As former advertising professionals, we frequently worked for clients marketing opioid products. One client told Lydia that their opioid had a low potential for abuse despite having no clinical evidence to support the claim. So, we implied less abuse potential in the marketing materials by pointing to data showing that the drug was slowly absorbed into the bloodstream. These sorts of non-relevant claims are common in pharmaceutical advertising. But with opioids, such tactics didn’t just mislead—they helped spark an epidemic. Purdue Pharma’s (formerly Purdue Frederick) marketing strategy is a template for building billion-dollar markets for medications treating everything from cancer to diabetes to depression. These markets don’t appear spontaneously; they are carefully planned and orchestrated.
Building a Blockbuster Brand
OxyContin, a long-acting formulation of oxycodone, was approved in 1996 and became a turning point in pain management. For decades, opioids had been reserved almost exclusively for severe, cancer-related pain—a practice grounded in common sense to minimize the risks of addiction and misuse. However, the 1990s marked a dramatic shift, as drug companies led by Purdue Pharma sought to expand their market by targeting a much wider audience.
Short-acting oxycodone had been available since the 1950s, but its use was confined mainly to oncologists and pain management specialists treating patients with severe, cancer-related pain. Purdue Pharma’s introduction of long-acting oxycodone represented an opportunity to change this paradigm. The company and others launched aggressive campaigns to convince physicians that long-acting opioids could be safely prescribed for all types of chronic pain.
This shift was driven by exaggerated claims and selective omissions from sales representatives and systemic efforts to manipulate scientific research, clinical guidelines, and industry-funded continuing medical education (CME).
Purdue’s strategy included:
- Promoting OxyContin to primary care physicians for conditions like back pain, arthritis, and migraines
- Claiming that long-acting opioids were less prone to abuse than short-acting ones
- Downplaying concerns about addiction risks
These tactics proved highly effective. OxyContin sales exploded from $45 million in 1996 to nearly $1.5 billion by 2002, marking the transformation of opioids from a last resort for severe cancer pain into a widely prescribed treatment for chronic pain across the board.
Leveraging physician influencers
Beyond advertising, Purdue relied heavily on key opinion leaders (KOLs)—physicians paid to promote the company’s perspective. These influential doctors spoke at conferences, authored guidelines, and advocated for expanding opioid use. Between 2013 and 2015 alone, opioid manufacturers paid KOLs over $29 million in speaking fees and honoraria.
Dr. Russell Portenoy, a prominent KOL, led organizations like the American Pain Society (APS), which received significant funding from Purdue. These groups were instrumental in crafting national pain management guidelines that endorsed opioids for all sorts of chronic pain, including backaches, migraines, and arthritis. They even lobbied state medical boards to adopt these recommendations.
The scientific foundation for these claims? A single, flawed study by Portenoy and colleagues examined just 38 patients. Despite its glaring limitations, this study became the bedrock of a narrative that opioids were safe and effective for long-term use in non-cancer pain—a narrative that would fuel a public health crisis. As media scrutiny intensified, Dr. Portenoy disassociated himself from Purdue. In reaction, Purdue created its own pain advocacy groups in 2011 – RxSafetyMatters and RxPatrol – to work with police, legislators, and healthcare professionals to prevent abuse and diversion. They created advocacy groups to address abuse concerns while expanding internationally through Mundipharma, selling opioids in over 50 countries. Critics liken this to Big Tobacco’s playbook—pivoting to global markets as U.S. regulations tighten.
The lasting consequences of unchecked marketing
The opioid epidemic underscores how unchecked marketing can shape public health. Until we recognize these commercial forces, we’re destined to repeat history.
Based on decades of experience in medical advertising, we expose the hidden side of the pharmaceutical industry’s story — empowering patients to make informed decisions about their health.
References:
Van Zee A. The promotion and marketing of OxyContin: commercial triumph, public health tragedy. Am J Public Health. 2009;99(2):221-227.
Hadland SE, Krieger MS, Marshall BD. Industry payments to physicians for opioid products, 2013-2015. Am J Public Health. 2017;107(9):1493-1495.
Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113-130.
Portenoy RK, Foley KM. Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986;25(2):171-186.
As former advertising professionals, we frequently worked for clients marketing opioid products. One client told Lydia that their opioid had a low potential for abuse despite having no clinical evidence to support the claim. So, we implied less abuse potential in the marketing materials by pointing to data showing that the drug was slowly absorbed into the bloodstream. These sorts of non-relevant claims are common in pharmaceutical advertising. But with opioids, such tactics didn’t just mislead—they helped spark an epidemic. Purdue Pharma’s (formerly Purdue Frederick) marketing strategy is a template for building billion-dollar markets for medications treating everything from cancer to diabetes to depression. These markets don’t appear spontaneously; they are carefully planned and orchestrated.
Building a Blockbuster Brand
OxyContin, a long-acting formulation of oxycodone, was approved in 1996 and became a turning point in pain management. For decades, opioids had been reserved almost exclusively for severe, cancer-related pain—a practice grounded in common sense to minimize the risks of addiction and misuse. However, the 1990s marked a dramatic shift, as drug companies led by Purdue Pharma sought to expand their market by targeting a much wider audience.
Short-acting oxycodone had been available since the 1950s, but its use was confined mainly to oncologists and pain management specialists treating patients with severe, cancer-related pain. Purdue Pharma’s introduction of long-acting oxycodone represented an opportunity to change this paradigm. The company and others launched aggressive campaigns to convince physicians that long-acting opioids could be safely prescribed for all types of chronic pain.
This shift was driven by exaggerated claims and selective omissions from sales representatives and systemic efforts to manipulate scientific research, clinical guidelines, and industry-funded continuing medical education (CME).
Purdue’s strategy included:
These tactics proved highly effective. OxyContin sales exploded from $45 million in 1996 to nearly $1.5 billion by 2002, marking the transformation of opioids from a last resort for severe cancer pain into a widely prescribed treatment for chronic pain across the board.
Leveraging physician influencers
Beyond advertising, Purdue relied heavily on key opinion leaders (KOLs)—physicians paid to promote the company’s perspective. These influential doctors spoke at conferences, authored guidelines, and advocated for expanding opioid use. Between 2013 and 2015 alone, opioid manufacturers paid KOLs over $29 million in speaking fees and honoraria.
Dr. Russell Portenoy, a prominent KOL, led organizations like the American Pain Society (APS), which received significant funding from Purdue. These groups were instrumental in crafting national pain management guidelines that endorsed opioids for all sorts of chronic pain, including backaches, migraines, and arthritis. They even lobbied state medical boards to adopt these recommendations.
The scientific foundation for these claims? A single, flawed study by Portenoy and colleagues examined just 38 patients. Despite its glaring limitations, this study became the bedrock of a narrative that opioids were safe and effective for long-term use in non-cancer pain—a narrative that would fuel a public health crisis. As media scrutiny intensified, Dr. Portenoy disassociated himself from Purdue. In reaction, Purdue created its own pain advocacy groups in 2011 – RxSafetyMatters and RxPatrol – to work with police, legislators, and healthcare professionals to prevent abuse and diversion. They created advocacy groups to address abuse concerns while expanding internationally through Mundipharma, selling opioids in over 50 countries. Critics liken this to Big Tobacco’s playbook—pivoting to global markets as U.S. regulations tighten.
The lasting consequences of unchecked marketing
The opioid epidemic underscores how unchecked marketing can shape public health. Until we recognize these commercial forces, we’re destined to repeat history.
Based on decades of experience in medical advertising, we expose the hidden side of the pharmaceutical industry’s story — empowering patients to make informed decisions about their health.
References:
Van Zee A. The promotion and marketing of OxyContin: commercial triumph, public health tragedy. Am J Public Health. 2009;99(2):221-227.
Hadland SE, Krieger MS, Marshall BD. Industry payments to physicians for opioid products, 2013-2015. Am J Public Health. 2017;107(9):1493-1495.
Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113-130.
Portenoy RK, Foley KM. Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986;25(2):171-186.