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Congressional Report: WHO Parroting Purdue Pharma Marketing in Prescribing Guidelines

May 23, 2019

In a report released Wednesday, U.S. representatives Katherine Clark (D-MA) and Hal Rogers (R-KY) accused the World Health Organization of allowing Purdue Pharma to have undue influence in the creation of its opioid prescribing guidelines, citing multiple WHO documents that parrot the pharmaceutical company’s marketing talking points.

“According to Purdue’s own internal planning documents, the company sought to influence the WHO’s recommendations on how health care providers and policy makers should administer prescription opioids,” Clark and Rogers said in the report. “Almost a decade later, multiple aspects of Purdue’s marketing strategy were included in two WHO guidelines on opioid prescribing.”

Specifically, the report says WHO’s Ensuring Balance in National Policies on Controlled Substances, Guidance for Availability and Accessibility of Controlled Medicines in 2011 repeated Purdue’s claim that opioids “are known to be safe and there is no need to fear accidental death or dependence,” and that Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses (2012) included messaging that “there is no maximum dosage of strong opioids, like OxyContin, for children.”

Further, the report notes, Persisting Pain in Children introduced a significant change in WHO’s model for treating pain. In its initial guidelines, WHO outlined a three-step treatment ladder: non-opioids, then a combination of non-opioids and low-strength opioids, and finally strong opioids, such as Purdue’s OxyContin, if necessary. Persisting Pain in Children included a recommendation for bypassing the second step. Pushing to replace the combination found in the step 2 with OxyContin was found to be part of Purdue’s planning documents from the 1990s, according to the U.S. representatives’ report.

Clark and Rogers acknowledge in the report that without complete financial records, they are unable to say with certainty that money flowed directly from Purdue to WHO, but add that a review of publicly available information suggests the pharmaceutical company obtained influence through financial ties with a series of intermediaries.

“We are highly troubled that, after igniting the opioid epidemic that cost the United States 50,000 lives in 2017 and tens of billions of dollars annually, Purdue is deliberately using the same playbook on an international scale,” Clark and Rogers wrote. “Moreover, we are disturbed that the WHO, a trusted international agency, appears to be lending the opioid industry its voice and credibility.”

In a statement emailed to NBC News, Purdue Pharma denied the claims in the congressional report, saying the report sought “to vilify the company through baseless allegations.”

“Purdue Pharma LP is solely based in the United States with no international operations,” the company said in the statement. “The company has never violated any applicable rules or guidelines and no formal complaint or enforcement activity has resulted from Purdue’s financial support or relationship with any third party.”

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