How the Legal Case Against Purdue for Deceptive Marketing of Oxycontin was Nearly Derailed

We recently posted about how Purdue Pharma and its top executives pleaded guilty to "misbranding" the potent narcotic drug Oxycontin. It turns out the pleas bargain was almost derailed. Yesterday, the Washington Post reported,

The night before the government secured a guilty plea from the manufacturer of the addictive painkiller OxyContin, a senior Justice Department official called the U.S. attorney handling the case and, at the behest of an executive for the drugmaker, urged him to slow down, the prosecutor told the Senate Judiciary Committee yesterday.

John L. Brownlee, the U.S. attorney in Roanoke, testified that he was at home the evening of Oct. 24 when he received the call on his cellphone from Michael J. Elston, then chief of staff to the deputy attorney general and one of the Justice aides involved in the removal of nine U.S. attorneys last year.

Brownlee settled the case anyway. Eight days later, his name appeared on a list compiled by Elston of prosecutors that officials had suggested be fired.

Brownlee ultimately kept his job.

Justice Department officials said it was not unusual for senior members to weigh in on major criminal cases, and a spokesman, Dean Boyd, said the department 'encourages healthy internal debate and discussion on complex cases like this one.'

Several former federal prosecutors also said that defense attorneys routinely try to appeal to high-ranking department officials in an effort to derail prosecutions. Still, Brownlee and other former prosecutors said nighttime calls such as Elston's, coming just hours before the end of a long, complex case, are unorthodox, particularly when the department's criminal division already has signed off on a case.

Brownlee said the head of the criminal division had authorized him that afternoon to execute the plea agreement.

This story is now linked to the ongoing controversy about whether the current US Attorney General improperly sought to fire several US Attorneys.

But the implications of this story for health care are additionally troubling. We have posted on many examples of deceptive and/or stealth marketing by pharmaceutical, biotechnology and device manufacturers, and questionable claims and advertising by hospitals and insurers and managed care organizations.

Physicians, particularly primary care physicians, working under increasing bureaucratic restraints and forced to see patients increasingly quickly now must also operate in a swamp of questionable marketing and pseudoevidence. When time is short, it is all too tempting to just prescribe the latest and greatest heavily promoted drug or order the the latest and greatest whizbang diagnostic test.

It is bad enough that corporate executives condone deceptive marketing of drugs and devices. It is worse to hear that government officials who are responsible for law enforcement seemed to want to cut those who were fostering deceptive advertisers and creating pseudoevidence some unjustified slack.

At least the US Attorney on the ground in this case stood up for what was right. But who else has the courage to stand up for some honesty in health care?