Marketer Calls Opioid Distribution Practices “More Sophisticated” She Has Seen | Legal matters


A marketer said that distributors accused of fueling the opioid crisis by shipping millions of doses of opioids to Huntington and Cabell County had some of the most sophisticated marketing it has ever seen.

Jakki Mohr, professor of marketing at the University of Montana, said distributors have engaged in marketing and have served as a channel between pharmaceutical manufacturing companies and customers.

She testified on Friday that distributors were marketing to manufacturing companies – like Purdue Pharma – prescribers and pharmacies to increase sales of pharmaceuticals. At the same time, they carried out public relations campaigns with a professional distribution association to create a better appearance to the media and the public.

Katherine Keyes, an epidemiologist specializing in opioid use disorders at Columbia University, later said the supply and oversupply of prescription pain relievers are directly linked to heroin abuse. and the opioid crisis.

The testimony took place Friday at the Robert C. Byrd courthouse in Charleston in the United States during a trial in which Huntington and Cabell County accuse the “big three” drug wholesalers – AmerisourceBergen, Cardinal Health and McKesson – of fueling the opioid crisis by sending excessive shipments of opioids to the region for eight years, before a reduction in the number of pills shipped caused users to turn to illicit drugs.

The defendants point to the Drug Enforcement Administration, doctors and poor health in West Virginia as the culprits.

When questioning Huntington’s attorney David Ackerman, Mohr said the defendants were providing a paid service for pharmaceutical manufacturers to market on their behalf, making reference to several brochures and presentations produced by the companies.

She said AmerisourceBergen was working with Xcenda and Lash Group. Xcenda is a specific unit of AmerisourceBergen which provides marketing services to manufacturers. Xcenda was acquired by AmerisourceBergen Drug Corp. in 2007, around the time the amount of prescription pills shipped to the region increased dramatically. Lash Group is a marketing consultant.

Mohr said that although separate companies, the groups worked together under the umbrella of AmerisourceBergen Drug Corp. to make a profit.

She said that before the arrival of “pay-per-click” ads on websites such as Google around the turn of the century, Bergen Brunswig – now AmerisourceBergen – had its own system, known as the “twinkle button.” .

The company would offer to advertise a product from a manufacturer at a price and when a pharmacist orders a certain product they can click a button on the system and an advertisement encouraging the purchase of OxyContin will appear, a- she declared.

Mohr referenced an email in which a Purdue Pharma employee encouraged the manufacturer to use distributor offers to market their product for better sales.

In another example, she said that if a manufacturer could subscribe to a “first script” service for $ 15,000, the distributor would notify pharmacists of a promotion for their business.

McKesson also had an “RX Focus Launch” program that automatically shipped newly launched drugs to subscribing pharmacists.

The companies have also created a patient membership program to ensure that people use the products after they have been purchased. They also used thought leadership marketing by hosting trade shows where pharmacists could learn about new drugs, and also offered continuing education courses, which are necessary to maintain licenses.

Mohr said distributors hired speakers at events to avoid payments from manufacturers’ books, which she said meant distributors were able to control what the speakers said.

Mohr said AmerisourceBergen also hired “key opinion leaders,” someone who could engage with a more personal audience, to promote the product.

Distributors have also engaged in public relations campaigns through their professional organization, the Healthcare Distribution Alliance, which represents all distributors.

The defendants requested that Mohr’s testimony be dismissed, saying she said marketing had taken place but failed to link it to sales related to Huntington and Cabell County. She has no experience in prescribing, sales or other areas, said AmerisourceBergen attorney Shannon McClure.

“The existence of marketing does nothing,” she said.

After Mohr left the witness stand, the plaintiffs returned to epidemiology through Keyes, who researched peer-reviewed articles and used his own education and calculations to determine abuse. heroin and the opioid crisis were directly caused by the oversupply of prescription pills in the county.

Using a mathematical equation based on data she interpreted, Keyes said she found that about 8.9% of Cabell County residents – about 8,200 people – were living with a disorder. opioid use.

An article written by Theodore Cicero in 2017 asked people entering treatment for specific opioid addiction that they regularly use for the first time to get high, Keyes said.

The study found that the majority of people with opioid use disorders in the 1960s and 1980s began their abuse with heroin rather than prescription opioids. In the 1990s, the number of users was even before prescription opioids became the primary drug used by people with substance use disorders from 2000 to 17.

Another study found that the higher the dosage of an opioid and the longer a person has been prescribed opioids, the more likely the user is to be diagnosed with a drug use disorder. opioids.

Patients who took high-dose opioids for 90 days were 122 times more likely to become addicted than those who used lower doses for less time, she said. A person prescribed a medium dose was 26 times more likely, and low doses were 15 times more likely.

As an example of the gravity of the situation, she referred to a study that linked smoking to lung cancer, which showed that smokers were 13 times more likely to have lung cancer than others. Compared to that, the link between opioid use and addiction is “extraordinarily high,” she said.

Keyes said several studies show economic conditions play a small role – less than 10% – in the opioid-related harms seen in the United States over the past 15 years. The crisis is primarily based on the availability and price of prescription opioids, she said.

The defendants argued during the trial that Huntington’s economic decline was a major factor in what led to the crisis.

Keyes will continue his testimony on Monday, answering questions from the defense.

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