Management Chapter 1 1 Teaching Note Profiting From Pain Business And The Opioid Epidemic This Case

TEACHING NOTE

Profiting from Pain: Business and the U.S. Opioid Epidemic

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This case illustrates the following themes and concepts discussed in the chapters listed:

Theme/Concept Chapter

Stakeholder analysis 1

Corporate social responsibility and citizenship 3

Government regulation of business 7

Consumer protection 14

Case Synopsis

This case describes the U.S. opioid epidemic and explores its causes. The case addresses the role

played by prescription drug companies, including Purdue Pharma, the maker of OxyContin; drug

TEACHING TIP: WHERE TO USE THE CASE IN THE COURSE

This case is integrative, in that it draws on many themes of the text. It may be used at the end of

the course as a final, integrative assignment, or with the study of Chapter 14 (consumer

protection). If used with Chapter 14, the instructor should refer to earlier work on social

responsibility and government regulation.

TEACHING TIP: VIDEOS

Several videos may be used in conjunction with this case.

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class, but the instructor may wish to assign it for outside viewing or show in class a short

Fox News aired a segment in a series called “Drugged” (3:34, May 31, 2018) in which host

Tucker Carlson interviews journalist Barry Meier, author of Pain Killer, about the role of Purdue

Pharma in the opioid epidemic. It is available here:

www.youtube.com/watch?v=juthG7JgS5I

Discussion Questions and Answers

1. How would you define the opioid epidemic referenced in the title of the case?

2. an outbreak or product of sudden rapid spread, growth, or development

Instructor prompt: Does opioid use in America fit this definition?

Yes. The opioid epidemic in the title refers to the rapid spread of addiction, injury, and death

associated with prescription opioids in the United States since the late 1990s. The CDC

called it “the worst drug overdose epidemic in [U.S.] history.”

Instructor prompt: What groups were most affected by the epidemic?

2. List the various businesses mentioned in this case, including drug manufacturers,

distributors, clinics, and illegal drug dealers. Do you believe they acted in an ethical

and socially responsible way, and why or why not?

Business

No, did not act responsibly:

Yes, acted responsibly:

Drug manufacturers

• Purdue Pharma

• Also: Teva, Johnson

& Johnson, Endo,

Allergan

• Aggressively

marketed Oxycontin,

causing its use to soar

• Downplayed potential

for addiction, without

solid scientific basis

• Found to have

misbranded

OxyContin “with

intent to defraud and

mislead”

• Did not properly

formulate first-

generation

OxyContin, allowing

for abuse

• Close correlation

between number of

opioids prescribed and

overdose deaths

• Brought to market a

drug that treated

severe pain

• In 2010, changed

formulation of

OxyContin so it could

not be crushed or

dissolved

• Lobbied for hard-to–

abuse formulations of

opioids

Distributors

• McKesson

• Also: Amerisource

Bergen, Cardinal

Health

• Paid $170 million in

fines for failure to

implement effective

controls to prevent

diversion for

nonlegitimate uses

• Shipped only FDA-

approved drugs

• Did not manufacture

or prescribe opioids

Pain clinics

• American Pain

• Prescribed almost 2

who had been patients

at AP died in Florida,

and more in other

states

Drug dealers

other drug dealers

directly to addicts

through street sales

3. What stakeholders were impacted by the actions of these businesses? Which were

helped, and which were hurt, and how?

The instructor can add a column to the right, continuing the board work in dialogue with

students, as follows. (Alternately, instructors might wish to distribute a blank handout and ask

students to work in small groups to fill in the cells.)

Business

Stakeholders helped

Stakeholders hurt

Drug manufacturers

• Purdue Pharma

• Also: Teva, Johnson

& Johnson, Endo,

Allergan

• Some patients with

chronic pain had

access to pain

medication who might

not have had access

previously

• Shareholders and

owners (e.g., Sackler

family) made a lot of

money

• Addicts: tens of

thousands of deaths

due to opioid

overdose

• Communities and

government: increased

costs for law

enforcement, health

care, public welfare,

child services

• Victims of crime (e.g.,

theft to support

addiction)

• Other businesses: loss

of economic

productivity,

difficulty hiring

Distributors

• McKesson

• Also: Amerisource

Bergen, Cardinal

Health

• Efficient delivery of

medication,

benefitting

pharmacies, hospitals,

and patients

• Shareholders made a

lot of money

• Failure to divert drugs

that were used

inappropriately led to

all the outcomes listed

above

Pain clinics

• American Pain

• Owners and doctors

made a lot of money

prescribing and

• Inappropriate

dispensing of opioids

led the all the

outcomes listed above

Drug dealers

to all the outcomes

listed above

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4. Do you believe that drug companies fraudulently marketed their products? Why or

why not?

5. In what ways did the government regulate the production and distribution of opioids?

Do you believe the government acted appropriately in doing so, and why or why not?

6. Looking at the case as whole, what organizations or individuals do you believe bear the

greatest responsibility for the opioid epidemic, and why? What should be the

consequences for those responsible?

• Counter argument: Opioids are highly addictive. Addiction causes changes in the brain,

making it almost impossible to quit without medical assistance. Individuals who attempt

• Counter argument: Purdue properly obtained FDA approval for OxyContin, for which

there was a legitimate medical use. It was not responsible for individuals who abused the

Teaching Tip: This argument raises the fascinating question: Why did the government keep

raising the quota? There is no public information about the negotiations that occurred between