By LAURENCE HAMMACK
THE ROANOKE TIMES

   WASHINGTON - A marketing campaign that helped make OxyContin the top-selling opium-based painkiller in the country is not selling well to some members of Congress.

    Purdue Pharma, which spent about $200 million last year marketing and promoting a painkiller that has been widely abused in parts of Southwest Virginia, was questioned about its practices Tuesday at a Senate committee hearing.

    Sen. John Warner, R-Va., who first asked the Health, Education, Labor and Pensions Committee to look into OxyContin abuse, said he supports calls from other legislators for a study by the General Accounting Office into Purdue Pharma's marketing practices.

    A spokesman for the office, which serves as the investigative arm of Congress, said the study will likely begin soon.

    Although some say the company's aggressive marketing of OxyContin has contributed to problems with abuse, Warner stressed that he and other committee members realize that any possible action by Congress must be tempered with awareness of the drug's benefits to thousands of people who suffer from chronic pain.

    "We're not going to leap to legislation," Warner said. The medical community, law enforcement, patient advocates and others need to be consulted before a decision can be made on what Congress might do to curb abuse of OxyContin, he said.

    At Warner's invitation, the committee heard from one of Purdue Pharma's harshest critics - Dr. Art Van Zee, a Lee County physician who says the over selling of OxyContin has contributed to an Appalachian epidemic that includes rampant addiction, dozens of fatal overdoses and rising crime rates.

    Van Zee told the committee that the company uses marketing data to pinpoint doctors who prescribe OxyContin the most, then dispatches its sales representatives to those physicians with the incentive of making twice their $50,000 annual salary in bonuses for high sales.

    Purdue Pharma has also given away free samples of OxyContin as a promotional effort, Van Zee said, and often pushes its product by underwriting pain management seminars where doctors receive perks both to attend and to speak.

    One Roanoke doctor paid $500 by Purdue Pharma to speak at such a gathering was Cecil Knox, who was indicted earlier this month in federal court on charges of overprescribing OxyContin and other narcotics to the point of causing death or serious injury to 10 of his patients.

    Purdue Pharma has said it did not use Knox extensively as a speaker.

    Van Zee, who is also leading a petition to have the Food and Drug Administration take OxyContin off the market, told the committee that current regulations allow the pharmaceutical industry to influence prescribing practices. "For me, that's a recipe for commercial success and public health problems," he said.

    Robin Hogen, executive director of public affairs for Purdue Pharma, said there is no truth to Van Zee's allegation that the company targets doctors who are the most liberal prescribers of OxyContin, which last year accounted for sales of more than $1 billion.

    "We actually spend more time with physicians who write fewer prescriptions, because that's where the potential is," he said.

    Paul Goldenheim, vice president for research at the Connecticut-based company, said the $200 million spent last year on marketing and promoting OxyContin represents about 20 percent of total sales, which is the industry norm. That figure also includes educational programs that warn of potential abuse of OxyContin, which the company has intensified since first learning of problems in some parts of the country in 2000, Goldenheim said.

    The Drug Enforcement Administration has said that excessive promotion of OxyContin has contributed to abuse, which occurs when addicts compromise the drug's time-release feature by crushing the pills and then swallowing, snorting or injecting the powder for an intense high similar to heroin's.

    An FDA official did not respond directly when asked Tuesday by Sen. Susan Collins, R-Maine, if he agreed with that assessment.

    All John Jenkins, director of the agency's Center for Drug Evaluation and Research, would say was that Purdue Pharma is "generally in compliance with FDA regulations." The company does not advertise OxyContin directly to potential patients, he said, although there is no regulation to prevent that.

    The primary goal of Purdue Pharma's marketing is effective pain management, Goldenheim said.

    "While some may characterize these activities as 'aggressive marketing,' we believe that our efforts to alert the medical community to the vast under-treatment of pain in the United States ... [were] in fact in the interest of public health," he said.

    Some lawsuits have claimed that Purdue Pharma overpromoted OxyContin while playing down its risks, but that allegation has yet to be proven in court. Earlier this year, a federal judge in Kentucky threw out part of a lawsuit that attempted to link the drug's abuse to the company's marketing efforts.

    The lawsuits, including one pending in Western Virginia, also claim that patients became addicted to OxyContin after first taking the drug as prescribed by a doctor. Sen. Hillary Clinton, D-N.Y., said the committee needs to examine that aspect of the problem as well.

    "We have a lot of people who are caught up in this OxyContin abuse who started off as legitimate users and then fell into the abyss," Clinton said.

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