTROLLED DRUGS, WITH their ability for abuse and diversion, can pose public fitness dangers which can be distinctive from—and extra complicated than—the ones of out of control pills while they're overpromoted and notably prescribed. An in-intensity evaluation of the promoting and advertising and marketing of OxyContin (Purdue Pharma, Stamford, CT), a sustained-launch oxycodone preparation, illustrates a number of the important thing issues. When Purdue Pharma added OxyContin in 1996, it changed into aggressively advertised and notably promoted. Sales grew from $forty eight million in 1996 to almost $1.1 billion in 2000.1 The excessive availability of OxyContin correlated with extended abuse, diversion, and dependancy, and via way of means of 2004 OxyContin had turn out to be a main drug of abuse withinside the United States.2
Under contemporary regulations, the Food and Drug Administration (FDA) is restrained in its oversight of the advertising and marketing and promoting of managed pills. However, essential modifications withinside the promoting and advertising and marketing of managed pills via way of means of the pharmaceutical industry, and an better capability of the FDA to alter and reveal such promoting, can definitely have an effect on public fitness.
OxyContin`s industrial achievement did now no longer rely upon the deserves of the drug in comparison with different to be had opioid preparations. The Medical Letter on Drugs and Therapeutics concluded in 2001 that oxycodone supplied no benefit over suitable doses of different robust opioids.three Randomized double-blind research evaluating OxyContin given each 12 hours with immediate-launch oxycodone given four instances each day confirmed similar efficacy and protection to be used with persistent lower back pain4 and most cancers-associated ache.5,6 Randomized double-blind research that in comparison OxyContin with managed-launch morphine for most cancers-associated ache additionally discovered similar efficacy and protection.7–nine The FDA's scientific overview officer, in comparing the efficacy of OxyContin in Purdue's 1995 new drug application, concluded that OxyContin had now no longer been proven to have a considerable benefit over conventional, immediate-launch oxycodone taken four instances each day apart from a discount in frequency of dosing.10 In a overview of the scientific literature, Chou et al. made comparable conclusions.11
The promoting and advertising and marketing of OxyContin passed off throughout a latest fashion withinside the liberalization of using opioids withinside the remedy of ache, specifically for persistent non–most cancers-associated ache. Purdue pursued an “aggressive” marketing campaign to sell using opioids in preferred and OxyContin in precise.1,12–17 In 2001 alone, the employer spent $two hundred million18 in an array of methods to marketplace and sell OxyContin.
Go to:PROMOTION OF OXYCONTINFrom 1996 to 2001, Purdue carried out extra than forty country wide ache-control and speaker-schooling meetings at inns in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended those all-expenses-paid symposia, wherein they had been recruited and educated for Purdue's country wide speaker bureau.19(p22) It is properly documented that this kind of pharmaceutical employer symposium affects physicians` prescribing, despite the fact that the physicians who attend such symposia accept as true with that such enticements do now no longer modify their prescribing styles.20
One of the cornerstones of Purdue's advertising and marketing plan changed into using state-of-the-art advertising and marketing facts to steer physicians` prescribing. Drug businesses collect prescriber profiles on man or woman physicians—detailing the prescribing styles of physicians nationwide—in an attempt to steer doctors` prescribing habits. Through those profiles, a drug employer can perceive the very best and lowest prescribers of precise pills in a unmarried zip code, county, state, or the whole country.21 One of the essential foundations of Purdue's advertising and marketing plan for OxyContin changed into to goal the physicians who had been the very best prescribers for opioids throughout the country.1,12–17,22 The ensuing database could assist perceive physicians with big numbers of persistent-ache sufferers. Unfortunately, this identical database could additionally perceive which physicians had been certainly the maximum common prescribers of opioids and, in a few cases, the least discriminate prescribers.
A moneymaking bonus gadget endorsed income representatives to growth income of OxyContin of their territories, ensuing in a big quantity of visits to physicians with excessive prices of opioid prescriptions, in addition to a multifaceted records marketing campaign aimed toward them. In 2001, similarly to the common income representative's annual profits of $fifty five 000, annual bonuses averaged $seventy one 500, with a variety of $15 000 to almost $240 000. Purdue paid $forty million in income incentive bonuses to its income representatives that year.19
From 1996 to 2000, Purdue extended its inner income pressure from 318 income representatives to 671, and its overall health practitioner name listing from about 33 four hundred to forty four 500 to about 70 500 to ninety four 000 physicians.19 Through the income representatives, Purdue used a affected person starter coupon software for OxyContin that furnished sufferers with a loose restrained-time prescription for a 7- to 30-day supply. By 2001, while this system changed into ended, about 34 000 coupons have been redeemed nationally.19
The distribution to fitness care experts of branded promotional gadgets including OxyContin fishing hats, crammed plush toys, and tune compact discs (“Get withinside the Swing With OxyContin”) changed into exceptional for a agenda II opioid, in line with the Drug Enforcement Administration.19

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Added Jan 10 '23



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