Drug Companies Didn't Want You to See These Allegations

A federal judge has unsealed previously secret details in a lawsuit filed by the city of Chicago against five makers of opioid painkillers. The new information includes amounts the companies paid to doctors to promote their drugs and how they wined and dined potential prescribers.

Chicago’s initial complaint was heavily redacted because the city—which obtained at least some of the information underlying its lawsuit via subpoenas—had confidentiality agreements with four of the drugmakers. Now, most of that redacted information is available.

Click the image to see the full lawsuit (PDF).

Some of the companies tried to influence treatment guidelines written by medical organizations, according to the newly unsealed claims—efforts that allegedly included spending hundreds of thousands of dollars to underwrite favorable publications about the use of the potent pain medications.

The Chicago lawsuit, and a similar one filed by two counties in California, alleges a two-decade-long campaign by the industry to persuade doctors to make the use of painkillers routine for chronic pain by obscuring the drugs’ risks and misrepresenting their efficacy.

In Chicago, the companies have filed a joint motion to dismiss the case, arguing that the U.S. Food and Drug Administration approved the uses that they promoted for the drugs—uses the city is now complaining about. The companies also argue there are “glaring deficiencies” in the Chicago filing that warrant a dismissal.

A federal judge last week ruled that much of the information that had been filed under seal as part of the city’s amended complaint against the companies could be made public despite objections from two of the companies. On Nov. 10, the city filed a new complaint revealing the previously secret details. (Click here to see the information that was blacked out in the first amended complaint, and the unredacted information filed this week.)

Among the new details are spending by the companies on speakers programs, which usually feature a doctor being paid to talk up the benefits of a drug to other physicians over a meal at a restaurant, according to the lawsuit. Cephalon, a subsidiary of Teva Pharmaceuticals Industries, spent $6 million on speakers programs to promote its drug Fentora when it launched in 2007, according to the complaint. In advance of the launch, the company hosted dinners for doctors in Chicago. On Oct. 3, 2006, Cephalon sales representatives hosted 17 Chicago prescribers for dinner at a cost of more than $4,000, according to the complaint. Two days later, 19 more medical professionals were treated to dinner at an upscale restaurant in the city at a cost of $3,500, the complaint says.

A Teva spokeswoman said the company had no comment.

Janssen Pharmaceuticals, a unit of Johnson & Johnson, spent almost $200,000 on speakers programs in Chicago from 2009 to 2013 to promote the painkiller Nucynta ER, the lawsuit alleges. The company paid 27 different physicians in the area to deliver the talks. Endo Health Solutions spent almost $4 million in 2008 to promote 1,000 speaker programs across the country.

“Janssen has acted appropriately, responsibly and in the best interests of patients with regard to opioid pain medications,” said Robyn Frenze, a Johnson & Johnson spokeswoman. Endo did not respond to a request for comment.

Chicago’s unredacted complaint also claims the companies sought to influence continuing medical education courses often required of doctors to keep their licenses current.

In one example, Endo Health Solutions funded a series of medical education newsletters sent to 60,000 prescribers, according to the city’s complaint. A survey of those who received the newsletter showed a leap in prescriber comfort level in putting patients on opioids, according to the lawsuit.

In another example, the lawsuit alleges several painkiller makers helped to underwrite a guide for treating pain published by the Federation of State Medical Boards, or FSMB, a trade organization representing state medical boards. Previously redacted information indicates that Endo provided $286,620 to support the guide. The lawsuit alleges that the book fails to mention and downplays risks related to the use of the drugs.

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