How an Opioid Giant Deployed a Playbook for Moulding Doctors’ Minds


From The BMJ: “The opioid giant Mallinckrodt, selling more in the US than Purdue Pharma, was forced by the courts to publish more than 1.3 million internal documents. Sergio Sismondo and Maud Bernisson sift through nearly 900 contracts to reveal the tricks used to shape scientific and medical opinions.

Mallinckrodt may be the largest seller of prescription opioids in the US that has garnered the fewest headlines. With $18bn (£14.1bn; €16.6bn) in sales from 2006 to 2012 and nearly 40% of all opioid pills sold on the US market, it was the lead producer of prescription opioids during that time.12 The more notorious Purdue Pharma ranked third. Mallinckrodt, with its baby blue 30 mg oxycodone tablets and various other opioids, paved a ‘blue highway’ along the Appalachians to Florida.3 These tablets were so popular that counterfeits in the same hue and with Mallinckrodt’s ‘M30’ marking—but containing fentanyl—are still sold on the street today.4

Mallinckrodt survives as a multimillion dollar corporation, despite settling with the US government for lax handling of its opioid supply and later being ordered to pay $1.7bn over accusations of misleading and deceptive marketing practices to boost opioid sales. It has twice filed for bankruptcy and has largely avoided paying,5 but it did have to turn over 1.3 million internal documents, mostly from 2009 to 2017, which became public.

. . . For those of us who study pharma influence, the document trove was an unprecedented window into the inner workings of how a corporation not just directly co-opts physicians to push pills but also seeks to increase sales by influencing medical science and opinion—an extensive marketing playbook that we call the ghost management of medicine.7

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  1. This is a story that should be broadcast far and wide – the pattern that the drug companies have used to take over the evidence base of “evidence-based practice” as well as grease every wheel along the way to enrich themselves and impoverish the rest of society

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