Purdue Pharma’s quest to stop OxyContin preauthorizations


Newly unsealed court records reveal just how far Purdue Pharmaceuticals went to prevent regulators from limiting OxyContin prescriptions, highlighting an arrangement in which the company paid a pharmacy benefits manager to prevent any limitations on the drugs.

According to court documents obtained by STAT, Purdue made it a priority behind the scenes to prevent regulators in West Virginia from placing any restrictions on OxyContin prescriptions in a state now ravaged by opioid overdoses. The company’s primary tool came in the form of rebates paid to Merck Medco, which was acquired by Express Scripts in 2012. In exchange, the PBM stifled attempts by state officials to place prior authorization restrictions on OxyContin prescriptions despite an increase in painkiller-related deaths.

The arrangement extended well beyond the state of West Virginia, a former Purdue official told STAT. Rebates were part of national contract aimed at avoiding prior authorization requirements, as well as keeping the drug on the least restrictive tier of the PBM’s formulary. The former official added that Purdue was not the only drugmaker to use rebates as a means of improving access to the opioids.

Express Scripts, the nation’s largest PBM, is facing multiple investigations regarding its relationship with pharmaceutical companies, according to Reuters. Over the past three months, the company received subpoenas from investigators in New York, Massachusetts and the Justice Department. In May, multiple pharmaceutical companies reported they were facing investigations regarding PBM contracts dating back to 2006.

Purdue has faced a litany of criticism regarding its opioid marketing practices, including its partnership with Abbott Laboratories and its failure to report a suspected drug ring to the proper authorities in California. Painkiller manufacturers are facing a wave of investigations and potential litigation as some state attorney generals search for new pathways to go after Purdue’s questionable marketing practices.