In the U.S., opioid-maker Purdue is bankrupt. Its global counterparts make millions.

Tactics used to persuade U.S. doctors that potent painkillers could be safely prescribed have been used abroad, an investigation shows.

23 min
(Tara Anand/For The Washington Post)
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At home in the United States, Purdue Pharma, the drugmaker accused of fueling the opioid crisis through its aggressive marketing of highly addictive pain pills, is bankrupt and facing thousands of lawsuits.

Abroad, its global counterparts are selling opioids — and still profiting.

Among the beneficiaries: some members of the Sackler family, who own Purdue and also sit atop a group of international companies known as Mundipharma, records show. The family faces a wave of litigation over Purdue’s alleged role in an opioid crisis that has claimed hundreds of thousands of lives and ruined countless more across the United States.

From 2020 to 2022, nine Mundipharma companies in Europe and Australia made profits of $531 million on sales and distribution of pharmaceutical and other products, according to a first-of-its-kind analysis conducted as part of an investigation by journalists in eight countries. Total profits are probably higher because the figure does not include amounts, if any, from Mundipharma companies in jurisdictions that do not require disclosure of financial data.

The analysis provides a glimpse into Mundipharma’s value to possible buyers as the Sacklers approach a Sept. 27 bankruptcy court deadline that could end mediation meant to determine how much the family could have to pay to settle lawsuits related to the opioid crisis.

The Sacklers have previously pledged to sell their international companies to compensate U.S. cities, states, tribes, victims and others ravaged by the epidemic. Purdue, based in Stamford, Conn., still sells opioids such as oxycodone, though the company has been saddled with years of investigations, litigation and a massive bankruptcy reorganization.

Some of the same tactics used to persuade a generation of U.S. doctors that potent painkillers could be safely prescribed have been used abroad, the investigation found.

Andrew Kolodny, an opioid policy researcher, says Mundipharma promoted opioids abroad. The company says it complies with local laws and regulations. (Video: Whitney Shefte for The Examination)

In Germany, Mundipharma sponsored a patients group that, on its website, encourages opioid use for chronic pain while minimizing addiction risk. In Italy, prosecutors accused two Mundipharma managers of illegally paying kickbacks to doctors to promote opioids, allegations the company disputes. In China, an internal company investigation raised concerns that scientific advisory boards were used as vehicles to promote products.

And in Brazil, the international reporting collaboration found the company paid prominent doctors to hold evening classes on treating pain. In a statement, Mundipharma said its products are “not likely to play a major part in any abuse of opioid prescription medicines” in that country, an assertion challenged by some addiction experts.

Mundipharma also said “strong” opioids now make up a smaller share of the companies’ total sales as they have diversified into other treatments. It stressed that the companies strive to adhere to local laws and regulations and work with local authorities to monitor for drug diversion or abuse.

“We recognise that there are risks associated with the use of prescription opioid medications, so all employees, regardless of role, undertake mandatory opioid awareness training,” the company said.

Pain and addiction specialists warn patients worldwide remain at risk.

“When opioids are being prescribed aggressively, people are getting addicted, lives are being ruined, communities are being devastated,” said Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University near Boston.

While they haven’t experienced the heights reached in the United States, opioid prescriptions and overdose deaths across Europe and other parts of the world have increased during the past decade “because the drug companies are using the same playbook as in the U.S.,” said Kolodny, an outspoken critic of opioid overprescribing who has served as a paid expert for plaintiffs in opioid litigation and has testified in court and Congress about drugmaker practices.

To tell this story, journalists from the Examination, The Washington Post, Finance Uncovered, Paper Trail Media, Der Spiegel, ZDF and other news outlets reviewed thousands of pages of public and sealed court documents, academic papers, company filings and websites of company-sponsored groups and spoke with doctors, patients, researchers and more than a dozen former Mundipharma employees.

The Sacklers said family members play no operational role in Mundipharma. In a statement, the families said they are focused in the United States on reaching a legal resolution that “provides substantial resources for people and communities struggling with a complex health crisis in America and not on regurgitated narratives that perpetuate false and misleading claims about their integrity.”

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