Thursday, January 19, 2023

the last book I ever read (Empire of Pain: The Secret History of the Sackler Family, excerpt seven)

from Empire of Pain: The Secret History of the Sackler Family by Patrick Radden Keefe:

Different drugs have different “personalities,” Michael Friedman liked to say. When he and Richard were trying to decide how to position OxyContin in the marketplace, they made a surprising discovery. The personality of morphine was, clearly, that of a powerful drug of last resort. The very name could conjure up the whiff of death. But, as Friedman pointed out to Richard in an email, oxycodone had a very different personality. In their market research, the team at Purdue had realized that many physicians regarded oxycodone as “weaker than morphine,” Friedman said. Oxycodone was less well known, and less well understood, and it had a personality that seemed less threatening and more approachable.

From a marketing point of view, this represented a major opportunity. Purdue could market OxyContin as a safer, less extreme alternative to morphine. A century earlier, Bayer had marketed heroin as morphine without the unpleasant side effects, even though heroin was actually more powerful than morphine and every bit as addictive. Now, in internal discussions at Purdue headquarters in Norwalk, Richard and his colleagues entertained the notion of a similar marketing strategy. In truth, oxycodone wasn’t weaker than morphine, either. In fact it was roughly twice as potent. The marketing specialists at Purdue didn’t know why, exactly, doctors had this misapprehension about its being weaker, but it might have been because for most physicians their chief exposure to oxycodone involved the drugs Percocet and Percodan, in which a small dose of oxycodone was combined with acetaminophen or aspirin. Whatever the reason, Richard and his senior executives now devised a cunning strategy, which they outlined in a series of emails. If the true personality of oxycodone was misunderstood by America’s doctors, the company would not correct that misunderstanding. Instead, they would exploit it.

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