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Purdue Pharma affiliate cashes in on overdose antidote

AP This undated image provided by Dr. Andrew Kolodny shows Purdue Pharma’s international affiliate, Mundipharma, promoting Nyxoid, a new brand of opioid overdose reversal medication, at a medical conference in Italy. The photo was taken by Kolodny, a frequent critic of Purdue Pharma who has testified against the company.

The gleaming booth towered over the medical conference in Italy in October, advertising a new brand of antidote for opioid overdoses. “Be prepared. Get naloxone. Save a life,” the slogan on its walls said.

Some conference attendees were stunned when they saw the booth’s company logo: Mundipharma, the international affiliate of Purdue Pharma — the maker of the opioid, OxyContin, widely blamed for unleashing the American overdose epidemic.

Here they were cashing in on a cure.

“You’re in the business of selling medicine that causes addiction and overdoses, and now you’re in the business of selling medicine that treats addiction and overdoses?” asked Dr. Andrew Kolodny, an outspoken critic of Purdue who has testified against the company in court. “That’s pretty clever, isn’t it?”

As Purdue Pharma buckles under a mountain of litigation and public protest in the United States, its foreign affiliate, Mundipharma, has expanded abroad, using some of the same tactics to sell the addictive opioids that made its owners, the Sackler family, among the richest in the world.

“The way that they’ve pushed their opioids initially and now coming up with the expensive kind of antidote — it’s something that just strikes me as deeply, deeply cynical,” said Ross Bell, executive director of the New Zealand Drug Foundation and an advocate of more naloxone availability.

Mundipharma’s antidote, a naloxone nasal spray called Nyxoid, was approved in New Zealand, Europe and Australia. Mundipharma defended it as a tool to help those whose lives are at risk, and even experts who criticize the company say that antidotes to opioid overdoses are badly needed. Patrice Grand, a spokesman for Mundipharma Europe, said in a statement that heroin is the leading cause of overdose death in European countries and nasal naloxone is an important treatment option.

Injectable naloxone has long been available; it is generic and cheap. But Nyxoid is the first in many countries that comes pre-packaged as a nasal spray. Nyxoid is more expensive than injectable naloxone, running more than $50 per dose in some European nations.

Some critics say Nyxoid’s price is excessive. Grand said the price reflects the company’s investment, manufacturing cost and the value of the technology, while recognizing the “prevailing financial pressures that exist within care sectors.”

The Sackler family’s pharmaceutical empire long has considered whether it might make money treating addiction, according to lawsuits. In the U.S., Purdue Pharma called its secret proposal Project Tango, the attorneys general of Massachusetts and New York have alleged, and discussed it in a September 2014 conference call that included family member Kathe Sackler.

In internal documents, the lawsuits allege, Purdue illustrated the connection it had denied publicly between opioids and addiction with a graphic of a blue funnel. The top end was labeled “Pain treatment.” The bottom: “opioid addiction treatment.” The slideshow said they had an opportunity to become an “end-to-end provider” — opioids on the front end, and addiction treatment on the back end.

In its response to the court, the family’s lawyers wrote that the plan was proposed by a third-party private equity fund as a potential joint venture and “at the very most, Project Tango was mentioned in passing on a few occasions and the proposal was subsequently abandoned.” A press release issued by the Sacklers said no member of the family or board had an active role in the presentations or supported the proposal. It called the lawsuits “sensationalized” and “misleading.”

New York’s lawsuit alleges in 2015, Project Tango was presented to Purdue’s board as a joint venture to sell the addiction medication suboxone that could become the “market lead in the addiction medicine space.”

Project Tango stalled. It was revised the next year, the lawsuits allege. A family’s press release said Purdue’s board rejected it.

In Australia, Mundi-pharma promoted naloxone.

As part of an Australian coroner’s investigation last year into six fatal opioid overdoses, Mundipharma submitted a document touting the benefits of naloxone. If people around the overdose victims had access to naloxone, the company wrote, many of those deaths may have been avoided. At the same time, Mundipharma was registering Nyxoid in Australia, a fact it acknowledged within its submission.

In the document, the company suggested officials change Australia’s laws to allow for easier access to naloxone and establish a national, free take-home naloxone program.

Mundipharma Australia denied its Nyxoid strategy had any connection to, or was influenced in any way, by Purdue’s Project Tango. Grand, the spokesman for Mundipharma Europe, also rejected any link.

“Mundipharma Australia and Purdue Pharma are independent companies,” the company wrote. “Mundipharma Australia introduced Nyxoid to help meet a clear clinical need.”

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