Scott Gottlieb denies pharma manipulation, but ties to opioid industry have dogged him for years.

By Paul Thacker

If not for the COVID-19 virus, the American media would be consumed by the opioid pandemic. Since 1999, more than 500,000 Americans have perished due to opioid overdoses—100,000 just in the last year. While denying culpability for decades, the pharmaceutical industry is finally paying a price, although a minor one. Purdue Pharma is now in bankruptcy, but the Sackler family who fueled the epidemic will escape legal accountability and walk away with billions.

Still, many are pushing to hold those responsible to account, the latest being a House investigation into the consulting firm McKinsey, which advised the FDA on drug safety at the same time that it was advising Purdue on ways to increase Oxycontin sales.

Just think about that for a moment—for years McKinsey played both cop and robber. Of course, this is absolutely heinous, and should not have happened. And of course, nobody will be prosecuted. But buried down in the House’s 53-page report are a few paragraphs on McKinsey employees emailing that they had influenced a 2018 speech on opioid safety by FDA Commissioner Dr. Scott Gottlieb.

“McKinsey had nothing to do with my speech,” Scott Gottlieb emailed The DisInformation Chronicle. Since leaving the FDA, Gottlieb has returned to the American Enterprise Institute as a senior fellow in healthcare policy. “I am not responsible for whatever inappropriate and inaccurate boasting the McKinsey partners do on their internal email, apparently seeking to take credit with each other for things they had no role in.”

The veracity of each side’s claim—McKinsey that they influenced the FDA Commissioner; Dr. Gottlieb that they didn’t—is impossible to prove. Washington is filled with elected officials and bureaucrats who deny undue influence, as well as innumerable lobbyists, consultants, and nonprofit advocates—even journalists!—who claim access and influence they really don’t have.

The problem for Dr. Gottlieb, however, is that ties to the opioid industry—both personal and through his employer, the American Enterprise Institute—have hounded him for years. After Trump nominated him to run the FDA, Senator Sherrod Brown of Ohio highlighted Gottlieb’s decades-long pharma ties. “He has supported allowing those same companies to rush their drugs — including potentially addictive opioid painkillers — onto the market before we’re sure that they’re safe,” Brown said.

“It’s his word against McKinsey’s,” said Dr. Andrew Kolodny, medical director of the opioid policy research collaborative at Brandeis University. “But we have strong evidence that they would have been capable of influencing a Gottlieb speech, because they were working so extensively with the FDA.”

When Trump announced Gottlieb’s nomination, reporters and congressional staff began digging through his financial disclosures. In a comprehensive analysis, The Intercept found that companies involved in manufacturing and distributing opioids had paid Gottlieb $45,000 in speaking fees.

Donald Trump’s pick to oversee big pharma is addicted to opioid-industry cash,” the story’s headline observed.

Mallinckrodt Pharmaceuticals, the maker of a highly addictive generic oxycodone pill, paid Gottlieb $22,500 for a speech in London last November shortly after the U.S. presidential election. Prosecutors have charged that the firm ignored red flags and supplied as many as 500 million suspicious orders in Florida for its oxycodone product between 2008 and 2012. Mallinckrodt reached a tentative settlement this week, agreeing to pay $35 million while admitting no wrongdoing.

The Healthcare Distributors Alliance, a trade group for the largest opioid wholesale distributors in America, also retained Gottlieb as a speaker last September.

When the Drug Enforcement Administration began going after some of these opioid distributors in 2012, Gottlieb penned an essay in the Wall Street Journal attacking federal law enforcement. The American Enterprise Institute republished Gottlieb’s essay which made the remarkable claim that by pursuing criminal activity the DEA “is burdening a lot of innocent patients, including those with legitimate prescriptions who may be profiled at the pharmacy counter and turned away.”

Like Gottlieb, the American Enterprise Institute is not shy about pocketing opioid cash.

Think tank fellow as corporate lobbyist

In 2019, ProPublica ran an explosive investigation into the American Enterprise Institute’s entanglement in Purdue’s media playbook to plant stories that downplayed Oxycontin’s role in addicting and killing Americans. According to emails and documents leaked to ProPublica, Purdue paid the think tank $50,000 annually from 2003 to the time of the story’s publication in 2019, for a total of $800,000.

During the years Purdue funded the think tank, the AEI’s Sally Satel penned several essays in outlets such as Slate and the New York Times that downplayed the dangers of Oxycontin. Like Gottlieb, Satel is an AEI senior fellow in health care policy.

“When you scratch the surface of someone who is addicted to painkillers, you usually find a seasoned drug abuser with a previous habit involving pills, alcohol, heroin or cocaine,” Satel wrote in 2004 essay for the New York Times, complaining that doctors were being locked up for prescribing opioids. “Contrary to media portrayals, the typical OxyContin addict does not start out as a pain patient who fell unwittingly into a drug habit.”

The New York Times identified Satel as a scholar at AEI, without noting her involvement with Purdue and the company’s funding of AEI. In her essay, Satel also cited a study, without noting that Purdue funded it and Purdue employees wrote it. Before publishing the piece in the Times, Satel sent a draft to Burt Rosen, Purdue’s DC lobbyist to ask him if it “seems imbalanced.”

When the Times published Satel’s essay, AEI’s fundraiser emailed Purdue’s Rosen about “Sally’s very good piece.”

“Great piece,” Rosen responded.

Satel told ProPublica that she does not accept personal payment for essays and that she had no idea that Purdue funded her employer, AEI. The investigation also noted:

Internal emails show the main Purdue contact with AEI was Rosen, the drugmaker’s in-house lobbyist based in Washington. In one email, Rosen described the leaders of the think tank as “very good friends” and also noted that former FDA Commissioner Mark McClellan ascended to that job after a stint at AEI as a scholar. Rosen also organized a group of pain reliever manufacturers and industry funded groups into an organization called the Pain Care Forum. It met to share information on government efforts to restrict opioid prescribing, according to records produced in litigation against Purdue.

Through a corporate opposition research firm called Dezenhall Resources, Purdue also began helping to place Satel on national programs around the country. In one example Dezenhall Resources and a Purdue vice president prepped Satel for an appearance on NPR’s “The Diane Rehm Show.” After this interview, Satel later denied the dangers of Oxycontin in Forbes (“OxyContin doesn’t cause addiction. Its abusers are already addicts”) and defended Purdue in a Wall Street Journal essay titled, “Oxy Morons

The summer before ProPublica’s 2019 expose on Satel, she penned an essay in The Atlantic that dismissed the known dangers of opioids. The essay made no mention of Purdue payments to AEI.

Regardless of Dr. Gottlieb’s opioid industry relationships, as revealed through financial disclosures and investigative journalists, Sid Wolfe, Founder and Senior Advisor to Public Citizen, said that Gottlieb’s ties to industry should have disqualified him from government service. Wolfe added that the Open Payments website shows that pharma companies paid Gottlieb over half a million dollars, mostly in consulting fees, before Trump nominated him.

“This is quite opposite of the necessary public health qualifications for FDA Commissioner,” Wolfe said.

EDITOR’S NOTE: Having the curtain pulled back on her relationship with the Purdue has not harmed the credibility of AEI’s Sally Satel in some journalism circles. Earlier this month, NPR quoted Satel criticizing the Centers for Disease Control and Prevention guidelines for limiting opioid use. NPR made no mention of Purdue’s history with Satel and AEI.

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