Disturbing research on OxyContin shows the problems of prescription drugs as a "market" and perhaps why we should have a national health system

If you consume media targeting older demographics, you are familiar with advertising for prescription drugs.

It can be fun to make fun of the names, the ads, and to be concerned about the various side effects of the drugs as outlined in the ads.

But there is no question that demand for such drugs increases as a result of the advertising.

A couple weeks ago, the New York Times published a story, "Damage From OxyContin Continues to Be Revealed," featuring the results of various research studies about OxyContin, the addictive prescription drug that is widely abused, reaping great profits for Purdue Pharmaceuticals, the company that made and marketed it.

Research results include:

• Perdue marketed the drug in states that had fewer regulatory requirements, with a finding that distribution was twice as high in the lightly regulated states concomitant with higher rates of addiction
• per capita OxyContin use was up to 250% higher in the states with lighter regulations
• 65% of the increase in overdose death rates was tied to the introduction and marketing of OxyContin
• because of the high rate addiction, when the formulation of OxyContin was changed, making it less satisfying to existing addicts, the shift to heroin as an alternative led to a skyrocketing of heroin use, a tripling of overdose deaths and a massive increase in Hepatitis B and Hepatitis C infections.

It definitely puts the whole system of pharmaceutical marketing under a scary light. And shows how the profit motive shapes the demand for particular drugs in ways that may have little to do with promoting positive health outcomes ("The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy," American Journal of Public Health 99:2 [2009]; "Propaganda that Masqueraded as Pharmaceutical Marketing," Psychology Today).

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Special addition on hydroxychoroquine and remdesivir

Obviously, we want cures for covid19, but the promotion of hydroxychoroquine has become political, pushed by financial and conservative interests as a potential victory for President Trump and as a way to push to the side the recognition of the management failures of the Trump Administration in reacting to the pandemic.

Politico reports ("Coronavirus gets a promising drug. MAGA world isn't buying it") that conservative  media remains wedded to hydroxychoroquine promotion in the face of more positive reports on remdesivir, which are promoted by more traditional scientific and medical experts.

That being said, remdesivir helps people recover more quickly, but it doesn't necessarily reduce the death rate ("Remdesivir Trial Missed a Huge Opportunity," Bloomberg).

Fortunately, it looks like there may be better drug candidates ("Old Drugs May Find a New Purpose: Fighting the Coronavirus," New York Times; "High hopes for Covid-19 vaccine developed by Oxford scientists," France24). But regardless it will take quite some time for a vaccine to be developed, to find drugs that may help those who become sick, etc.

But it's also pretty damning that a cure becomes more about politics and less about science. From the Politico article:

Indeed, the same segment of the right that claimed scientists and the media were deliberately downplaying hydroxychloroquine in order to hurt Trump’s standing are now the ones downplaying remdesivir. On Fox News, Laura Ingraham suggested that remdesivir, as a newer drug being produced by the pharmaceutical company Gilead Sciences, could be unsafe and expensive. Those who initially helped raise the profile of hydroxychloroquine raised doubts about the remdesivir studies.

The unexpected reaction appears to stem from the differences in how the two drugs came into the public spotlight. Hydroxychloroquine bubbled up through the MAGA grassroots — little-known investors promoted it online, got on Fox News and suddenly the president was talking about it from the White House. Remdesivir’s progress came through a government-funded trial that had the blessing of Dr. Anthony Fauci, the bête noire of Trump hardliners who blame the government’s top infectious disease expert for undermining the president and causing unnecessary economic damage with his social-distancing guidelines.