In the wake of decades of contentious legislation, billions of dollars in penalties, and hundreds of thousands of opioid war casualties, last week the abominated OxyContin maker Purdue Pharma officially ceased operations.
The Connecticut behemoth’s bankruptcy proceedings started in 2019 on the wings of several thousand devastating lawsuits over its notorious deceptive marketing of Oxy starting in the ’90s. Purdue went out via a $7.4 billion settlement plan for compensating victims and funding initiatives to mitigate the epidemic that it manufactured, doused in rocket fuel, and ignited with flame throwers.
Massachusetts is expected to receive about $105 million from the Purdue pot “to help support opioid prevention, harm reduction, treatment, and recovery throughout the Commonwealth.” That’s nearly 10% of the roughly $1.1 billion that the commonwealth is slated to get in total from a range of culprits for remediation through 2038. Another tranche is coming from the consulting giant McKinsey, which BINJ reporting showed had continued its work advising the state on healthcare matters despite paying out for its “illegal and dangerous partnership with Purdue Pharma”
Some industry watchers have applauded the transition to the Knoa Foundation, a 501(c)(4). The new entity will still make and sell OxyContin, but is restricted from marketing the prescription painkiller. The not-for-profit’s larger reinvigorated mission includes the distribution of “millions of doses of lifesaving opioid use disorder treatments and overdose reversal medicines, with no obligation to maximize profits.”
But in addition to some criticisms that the settlement shut out too many families of OxyContin victims, others recommended that Purdue should have had its organs harvested rather than merely reorganized. Researchers have shown how intertwined the enterprise was with power and influence in the private and public sectors, and are skeptical that the opioid scourge can now be effectively managed with help from the business that started the problem working under a new name and logo.
In a statement regarding the bankruptcy milestone, Mass Attorney General Andrea Joy Campbell noted both the positive and negative. “This settlement, now effective after years of tireless advocacy, is a long-awaited milestone in holding the Sackler family accountable for fueling a crisis that stole lives, fractured families, and left lasting pain in our communities,” the AG said. A prior version of the settlement that would have shielded the individual Sacklers and other Purdue bigwigs from further litigation was rejected by the Supreme Court of the United States.
Campbell continued: “While no amount of money can undo the devastation, I am hopeful that it will deliver critical resources to support healing, prevention, and recovery. I am deeply grateful to the families who turned unimaginable pain into purpose and helped drive this work forward.”
A new beginning?
Noting that the new brand was “established with the key stakeholders and creditor constituencies, including the United States Department of Justice, the States, Territories and other governmental entities, personal injury victims, and other stakeholders,” Knoa released a statement on May 1 explaining that it “begins operations as an independent company created to ensure safe access to medicines that are critical to patient care and to support communities with a purpose dedicated to abating the opioid crisis and improving public health.” (Running a media release on a paid newswire apparently doesn’t meet the prohibited marketing standards).
The switch from satan toward godliness appears to have started in May 2024, with the launch of a partnership with a national cooperative group purchasing organization. Working with the State of Minnesota-run MMCAP Infuse, Purdue announced plans “to provide buprenorphine and naloxone tablets CIII (generic Suboxone), a medication for opioid use disorder (‘MOUD’), at low cost to correctional facilities for incarcerated individuals with opioid use disorder.”
In 2024, the company “provided for distribution 2 million tablets of buprenorphine and naloxone tablets at one penny per tablet.” Last year, it “committed to exceeding that number by 50%, for a total of 3 million tablets.”
For those who have been advocating for more access to drugs like methadone and Suboxone in Mass, it’s a recovery dream come true. One of the current open contracts that will widen the supply chain is worth more than $75 million over 10 years; at Knoa’s rock bottom prices, the commonwealth could secure a stockpile of generic Suboxone to cover innumerable future addicts who have yet to become addicted to opioids.
On the other hand, for anyone who questions the prudence of policies and trends that will likely increase the number of people on recovery drugs, it could seem like we’re in or at least headed for a treatment pharma crisis, powered by some of the original sinners, on par with the original Oxy wipeout.
A 2021 study out of Harvard Medical School and other Greater Boston research institutions warned of “a notable lack of progress geared towards preventing the same aggressive and often illegal marketing practices by these and other pharmaceutical companies going forward.” The authors wrote, “As opioid manufacturers restructure and pivot towards different product areas, clinicians and policy makers should be mindful that without stricter scrutiny the stage is set for history to repeat itself.”
Knoa is not allowed to market its products at all. But with many of the same relationships and people in play, and states across the country struggling with drug-dependent populations hungry for what they are slinging, the products are likely to sell themselves.
‘Interconnected influence’
In a 2024 study “unraveling Purdue pharmaceutical’s role in the global response to the opioid crisis,” University of Toronto researchers investigated “interconnected influence” stemming from, among other unholy relationships, “close ties between the pharmaceutical industry and regulatory bodies.”
Citing prior research which already placed Purdue at the “core root of the opioid crisis” and “the root of the ongoing illicit opioid issues in Canada and the United States,” and drawing on information from state and federal violations compiled by the policy resource center Good Jobs First, the analysis revealed a “socio-technical centrality of Purdue in influencing the response to the harms it caused,” and underscored “the need for stronger regulation and increased transparency surrounding the interactions between pharma, patient groups, governments, and international organizations.”
But while Knoa Pharma is designed as a “public-minded” successor to Purdue Pharma, several of its key figures have direct ties to the opioid crisis—as litigation adversaries, corporate turnaround experts, and advocates for recovery meds like Suboxone.
Marc Kesselman, the interim CEO, is a direct link to Purdue Pharma. He served as general counsel and chief legal officer, and was hired in 2018 to manage the onslaught of litigation the company faced and to navigate its Chapter 11 proceedings.
Dr. Rahul Gupta, a Knoa Foundation trustee, is a leading figure in the advancement of opioid recovery drugs. As the former director of the White House Office of National Drug Control Policy under President Joe Biden, he is also a buprenorphine-waivered practitioner and spent his tenure at the ONDCP aggressively pushing for the removal of barriers to prescribing buprenorphine.
There are also pharmaceutical executives, as well as Steve Bullock, who will serve as the monitor of the trust. The former governor and attorney general of Montana is an adversary turned overseer, having been one of the first to sue Purdue Pharma (and other manufacturers) for fostering the epidemic.
Bullock’s position as the independent monitor is to ensure Knoa Pharma adheres to the strict injunctions preventing the promotion of opioid products. As for which and how much of their drugs wind up where and how they are used, that’s up to the politicians and procurement programs in states nationwide.
