"The Role of Purdue Pharma and the Sackler Family in the Opioid Epidemic" Full Hearing Transcript

Chairman Maloney: (00:00) We'll begin the hearing in just a moment when you, they tell me that they are ready to begin the live stream. Millions of American families whose lives have been ravaged by a nation's opioid epidemic. For decades now, parents and family members have watched with broken hearts as their loved ones, struggled with opioid addiction. Chairman Maloney: (00:43) Since 1999, nearly half a million lives have been cut short by opioid overdoses in the United States alone. These lives were taken from us too soon. They were taken unnecessarily and they were taken unfairly. But each life lost, they have been many other family members, parents, siblings, children, and loved ones left to pick up the pieces. Chairman Maloney: (01:09) And right there in the middle of all this suffering was Purdue Pharma. The manufacturer of a highly addictive prescription pain killer, Oxycontin. This company played a central role in fueling one of America's most devastating public health crisis. Purdue has generated more than 35 billion in revenue since bringing Oxycontin to market. Chairman Maloney: (01:35) Purdue has been owned by the Sackler family since 1952. The Sackler family has profited enormously from the Oxycontin business. Since bringing this painkiller to market, the family has withdrawn more than 10 billion from the company. Purdue has now admitted that after it got caught in 2007, after it pled guilty and paid a fine, it continued to commit crimes for another decade, like nothing happened. Documents obtained our committee by the Department Of Justice and by State Attorneys General show that members of the family were directly involved with the day-to-day operations of the company. Chairman Maloney: (02:19) And they launched an incredibly destructive reckless campaign to flood our communities with [inaudible 00:02:28] at behest of the Sackler family, Purdue targeted high volume prescribers to boost sales of Oxycontin. Ignored and worked around safeguards intended to reduce prescription opioid misuse, and promoted false narratives about their products to steer patients away from safer alternatives, and deflect blame toward people struggling with addiction. And most despicably Purdue and the Sacklers work to deflect the blame for all that suffering away from themselves and onto the very people struggling with the Oxycontin addiction. Chairman Maloney: (03:11) Yet, despite years of investigation and litigation, no member of the Sackler family has ever admitted to any wrongdoing, taken any responsibility for the devastation they caused, or even apologized for their actions. In their settlement with the Justice Department, Sackler family members admitted no liability. I believe that it was appropriate that Purdue pleaded guilty to criminal charges because that's what it was, a crime. It was a crime against the American people. Chairman Maloney: (03:48) And with all the evidence that the Sackler family was directly involved in Purdue's criminal actions, they were pulling the strings in fact, they should not escape accountability for these criminal actions this time around. Today, for the first time, two members of the Sackler family, David Sackler and Kathy Sackler, will be testifying publicly before the American people about their role in the opioid crisis. They hold senior positions in the company and on the board of directors. As these documents show, they placed their insatiable thirst for personal wealth over the lives of millions of American families they destroyed. It is my hope that today's hearing would give the American people, including the scores of victims who have had their families shattered, an opportunity to hear directly from those responsible for these atrocities. I do want to thank both members of the Sackler family appearing today for agreeing to testify voluntarily, without the need for subpoenas. We will also hear from the CEO of Purdue. Chairman Maloney: (04:59) I would like to note that this investigation was launched by my predecessor Chairman, Elijah Cummings. He cared deeply about this issue because he saw how Purdue and others intentionally targeted the most vulnerable among us. He worked very closely with another senior member of our committee, Congressman Mark DeSaulnier, of California, who I now recognize for two minutes for his opening statement. Mark DeSaulnier: (05:33) [inaudible 00:05:33] also want to mention our former Chair, our good friend and Elijah Cummings. Like myself, he was a survivor of cancer, and he suffered, and he welcomed appropriate use of painkiller. Unfortunately, he's not with us today. Although in spirit, I believe he is. It's been said in the Bible, according to Luke, that to those who much is given, much is required. Sackler family has been given so much; great education, billions of dollars, a company with a solid reputation at the time. And they've changed it with unbelievable marketing. And as the record shows a willful belief in making more, making more. Mark DeSaulnier: (06:22) There are a lot of Americans in this country who are in jail right now. Most of them, people of color, black, like Eric House. A man, who was sentenced to life in prison for selling $30 worth of marijuana. He didn't have the kind of resources he wasn't given like so many other people in our prison system, for selling small amounts of drugs. Mark DeSaulnier: (06:48) And heres this family, with this powerful, powerful platform, it's really sad. $78.5 billion it cost Americans every year, according to the Center For Disease Control, 91 Americans on average lose their lives every day. And as the Chair said, countless others suffer. I'm so glad that we are looking into it. And it's my hope we will have real concrete measures to make sure this never happens again. And most importantly, for me, I'm looking for justice, and I haven't seen it yet. Thank you, Madam chair. I yield back. Chairman Maloney: (07:25) Thank you, sir, for your leadership. I would now like to play video statements from individuals who have bravely come forward to share their personal experiences with addiction with the committee. Barbara Vanryan: (07:46) My name is Barbara Vanryan. In July, 2004, I got the call that no mother ever, ever wants to get. It was UC San Diego Medical Center informing me that my 24 year old son, Patrick Stewart was in ICU and was not expected to live. Patrick was a graphic designer and a certified personal trainer. He was given a single Oxycontin, and that single Oxycontin stopped his breathing in his sleep. Barbara Vanryan: (08:18) Words have not been invented that can convey the horror and the pain of losing a child, and the countless ways in which it changes everything forever. The first year I woke each morning, wishing that I too, were dead. I stayed alive for the others I love and to fight, to keep this from happening to others. Barbara Vanryan: (08:42) I'm here to tell you that the grief from the loss of a child is not a process. It is a lifelong weight upon one soul. A weight for which I hold Purdue and the Sacklers, responsible. Thank you. Nan Golden: (09:05) Thank you, House Oversight Committee. My name is Nan Golden. I'm an artist and a survivor of the opioid crisis. In 2014, I was prescribed Oxycontin for a wrist surgery and was addicted within a few days while using as prescribed. Doctors continue to prescribe it to me for pain and then anxiety. Oxycontin damaged really emotionally, physically, and financially. Nan Golden: (09:33) Before Oxycontin, I traveled constantly and showed my work in museums around the world. My addiction destroyed my relationships with my friends and family, and almost ended my career of 50 years. I spent my entire savings and was locked in my house for three years. I delayed treatment because of my crippling fear of withdrawal. Nan Golden: (09:58) It's a form of torture. I overdosed in 2017 and spent months in the detox clinic. I regret the years I've lost, which are irretrievable. Now, I try to speak for the half a million that no longer can. Speaker 1: (10:21) Thank You House Oversight Committee for inviting families in to tell their stories. My son, Jeff was prescribed Oxycontin after a knee injury in his junior year of high school. The doctor told him to take those pills every four hours, even if he wasn't experiencing pain. He told him to take them for months as he worked through physical therapy and tried to heal from that knee injury. No one told us that it might not be easy for Jeff to stop using those pills when the prescription ended. Speaker 1: (10:52) No one told us the risks of addiction. Certainly, no one told us that my son might die of an overdose 10 years later, which is what he did on August 5th, 2014. And now our family approaches another holiday season without my son. The damage and the pain, and the grief is lifelong, and Purdue Pharma and the Sacklers need to be held accountable for what they've done to our family, and countless other families. Thank you. Tiffany Scott: (11:29) Hello. My name is Tiffany Scott, mother of 28 year old Tierra Brown Louis. Tierra was a young adult who loved to sing and dance, and hang out with her friends and family. And she also was one who live with a chronic health condition. A health condition in which she was legally prescribed prescription opiates, including Oxycontin. Tara was introduced to Oxycontin in the ninth grade after she experienced a medical emergency and was admitted at a local hospital. Tiffany Scott: (11:57) She was discharged with a prescription of Oxycontin, which was filled by me, by her mother, and received several appointments thereafter and continuous prescriptions of the same medication; of Oxycontin. Tierra became opiate dependent. She started drug seeking. She started missing classes in school. She started disconnecting with family and friends. She ultimately dropped out of ninth grade. She never returned to high school. She became criminal justice involved. She started disconnecting with her parents, both her mom and dad. Tiffany Scott: (12:31) She socially isolated from everyone. She never returned to her normal self. She never recovered. Tierra understood that she was a person in active addiction. She knew that she was dependent on her medication. She knew about Oxycontin. She looked it up. She talked to people about it. She started to self-advocate. She became a peer recovery coach. She started to give back. She wanted her pain managed successfully. Tiffany Scott: (12:59) However, due to her opiate dependence, that dependence of Oxycontin, she could not get it right. She kept asking. She kept seeking support. And when it was unsuccessful, she experienced a [inaudible 00:13:13] crisis in May of this year. Ultimately in resulting in her death, she was found unresponsive on May 17th of 2020. Tiffany Scott: (13:22) And if there's anything that I can say to anyone who's listening to this call today that the effects of Oxycontin is impactful. And if you can do anything, if nothing else, please remember our names. Remember my name. My name is Tiffany Scott, the mother of Tierra Brown Louis, a person who lost her life as a result of Oxycontin. Thank you for having me today. Pete Jackson: (13:52) Chairman Maloney, members of the committee, I'm Pete Jackson, speaking to you because in 2006, I lost my 18 year old daughter, Emily, from a single Oxycontin pill. I'd like to tell you a little bit about my daughter. She was a sweet, friendly girl. She was the core of our family. She would tell us she loved us every single day. She had this big heart, and she had a group of close friends, and they would turn to Emily when their own lives were in turmoil. She was a gifted comedian and she used her gift to lift up the people around her. Pete Jackson: (14:35) In August of 2006, Emily was staying with her cousins to console them, after they'd lost their father to cancer. And one night, her cousin offered Emily some of her dad's Oxycontin. Emily took one pill. She went to sleep on the couch, and she never woke up. The Oxycontin had induced respiratory depression, and she simply stopped breathing. Pete Jackson: (14:59) That morning, I got the worst phone call of my life. My wife, her son, and I were deeply traumatized by Emily's accidental death. She was just three days from her first day in college. She had her whole life ahead of her. Our family is forever broken. Thank you. Chairman Maloney: (15:25) All of these stories are heartbreaking before I recognize ranking member, Comer, I would like to say that I know that this issue is just as important to him as it is to me. Our staffs have been working together on this investigation and on this hearing. And I want to thank him for helping us arrange today's hearing. Chairman Maloney: (15:47) We may not see eye to eye on every issue, but the opioid crisis has ravaged communities across the country. And it does not discriminate based on red States, or blue States. Mr. Comer, I thank you for your help with this hearing. Recognize you for as much time as you would like. James Comer: (16:12) Thank you, Madam Chair. The opioid epidemic has calls untold harm to millions of Americans. And in my district in rural Kentucky, thousands of my constituents have lost friends and loved ones to this scourge. Before us today, we have one of the largest manufacturers of opioids in the country, and the family that profited off the epidemic, perhaps more than any other. James Comer: (16:36) Over the past 20 years, Purdue Pharma and the Sackler family, which has owned Purdue pharma since the 1950s and had many family members in senior leadership and on the board of the company, have made billions from the proliferation of opioids. They have consistently spread lies in order to minimize the harmful effects of opioids, and increase the numbers of Americans on their drug, Oxycontin. Purdue Pharma created false advertising documents to provide doctors and patients illustrating that time released Oxycontin was less addictive than other immediate release alternatives. James Comer: (17:16) Furthermore, they sought out doctors who were more likely to prescribe opioids, and encourage them, to prescribe Oxycontin because it was safe. They did this because Oxycontin quickly became a cash cow for the company. In 2007, these lies resulted in Purdue Pharma pleading guilty to felony charges of misbranding Oxycontin, and paying more than $600 million in criminal penalties. James Comer: (17:46) However, this did not stop produce marketing campaign. It just send it underground. Purdue spent the next decade misleading the DEA, defrauding the United States, paying kick backs to companies that would steer patients onto Oxycontin, and exacerbating the opioid epidemic. All the while, the Sackler family profited immensely from the deaths of millions of Americans. James Comer: (18:16) Since the 2007 settled, more than 2,600 federal and state lawsuits were brought against Purdue seeking restitution for the pain and suffering caused by Purdue and the Sackler family. During this time, the Sacklers began taking money out of the company, over $10 billion worth. Known by Forbes magazine as the Oxycontin clan, the Sacklers are now one of the 15 wealthiest family in the country, even richer than the Rockefeller. In September of 2019, Purdue filed for chapter 11, bankruptcy, in an effort to settle these suits based on the companies role in the opioid crisis. In October of this year, Purdue again, pled guilty to criminal charges related to its marketing of Oxycontin, including conspiracy to defraud the United States in violations of the anti-kickback statute. Additionally, Purdue reached a civil settlement with the DOJ, of more than $8.3 billion in civil penalties for Purdue. The dissolution of Purdue pharma, $225 million in civil penalties from the Sackler family. However, October settlement does not conclude the bankruptcy negotiations that are still ongoing. These negotiations could result in billions in restitution, to American families. James Comer: (19:46) Madam Chairwoman, I support this here, as you mentioned in your opening statement. However, I am concerned that holding this hearing in the midst of a multi-billion dollar settlement negotiation will delay and reduce needed restitution for millions of Americans. We talked with the mediator, leading the negotiations, and no party thought having this hearing right now is a good idea. James Comer: (20:08) I told you this before the hearing was scheduled for the first time, and I asked that you delay the hearing until January. You schedule it anyway. Then after realizing the mistake, you canceled the hearing. Yet now, the hearing's back on. And why? I hope it's not because of a New York Times op-ed pressuring you to move forward. Madam Chair can be influenced by a single law professor. There's too much at risk. James Comer: (20:35) I hope that having these hearings, this hearing today does not delay a settlement and result in victims getting less restitution from Purdue and the Sackler family. In this committee, we should do more than identify a problem, and benefit from a short term media mention. We should hold people accountable. I want to hold Purdue Pharma accountable. And I sure as hell don't want to do anything that would help the Sackler family in any court of law. Madam Chair, I yield the remainder of my time and I look forward to your response. Thank you. Chairman Maloney: (21:22) Ms. Miller. I now yield to Ms. Miller. Carol Miller: (21:27) Thank you. Chairman Maloney and Ranking Member Comer. Today's hearing is of the utmost importance to my state of West Virginia, and to many other States across our nation who are facing, and have faced, the devastating impacts of the opioid epidemic. In 2018, there were over 46,000 opioid related overdose deaths in the United States. In that same year, we lost over 700 West Virginians to opioid related overdoses. I know these faces; the victims, their families, they're the person you're standing next to in the line at the grocery store. It's the person who's sitting next to you on the Pew in church. They are your neighbors and your friends. A single life lost to an addiction is one to many. And unfortunately my state has lost thousands of family members over the years to this disease. Throughout the United States, we have seen this epidemic evolve into three stages. First, the individuals were prescribed and then abused their prescription opioids. The second wave was heroin. Carol Miller: (22:43) And of course the third wave is the synthetic, oh gosh, Fentanyl, out of China, Mexico, wherever. The studies that show that those who began to use opioids in the 2000's, 75% of them started with prescription opioids. In a large part, this was due because of the actions that the company represented here today. Purdue Pharma has recklessly and irresponsibly marketed Oxycontin to increase the number of prescriptions to patients, which ultimately resulted in patients becoming addicted to this drug. Carol Miller: (23:22) We've seen the shift to heroin and the other dangerous substances like fentanyl, as prescription opioids became too expensive and too hard to find. These drugs often pose their own risks. And they are only found on the street. For example, in 2016, my hometown of Huntington experienced 28 overdoses in a single day as a result of a contaminated batch of heroin. Thanks to the heroic actions of our emergency responders, 27 of those 28 lives were saved. Carol Miller: (23:59) As a result of this epidemic, families have been decimated. Children are growing up without parents. And I can tell you about those babies that are being born exposed to drugs in the womb. For every thousand babies born in West Virginia, 56.2 are born exposed to opioids. I have sat with those mothers who have made the courageous decision to seek treatment, and I've held those babies struggling with symptoms of withdrawal. It is heartbreaking. Carol Miller: (24:27) This epidemic is shaping generations across my state, and many others. Ask the teachers in the school system, ask the principals, because they're trying so hard to teach these children who were drug exposed, all through the pregnancy and birth, the doctors didn't know what was in their system. Since coming to Congress, I have made addressing the opioid epidemic a priority. I've supported our administration's work to increase access to Naloxone, and provided much needed federal dollars to our treatment centers to help the folks get the help that they need. Carol Miller: (25:04) I've also supported creative community-based solutions that are the result of our local communities, who are coming together and helping our neighbors in need. While we've made great strides to address this terrible epidemic, we must also ensure to address the actions taken by Purdue Pharma in pushing Oxycontin to patients. I hope that we get some of those answers today. Thank you, Madam Chair and I yield back the balance of my time. Chairman Maloney: (25:37) Yields back. Now, I will introduce our witnesses. Our first witness today is David Sackler, who was a member of the board of directors of Purdue Pharma from 2012 to 2018. Our next witness is Dr. Kathy Sackler, who was a vice president and member of a board of directors of Purdue pharma from 1990 to 2018. Chairman Maloney: (26:02) Finally, we'll hear from Dr. Craig Landau, who is the current president and CEO of Purdue Pharma. The witnesses will be un-muted so that we can swear them in. So please unmute them. Please raise your right hands. Do you swear, or affirm, that the testimony you're about to give is the truth, the whole truth, and nothing but the truth, so help me, God? Speaker 2: (26:36) I do. David Sackler: (26:36) Yes, I do. Chairman Maloney: (26:38) Let the record show that the witnesses answered and were affirmative without objection. And written testimonies and statements, will be part of the record. With that, Mr. Sackler, you are now recognized for your testimony. David Sackler: (26:51) Thank you. Chairwoman Maloney, Ranking Member, Comer, and members of the committee. I appreciate the invitation to appear before you. I'm here to give my views and response to the committee's questions. I want to express my family's deep sadness about the opioid crisis. Oxycontin is a medicine that Purdue intended to help people. And it has helped, and continues to help millions of Americans. David Sackler: (27:19) Far too many lives have been destroyed by addiction and abuse of opioids; including Oxycontin. There are many lawsuits that have blamed Purdue and my family for the opioid crisis. While we deny liability, and our vigorously contesting these claims, we want to respond to the opioid crisis. David Sackler: (27:38) Because the prescription medicine that our company manufactured and sold, which was never intended to harm anyone ended up being part of a crisis that has harmed too many people. We are prepared to dedicate billions of dollars and relinquish our interest in Purdue, to fund a settlement that will bring help to those who need it. We are currently engaged in a court order, confidential mediation, to forge a settlement, the contemplates are contributing the entire company along with billions of dollars to abate and address opioid addiction, and abuse. I joined the Purdue board of directors in 2012 and served as a director until 2018. I joined the board because I was hopeful that Purdue's medicines could help people. Like the rest of Purdue's board, I relied on Purdue's management to keep on top of the medical science, and ensure the company was complying with all laws and regulations. David Sackler: (28:35) Some people seem to think that Purdue's board of directors included only members of the Sackler family. But the board also included outside directors who are highly credentialed and prominent professionals from beyond our family. It was my family's intention, and I believe the whole board's goal, to create products that helped patients. Oxycontin is an FDA approved medication available only by prescription, and has been prescribed by doctors to relieve the suffering of millions of Americans. David Sackler: (29:07) Over the years, Oxycontin has been on the market, Purdue work to reduce the risks of addiction and abuse in a number of ways. In the past 20 years, Purdue spent more than a billion dollars on anti abuse and diversion initiatives. Purdue instituted, what I understand was the first voluntary abuse and diversion detection program in 2002. This program was expanded and endorsed by various state governments, who later required Purdue to keep the program in place. And I understand it was used as a model for at least one other pharmaceutical company to follow. The board received regular reports from management, including from former DEA professionals, and former federal prosecutors, confirming Purdue's abuse and diversion detection program was functioning well, and as intended. That was also the conclusion of an outside auditor, approved by the New York State Attorney General. Purdue instituted a strict compliance program that was designed to ensure that Purdue, and its marketing, complied with all laws. David Sackler: (30:14) The board received regular detailed, documented reports, for management that Purdue was effectively implementing that compliance program, and that the company was operating in compliance with law. Purdue also developed the first abuse deterrent opioid. And Oxycontin pill that could not be easily crushed, snorted, or dissolved into water and injected. When thinking about the opioid crisis, I believe it is necessary to keep in mind two medical problems. David Sackler: (30:43) On the one hand, many Americans suffer from terrible pain and need pain relief. On the other hand, the medications like opioids that treat this pain have a potential for abuse and addiction. The FDA and the medical establishment have always had to balance these medical problems. Prescription opioids are used successfully to treat millions of Americans every year. David Sackler: (31:07) Let me conclude by saying this. What you've heard from the press about the Sacklers is almost certainly wrong, and highly distorted. We also fully acknowledge that there is an opioid crisis that has ruined too many lives. And that Oxycontin, addiction and abuse played a role in that. We are truly sorry to everyone who's lost a family member or suffered from the scourge of addiction. Thank you for giving me the opportunity to make this statement. I'm available to answer your questions. Chairman Maloney: (31:43) Kathy Sackler. Kathy Sackler? Kathy Sackler, you're now recognized. Kathy Sackler: (31:53) Thank you, Chairwoman. I was un-muting. Chairman Maloney: (32:00) We can hear you. Chairwoman Maloney: (32:00) We can hear you. Dr. Sackler: (32:03) I just said, thank you. I was just unmuting my microphone. Chairwoman Maloney: (32:11) Chairwoman recognized. Dr. Sackler: (32:13) Thank you. Chairwoman Maloney, ranking member Comber, members of the committee, thank you for inviting me to the hearing today. I appreciate your invitation and the opportunity to appear voluntarily and answer the committee's questions to the best of my knowledge and recollection. Dr. Sackler: (32:39) While I'm here to be responsive to the committee, I want to start by speaking to the families who have lost loved ones to addiction and overdose. I know the loss of any family member or loved one, is terribly painful and nothing is more tragic than the loss of a child. As a mother, my heart breaks for those parents who have lost their children. I am so terribly sorry for your pain and loss. While every family tragedy is unique, I do know how deeply it hurts. I lost my brother, Robert, to mental illness and suicide, when he was only 23 years old. I have learned from my own experience that our loved ones are not to blame for their mental illness or addiction. They deserve compassion and access to effective treatment and support, not stigma. Dr. Sackler: (34:03) Under the difficult circumstances of the pandemic, when resources are increasingly constrained, people are still struggling with addiction and patients are still struggling with serious pain. That is why I and my family are even more intent on achieving the kind of solution that will provide meaningful resources to these individuals and these families and these communities who have suffered so. When I served on the board of Purdue, I acted honestly, conscientiously, and in good faith. I took my fiduciary responsibilities to heart and followed my conscience. My focus mostly was on the needs of patients and doctors. It distresses me greatly and angers me greatly that the medication that was developed to help people and relieve severe pain, has become associated with so much human suffering. Thank you. Chairwoman Maloney: (35:42) Thank you. [inaudible 00:35:47] you're now recognized. Can't hear you. Craig Landau: (36:07) I apologize, I thought I was being unmuted, sorry. Chairwoman Maloney, ranking member Comber, distinguished members of the committee, thank you for the opportunity to be here today. My name is Craig Landau and since June of 2017, I've been the president and CEO of Purdue Pharma. I'd like to start by recognizing and thanking the individuals who've shared their stories, their stories of loss and their stories of addiction. They're heartbreaking and I have no words, I can't imagine the pain. I'm an anesthesiologist, and before pursuing a path in clinical research in the pharmaceutical industry, I practiced medicine and I treated patients in both the private practice and academic settings. I also served as a physician in the United States Army Reserves Medical Corps for more than 14 years. My last deployment in 2004 was part of operation enduring freedom, where I provided support to our troops serving in both Iraq and Afghanistan. Craig Landau: (37:13) Treating patients, including wounded service members, left indelible mark on me. I've seen with my own eyes, the positive impact we can have on the lives and wellbeing of patients, when pain and suffering are eased. Medicines, including opioids, are often effective as part of a multidisciplinary approach to treating pain. That can also involve other nonpharmacologic treatments, as well as other interventions. But in every case, proper training and experience on the part of the treating physician, are essential for good decision-making and patient care. But as with any medical condition, the benefits and risks associated with treating pain, must be carefully considered. One very important risk associated with the use of opioids, is addiction. I've listened to individuals in recovery describe their struggle with addiction. In meetings, both public and private, I've heard heartbreaking stories like we heard today, from grieving parents whose children died from an opioid overdose. Craig Landau: (38:15) As a father and as a human being, I can't imagine the despair, the emptiness and the anger these parents must feel every single day of their lives. Each and every instance of addiction, of overdose and death is a human tragedy, for the individual, for their families and for all of us as a society. And with this in mind, I'd like to address those who've been directly affected by the opioid crisis. As stated earlier on November 24th, Purdue pled guilty to three felonies in federal district court, based on certain past practices related to its opioid medicines. To everyone listening who's been impacted by the opioid crisis, I want to be clear and I want to speak directly to you. On behalf of Purdue, as its current leader, I'm profoundly sorry. In trying to strike a careful balance between supporting physicians who treat patients with pain and mitigating the serious risks associated with the opioid medications, Purdue fell short. The company accepts full responsibility for its wrongdoing and as Purdue's leader, I'm determined to lead all of our efforts to help address the opioid crisis, as quickly and effectively as I can. Craig Landau: (39:34) We're charting a new course. The company changed leadership by bringing me in as CEO, I've made numerous changes to the leadership and management team of the company, and also to our strategies. Perhaps most notably, almost three years ago, I ended the promotion of all Purdue's opioid products, by sales representatives. The company has also brought in a new independent chairman of the board, as well as other very highly qualified directors. It's been almost two years since a member of the Sackler family has served on the board of directors. And last fall, we announced the plan to dedicate 100% of Purdue's assets and resources and capabilities and know-how, to the American people in the form of a public benefit company. And I hope we can discuss the details and the merits of that plan today. Craig Landau: (40:26) Under that plan, Purdue as we know it, would cease to exist and the Sackler family would have no role in the design, the governance or the decision-making of the new company. The new company would provide millions of doses of medicines, both to treat addiction and also to reverse opioid overdoses, for free or at low cost. Simply put, this plan and these medicines will save lives. Our top priority must be to deliver maximum resources as quickly as possible to those who need them, period. The proposed resolution does that and I'm committed to seeing it through. So I appreciate your invitation to voluntarily appear here today, I believe accountability and this very process are absolutely essential to support progress. I look forward to answering your questions. Thank you very much. Chairwoman Maloney: (41:23) Thank you. And I now recognize myself for five minutes. I want to focus on one event that I believe was a real turning point in this story, and that is Purdue's settlement with the Department of Justice in 2007. From 1997 to 2007, the Sackler family withdrew through a total of about 126 million from the Purdue company. Then in 2007, Purdue reached a settlement with the Justice Department over criminal charges and pleaded guilty and paid a $600 million fine. Now, normally when a company is forced to plead guilty to criminal charges, it's owners and executives feel a sense of shame and they commit to cleaning up their act, but not the Sackler family. Instead, they double down, they continued their practices and they took the 2007 settlement as a signal that they should withdraw even more money from Purdue. Chairwoman Maloney: (42:24) [inaudible 00:42:24] to get out as much money out as possible, as quickly as possible, and all so that they could prevent the money from going to the victims, the suffers from the opioid crisis. According to documents filed in litigation starting in 2008, right after the 2007 settlement, Purdue distributed more than 10 billion to the Sackler family and the companies that they control. That's almost 80 times what the family had received before 2007. In 2008, Richard Sackler wrote a memo to members of the family, including the two Sackler's here today, where he proposed that the company needed to, "distribute more free cash flow to the Sackler family." So Mr Sackler, when you received that email from your father in 2008, did you know that attorneys general were investigating Purdue's conduct and that settlements or judgements would be coming and individuals were suing too, thousands, numerous states. Did you know? Mr. Sackler: (43:34) Madam chairwoman, I believe based on the record ... Madam Chairwoman, if you'll permit me, I don't know what email you're referring to. But the answer to your question is no, I don't believe I knew that and I don't believe anyone knew that lawsuits that really began in earnest in 2017, would be coming back in 2008. I'm sorry ma'am, you're muted. Madam chair ... Thank you. Chairwoman Maloney: (44:18) We're going to ... Excuse me, we're having technical issues. We're going to take care of these technical issues. I can't hear you and see you, we're trying to correct it. We'll briefly recess. Chairwoman Maloney: (44:31) (silence) Chairwoman Maloney: (51:36) ... technical problems. Resuming our conversation, Mr. Sackler. When you received that email from your father in 2008, did you know that state attorneys general across the country were investigating Purdue's conduct and that additional settlements or judgements would be coming? Mr. Sackler. Mr. Sackler: (52:01) Based on my recollection of the time period, no. Purdue, at that point, had settled with most or a large percentage of the attorneys general, as well as public, excuse me, private injury plaintiff's. Management made repeated presentations to the board of directors after that point, that the ... Chairwoman Maloney: (52:24) Thank you for your answer. My time is limited. And I think that it is clear that you did know that settlements and judgments were coming and you were trying to siphon off as much money as possible before that happened, and I can prove it. Mr. Sackler, in May of 2007, one week after Purdue's settlement with DOJ, on charges of misbranding and agreed to pay 600 million in fines, you sent an email to other family members and said, "We're rich? For how long? Until which suits get through to the family." So let's cut to the chase, were you trying to cash out profits so that opioid victims couldn't claim them in future lawsuits? Mr. Sackler: (53:18) No, I don't believe that that's what I meant then and I don't believe that's how I've acted. Since then the suits that I was referring to ... Chairwoman Maloney: (53:27) Mr. Sackler, then may I ask why did you increase the amount of money you were withdrawing from Purdue so substantially in 2008? 126 million before 2007, in 2008, 10 billion. Mr. Sackler: (53:44) Ma'am, I believe you're mistaken on the record. The distribution in 2008 was nowhere close to $10 billion. Chairwoman Maloney: (53:54) Over 10 billion, over 10 billion. Over 10 billion, over 10 years. If you won't admit that much, then let's go to the next email. In September of 2014, another family member, Mortimer Sackler, emailed your uncle Jonathan, stating that Purdue was in "a death spiral." Jonathan Sackler then responded with, "We've taken a fantastic amount of money out of the company." Mr. Sackler, do you agree that the billions of dollars that Purdue transferred to your family and the companies that your family controls after 2008, left less money for future plaintiffs or creditors? Yes or no. Mr. Sackler: (54:37) Ma'am, I think you've mischaracterized that email. It's my belief, and I believe the distribution- Chairwoman Maloney: (54:46) Reclaiming my time, I think the email speak for themselves. It's a simple question, did the money that you and your family withdrew from Purdue, leave less money for future plaintiffs in suits over Oxycontin? And I'd like to find out more about where the money you withdrew from Purdue went and where it is today. The New York attorney general, Tish James office, found that your cousin Mortimer Sackler received several transfers that came through offshore shell companies and were routed through Swiss bank accounts. In 2009 alone, he received 64 million in wire transfers, through an offshore shell company based in Guernsey, in the Channel Islands, near France. Mr. Sackler, how many shell companies do you and your family control? Mr. Sackler: (55:40) Ma'am, I cannot speak for our entire family, but based on what I know of the transfers that you're referring to, I believe Mortimer has stated or would state if he were here, that those were all appropriate, documented and disclosed. Chairwoman Maloney: (56:01) Well, in this case, the question was, how many shell companies do you and your family control? If you don't know the answer, can you commit to getting that information to the committee? Mr. Sackler: (56:15) Well, that's really a question for the lawyers. We're involved in a confidential mediation. I believe the family's- Chairwoman Maloney: (56:24) Then let the lawyers get back to the committee with the answer. How much of your family's wealth is currently in foreign bank accounts? Mr. Sackler: (56:34) Of our family's wealth? I don't believe ... a very small amount, if any. Chairwoman Maloney: (56:42) Okay. Then get your lawyers to get the information back to the committee, so we know about that. I think it's clear that your family has tried to fraudulently shield money for your own personal benefits. I think it's appalling. Those profits, in my opinion, should be clawed back. You and your family should compensate the American public for the harm that you've caused, and you should be held fully accountable for your actions. But now I'd like to turn to Dr. Landau next. Just last month in your settlement with the Justice Department, your company pleaded guilty to conspiracy to defraud the US government, this misbranding of Oxycontin and illegal kickbacks. You pleaded guilty to criminal charges. Who committed these crimes? Which individuals at Purdue, committed those crimes. Mr. Landau. Craig Landau: (57:42) Thank you for that question, Chairperson Maloney. You're correct, the company pled guilty in US district court to three felonies or specific crimes committed during a specific period, and we're taking full accountability and responsibility for those crimes. We have over $8 billion of fines and penalties issued to us. We have a commitment for ongoing cooperation with the Department of Justice and a commitment to create a public repository for all documents deemed relevant, so that the American people can see for themselves what did or did not occur. Chairwoman Maloney: (58:25) Thank you, but that's not the question I asked. I asked who committed the crimes? We know that there were crimes, who committed them? All kinds of crimes. And I'm sorry, you're the CEO of the company and you've pleaded guilty to crimes, and you're now telling me, by not answering the question, that you don't know who actually committed those crimes. If you don't know who committed those crimes, then you can't be sure that they're no longer working for Purdue. Will you at least commit to getting the names of the people who committed these crimes to the committee, after you talk to your lawyers? Crimes were committed, who did them? Who were the ones that bribe doctors and pharmacies? Who were the ones that conspired to defraud the US government? Who were the ones that misbranded Oxycontin and said it was safe, when it's not, that it can kill people, as we've heard from our witnesses? So if you could talk to your lawyers and get that information. Chairwoman Maloney: (59:27) So to sum it up, the Sackler family made billions of dollars by fueling an opioid crisis, over $35 billion, that has claimed the lives of thousands and thousands of Americans, and has caused an enormous amount of pain for families across the country. In light of all of this, Mr. Sackler and Dr. Sackler. I'd like to ask you one final question and I'd like to begin with you, Dr. Sackler. Will you apologize to the American people for the role you played in the opioid crisis? Dr. Sackler. Dr. Sackler: (01:00:22) I would be happy to apologize to the American people for all of the pain they've suffered and for the tragedies that they've experienced in their families. And I thought I did that earlier in my opening comments, that was my intention. I also am very angry. I'm angry that some people working at Purdue, broke the law. I'm angry about it from 2007, and I'm angry about it now, again in 2020. I think that- Chairwoman Maloney: (01:01:03) I know you're angry and I'm sorry, but that's not the apology we were looking for. You apologized for the pain people have suffered, but you've never apologized for the role that you played in the opioid crisis. So I'll ask you again, will you apologize for the role you played in the opioid crisis? Dr. Sackler: (01:01:28) I have struggled with that question. I have asked myself over many years. I have tried to figure out, is there anything that I could have done differently, knowing I knew then, not what I know now. And I have to say, there is nothing that I can find that I would have done differently, based on what I believed and understood then and what I learned from management in the reports to the board, and what I learned from my colleagues on the board. And it is extremely distressing. Chairwoman Maloney: (01:02:15) Mr. Sackler, will you apologize for the role that you played in the opioid crisis? Mr. Sackler: (01:02:21) Well, I echo much of what my cousin said, but I will say to the American people, I am deeply and profoundly sorry that Oxycontin has played a role in any addiction and death. While I believe I conducted myself legally and ethically, and I believe the full record will demonstrate that, I still feel absolutely terrible that a product created to help, and has helped so many people, has also been associated with death and addiction. Chairwoman Maloney: (01:02:59) Well, I know I've gone way over my time, so I want to give the same amount of time, if not more, to ranking member Comber, but he wants to go last. So I will now recognize the gentleman from Georgia, Mr. Hice. Mr. Hice, you are now recognized for questions. Mr. Hice? Speaker 3: (01:03:25) Oh, okay, go to Mr. Grossman. Chairwoman Maloney: (01:03:31) We seem to have technical problems. Mr. Glenn Grossman, I now recognize you. Glenn Grossman: (01:03:42) Can you hear me? Chairwoman Maloney: (01:03:43) Yes, we can. Glenn Grossman: (01:03:45) I'll start off with Dr. Landau. What type of marketing strategies did Purdue utilize to increase sales of Oxycontin? Craig Landau: (01:03:57) Sorry, I was on mute. A representative for the ... Dr. Landau: (01:04:02) Representative, for the period up to becoming CEO in 2017, I was responsible for research and development, clinical development, developing new medicines. I wasn't responsible for sales and marketing and had no underlying expertise. So I- Speaker 4: (01:04:20) Are you familiar with bonuses paid to sales representatives or promoting? Okay. We are told here that people are getting up to 240 grand to sales reps to encourage more prescribing of Oxycontin. Is that accurate? Dr. Landau: (01:04:41) I don't know that I could answer the question because that wasn't my area of responsibility. I apologize. Speaker 4: (01:04:46) Okay. Does David know the answer to that question? David Sackler: (01:04:53) Sorry, is that directed towards me? Speaker 4: (01:04:56) Yeah, yeah. David Sackler: (01:04:57) Congressman. I'm sorry, I don't know the answer to that question. Speaker 4: (01:05:02) Good grief. Do you know what time Purdue learned of the highly addictive nature of Oxycontin? David Sackler: (01:05:12) I'm sorry, I'm not sure I heard you correctly. Can you repeat the question? Speaker 4: (01:05:15) At what time did Purdue, what year about did you learn that Oxycontin was highly addictive? David Sackler: (01:05:21) I think the highly addictive nature or the addictive nature of opioids is something we've known. Doctors and patients and Purdue has known since the beginning of the use of opioids, a millennia ago. Speaker 4: (01:05:37) Okay. Could you tell us the increase in the number of Oxycontin, say, prescribed between, say ... When was it first marketed? Oxycontin? David Sackler: (01:05:48) It was approved in 1995, but most people, I believe, would draw the launch as 1996. Speaker 4: (01:05:57) Okay. Was there an increase in the amount of Oxycontin prescribed between, say, the year 2000 and 2010? David Sackler: (01:06:05) No. In aggregate, Oxycontin prescriptions, I believe, peaked in 2003. So if you're picking 2000 to 2010, I'm doing this off the top of my head, I believe prescriptions would have been down over that period. Speaker 4: (01:06:19) Well, I'm going to say from 2000 to 2003, was there a significant increase? David Sackler: (01:06:25) I'm not sure how significant the increase was. I don't have the numbers in front of me. Speaker 4: (01:06:30) Okay. Could you tell us approximately the amount of Oxycontin, say in the peak years, the early 2000s, the amount of Oxycontin prescribed per capita in the United States compared to, say, Europe or Canada? David Sackler: (01:06:48) Well, I'm not sure that I can do that because I don't recall the years Oxycontin was approved in those various markets. So I'm not sure I can draw that comparison. Speaker 4: (01:07:02) Was it significantly more prescribed in the United States than other Western countries? David Sackler: (01:07:08) I don't know the answer to that. I mean, Purdue versus the other Western countries, Purdue introduced Oxycontin, other countries introduced it later, but also other opioids. So it's not an easy comparison. I believe the answer that you're looking for is that yes, the United States, as a whole, is the largest consumer of opioids writ large in the world. Speaker 4: (01:07:36) Okay. Did that ever hit you as unusual or kind of alarms should be going off or why so many more opioids were prescribed in the United States than other countries? David Sackler: (01:07:46) Well, it struck us definitely that there was a discrepancy. However, I think it's worth keeping in mind Oxycontin was a very small percentage of US prescriptions and is designed for a very small subset of patients. So while the United States leads the world in opioid prescribing, most the overwhelming majority of that is immediate release opioids. Oxycontin represented just a tiny fraction. Speaker 4: (01:08:16) Do you know how many people were dying, say, of opioid overdoses in this country in the early 2000s? David Sackler: (01:08:22) I don't know that data. I know the current numbers. Speaker 4: (01:08:27) Tens of thousands, right? David Sackler: (01:08:29) I believe that's correct. Speaker 4: (01:08:32) Okay. Do you feel any guilt for that? I mean, I'll put it this way. Even 15 years ago, I think people were, there was anecdotal evidence out there, just average persons talking to each other, they were amazed the amount of opioids being prescribed by healthcare professionals. Okay? Were you of that? Or did you hear stories about that? David Sackler: (01:08:57) Well, we became aware of Oxycontin, if you're asking about Oxycontin in specific, they became aware of widespread abuse of Oxycontin in, I believe, 2000, 2001 time period as it became reported upon in the press. Speaker 4: (01:09:17) Okay. Obviously, we got a lot of briefing here for this today. And a lot of it seems to focus on the massive amount of money that Purdue made selling Oxycontin. Could you guess how much? I think there's a high markup on pharmaceuticals. Can you guess how much money Purdue made or your family made selling Oxycontin? David Sackler: (01:09:46) I don't know the exact number, so I wouldn't hazard a guess. I do know the distributions- Speaker 4: (01:09:54) Yeah, guess wildly. David Sackler: (01:09:57) I would guess Purdue ... Well, what do you mean by made? Profit or revenue? Speaker 4: (01:10:03) Well, we'll say both. We'll do both. David Sackler: (01:10:09) Okay. My guess is Purdue's revenue, what I've seen reported is around $30 billion of revenue. And my guess for profit is probably somewhere in the neighborhood of, before taxes, probably about half of that. Speaker 4: (01:10:33) Okay. So maybe after taxes, probably over $10 billion. David Sackler: (01:10:39) I'm sorry, sir. The taxes are significantly higher. It's not a corporation. Speaker 4: (01:10:44) Okay. I mean, well, you said profit being about 15. Okay. Couldn't be significantly higher, maybe a little bit less than that. Okay. You say you're sorry for what happened. And obviously, thousands of people have died, tens of thousands of people have died, I think, because of the over selling or over marketing of Oxycontin. It's become kind of a trendy thing among the billionaires of the country, at least among a few of them, to say that they're going to give back even all of their wealth by the time they die. Does your family, have they considered giving back significant segments of this, whatever it is, $12 or $13 billion to charity of some nature? Do you feel these gains were ill gotten? I guess I'll put it that way. David Sackler: (01:11:43) Well, if you'll permit me, I'd like to answer your first question because I think it's important to gain an understanding of the settlement process that's ongoing. And it's our belief that the settlement that the family has proposed represents more than the family ever received during a sale of Oxycontin. So I think, in our opinion, sir, the answer is yes. We are in settlement negotiations to hopefully conclude at doing what you're suggesting. Speaker 4: (01:12:21) What percentage of sales was Oxycontin for Purdue Pharma, say at the high watermark, say in the year 2000? What percent of- Madam Chairman: (01:12:30) [crosstalk 01:12:30] expired. But the gentleman, Mr. Sackler, may answer the question. David Sackler: (01:12:34) It was quite a large percentage, I believe around 90%. Speaker 4: (01:12:40) Wow. Very interesting. Thank you for giving me some extra time, Madam Chairman. Madam Chairman: (01:12:46) Thank you for your question. The gentlewoman from the District of Columbia, Representative Norton, is recognized. Senator Norton. Representative Norton: (01:12:57) I thank you, Madam Chair. I appreciate very much this hearing. You delayed it in order to make it as fair as possible. And I certainly appreciate the members of the family who are here. And I want to focus on other families. I want to focus on the families who've been victimized by Oxycontin. Mr. Sackler, for the last 20 years, if we look back, we find almost half a million Americans have lost their lives from opioid overdoses. And of course, your family has expressed empathy for them. I have a exchange from a 2001 email obtained by the Connecticut attorney general, who was an acquaintance of your father's, rather an acquaintance of your father's wrote to your father. And here I'm quoting. "Abusers die. Well, that is the choice they made. I doubt a single one didn't know the risks." Mr. Sackler, your father responded, "Abusers aren't victims. They are the victimizers." End quote. Now, does your family still believe that people with addiction are victimizers? David Sackler: (01:14:18) No. Not in any way. I know my father has apologized for that comment and comments like it in the past. And I know in the 20 years since that email, roughly 20 years since that email was written, I believe his views on abuse and addiction have changed significantly. Representative Norton: (01:14:38) I very much appreciate that correction of his views then. Sorry, somebody needs to mute in here. The Chair indicated in her remarks earlier that we had received letters from dozens of people all over the country. And I'd really like to focus on these people. For example, we began this hearing appropriately with video from people who had, in fact, been victims of the opioid crisis. We have a letter from a mother in North Carolina who lost her child, 20 years old. Hasn't recovered yet. She said, " The pain is too intense, it's more than I can bear. I have trouble finding a will to live and carrying on every single day." The committee has another letter from a man in Colorado whose brother first took Oxycontin when he was simply getting his teeth removed. He said, "It didn't take long to discover he could get it anywhere. Could get it in a bar. It was just not hard to get." The man's brother died. He said he had been very quiet about it, but it isn't easy to stay quiet any longer. Representative Norton: (01:16:19) This person created a map for families to share their stories of loved ones grappling with addiction. And more than 202,500 stories have been posted on his map. People come to that map to post their stories. Mr. Sackler, I'd like your personal response to the ... I wanted to lay out these stories we've been receiving. And I'd like your personal response to these stories. Do they indicate to you that you feel remorse? How would you respond to them in your own words? I can't hear it. He's muted. David Sackler: (01:17:11) I'm sorry. I feel tremendous empathy, sorrow, and remorse that a product like Oxycontin that was produced to help people, and I believe has helped millions of people, has also been associated with stories like you're telling. I feel incredibly sorry for that. And I know our entire family does as well. Representative Norton: (01:17:40) Madam Chair, I thought it was important to let the family speak for themselves and to hear from the Sackler family, Mr. Sackler in this case, a personal apology going to individual families. And I thank you and yield back. Madam Chairman: (01:18:00) The gentlelady yields back. Mr. Armstrong, you are now recognized for question. Mr. Kelly Armstrong. Mr. Armstrong: (01:18:04) Thank you. Thank you, Madam Chair. 2007 Department of Justice concluded a prosecution on Purdue Pharma. Pled guilty to five years probation, $634.5 million in fines. Mr. Sackler, approximately in 2007, what was the number of sales for Oxycontin? David Sackler: (01:18:26) I don't remember the exact sales. Mr. Armstrong: (01:18:28) It's about a billion bucks. Do you know what happened to the sales of Oxycontin after you pled guilty in federal court? David Sackler: (01:18:36) I believe that- Mr. Armstrong: (01:18:36) 2008, 2.2 billion. 2009, just under three billion. 2010, over three billion. 2011, under three billion. 2012, about 2.7 billion. 2013, 2.6. 2014, 2.4. Mr. Sackler, you want to ask what you could've done differently, look at your own damn balance sheet. The year after you pled guilty, you say you didn't know what was going on. You knew what had happened. And to a bankruptcy audit. From 1995 to 2007, you withdrew $1.3 billion from Purdue Pharma. You just testified that about 90% of your profit out of Purdue Pharma was from Oxycontin. You know the number you withdrew from 2008 to 2018, Mr. Sackler, as a family? David Sackler: (01:19:25) I believe it's approximately $10 billion. Mr. Armstrong: (01:19:28) It's about $10.7 billion. 90% of that was related to Oxycontin? David Sackler: (01:19:35) I believe that's approximately right. And of that money, about half was paid in taxes. Mr. Armstrong: (01:19:42) Fantastic. Thank you for that. As people who fund the government from tax payer, we really do appreciate that. So my question is do you have cable? David Sackler: (01:19:52) I do have cable, yes. Mr. Armstrong: (01:19:53) Do you get your newspapers? David Sackler: (01:19:56) No, I don't receive subscriptions to newspapers. I get my news online. Mr. Armstrong: (01:20:01) I was practicing criminal defense at the time all of this was going on. And I wish we could have every one of these companies in here in every different way. But I think this goes beyond the pale of believability to think that after settling with the federal government in 2007, you can honestly say, watching the sales of your own company's drugs, that you didn't know a problem was coming down the pipe. And to say that just defies believability and is absolutely abhorrent and appalling to the victims of opioid addiction. Mr. Armstrong: (01:20:37) We have went through this, we've watched this happen. We've watched it happen in our communities, we've watched it happen from one end to the other. And I have no doubt in my mind that there were people within your company doing things differently. But I also have no doubt in my mind, just by looking at your own balance sheet, that you think claiming plausible deniability to any of this makes any sense whatsoever. Mr. Armstrong: (01:21:01) And the last thing I would just say before I yield back is that as we continue to move through this, and as we continue to do this, you know who benefits the best from these remote hearings? The witnesses. Because we don't get the [inaudible 01:21:14] we should. And we don't get the way this should be. And I agree we're in the middle of a pandemic and I agree these things are difficult, but when we have technical difficulties, these are the exact kind of hearings that the American people need to hear about. Congress's opinion is at an all time low, and rightfully so in my opinion, but we actually serve a very important purpose. And one of it is to hold people accountable. Mr. Armstrong: (01:21:38) If one of my clients sold five pills of Oxycontin on the street and got tied up in federal court, you know what their criminal penalty is? It's a 10 year minimum mandatory sentence in federal court. And in these opening statements, we get vigorously defend about everything. We defend any wrongdoing. But you all have pled guilty four times in federal court, once in 2007 and three times in 2020. And at least acknowledging that either in your testimony or an opening statement would have been, I think, relevant, important, and probably given you more credibility with me and the rest of the committee. And with that, I yield back. Madam Chairman: (01:22:18) The gentleman yields back. I now recognize the gentleman from Tennessee, Mr. Cooper. You are now recognized, Mr. Cooper. Mr. Cooper. I can't hear you. Can you unmute? Mr. Cooper? Mr. Cooper: (01:22:29) Can you hear me? Madam Chairman: (01:22:36) Now we can hear you. Mr. Cooper: (01:22:37) Thank you, Madam Chair. Mr. Sackler, I'd like to ask you some questions about you and your family's involvement in the management of Purdue on the board of directors. According to the DOJ, Department of Justice, they said the name Sackler, as members of the Purdue board, exercised substantial oversight over Purdue management. Mr. Sackler, isn't it correct that up until 2018, the Sackler family always had a majority of the board seats at Purdue? David Sackler: (01:23:13) I believe that's true, yes. Mr. Cooper: (01:23:16) So you, as a family, made decisions about all aspects of Purdue? Marketing, budgets, financial distributions. Didn't you, as a family? David Sackler: (01:23:28) Well, with the help of qualified outside directors and management. Mr. Cooper: (01:23:35) But you do have the board seats, the votes to do it. And you served on the board, I understand it, from 2012 to 2018. So you personally exercised influence of the board? David Sackler: (01:23:50) There was a large board and there were a large number of directors and a split board structure. So I don't know what you mean by me personally influencing things. I don't think I would agree with that. Mr. Cooper: (01:24:03) I think Upton Sinclair once wrote that a man has difficulty understanding something if his salary depends on his not understanding. Let's move on to Dr. Landau. Dr. Landau, according to documents obtained by the Massachusetts attorney general in 2017, you wrote that Purdue operated with quote, "the board of directors serving as the de facto CEO." Is that correct, Dr. Landau? Dr. Landau: (01:24:35) Representative, my comments regarding the board acting as de facto CEO was a consequence of the Sackler zoning. Many pharmaceutical companies around the world, in the absence of an appointed global position to look out over all of them, so by default, the governance body was the board of directors for each of the companies, including but not limited to the US. Mr. Cooper: (01:24:58) And it's the same Sackler family that is refusing to admit a personal liability and culpability here. The company has pled guilty, as I understand it, but not individual members of the Sackler family. Dr. Landau, with outside consultants like McKinsey, it's my impression that they wrote as far back as 2008 that in the US, the board of Purdue Pharma is involved in all levels of decision-making in the company on a weekly basis. Another McKinsey consultant wrote both the brothers, the Sackler brothers who started the company, viewed all employees like the guys who trim the hedges. Employees should do exactly what's asked of them and not say too much. This consultant further noted that Purdue, said, "As a manager, you get rewarded for pandering to the board." Mr. Sackler, does that ring true with you? David Sackler: (01:26:12) No, it does not. Mr. Cooper: (01:26:15) It's apparently referring to your father and his brothers. David Sackler: (01:26:19) My father only had one brother who's deceased. If you're referring to my grandfather, my belief is he would have been horribly offended by that comment and viewed people who worked for him as valuable, imbued with a great deal of autonomy. And knowing the people within the organization, I don't think they would agree with that either. Like Mr. Landau. Mr. Cooper: (01:26:54) So you paid McKinsey's fine and hefty fees for them not telling the truth? David Sackler: (01:27:01) I wasn't a part of that McKinsey engagement. That was done by management. And McKinsey can express whatever opinion they want. That doesn't necessarily make it the truth. Mr. Cooper: (01:27:17) Watching this hearing has been difficult. First, hearing the testimony of the victims of your drugs. And I know that we all are looking for a good solution for pain, but folks like Anna Lembke, L-E-M-B-K-E, an addiction specialists at Stanford University, wrote a book way back in 2016 called Drug Dealer, MD that pointed out a lot of the issues that we're dealing with in the hearing today. Do you know if any members of the board of directors read Dr. Anna Lembke's book, or were aware of that book? David Sackler: (01:27:55) I don't know if any members of the board of directors read a specific book, no. Mr. Cooper: (01:28:03) Have you read it? David Sackler: (01:28:04) I have not read it. Mr. Cooper: (01:28:06) I used to teach health policy at Vanderbilt Business School, and I required all of my students to read it. So perhaps the students at Vanderbilt were ahead of the board of directors at Purdue. Again, if you're not interested in discovering the truth and if your salary depends on your not understanding the truth, then you're not going to see the truth. Madam Chairman: (01:28:30) Gentleman's time is expired. And the gentlemen may answer his question. David Sackler: (01:28:36) I'm sorry. I didn't take that as a question. Can you rephrase it, please, Congressman? Mr. Cooper: (01:28:42) Let me conclude by saying watching you testify makes my blood boil. I'm not sure that I'm aware of any family in America that's more evil than yours. Thank you, Madam Chair. Madam Chairman: (01:28:59) The gentleman's time is expired. The gentleman from Louisiana, Mr. Higgins, is now recognized for five minutes. Mr. Higgins. Mr. Higgins: (01:29:08) Madam Chair, thank you for all of this. And Dr. Landau, just to advise you, I'm going to be directing questions to you. And thank you for your military service, Dr. Landau. If you're there, we have technical challenges, have you ever ingested Oxycontin? Dr. Landau: (01:29:35) I'm sorry, Representative. Did you ask me if I ever adjusted Oxycontin? Mr. Higgins: (01:29:40) Ingested? Dr. Landau: (01:29:42) Oh, I'm sorry. Mr. Higgins: (01:29:42) Have you ever ingested Oxycontin? Dr. Landau: (01:29:46) No, sir. Mr. Higgins: (01:29:50) As a soldier in theater and as a doctor, have you personally been around your fellow man that's suffering extreme pain, traumatic pain? Dr. Landau: (01:30:05) Representative, sadly, I have. I treated patients, as I mentioned in my oral testimony. Mr. Higgins: (01:30:11) Understood. It's quite an intimate interaction, is it not, when you're trying to help someone that's in incredible pain? In your opinion, what would that person do to make that pain end at that moment? Dr. Landau: (01:30:32) Well, I believe I understand what you're asking. And pain can be so severe to drive people to do many different things, sometimes extreme. Mr. Higgins: (01:30:48) The answer I'm looking, it's not a complicated, it's not a trick question. The answer is if you had extreme pain, insufferable pain, you'd do almost anything to end that pain. You would certainly ingest a pain killer. And what I'd like to get at during my brief time of questioning is some contradictions regarding Oxycontin. As it was understood to be developed as a very effective pain medication to be used, obviously, according to prescription. But it quickly became, listen, I was a police officer, a street cop, for 12 years. Full-time civilian. I was an MP in the Army. But beginning in 2004, I was a full-time civilian police officer. And most of the world, most of America, came to know what Oxycontin was in 2003 when Rush Limbaugh went through his addiction period, and to his credit, courageously and candidly admitted it on the air and went into treatment. Mr. Higgins: (01:32:06) And prior to that, Oxycontin, unless you were directly involved in it with pain management, America didn't really hear about it. But if you think about the timing in becoming a full-time police officer, street cop, SWAT cop in 2004 until I decided to run for Congress in 2016, that was a period of time that America really went through opioid addiction in incredible numbers of increased addiction, heavy impact in communities across the country. And Oxy, Dr. Landau, Oxy was known to be so addictive it was known on the street. Cops get injured all the time. And we would know, generally speaking, I'm sure you could find exceptions, but if we got injured, we wouldn't take Oxy because it had a reputation as a one dose addiction. Mr. Higgins: (01:33:17) Now, my point is if you're in extreme pain, you've acknowledged this, we find ways in modern pharmaceuticals to manage that pain and deal with it. But Oxy was so powerful and so addictive, regardless of how effective it was, it's not arguable, it's just it was so addictive the street knew that it was a serious problem. And yet, this is my question to you. How on earth did Purdue decide to pursue this policy of pushing Oxy as a less than 1% risk of addiction? To me, that's like a real betrayal. If there was some righteousness behind the development of this drug, for it to be used properly and for the right reason, extreme pain management, that's understandable. But how, knowing as addictive it is, how did Purdue get to the point of pushing this drug as a 1% addiction drug? And I'll give you my time to respond. Dr. Landau: (01:34:31) I understand. I appreciate your service. And I appreciate the question, Representative Higgins. Look, addiction, I'm a physician, right? And addiction is a devastating disease. It's a chronic relapsing, but treatable disease. And we've known, the company has known that oxycodone, like other Schedule II opioids and products, carry a risk of addiction. Science has changed, our understanding of the science has changed over time. I wasn't present for the development or approval of the product or the creation of it. Mr. Higgins: (01:35:05) How could the street know before Purdue's board knew? How could the street know? Madam Chairman: (01:35:11) The gentleman has asked a good question, but his time has expired. Dr. Landau, please answer his question. Mr. Higgins: (01:35:16) Thank you, Madam. I apologize. Dr. Landau: (01:35:19) That's okay. Representative Higgins, I do want to respond to your question. My recollection is that the package insert or labeling for the product has changed over time. And in 2001, it was changed by FDA to include the highest level of warning possible in a package insert, which is the inclusion of what we call a black box warning, which calls attention to the risk of abuse, misuse, and addiction specifically. It's a terrible scourge. Now, I'm not minimizing the impact that this has had on the population. So in essence, I'm agreeing with your concern. Madam Chairman: (01:35:57) Thank you. The gentleman's time has expired. The gentleman from Virginia, Mr. Connolly, is recognized. Mr. Connolly. Mr. Connolly: (01:36:03) Thank you, Madam. Chairwoman Maloney: (01:36:03) Mr. Connolly is recognized. Mr. Connolly. Mr. Connolly: (01:36:04) Thank you, Madam Chairwoman. Can I be heard? Chairwoman Maloney: (01:36:09) Yes, you can. Mr. Connolly: (01:36:12) Thank you. And thank you for holding this hearing. There's another book that I had the privilege of interviewing the author on C-SPAN called Dope Sick. And Dope Sick, by Beth Macy, documents the introduction of Oxycontin as almost a miracle pain treatment, and how pharma deliberately marketed that drug to more rural parts of my state, Virginia, where the level of susceptibility in many rural clinics and doctor's offices to this miracle drug, and to the very aggressive marketing and the promises of pain treatment and pain therapy were overstated, and of course, the dangers of addiction understated. Mr. Connolly: (01:37:15) That book also documents the fact that there was very early evidence on the street, as Mr. Higgins said, that this had unusual addictive qualities. And all of a sudden, crime rates were up because people craved the drug. Doctors were over prescribing it with the encouragement of pharma. Mr. Connolly: (01:37:41) And so we're not talking about criminals in the underground world seeking another high. We're talking about people who became addicted under the supervision of their position with prescribed drugs. I had a constituent. His son died. He was an athlete and a scholar at NYU. Came from Fairfax, Virginia. And had an injury playing football. He was treated for that injury and was prescribed for pain medicine, Oxycontin. And he became addicted through no fault of his own. And that young man did everything he could. He went to multiple rehab centers. He couldn't lick the addiction. Mr. Connolly: (01:38:39) That's how powerful it is. Even those who can lick the addiction often find themselves for years in rehab, trying to kick the addiction because it's that powerful. That's why many, when they can't get Oxycontin, as a substitute turn to heroin. And dope sickness is the downside of getting off it. You get sick. If you don't stay on a regimen of some drug treatment like Naloxone, you're going to be in deep trouble. You can't go cold turkey. Mr. Connolly: (01:39:16) Therapy here is different than with other substance abuse. And what's so tragic, Mr. And Ms. Sackler, is your family knew about this. You knew that it was too potent, and you did nothing about it as a family. You knew that people were getting addicted, and you did nothing about it as a family, other than benefit from it financially, as the chairwoman has pointed out, to the tune of $10 billion. Mr. Connolly: (01:39:52) Hannah Eric wrote about the banality of evil. Mr. Cooper called you the most evil family in America. I don't know if that's true. I don't know that your intentions were evil. They were certainly self-aggrandizing, and they certainly turned... In that self aggrandizement, you had to turn a blind eye to the suffering that your company and that one drug inflicted on the American people, to actually creating a crisis. And you bear that responsibility and will bear that responsibility for the rest of your lives. Thank you, Madam Chairwoman. Chairwoman Maloney: (01:40:34) [inaudible 01:40:34] the gentle woman for West Virginia, Mrs. Miller, you are now recognized. Mrs. Miller. Mrs. Miller: (01:40:40) Thank you, Chairwoman Maloney and ranking member Comer. I do want to reiterate the points that I made during my open statement. My state has been hit really hard with the opioid epidemic. In fact, we became pioneers on how to deal with these drug exposed babies. The First Lady three times has visited Lily's Place, as we've learned how to deal with infants born with... They don't like to call it addiction. They call it drug exposure. Nonetheless, we'd been hit so hard, and I am thankful for the efforts on the federal, the state, and the local level to address addiction in our communities. And I am grateful for the progress we've made, but I cannot underscore the magnitude, the magnitude of this epidemic on my state, and how it is not only shaped what's happening right now, but our future generations of West Virginians. Mrs. Miller: (01:41:39) Dr. Landau, what efforts has Purdue taken to educate the doctors about the dangers of over prescribing Oxycontin? And has it been effective? Dr. Landau: (01:41:53) Thank you for the question, Representative Miller. Although I haven't been, until becoming CEO, responsible for the commercial organization, it was my belief that the safety and risks associated with medicines were represented to and discussed with physicians as part of a balanced discussion. Representatives would visit with physicians. Dr. Landau: (01:42:21) But I think more importantly and more directly related to your question, the company has been very active over the years in risk mitigation and actually played a lead role in the development of what's called the risk evaluation and mitigation strategy. It was developed, I believe, and finalized at or around 2010. And in that process, Purdue, along with a number of other companies, proposed that prescriber education be mandatory, in order to prescribe controlled substances, and that doing so be linked to the registration process for DEA certification. So, the company then, and now, feels strongly that mandatory education... Because as Representative Connolly talked about in the example of a friend whose son died after being prescribed Oxycontin for a sports injury, that prescription may not have been appropriate in the first place. And prescriptions start with the pen of a physician, and physicians need to demonstrate a level of competence before they issue a prescription and before medicines get into the hands of legitimate patients who might not otherwise require or benefit from these medicines. Mrs. Miller: (01:43:36) Well, what has Purdue done to educate the patients about the dangerous also of abusing Oxycontin? Dr. Landau: (01:43:45) Purdue, over time, has been a substantial supporter through public awareness campaigns and third-party education organizations, putting forward key messages related to safe storage of medicines and proper disposal of prescription medicines. We know that the vast majority of medicines that wind up in the wrong hands actually come from friends and family members. Sometimes they come from the medicine cabinet of a legitimate patient, who was prescribed the medicine for a legitimate medical condition by a well-trained provider. So we've been a supporter of education directed at recipients of pain medicines, directed at school children through a program run by [inaudible 00:08:32], to get the word out to students at a young age that they need to be careful, and they need to be aware of the dangers of prescription medicines and abuse and addiction in general. Mrs. Miller: (01:44:45) Well, my next question was really related to that, about what you've done to help communities that have been negatively impacted. So you are in the school systems, trying to teach the children what drug use can do to their body? Dr. Landau: (01:45:03) Yes, definitely. We have an active program, active support of the organization I mentioned, and we're also active through our office of corporate social responsibility, very active in supporting community-based programs and in education and addiction, at recovery, at retraining and reentering the workforce, in states like North Carolina, Connecticut, and Tennessee, examples come to mind [crosstalk 01:45:32] Mrs. Miller: (01:45:32) I'm sorry, I need to interrupt you because I do want to ask the members of the Sackler family if they have ever visited Appalachia, to see the impacts of the epidemic firsthand. In my time that's left. Mr. David Sackler: (01:45:46) I have visited Appalachia, but not for the express purpose of fact finding or what you're suggesting. Mrs. Miller: (01:45:58) So why did you visit Appalachia? Mr. David Sackler: (01:46:01) I visited with my wife for a vacation. Mrs. Miller: (01:46:08) Well, I really think it would behoove you to actually go into some of these communities that have just been so devastated, so that you understand how the epidemic, on a firsthand basis, has directly affected a huge amount of people all through Appalachia. Thank you, Madam Chairwoman. Chairwoman Maloney: (01:46:29) Thank you. Thank you for your very meaningful questions. The gentleman from Illinois, Mr. Krishnamoorthi is recognized. Mr. Krishnamoorthi. Mr. Krishnamoorthi: (01:46:39) Thank you. Chairwoman Maloney. Can you hear me? Chairwoman Maloney: (01:46:42) Yes, we can. We can hear you. Mr. Krishnamoorthi: (01:46:44) Dr. Kathy Sackler, I have a question for you. According to the Washington Post, in 2001, Richard Sackler, the former CEO and chairman of Purdue Pharma, wrote in an email, the following. He said, "We have to hammer on the opioid abusers in every way possible. They are the culprits and the problem. They are reckless criminals. Mr. Krishnamoorthi: (01:47:12) Dr. Kathy Sackler, I assume you do not agree with your cousin Richard Sackler, that opioid abusers are reckless criminals and culprits and the problem, correct? Dr. Kathy Sackler: (01:47:24) Correct. Mr. Krishnamoorthi: (01:47:26) Richard Sackler also made another doozy. He said people addicted to opioids were "being glorified as some sort of populous victim." Mr. Krishnamoorthi: (01:47:38) Now let me go to David Sackler for a moment. Mr. Sackler, I'd like you to look at image one, which should pop up on your screen now. Staff, can you put image one up? Mr. Sackler, this is your home in Bel Air California, correct? Mr. David Sackler: (01:48:00) No, I've never even spent a night there. [crosstalk 00:12:04]. Mr. Krishnamoorthi: (01:48:05) Property in California? Mr. David Sackler: (01:48:07) A trust for my benefit owns it as an investment [crosstalk 00:01:48:10]. Mr. Krishnamoorthi: (01:48:11) Oh, the trust owns that. Yes. Mr. Sackler, the trust bought this for $22.5 million in an all cash deal, according to Curbed LA from March 8, 2018. Mr. Krishnamoorthi: (01:48:23) Let's go to image two for a moment, please. Core staff. Mr. Sackler, do you recognize this particular property in Manhattan? This was your former home? Mr. David Sackler: (01:48:35) Yes. We sold that [crosstalk 01:48:38]. Mr. Krishnamoorthi: (01:48:38) Yes. You sold it for $6.1 million in 2019. So let's just recap. You bought a property in LA in 2018 through your trust. At the same time that year, there were 15,000 prescription drug opioid deaths. In 2019, you had another property that you sold, this one for $6 million. And in 2019, unfortunately, opioid deaths went up by almost a 5%. Now, Mr. Sackler, I know that people got addicted to prescription drugs, such as Oxycontin. I would submit, sir, that you and your family are addicted to money. Mr. Krishnamoorthi: (01:49:22) Now, Dr. Landau, I'd like to turn a question over to you. It turns out that after the first round of felonies that Purdue Pharma committed in 2007, you add the chief medical officer around that time, went to the FDA to try to lobby against them, putting in a rule to make it harder for physicians to prescribe Oxycontin. Core staff, can you put up document 13 on the slide show? Mr. Krishnamoorthi: (01:49:55) At that time, you made a 2009 presentation in September of that year with your consultants at the FDA. And in that presentation, you said, in this slide, "Who at Purdue takes responsibility for all these deaths?" Referring to opioid deaths. And the answer, "We all feel responsible." Now, Dr. Landau, I presume that when you refer to we, that includes you, correct? Dr. Landau: (01:50:24) With respect to representative that wasn't a slide that was presented. Actually, it was not a final slide. It was materially in preparation for [crosstalk 00:14:34]. Mr. Krishnamoorthi: (01:50:34) You don't feel responsible. Is that what you're saying? Dr. Landau: (01:50:37) Absolutely not, is what I'm saying. Mr. Krishnamoorthi: (01:50:40) Oh, okay [crosstalk 01:50:42] ask you this. You don't feel responsible for any of that. So let me go to this question. You do admit that Purdue Pharma just admitted to committing three felonies, correct? Dr. Landau: (01:50:59) Representative, at no time in my Purdue career was [crosstalk 01:51:06]. Mr. Krishnamoorthi: (01:51:05) It's a yes or no question. Did Purdue Pharma agree that it committed three felonies? Dr. Landau: (01:51:12) As I said in my opening statement, Purdue pleaded guilty to three felonies in federal district court. Mr. Krishnamoorthi: (01:51:19) Dr. Landau, the CDC looked at Oxycontin and said the following. "We know of no other medication that's routinely used for a non-fatal condition that kills patients so frequently." Dr. Landau, I would respectfully submit that as you seek a $3 million bonus from the bankruptcy court at this point in time, that you remember what the CDC found, and you remember that you indeed are partly responsible for those deaths that you and your products helped create. Thank you. Chairwoman Maloney: (01:52:01) Mr. Landau [inaudible 01:52:02] respond? Dr. Landau: (01:52:04) Oh, I'm sorry. I didn't know it was a question. I would like to respond [crosstalk 01:52:10] I would like to respond by saying to the representative, I've dedicated my entire career to helping patients, both through the practice of medicine and then by developing medicines and mitigating their risk. So you'd be inhuman not to feel remorse for the actions of the company and the implication of the product in so many bad outcomes. But I do believe that the product has helped a great many individuals suffering from pain, individuals who the medicine was developed for and intended for. So I'm not [crosstalk 00:16:46]. Mr. Krishnamoorthi: (01:52:47) $3 million bonus. Will you forego this $3 million bonus you're taking out of the pockets of the people that should get that money from the bankruptcy court? Dr. Landau: (01:52:58) Representative, I agree accountability is critical [crosstalk 01:53:01] I have already willingly made significant monetary concessions in order to move the bankruptcy process forward. Mr. Krishnamoorthi: (01:53:12) So the answer is no. You want that $3 million at the expense of those opioid victims. Shame on you, Dr. Landau. Shame on you. Chairwoman Maloney: (01:53:19) The time has expired. The gentleman from Pennsylvania, Mr. Keller, is recognized for five minutes. Mr. Keller. Mr. Keller: (01:53:28) Thank you, Madam Chair. And I appreciate you holding this important hearing. For decades, drug overdose deaths have remained at an unacceptable level across the United States. Just last year, we lost over 4,400 Pennsylvanians due to drug overdose. That's 12 deaths per day on average, which is 12 too many. I hope this committee and the House of Representatives can get to work on solutions that save lives and enhance the 21st century Cures Act and Comprehensive Addiction and Recovery Act. Mr. Keller: (01:54:07) Thanks to these efforts and President Trump's leadership on the issue, more resources are available to fight the opioid epidemic. Naloxone is more widely available to prevent overdoses, which has led to encouraging downward trends. However, more work is needed to reduce deaths related opioid [inaudible 00:18:27]. This includes holding companies like Purdue accountable for their deceptive tactics. Mr. Keller: (01:54:32) Starting in 1996, Purdue Pharma and the Sackler family marketed Oxycontin, a drug at the forefront of our nation's opioid epidemic, as having much lower addiction risks to patients, which sharply contrasts with the reality that this drug has cost lives and torn families apart. Mr. Keller: (01:54:53) So just a couple of questions I would have for Dr. Landau. What is your company doing to educate patients and providers about the danger of over prescribing opioids? Dr. Landau: (01:55:06) Thank you for the question. It's obviously a very important topic. The company has, for some time, been syndicating the guidelines produced by the Centers for Disease Control since they were issued in early 2016, which I fully support. We're also, as I mentioned in earlier testimony, supporting a tremendous amount of education throughout third-party resources, to bring to bear and bring to the surface important information relating to both the prescription of opioids, their safe storage, their disposal, the consequences of addiction, with an emphasis on children, on school children, to prevent them from their initial exposure, which can have devastating consequences, as we've heard in earlier testimony from family members who've lost loved ones. Mr. Keller: (01:56:12) Also, it's my understanding that as CEO, you have instituted reforms, such as ending your company's use of tactics like detailing, where sales representatives target prescribers in an effort to boost sales. How would you recommend Congress work with the pharmaceutical industry to prevent opioid addiction? Dr. Landau: (01:56:31) That's another tremendously important question, and I appreciate it. You're correct. Soon after becoming CEO in 2017, I made a decision to stop the sales representative based promotion of opioids. We also decided to eliminate whatever speakers programs remained for our products. Dr. Landau: (01:56:53) What I would recommend, as part of the solution, as I understand the purpose of this hearing is intended to solicit ideas, is to make training for prescribed... for opioids mandatory, as I mentioned earlier. And I would also suggest that efforts being made to require all of the medicines within this class, controlled release and immediate release opioids, to have barriers introduced, to make them less susceptible or less attractive as drugs of abuse. Addiction is a tougher issue. It's a complex medical condition with various contributing factors. I think education of physicians, access to healthcare, are vital. Mr. Keller: (01:57:44) Okay. One other thing [inaudible 01:57:45] can you speak to the effectiveness of non-opioid pain management for things like nerve blocks [inaudible 00:21:55]? Dr. Landau: (01:57:58) Yes. I had a little trouble hearing the question, but I believe the thrust of it is speaking to treatments other than opioids to manage pain. So as a physician and as a physician who's treated pain patients, I am a full supporter of what's referred to as a multidisciplinary approach to pain. Opioids and other pharmacologic options represent a series of options, but there are other options, which in my view, need to precede the decision to initiate therapy with opioids. And these are non-pharmacologic options. Physical therapy, behavioral therapy, cognitive therapy, rehabilitation, biofeedback, there are a number of modalities that are available that can be quite effective in combination with, or in place of, the decision to write a prescription. And I believe there are certain barriers to patients at present, preventing or reducing access to those important treatments. So I would encourage any action that can be taken to open access up for patients for those types of therapies. Mr. Keller: (01:59:15) [crosstalk 01:59:15] Thank you. Madam Chair, I yield back. Chairwoman Maloney: (01:59:21) Gentleman from Maryland [inaudible 01:59:21]. Speaker 5: (01:59:21) Thank you, Madam Chair. Dr. Landau, has any executive in the Purdue company ever spent a day in jail for the actions of the corporation? Dr. Landau: (01:59:32) I believe not. Speaker 5: (01:59:35) Madam Chair, it's easy to feel outrage about the misdeeds of this corporation, but what about our government that gives license to this corporate irresponsibility and criminality and impunity? Speaker 5: (01:59:48) Mr. Sackler, as part of the DOJ settlement, did you have to admit any wrongdoing or liability or responsibility for causing America's crisis of opioid addiction and death? Mr. David Sackler: (02:00:03) No, we did not. Speaker 5: (02:00:05) Were you interviewed by the Department of Justice as part of this investigation about your role in these events? Mr. David Sackler: (02:00:12) No. Speaker 5: (02:00:14) Do you take any responsibility for causing America's nightmarish experience with the opioid crisis? Mr. David Sackler: (02:00:24) Although I believe the full record, which has not been publicly released yet, will show that the family and the board acted legally and ethically, I take a deep moral responsibility for it because I believe our product Oxycontin, despite our best intentions and best efforts, has been associated with abuse and addiction and [crosstalk 02:00:52] Speaker 5: (02:00:52) You're using the passive voice there when you say it's been associated with abuse, which implies somehow, you and your family were not aware of exactly what was taking place in the country. Speaker 5: (02:01:03) Madam Chair, look at what the consequences is of this corporate recklessness and governmental toleration of it. The DOJ in 2007 let the Sackler family get away with murmurs of regret for what other people felt and so on, a mere slap on the wrist. In 2007, the department settled misbranding charges with the company, but required no admission of wrongdoing. Nobody's spent a day in jail. And then, documents obtained by our committee now show that after this toothless 2007 settlement, members of your family proceeded to deliberately, aggressively, and recklessly push Purdue executives to flood the market even more with Oxycontin, including by targeting high volume prescribers and pushing higher strength doses of the drug. Speaker 5: (02:01:55) Consider this email that Dr. Richard Sackler sent in March of 2008 to the CEO of Purdue. He wrote, "I want the organization to stretch, not idle as so much of it has for a long time." Dr. Sackler was complaining about corporate revenues, as Oxycontin sales more than doubled to hit an extraordinary $2.3 billion. That is the consequence of government complicity with this corporate misconduct. Speaker 5: (02:02:25) The DOJ settlement requires Purdue now, this new sweetheart deal requires Purdue, but not your family, to set up a public document repository containing all documents Purdue handed over to DOJ, but the repository doesn't come into being until after bankruptcy is over, and it doesn't apply to documents in control of your family. Speaker 5: (02:02:47) So I want to ask you, Mr. Sackler, right now, about the transparency that you say you champion. Will you commit today, to the US Congress and to the American people, to contribute any documents that you have to the public document repository that's being created as a result of this settlement? Mr. David Sackler: (02:03:10) I have no problem with transparency, with everything that is relevant to Purdue, as it relates to the Sacklers. None at all. I think people have a misimpression through various media sources of the level of scrutiny that the family has gone through, as a result of the bankruptcy proceedings and the investigation therein. And I don't say that as a complaint, but I think people need to understand that a blanket commitment [crosstalk 02:03:43] well, okay [crosstalk 02:03:46] Speaker 5: (02:03:45) Will you turn over the documents that you have produced to the Department of Justice? Mr. David Sackler: (02:03:52) That's a question for the lawyers, sir [crosstalk 02:03:55] Speaker 5: (02:03:55) I've got two final questions. It's been reported that members of your family talked about milking the company, and then proceeded to remove millions or billions of dollars in excess profits from it prior to bankruptcy. Did you participate in conversations where you talked about milking the company and getting as much money out as quickly as you could before the bankruptcy took place? Mr. David Sackler: (02:04:19) I can't recall those specific conversations. However, I disagree with your assertion of even what milking the company meant in that context. I think it is being badly taken out of context. Speaker 5: (02:04:33) All right. Finally, as part of this settlement discussion, there's been the idea floated of turning Oxycontin, essentially turning this into a public benefit corporation. A lot of attorney generals, at least 24 of them, oppose this idea. They want it stripped out. I would like to submit for the record, Chairwoman Maloney, a letter from the state attorney generals, and specifically from the attorney general of Massachusetts, Ms. Healey, who says that this is a perversion of the justice process, essentially to get the government involved in promoting this drug. And so I would like to submit that for the record, if I could. Chairwoman Maloney: (02:05:14) So ordered. So ordered. Thank you for bringing it up. Speaker 5: (02:05:21) I will yield back. Thank you. Chairwoman Maloney: (02:05:23) I want to really comment very briefly on your focus on transparency, that talking to many of the families, they want to see more documents. They want to see what's being held in these court decisions. And I, for one, am going to put up on our website every document we got preparing for this hearing, so that the public can see these emails, the other information that we brought together. Thank you for your questioning. Chairwoman Maloney: (02:05:51) The gentleman from Kentucky, Mr. Comer, is now recognized for five minutes. I do not believe there are other speakers on your side that I can see on the roster here. Mr. Comer, thank you again for your cooperation and help with this hearing. You are now recognized for as much time as you would like. Mr. Comer: (02:06:14) Thank you, Madam Chair. I'm going to address my questions for the Sackler family. And first of all, do you all consider the doctors who prescribed Oxycontin complicit in any of this? We've already had extensive questions and discussion about the damage caused by Oxycontin, and not just in rural America, but in basically every county in America, every family in America has someone they know who has suffered addiction, and the cost to society cannot be measured. But I'm wondering, do you blame any of this on the doctors who prescribed Oxycontin? Mr. David Sackler: (02:07:05) I would say that this is an incredibly complex problem, with roots dating back long before the introduction of Oxycontin. And the medical establishment as a whole, and doctors as a whole, are the gatekeepers of prescription opioids. These products are available only by prescription. So one has to examine that, as a cause. As far as blame, I am not here to assign blame at all, but I do [crosstalk 00:31:41]. Mr. Comer: (02:07:42) Let me stop you there. So I asked that question because I don't know what role doctors played. I don't know if they made informed decisions, or if they were misled. That leads me to my next question. Did you ever approve a marketing plan which failed to adequately- Rep. Comer: (02:08:03) ... or approve a marketing plan, which failed to adequately inform doctor of the major risks of Oxycontin, such as abuse, addiction, overdose, and death. Mr. Sackler: (02:08:12) I believe the record will be clear that I never did such a thing. Rep. Comer: (02:08:18) In 2007, Purdue Pharma pled guilty to misbranding Oxycontin based on claims it was less addictive than short-term alternatives. This year, Purdue pled guilty to very similar charges based on actions that appeared to have been directed by your family, the Sackler family. Your family profited a great deal from Oxycontin. Do you believe opioid victims and their families have been adequately compensated for the deception perpetrated by Purdue Pharma and your family? Mr. Sackler: (02:08:54) I would like to address that in two parts, if I may. The first part is I believe that the record in full will clearly demonstrate that the current guilty plea that Purdue has undergone was activities that the board was completely unaware of, and it was contrary to board instruction, in some cases. Mr. Sackler: (02:09:24) I think that it will be very clear when the documents are released. However, compensation for victims is an incredibly important thing, and it's my belief that the bankruptcy process offers the best and most transparent and most equitable way to address the opioid epidemic. I know it's been widely criticized in the media, but I think that's a lack of understanding. It permits for an orderly distribution of funds, whatever they may be. It creates a public benefit company, the first of its kind in the pharmaceutical industry and I- Rep. Comer: (02:10:13) Well, let me interrupt you there. Let's talk about the bankruptcy process. Having served as a director of a community bank for many years, I'm very familiar with the bankruptcy process. What often happens is companies get into trouble, financial trouble, and they file bankruptcy. Then they suddenly reappear as you are mentioning in a new company, and they just wipe away all the debt that they have to their creditors. Rep. Comer: (02:10:53) It's not my favorite part of the law, watching companies be able to shield by bankruptcy. It's my understanding that your family has offered creditors in the bankruptcy proceeding just $3 billion to avoid larger payout to victims. Is your family attempted to take advantage of the bankruptcy system to shield its billions from justice for the American people? Mr. Sackler: (02:11:19) No, I don't believe that is accurate in any way. Rep. Comer: (02:11:24) Well, it would seem otherwise, and I think that everyone on this committee would disagree with your answer to that last question. Look, we don't agree on a lot in this committee in a bipartisan way, but I think our opinion of Purdue Pharma and the actions of your family, I think, we all agree are sickening. It's not just the cost to the families. It's the cost to society. Rep. Comer: (02:11:55) Every county in my congressional district, about 35, one of the things on their wishlist is always more money for drug rehab centers, more money to help people and help communities cope with the expense of withdrawals. This all started through Oxycontin and marketing and misleading doctors and misleading patients about the benefit of your drug. Rep. Comer: (02:12:29) I am sympathetic to people that have pain. There are people in America that have legitimate pain, and they need help for that thing. But when you say that you didn't know when you created this drug what would happen, that may be true. But what I pointed out in my questioning, what others have pointed out today is your company knew this, that it was addictive, that it was creating deaths, creating disruptions, creating all sorts of havoc in America, but yet you continued marketing this product. Rep. Comer: (02:13:08) Now, you've got to the point to where everybody knows the damages of Oxycontin, so you filed bankruptcy to avoid the majority, the overwhelming majority, of the costs that you've passed on to society. You're going to reorganize, I assume, in a benefits corporation or however you're going to reappear and continue to profit. Maybe not with Oxycontin, but you continue to operate. Rep. Comer: (02:13:43) When I know of doctors that have over prescribed pain pills that have lost their licenses. I know of families that have lost loved ones. I know families that have been torn apart, because of what your family and your company continued to market to the American people. It's just sickening to me, and I share the outrage of just about every American. Rep. Comer: (02:14:09) I'm just sick to see what it appears to me as a family and a company that's going to use the bankruptcy process to get out of this and to continue to be one of the wealthiest families in America. It's unacceptable, and I just, I'm just sickened, sickened the more I read about the actions of Purdue Pharma. With that, Madam Chair, I yield back. Rep. Maloney: (02:14:37) Thank you. Thank you, Mr. Chairman, for your cooperation, ranking member, on this. I ask unanimous consent to place in the record of the statement by the Massachusetts Attorney General Maura Healey, that mirrors many of the things that you were saying. Rep. Maloney: (02:14:56) Just to quote from it, "If we let powerful people cover up the facts, avoid accountability, or create a government sponsored, Oxycontin business. That's not justice, it's offensive and wrong." I asked unanimous consent to put her statement, it's quite long, into the record. So ordered. Rep. Maloney: (02:15:20) I now recognize Mr. Sarbanes. He is recognized for five minutes, Mr. Sarbanes. Rep. Sarbanes: (02:15:29) Thank you very much, Madam Chair. Can you hear me? Rep. Maloney: (02:15:33) Yes, we can. Thank you. Rep. Sarbanes: (02:15:35) Thanks very much. We've heard plenty of testimony today about the timeline here, that in 2007, Purdue Pharma pleaded guilty to illegally misbranding Oxycontin in this effort to mislead doctors and patients about the drug's risk of addiction. There was a fine, Congressman Raskin indicated that that was really just a minor slap on the wrist for the company, and I certainly agree with that. Rep. Sarbanes: (02:16:06) But what's breathtaking here is that it looks as though that settlement and that fine that was entered into by the company was a signal to the family that with litigation coming down the road, the efforts to maximize profits from Oxycontin should be redoubled. You basically went to the mat to try to pull as much money in profit from the company and from its activity, as you could, because you knew that this cash cow was going to come to end. The gravy train was going to be over at some point. Rep. Sarbanes: (02:16:51) Just stepping back, looking at it in those very simple terms, a reasonable person can not reach any other conclusion about the behavior of the family in the wake of that 2007 penalty that you experienced, so that was cynical. I think as you can tell from the committee's perspective here, we view that as really obscene in terms of what you decided to do next. Rep. Sarbanes: (02:17:21) Dr. Landau, I'm not going to ask you a question, but I do want to quote, again, I think Congressman Cooper mentioned, that you at one point acknowledged that Purdue was operating in a way, where the board of directors was serving as the de facto CEO. This notion, and we've heard it today from the family that, oh, we were just following management's recommendations and so forth, is a little bit absurd because the family had control of operations. They knew exactly what was happening, and they were going to push this agenda in terms of what ended up broadening the addiction crisis across the country. Rep. Sarbanes: (02:18:08) According to internal documents that were obtained by the committee and the Massachusetts Attorney General, the Sacklers as board members were ordering a company. This is again, after the slap on the wrist in 2007, to hire hundreds more sales reps, directed those reps to target the highest prescribers of Oxycontin, push [inaudible 02:18:32] strength dosage of Oxycontin, approve misleading marketing materials that downplayed the risk of the addiction, rewarded employees for selling more drugs. Rep. Sarbanes: (02:18:45) There was one marketing campaign called Evolve to Excellence, which was designed to, "Turbocharge sales by reorienting most of the company's sales efforts to target the highest prescribing doctors." This would, where they would write and target sales visits to doctors who wrote 25 times as many Oxycontin prescription. Rep. Sarbanes: (02:19:10) You knew what was happening. You knew what was going on. This was designed to pull as much money out of the company as you possibly could before these penalties and lawsuits and other actions were going to come at you. The company's patients saving cards, supposedly intended to expand access to Oxycontin, were consistently tracked and evaluated because Purdue knew these cards were a powerful way to keep patients on opioids longer. Is that right, Mr. Sackler? Mr. Sackler: (02:19:44) My understanding is that the patient savings cards were designed to help people afford their medication. Rep. Sarbanes: (02:19:50) Okay. That's a perfect answer, because it represents the way in which the narrative that you've put together, everything that was in fact designed to take advantage of people and exploit their weakness was presented by Sackler and Purdue as trying to help those patients. This is where the crisis originated. This is why thousands of people across the country became addicted, because of this rosy story and narrative that you painted. Rep. Sarbanes: (02:20:24) The Sacklers, not just Purdue, the Sacklers need to be held accountable. Before 2007, I think it's fair to say that, at best, the family was morally blind in its actions and conduct. After 2007, the family became morally bankrupt, not financially bankrupt. You're doing very well. You're rich, and that's [inaudible 02:20:51] when you look at the situation of these families, this wasteland across the country that's been caused by what the family did. Rep. Sarbanes: (02:20:58) I hope that there will be some repercussions, some consequence for the family, for its conduct, and with that, I yield back, Madam Chair. Rep. Maloney: (02:21:09) Thank you. The gentleman yields back, and the gentleman from Alabama, Mr. Palmer, is now recognized for questions, Mr. Palmer. Rep. Palmer: (02:21:17) Thank you, Madam Chairman. The United States is reported to consume about 90% of the world's opioids, and part of this goes back to something that was in the Affordable Care Act that mandated that 1% of Medicare inpatient payments be withheld from hospitals based on patient satisfaction, and this is something that we had a field hearing in this committee. Madam Chairman, you may have been there at Johns Hopkins Hospital, and we talked about this as part of the problem. Rep. Palmer: (02:21:57) The issue that I want to bring up is the role of Purdue Pharma in pushing this. The Joint Commission is a US-based, non-profit tax-exempt 501 organization that accredits more than 22,000 healthcare organizations and programs. According to a Wall Street Journal article, The Joint Commission published a guide, sponsored by Purdue Pharma, on pain management. Rep. Palmer: (02:22:26) The guide reportedly stated some clinicians have inaccurate and exaggerated concerns about addiction, tolerance, and risk of death related to the use of Oxycontin, and so there was no evidence that addiction is a significant issue when persons are given opioids for pain. What I would like to know from Mr. Landau is, did Purdue Pharma fund any of that research done by The Joint Commission? Mr. Landau: (02:23:02) With respect, Representative Palmer, I don't know. I said in earlier testimony that before becoming CEO, I was entrenched in research and development, and that would have been in an area outside of my area of responsibility. I could get back to, certainly after the hearing with that information. Rep. Palmer: (02:23:22) Mr. Sackler, did Purdue Pharma fund any of the research published by The Joint Commission? Mr. Sackler: (02:23:33) I simply don't know. I, unfortunately- Rep. Palmer: (02:23:36) The answer to the question is yes. Oxycontin was approved by the Food and Drug Administration in 1995, and your company mounted an aggressive marketing campaign that the FDA warned, in 2003, was misleading. Are you aware of that? Mr. Sackler: (02:24:05) My recollection is that the FDA's warning letter in 2003 related to a single ad in a journal article. Rep. Palmer: (02:24:15) What I'm pointing out here is what appears to me to be a intentional effort to mislead not only patients, but physicians and hospitals in working through The Joint Commission, which has tremendous influence, obviously, they're an accrediting organization, and that your company has heavily invested in them. They're a 501c3. Rep. Palmer: (02:24:41) You've made significant contributions through your company to The Joint Commission, and it seems to me that, obviously, Purdue knew that there were major problems with Oxycontin, but you aggressively, and I think, in a dishonest way, pushed this drug on doctors. It only ramped up after the changes in the Affordable Care Act that that made pain management one of the key factors in whether or not hospitals could get their full payments from Medicare or taking care of Medicare patients. Rep. Palmer: (02:25:26) The Joint Commission even went so far as the frame pain management as a patients' rights issue. That's disturbing. I just want to know how much money Purdue Pharma put into The Joint Commission. Mr. Sackler: (02:25:44) I don't know. Rep. Palmer: (02:25:47) Would you be willing to get that information, or Mr. Landau, get that information, provide that to this committee? Mr. Landau: (02:25:56) Yes, I'll take that request back for sure, representative. Rep. Palmer: (02:25:59) Madam Chairman, can the committee make sure that they follow up on that? You're muted. Rep. Maloney: (02:26:09) [inaudible 02:26:09] point. We will follow up. Thank you. Rep. Palmer: (02:26:12) Thank you very much. I see that my time has expired. I would just like to conclude by saying this, that Alabama has the highest use of opioids in the country. Now, I know West Virginia has the highest death rate. When we had this field hearing at Johns Hopkins, there were plans in place to remove the pain management from the ratings for the hospitals, and I think that's been done. Rep. Palmer: (02:26:43) But it was only after we were seeing 60 to 70,000 people per year die from drug overdoses. This is an unspeakable tragedy that has taken place in this country, and I think Purdue has a tremendous responsibility here to make it right. Madam Chairman, thank you for the indulgence. I'll yield back. Rep. Maloney: (02:27:09) Thank you. The gentleman from Vermont, Mr. Welch, is recognized for five minutes. Rep. Welch: (02:27:18) Thank you, Madam Chair. Dr. Sackler, you served on the board from, as I understand it, 1990 to 2018, is that correct? Dr. Sackler: (02:27:29) Yes, that's correct. Rep. Welch: (02:27:32) You were there when there was the rollout of Oxycontin in 1996, correct? Dr. Sackler: (02:27:38) Yes. Rep. Welch: (02:27:41) I understand that that rollout occurred even as a study showed that 82% of patients had an adverse reaction. Do you recall that? Dr. Sackler: (02:27:51) No, I was not aware of that. Rep. Welch: (02:27:54) Well, in 1997, there was a memo issued by Purdue to the sales representatives, and I want to quote from this email, "Your priority is to sell, sell, sell Oxycontin." Do you recall that? Dr. Sackler: (02:28:15) I do not. Rep. Welch: (02:28:17) Well, you were on the board. Is that consistent with your recollection of the role that Purdue had to make Oxycontin the most used drug in the world? Dr. Sackler: (02:28:28) That was not my goal, and I don't recall hearing that espoused as the board's goal either. Rep. Welch: (02:28:35) Let's just go through this. Purdue set up a very elaborate system to have doctors go to Pebble Beach and be given fees for speaking, to have sales representatives trained to knock on doctor doors. Do you recall those matters that were part of the sales plan? Dr. Sackler: (02:28:55) As the director of the company, I would not know the specific actions and speakings of the sales department. Rep. Welch: (02:29:05) I'm not going to go into the details on that, but there was a fundamental decision that the board made to sell, sell, sell Oxycontin. Now, do you know the name of the company Practice Fusion? Dr. Sackler: (02:29:20) I never heard of the name of the company Practice Fusion until I was- Rep. Welch: (02:29:27) Purdue Pharma had an agreement with them. It was a medical records organization, and it provided a digital alert to doctors about opioids and it increased prescriptions, and your company, Purdue Pharma, gave a Practice Fusion a $1 million kickback. Do you know about that? Dr. Sackler: (02:29:50) When I was in the middle of trying to answer the first question to say that I never heard of Practice Fusion until my attorneys advised me of it as regards to plea. Rep. Welch: (02:30:05) I don't have much time, so I have to interrupt. You're [crosstalk 02:30:08] Dr. Sackler: (02:30:07) Sorry, I learned about it through Purdue plea. Rep. Welch: (02:30:10) All right, there was a Wall Street Journal article reported that Wharton, Notre Dame and the RAND Corporation did a study that showed in states where you did your marketing program, you, Purdue, it was vastly more prescriptions than in five States where you didn't. Does that sound right? Dr. Sackler: (02:30:30) Again, I didn't have that knowledge, and I don't have that recollection, but if you say so, I accept that. Rep. Welch: (02:30:37) These are all federal [crosstalk 02:30:39] Dr. Sackler: (02:30:39) Yeah, I trust they're accurate. Rep. Welch: (02:30:41) All right. Now your career on the board coincided with another person who sold, as his career, drugs. His name was Juan Guzman, El Chapo. I don't know if you've ever heard of him. Dr. Sackler: (02:30:55) In the newspaper, I've seen his name. Rep. Welch: (02:30:57) All right, he was sentenced to life in prison, and Purdue Pharma pleaded to three felonies, yet no one from the Sackler family is in jail. Many of us think that's not right, but let me ask you this. The federal government is seeking $12 billion in assets from Juan Guzman, El Chapo, the amount that audits suggest he made in the illicit sale of drugs. Do you think it's the right of the taxpayers to get that money back from Mr. Guzman? Dr. Sackler: (02:31:35) I don't think I can give you an answer to that. I don't know anything about- Rep. Welch: (02:31:39) You don't have an opinion about [crosstalk 02:31:40] Dr. Sackler: (02:31:40) ... certainly the legal. It's [inaudible 02:31:44] Rep. Welch: (02:31:44) All right, let me ask you this. The audit that was done of the Sackler family and Purdue concluded, this is federal, that the profits to you and to your family members is $12 billion. Is there any reason you can give us why every single dollar should not be returned to the government for distribution to the victims of Purdue Pharma? Dr. Sackler: (02:32:20) I really don't know the answer to that either. I'm sorry. Rep. Welch: (02:32:24) Well, you do know the answer. It's a yes or no. Dr. Sackler: (02:32:37) Can you repeat the question? Maybe I didn't understand it. Rep. Welch: (02:32:43) The government is seeking $12 billion from El Chapo. That's the profit of his sales. The federal government audit of the Sackler family is that your family, you and your fellow members of the Sackler family, have $12 billion in profits from your aggressive marketing and sales of Oxycontin. Is there any reason why that money, every single dollar, should not be returned and recovered by taxpayers for distribution to families? Dr. Sackler: (02:33:22) I would think that you would agree that the way that such a determination would be addressed would be for the Justice Department to conduct proper investigations and procedures, which I believe they are doing. I think this is up to the responsible government agencies. I don't think this is something I can opine on actually. Rep. Welch: (02:33:57) El Chapo got a life sentence, and he's going to forfeit $ 12 billion. The Sackler family through Purdue has three felony convictions, but no one's in jail, and it has it's billions still. Dr. Sackler: (02:34:09) Excuse me, the Sackler family doesn't have a felony conviction. Purdue Pharma has a felony conviction. I'm an individual person. I worked as a director at Purdue. I'm a beneficiary owner of Purdue, but I am not... There are no allegations that have been put forward or accusations that have been put forward against me or other directors of Purdue. Dr. Sackler: (02:34:38) There were also five or six independent outside directors that participated fully in every decision that was made at the board of directors. I think that it's including some of the decisions you've cited today. I think that's the status as of now. Rep. Welch: (02:35:06) Well, my time is up, but just I'll conclude that your testimony is you don't know nothing about nothing and things happen, but you don't know how. People are responsible, but you don't know who. Thank you. I yield back. Rep. Maloney: (02:35:20) The gentlemen yields back. The gentlewoman from Illinois, Ms. Kelly, is recognized. Ms. Kelly, you're now recognized. Can you hear us? Rep. Kelly: (02:35:31) Yes, I can. Thank you, Madam Chair, for holding this hearing. I would like to ask a few questions about Purdue's efforts to target opioid prescribing to seniors and patients covered by the Medicare program. Rep. Kelly: (02:35:44) The Medicare program is a crucial part of America's safety net and our nation's promise to its seniors. Millions of seniors rely on Medicare Part D to cover the cost of their prescription drugs. It appears seniors who access healthcare through Medicare are critically important to Oxycontin sales. One internal Purdue document stated that the company targeted, and I quote, "Patients over the age of 65 as more Medicaid Part D coverage is achieved." Rep. Kelly: (02:36:13) Purdue's strategy to target Medicare patients had many dimensions, and it extended to the company's approach to providers and prescribers. In Massachusetts, for example, a Purdue supervisor coached sales representatives to follow the company's " geriatric strategy" when promoting Oxycontin providers, and to "keep the focus on the geriatric patients." Mr. Sackler, are you familiar with produced geriatric strategy? Mr. Sackler: (02:36:43) I'm not sure I'm familiar in detail, but what you read, I am familiar with. Rep. Kelly: (02:36:50) As part of this strategy, Purdue made false claims about the Oxycontin's benefit to elderly patients, and even provided doctors with staged photographs featuring fake patients to humanize the sale, and I quote, "Bring the heart into it." Rep. Kelly: (02:37:06) For example, sales reps allegedly told one Massachusetts doctor that putting elderly patients on Oxycontin would improve safety from potential falls. When in reality, elderly patients on Oxycontin have increased risk of falling and breaking the bones. Dr. Landau, you're a trained physician, can you point the committee to scientific evidence demonstrating that Oxycontin would improve safety for elderly patients from potential falls? Mr. Landau: (02:37:37) Representative, I'm not aware of that communication, but I can't at this time, no. Rep. Kelly: (02:37:42) Purdue's focus on Medicare became further entrenched after instituting McKinsey's Evolve to Excellence program. Part of this plan included ranking prescribers based on "value deciles." Access to federal healthcare programs like Medicare was one of the metrics used to analyze prescribers. Purdue also rewarded doctors who are high volume Medicare prescribers under this plan. Mr. Sackler, you and the rest of the board personally approved the Evolve to Excellence plan. Correct? Mr. Sackler: (02:38:16) No, I believe elements of it were incorporated into management's proposal, which was then approved by the board. But no, I don't believe the entire Evolve to Excellence plan was ever voted on by the board in that way. Rep. Kelly: (02:38:31) The buck stops with all of you, so even if you didn't vote on the whole plan, the buck still stops with you. Between 2013 and 2017, Purdue paid the highest value Medicare describer of Oxycontin approximately $475,000 [inaudible 02:38:52]. According to internal communications obtained by DOJ, the prescriber was, "Not a strong speaker or presenter," but he did engage in "'heavy prescribing,' particularly in large doses for a long period of time." Rep. Kelly: (02:39:08) I just want to end by saying my husband had surgery, and when he finished his surgery, he was prescribed opioids, Oxycontin, but my husband decided not to take it. The interesting part about my husband is that he's a trained anesthesiologist. With that, I'll yield back. Rep. Maloney: (02:39:36) Technical difficulties, the gentle lady yields back. I now recognize a gentleman from California, Mr. DeSaulnier, you are now recognized, and thank you for your leadership on this issue. Rep. DeSaulnier : (02:39:50) Thank you, Madam Chair. As bad as this has been, and I would like to remind people that Purdue Pharma is a privately held company. Speaker 6: (02:40:02) Purdue Pharma is a privately held company, owned by the Sackler family, largely created by the Sackler family through multiple generations, and there's been a lot of fault on this issue, distributors, FDA, the DEA, and Congress. We allow for this marketing, whereas Mr. Palmer pointed out, the U.S. has less than 5% of the world population, but over 80, 90% of the use of opioids. It's supposed to relieve pain, and it does, but it has also been abused. And the marketing has been at the crux of this. In many ways, Purdue Pharma is a marketing company, as much as it is a drug company. So it's so important, Madam Chair, that we pursue this. Speaker 6: (02:40:55) Other members have brought up the issue of justice and evil, we have to go beyond this hearing. And I want to thank all the members and the bipartisanship that has brought this. For all the damage that's been done, it's even bigger than this issue. It's part of what's wrong with this country, is that people think that they can ask for forgiveness, but not ask for permission and not think about the consequences of their actions. It's somebody else's fault. Speaker 6: (02:41:26) I became involved in this issue, like many of us do, because of constituents, parents who have lost children. One, April Rivera, has become a leader on these issues. Her son died, unfortunately, in justice. The doctor who was writing that prescription in a well-publicized story on a case in Los Angeles was indicted and convicted and is now in jail. Bob Pack, the other constituent, lost a child when they were out walking on a Sunday afternoon, the family, wife was pregnant with twins, when they were hit by a car, a Mercedes, with a woman who was using this product, and he has dedicated himself. Speaker 6: (02:42:09) I, at the time, was in the state Senate and I introduced a series of bills and worked closely with the then Attorney General, soon to be vice-president of the United States, Ms. Harris. And one of the bills simply took our prescription monitoring system and updated it so that the DOJ would have real-time information about who's abusing, whether it was pharmacies, doctors, or clients. The pharmaceutical industry fought that. Fought it very hard. I couldn't get it out of the committee of jurisdiction of which I was a member of the health committee, even though I had been promised votes by colleagues. Speaker 6: (02:42:48) Thanks to the Los Angeles Times, and I want to thank all the writers, people who've written books, phenomenal writing on this. They're not to blame. They are the people who brought this to our attention, and the journalists who have covered these stories. It came my attention, it was obvious to me as I watched this up closely, that the pharmaceutical industry, and it wasn't just Purdue, that the pharmaceutical industry was determined to make sure that we didn't have that information because they wanted to continue to addict people. They wanted to continue to make money. This was the perfect business model, you had a product that would addict your clients, you marketed it to people who didn't need the product, and the physicians were told it was safe. Speaker 6: (02:43:37) Dr. Orlando, you wrote a note that said there are too many prescriptions being written, too high a dose for too long for conditions that often don't require them, by doctors who lack the requisite training in how to use them appropriately. But isn't it true, doctor, that granted prior to you having the position you have, that Purdue Pharma, at the direction of the Sacklers, Sackler family members, spent money convincing doctors that there was no risk or very little risk? Isn't that true? Dr. Orlando: (02:44:16) So Representative [crosstalk 00:04:17]. Yes, that's not my understanding. No. Speaker 6: (02:44:20) Okay. Well, the record states otherwise. So while I appreciate and believe in redemption, I'm not interested in contrition here. There's too much damage that's happened and justice has to be met. As I said in my opening comments, people of color, poor people do much less damage to this country, and don't get to come in and say they're sorry. Although, I'm sure they are sorry when they're caught. There has to be justice in this case. And I hope we pursue that in this venue, Madam Chair, but I also hope that people in the Department of Justice and at the state level continue to pursue justice because if they don't, this is going to happen again. I yield back. Madam Chair: (02:45:09) Thank you for your heartfelt comment. I can assure you, we are planning future hearings and we need your help in doing that. Madam Chair: (02:45:18) The gentleman yields back. The gentlewoman from the Virgin Island, Ms. Plaskett, is recognized for five minutes. Ms. Plaskett: (02:45:27) Thank you very much, Madam Chairwoman. And thank you to the witnesses for being here this morning. Ms. Plaskett: (02:45:34) The documents that have been obtained through federal and state investigation confirm revealing tactics used by the company Purdue to drive up sales and medically unnecessarily prescribe Oxycontin and other opioids. And there is, within those documents, allegations and information as to the Sackler family's involvement in these efforts. I wanted to talk about some of that documentation and ask you all if you would answer some of that. Ms. Plaskett: (02:46:06) Mr. Sackler, I would like to ask you about an email your father, Dr. Richard Sackler, sent in March of 2008. This is document five in your materials. Your father sent this email after receiving sales projections for the upcoming year, which he apparently felt were not ambitious enough. He wrote an email to the then CEO, John Stewart, and members of your family, including witness here, Dr. Kathe Sackler, calling the projection, "a typical low ball number" and asking the family to, "give me support in these matters." He concluded, "I want the organization to stretch, not idle as so much of it has for a long time." Mr. Sackler, by stretch I assume he meant he wanted to increase Purdue's revenues. Is that correct? David Sackler: (02:47:00) Well, in this case, he's referring, I'm pretty certain, to the forecasting effort that Purdue was making and wanting to get better forecasting out of management. I think that that's clear. Ms. Plaskett: (02:47:13) So are you saying better forecasting, meaning more detail? Or, are you saying forecasting of sales meaning increase in sales thereby increase in revenues? David Sackler: (02:47:23) No, I believe what had happened prior to this is that there have been a number of years where management had set sales targets that they had exceeded and his desire, as I read this, is for a more accurate sales forecast. That's relevant because it relates to the expenses that a company can set, whatever that forecast- Ms. Plaskett: (02:47:49) Sure, I understand that. It's important as well for shareholders to have an accurate information as to that. When he says that the organization to stretch, not idle, what did you mean by that? Stretch would not mean necessarily to ... What did he mean by that in your opinion? David Sackler: (02:48:08) Well, I'm not entirely sure what he meant by that, but I take it to mean work hard to achieve ambitious goals. Ms. Plaskett: (02:48:16) So you knew what he meant in the first part, but now you're not sure what he meant when he said, I want the organization to stretch? David Sackler: (02:48:24) I've given you my best judgment as to what I think he means. Ms. Plaskett: (02:48:29) So when he asks for support ... I'm sorry, go on, sir. David Sackler: (02:48:32) No, no, please go on. Ms. Plaskett: (02:48:34) When he asked for support on these matters from the family, it looks as he though was asking for the family members to pick the same position during a board meeting or both. Would that be a correct assessment of the support that he would need on those matters? David Sackler: (02:48:48) Well, he may be asking for it, but I don't know if he received it. Quite often, he- Ms. Plaskett: (02:48:53) I didn't ask you if he received it. I asked you if by support he meant for the family members to take the same position during a board meeting or a vote. David Sackler: (02:49:02) I believe that's what he's asking for, yes. Ms. Plaskett: (02:49:04) Thank you. Your father continued to use the Sackler's family leverage or request leverage within the company to advocate for higher earnings targets. According to the Department of Justice, Dr. Richard Sackler, again, opposed to the proposed budget in 2010, complaining that it would "lean to a Oxycontin tablet forecast that is almost the same as our sales of 2009." When an executive countered that there is no basis for a higher projection, he responded that, "This is a matter that the board will have to take up and give you a settled direction." Dr. Orlando, "settled direction" just meant that the board would override management and set the sales target, is that what would happen? Dr. Orlando: (02:49:51) Hi, representative. I'm not sure I could answer ... I'm not certain I was part of those conversations and I'm not sure what he meant by that. Ms. Plaskett: (02:49:59) Well, I'm sure you've seen these documents before. What would you take as a CEO of this corporation, a settled direction that a board would have to take up and give, to you as an executive? Dr. Orlando: (02:50:12) Well, I think a settled, just generally speaking, a settled direction means alignment or agreement on whatever the issue is in question so that could be communicated to management. Ms. Plaskett: (02:50:25) And the board would agree on that and give that direction to management, correct? Dr. Orlando: (02:50:32) Well, in this instance, I'm not certain. As I mentioned, I'm not- Ms. Plaskett: (02:50:36) [crosstalk 02:50:36]. I didn't ask you if you were certain it happened. I asked you if that is what could happen. Dr. Orlando: (02:50:43) Any number of things could happen. Again, I'm not part of that conversation. Ms. Plaskett: (02:50:47) [crosstalk 02:50:47] one of those scenarios, doctor? Dr. Orlando: (02:50:51) Potentially, I suppose. Ms. Plaskett: (02:50:54) You suppose? Dr. Orlando: (02:50:56) I'm not really sure what you're asking me, representative. Ms. Plaskett: (02:50:58) I think I was very clear on what I asked you, which was in the matter board taking up and giving settled direction, does that mean that a board could override management and set the sales targets of the company? Dr. Orlando: (02:51:14) I would say that that is possible, but I'm not certain that happened. Ms. Plaskett: (02:51:17) Okay. Thank you. Finally, a direct answer. I yield back. Madam Chair: (02:51:21) The gentlelady yields back. I now recognize the gentleman from California. The Vice Chair Gomez is recognized. Congressman Gomez. We can't hear you. Jimmy Gomez: (02:51:40) Thanks. I'm not in chair. Madam Chair: (02:51:42) [inaudible 00:02:51:43]. Jimmy Gomez: (02:51:44) Can you hear me now? Madam Chair: (02:51:45) Yes, we can. Jimmy Gomez: (02:51:46) Thank you, Madam Chair. One of the troubling aspects of the Sackler family's role in the opiod epidemic, and there are many, is how you actively deceive doctors and the public about the dangers and addictiveness of Oxycontin. Jimmy Gomez: (02:52:04) Mr. Sackler, it is a scientific fact that Oxycontin is more potent than morphine, correct? David Sackler: (02:52:15) Though the FDA has removed relative potency from the label, I believe, at this point, I do agree it is more potent than morphine. Jimmy Gomez: (02:52:25) Thank you. With that fact in mind, I want to ask you about a May, 1997 email exchange that your father had with Michael Friedman, a senior executive who later became CEO of Purdue. In the email, Mr. Friedman told your father, "We are well aware of the view held by many physicians that oxycodone is weaker than morphine." Mr. Friedman ended the email by telling your father that he had no plans to correct the misconception. Your father agreed, telling Mr. Friedman, "I agree with you. Is there general agreement or are there some holdouts?" Jimmy Gomez: (02:53:03) A few days later, your father received an email from another Purdue executive, Michael Cohen. this is document one in your materials, which is this email here. Mr. Cohen wrote your father that, "Since oxycodone is perceived as being a weaker opiod than morphine, it has resulted in Oxycontin being used much earlier for non-cancer pain." Mr. Cohen ended the email by saying, "It is important that we be careful not to change the perception of physicians towards oxycodone when developing promotional pieces." Instead of instructing Mr. Cohen to correct the misconception, your father forwarded the email to Mr. Friedman with positive feedback, telling him, "I think that you have this issue well in hand." Purdue, under your family's leadership, then targeted doctors with more advertisements downplaying the addictiveness of the opioid. Let's play one ad from 1998. Speaker 7: (02:54:12) Once you've found the right doctor and have told him or her about your pain, don't be afraid to take what they give you. Often, it will be an opioid medication. Some patients may be afraid of taking opioids because they're perceived as too strong or addictive, but that is far from actual fact. Less than 1% of patients taking opioids actually become addicted. And any drowsiness that might occur when you start to take the medication will soon wear off in most patients. Jimmy Gomez: (02:54:52) The claims in this video were clearly false. In fact, in 2007, Purdue pleaded guilty in federal court to falsely promoting Oxycontin as, "less addictive, less subject to abuse and diversion, and less likely to cause tolerance and withdrawal than other pain medications." Purdue paid over 600 million as part of that plea agreement and Mr. Friedman pleaded guilty as well. Jimmy Gomez: (02:55:17) Mr. Sackler, did you plead guilty in 2007? Can't hear you. Can't hear you. Sorry about that. David Sackler: (02:55:28) I did not. I was not a member of the board or had any other formal affiliation with Purdue in 2007. Jimmy Gomez: (02:55:36) Did your father, Dr. Sackler, plead guilty in 2007? Just a simple yes or no is fine. David Sackler: (02:55:42) I believe the Department of Justice investigated him and no, he did not plead guilty. That's my understanding. Jimmy Gomez: (02:55:50) Did anyone in the Sackler family plead guilty in 2007? David Sackler: (02:55:55) Again, the same answer, I believe the Department of Justice evaluated it and no member of the Sackler family pleaded guilty. Jimmy Gomez: (02:56:03) Yeah. And the reason why we're asking that is the entire Sackler family has emerged from the plea agreement, unscathed. And this has [inaudible 02:56:12] in your family to continue its false and misleading promotion of Oxycontin. In the years that followed, you ordered Purdue Pharma to hire hundreds more sales reps to visit doctors. You directed the sales reps to encourage doctors to prescribe the highest dosage of Oxycontin and continued to downplay the dangers and addictiveness of the drug. And now again, DOJ is settling its case against you without holding you or your family criminally liable for the deception of doctors and the public. I believe that the American people deserve better. With that, I yield back. Madam Chair: (02:56:55) The gentlewoman from Massachusetts, Ms. Pressley, is recognized for five minutes. Ayanna. Ayanna Pressley: (02:57:02) Thank you, Madam Chair for convening this important hearing. The crisis of opioid addiction has destabilized families and communities throughout the country, including in the Massachusetts [inaudible 00:17:13], which I have the honor of representing. Now, while the Commonwealth in 2014 was the first state to declare opioids, a public health emergency, my constituents are still, to this day, fighting addiction and trying to heal from the pain and trauma created by the Sackler family. Despite the habit reeked by the Purdue Pharma, community-based recovery centers have served as critical resources like the Massachusetts Organization for Addiction Recovery, and STEPRox, who have cared for my constituents with compassion. Ayanna Pressley: (02:57:44) As the daughter of a parent who's struggled with opioid substance use disorder, I know firsthand that we need to invest in these support systems and end the stigma and the criminalization of addiction. People who are battling addiction are not criminals. They are not misbehaving. They are managing a heroin disease that afflicts them and impacts their family every single day. Ayanna Pressley: (02:58:10) Mr. Sackler, yes or no, do you agree that addiction is a disease? David Sackler: (02:58:15) I do, yes. Ayanna Pressley: (02:58:17) Dr. Sackler, yes or no, do you agree that addiction is a disease? Dr. Kathe Sackler: (02:58:22) Yes. Ayanna Pressley: (02:58:24) Based on documents obtained from the Massachusetts attorney general, this wasn't always your family's view, particularly when the opioid crisis was first unfolding and generating bad press for Oxycontin, according to an internal email marked as document three on page four, Dr. Richard Sackler wrote, and I quote, "The abusers are misbehaving in a way that they know is a serious crime. They are doing it in complete disregard of their duties to society, their family and themselves. The notion that this is genetically programmed is nonsense." He went on to write, "The fact is that many other people have the same tendencies and are not drug abusers. They are criminals." Ayanna Pressley: (02:59:08) Mr. Sackler, do you agree with your father's words that people struggling with addiction are criminals? Yes or no? David Sackler: (02:59:14) No I don't. And in the almost 20 years since this was written, I know my father has both apologized for these words and has come ... I'm sorry. Please, go ahead. Ayanna Pressley: (02:59:27) Thank you. You're cutting my time. In one email marked as document two on page two, he wrote, "We have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals." Ayanna Pressley: (02:59:41) Mr. Sackler, who do you believe is the criminal, the person struggling with addiction or the corrupt pharmaceutical executive that has monetized the addiction? David Sackler: (02:59:53) Well, I don't believe that people struggling with addiction are criminals, though- Ayanna Pressley: (02:59:59) Are you- David Sackler: (02:59:59) But I don't believe [crosstalk 03:00:02] No, I do not- Ayanna Pressley: (03:00:05) I certainly vehemently disagree. I'm going to reclaim my time. Ayanna Pressley: (03:00:08) I also just want to take a moment to just acknowledge the equitable outrage, which I appreciate from both sides of the aisle, about this unjust predatory practices which have decimated communities and destabilized families. I wish that there had been those same sentiments during the crack cocaine epidemic which decimated urban communities and black families still today. Blaming people with substance use disorder is shameful. Your family's rhetoric fuels the stigma and harmful policies that have denied people in need the resources they require to overcome their addiction. We do not need another failed war on drugs. What we need is a reckoning and accountability for drug companies who put profits over people and rob us of lives and freedom of our loved ones. You have created a nationwide epidemic. 450,000 people have died. Let me be clear, people struggling with addiction are not criminals. Your family and Purdue Pharma, you are the criminals. You are the ones who disregard your duties to society, and you should be ashamed of yourselves. I yield back. Madam Chair: (03:01:19) Thank you. The gentlelady yields back. The gentlewoman from Michigan, Ms. Tlaib, is recognized. Ms. Tlaib. Rashida Tlaib: (03:01:26) Thank you, Chairwoman. This question line, I would like to have it go towards Mr. Sackler. Just want to make sure he's listening. David Sackler: (03:01:39) Yes, I am listening, Congresswoman. Rashida Tlaib: (03:01:40) Great. I want to ask you a few questions about the effects that involve all Evolve to Excellence, I think some of my colleagues had mentioned it, it's a sales campaign that you and your family approved as members of the board. Do you remember that campaign? David Sackler: (03:01:53) Yes, it was a management-led initiative. Rashida Tlaib: (03:01:56) Yeah. Yep. Yep. You were on the management. So the sales campaign intentionally targeted high prescribing doctors. One particular doctor, Doctor One, he actually was called 290 times between 2010 and 2018. That's more than three times a month for eight years. Yes or no, is that a lot of sales calls to one doctor, Mr. Sackler? David Sackler: (03:02:20) Well, I'm not certain where you're drawing that information from so I can't really- Rashida Tlaib: (03:02:25) It's okay, I [inaudible 03:02:26] some of the lawsuits. This is information. Again, you targeted high prescribing doctors. You had folks call them 290 times between the years of 2010 and 2018. Purdue received three different reports of concern regarding Dr. One, this is a real case, that between 2009 to 2011. In 2009, a local pharmacist reported Doctor One to Purdue, asserting that there were, "all kinds of problems with the [inaudible 03:02:56] of Oxycontin related to Dr. One." Mr. Sackler, just one year later, a 2010 report highlighted the same doctor, Dr. One, was nicknamed the Candyman because, "She will immediately put every patient on the highest dose of narcotic she can." Does it trouble you that nearly 300 sales calls were placed to a doctor nicknamed the Candyman, Mr. Sackler? David Sackler: (03:03:23) Yes, it does because the board had put in place systems and controls to prevent such things from happening- Rashida Tlaib: (03:03:31) Well, I mean, is that a sign, Mr. Sackler, of an effective anti-divergent program to you? David Sackler: (03:03:35) Well, the board was never made aware of this. In fact, the board was- Rashida Tlaib: (03:03:39) [inaudible 03:03:41]. David Sackler: (03:03:42) I'm sorry, I don't mean to talk over you. Rashida Tlaib: (03:03:45) Mr. Sackler, I don't mean to talk over you as well, but it's just frustrating because your words don't match the actions, your constant ... I've been listening, I'm wondering I'm always the last person to be able to ask questions so I get to listen to much of your answers, and so just bear with me and my frustration that, again, your answers don't match up. I fully believe you will not be settling these cases out of court unless you were in the wrong doing. Rashida Tlaib: (03:04:11) So Purdue placed Dr. One on a no call list in August, 2010, however, sales representatives were told to resume calling her in October, 2011, Mr. Sackler, and they continued to do so until May, 2018. Dr. One is not an isolated incident. It actually shows the intent of your company, your family's company. Rashida Tlaib: (03:04:34) Another doctor who we can refer to as Dr. Two was first flagged through his abnormally aggressive prescribing practices in 2003, Mr. Sackler. And so then in 2013, the board of medical examiners filed a complaint against this Dr. Two, a complaint described the excessive amounts of Oxycontin that he prescribed to certain patients. It wasn't until April, 2013, a full 10 years after it was initially flagged, that Dr. Two was added to the do not call list. Between 2007 and 2013, do sales representatives call Dr. Two, guess what, Dr. Sackler? 146 times. Rashida Tlaib: (03:05:15) But the story doesn't end there, Purdue sales representatives removed Dr. Two from the do not call list. Can you believe that? But still they called him 117 times between 2015 and 2018. So Mr. Sackler, you said, and again, you are responsible here because you said on Purdue's board of directors, while the company turned a blind eye to the dangerous practices and worked around these crucial safeguards, did you [crosstalk 03:05:45] any action to prevent the company sales reps from calling. Did you just prescribe those like Dr. One and Dr. Two? David Sackler: (03:05:51) Yes, I believe the record clearly demonstrates that the board took a significant number of steps to prevent the exact thing that you're reading, and I'm frustrated and disappointed that they may have come up short. But I think- Rashida Tlaib: (03:06:06) Yeah. I mean frustration and disappointment's great, but I think you need to pay up and you need to really be held accountable for the fact that you all turned a blind eye or just pretended that you didn't know, but you benefited from it because you saw the money still continue to come in. The blame for Purdue's dangerous sales tactics rest squarely with the Sackler family. You know it. That's your family's name. And directing [inaudible 03:06:25] the Sackler family established clear goals, they wanted more sales of prescription opiates at higher strengths. They incentivized it for sales reps to meet those expectation. If so, Mr. Sackler, and my district was caught flooding, my district with the opioids, we know damn well that they would be tried and locked up. They would be thrown into jail. Rashida Tlaib: (03:06:48) So my question is, why is it okay that people like you who are directly responsible for causing a national opiod addiction pandemic, people who are directly liable for hundreds of thousands of lives lost, are instead rewarded with millions of dollars in salary and walk free? You're using our bankruptcy process and everything to walk free. People at the top of this company, including those testifying today, Madam Chair, should pay billions in compensation to families they devastated and serve time proportionate to the crisis they unleashed. That is being held accountable for deaths. These are family members, Mr. Sackler, not enough apology or words is going to make up for it. You all have to not only pay for it, but you all have to be treated equally as anybody, again, in my district that would be doing the same thing you all just did. Thank you. I yield. Madam Chair: (03:07:41) The gentlelady yields back. And as the request of one of the witnesses, we're going to take a 10 minute recess. We will reconvene in 10 minutes at the request of one of the witnesses. Recess. Madam Chair: (03:07:53) (silence) Speaker 8: (03:17:36) Tonight, the gentle lady from the great state of Florida. Ms. Wasserman Schultz is now recognized, Ms. Wasserman Schultz. Ms Wasserman Schultz: (03:17:42) Thank you, Madam chair. Around the time I was elected to Congress in 2004, South Florida was overrun by pill mills. So-called clinics, where anyone with cash would walk away with dangerously addictive opioids. Ms Wasserman Schultz: (03:17:56) From August, 2008 to November, 2009, on average, a new pain clinic opened in Broward County, my home County and Palm beach counties, every three days. These pill mills caused suffering and death in my district and across the country. Dr. Sackler while you were on the board of directors, Purdue Pharma kept detailed records on everyone who prescribed Purdue products as abuse and diversion detection program. Is that correct? Dr. Sackler: (03:18:25) I'm sorry. I didn't hear that. Can you repeat that, I beg your pardon? Ms Wasserman Schultz: (03:18:31) Madam chair, if I can have the time restored. What did you not hear? Dr. Sackler: (03:18:38) I don't know what I [inaudible 03:18:40] hear, because I didn't hear it. Sorry, I have a little trouble hearing, there's noise in the background and I couldn't hear. Ms Wasserman Schultz: (03:18:49) Okay. I don't have noise in my background. Dr. Sackler, while on the board of directors, Purdue Pharma kept detailed records on everyone who prescribed Purdue products as part of its abuse and diversion detection program. Is that correct? Dr. Sackler: (03:19:04) The abuse and diversion program? Yes, yes. I guess. Ms Wasserman Schultz: (03:19:14) Okay. If the data suggested high volume prescribers were abusing or diverting prescriptions, they were placed on the region zero list, meaning that Purdue sales representatives should not continue to call the prescriber. Are you familiar with the regional zero list? Dr. Sackler: (03:19:31) I'm not familiar with that program. That program was overseen and managed by the legal department. The board did however, have reports from the legal department about the program. Ms Wasserman Schultz: (03:19:45) Okay, so- Dr. Sackler: (03:19:46) [crosstalk 03:19:46] I would know. Ms Wasserman Schultz: (03:19:48) Well, to go through, there were many problems with this region zero, list ranging from a lack of timely reporting to the fact that only a small fraction specific high volume prescribers ended up on the list. Ms Wasserman Schultz: (03:19:58) Purdue even encouraged sales tactics that increased the number of prescriptions filled by prescribers on this do not call list. For example, Purdue allowed its agents to call prescribers who worked in the same practice as those on region zero lists. Sales representatives would also aggressively market Oxycontin to the pharmacies used by high volume prescribers. Dr. Sackler are you familiar with those practices? And don't you think they undermine the efforts- Dr. Sackler: (03:20:25) Absolutely not. I am not familiar with those practices nor were any of those practices ever discussed or reported or mentioned at a board meeting. Ms Wasserman Schultz: (03:20:36) I'm going to move on. I'm going to move on to Mr. Sackler. Mr. Sackler you sat on the company board during this time. Is it true that Purdue staff regularly provided updates to the board of directors and you and members of your family regarding [inaudible 03:20:49] reports of concern about the abuse of Purdue's prescription opioids? Mr Sackler: (03:20:55) I'm sorry. It is a little bit hard to hear you. Your connection keeps cutting out. Ms Wasserman Schultz: (03:21:00) Madam chair. I think somebody is not on mute because I can hear everybody fine and I don't have any noise in my background. Are you able to hear me, Mr. Sackler? Mr Sackler: (03:21:10) I can now, yes. Ms Wasserman Schultz: (03:21:12) Okay. Speaker 8: (03:21:13) Would the staff mute everyone so that the Congresswoman can be heard with her questions and Mr. Sackler can be heard. Please mute all the backgrounds. Ms Wasserman Schultz: (03:21:26) Except mine. Okay. Is it true that Purdue staff regularly provided updates to the board of directors, including you and members of your family regarding so-called, "Reports of concern." About the abuse of Purdue's prescription opioids? Mr Sackler: (03:21:42) I don't remember those reports of concern that you're detailing. I don't remember that at all. I remember reports about the abuse and diversion program in general, but not specifically what you're referring to. Ms Wasserman Schultz: (03:21:56) Let me ask you further questions to jog your memory. If Purdue Pharma was more proactive in investigating whatever you want to call them. The information that you were being given about the widespread abuse of your own Oxycontin prescription opioids, then shouldn't you have been notifying local medical boards or law enforcement and gotten more engaged and wouldn't that have saved lives? Mr Sackler: (03:22:26) Well, I think that that's a terrific question and thank you for asking it. The 2007 settlement with state attorneys general provided within it, as I understand it, the ability for those attorneys general or other law enforcement within the state [crosstalk 03:22:46] I'm trying to answer your question. The answer is yes, we did that. However, some states chose not to avail themselves of the data. Ms Wasserman Schultz: (03:22:54) [crosstalk 03:22:54] my time. I'm not asking about what others should have done. I'm asking specifically about whether Purdue should have done more to notify law enforcement and medical regulators about the abuse and the recklessness that providers that you worked with were over prescribing your product? Mr Sackler: (03:23:16) As I understand the ADD program, there was a process and system in place for doing that. I believe the program over its life reported over 200 doctors to relevant authorities. And the data on region zero, whether or not those doctors merited reporting was available to states. Ms Wasserman Schultz: (03:23:40) You're shirking your own responsibility here. Reclaiming my time madam chair. I want to point out Purdue pharma actively thwarted the United States, and this is according to the DDA assistant administrator. That Purdue pharma actively thwarted the United States efforts to ensure compliance and prevent the diversion. And Mr. Sackler, internal documents obtained by the Massachusetts attorney general showed that a significant number of these reports of concern were brought to the board's attention, but never investigated. Ms Wasserman Schultz: (03:24:09) And according to an interview with a Purdue Pharma attorney in 2013, the company only made reports about 154 prescribers, which is about 8% of your region zero database. There was a strong financial disincentive for Purdue to shut down pill mills or curb reckless providers. Taking these actions would have hurt the bottom line, it also would have saved countless lives. When the choice was between profits or people's lives, it's very clear that Purdue Pharma always chose to maximize profits. At best, this behavior is negligent. At worst, it represents a deadly and deliberate strategy that made your family rich, while harming hundreds of thousands of people. Thank you for the indulgence, Madam chair, I yield back the balance of my time. Speaker 8: (03:24:57) [inaudible 03:24:57] now will recognize the gentle woman from California, Representative Katie Porter. You are now recognized. Katie Porter: (03:25:06) Hello. Mr. Sackler, thank you for joining us today. In May of 2007, Purdue Pharma and three of its top executives pleaded guilty to fraudulently marketing Oxycontin. Do you know how much money your family withdrew from Purdue Pharma in various transactions between 2008 and 2007? Mr Sackler: (03:25:31) I'm sorry, between 2008 and 2007? Katie Porter: (03:25:33) 17. Mr Sackler: (03:25:36) Okay. I believe that number is a little bit more than $10 billion of which half or so was paid in taxes. Katie Porter: (03:25:44) 10 billion. Those distributions started off slowly. From 1997 to 2007 in the 10 years prior, your family withdrew a total of 126 million. Compare that to the next 10 years, 10.4 billion. All of a sudden, the Sackler family right around 2007 started really pulling money out of Purdue Pharma. Mr. Sackler, do you recognize this message? Mr Sackler: (03:26:18) I'm sorry. I'm not sure I can read that. Let me change the WebEx here. Katie Porter: (03:26:21) I'll read it to you. On May 17th, 2007, you wrote an email that said to your family, "What do you think is going on in all these courtrooms right now? We're rich. For how long? Until which suit gets through to the family." Did you write that email? Mr Sackler: (03:26:43) I believe so. Yes. Katie Porter: (03:26:46) Mr. Sackler, what was the sudden urgency that all of a sudden your company went from storage ship of Purdue Pharma, picking out 120 million over 10 years to 10.4 billion over 10 years. What happened? Mr Sackler: (03:27:03) Well, I believe a few things happened. Number one, we settled the legal issues that I was concerned about in that email in the intervening- Katie Porter: (03:27:15) Mr. Sackler, are you suggesting that you kept money in the company while you were facing legal issues and then took it out once you resolved the legal liability? Mr Sackler: (03:27:26) No, I'm not suggesting that. I am telling you why we did what we did as best I can recall. Which shall I [crosstalk 03:27:37]- Katie Porter: (03:27:36) Mr. Sackler, let me ask you. Why should the family not transfer back the $10.4 billion to be used to pay the creditors in this case, including victims of opioid abuse? Mr Sackler: (03:27:52) Well, for a number of reasons, I think the most important- Katie Porter: (03:27:55) Do you not have the money? Mr Sackler: (03:27:58) Ma'am, I'm trying my best to answer one at a time. Would you like me to answer the money question? Katie Porter: (03:28:05) Yes, please. Mr Sackler: (03:28:07) As I said, in your opening questioning. Of the 10 billion that you referenced, roughly half went to taxes. So that money we do not have, it was paid in taxes. Does that answer your question? Katie Porter: (03:28:26) Okay. But you still have over 4 billion that was not paid in taxes? Do you still have that money? Mr Sackler: (03:28:34) We do. We still have that money. Katie Porter: (03:28:38) Reclaiming my time. Under the proposed settlement that has been reached with the Department of Justice, which would be the cornerstone of this bankruptcy. How much is your family going to chip in to repay the creditors? Mr Sackler: (03:28:52) I'm sorry. You're considering the DOJ settlement the cornerstone of the ... the total settlement offer to creditors has been valued at more than 10 billion. So, that's the best I can do for you. Katie Porter: (03:29:06) Okay. Let me help you out. And Mr. Lando, perhaps you can ask Mr. Huebner, the bankruptcy attorney about this. I have some questions about the Uniform Fraudulent Transfer Act, section 4A2. Before I came to Congress, I was a law professor and wrote this book, the Law of Debtors and Creditors. It's a bankruptcy law textbook. And UFTA section 4A2 makes it a fraudulent transfer to remove money from a corporation without receiving any value. We all agree, Purdue didn't get anything out of giving the money away to the Sacklers. That didn't help the company, it helped the Sacklers. And the second factor is that when the money out of the company, what was left reasonably could have been believed that the debtor would incur an inability to pay the debtors debts as they come due. Now, David Sackler wrote this email. Mr. Lando, why are there no thoughts on transfers in this case? Mr Lando: (03:30:09) With respect representative, I'm not familiar with the bankruptcy code. I'm a physician, and I think there are many lawyers that have the expertise, including Mr. Huebner who we're actively working on the assets to your questions. Katie Porter: (03:30:22) But you do understand that you are the statutory debtor-in-possession under 1107, and you have all of the fiduciary duties of a trustee in bankruptcy at this time, to recover every last dollar that can be recovered for the creditors in this case. The creditors in this case do not include the Sackler family. Mr Lando: (03:30:39) Yes, I do. And I know that there are appropriate individuals. There's a special committee of our board working with the creditors to resolve all of the transfers made from the company since 2008. Katie Porter: (03:30:52) I yield back. Speaker 8: (03:31:02) [inaudible 03:31:02] yields back. Mr. Comer, before we adjourn, I want to recognize the ranking member Comber for any closing remarks. And again, thank him for his leadership and help along with Mark Sonye with this hearing. Mr. Comer, you are now recognized, Mr Comer: (03:31:20) Well, thank you, Madam chair. And I just want to say that it's good for us to hold a hearing where both sides actually agree. And I hope that we could have more of those hearings in the next Congress. Let me conclude by addressing the topic of this hearing and let me be direct with the Sackler family. There's no one in Congress more pro-business than I am. I'm 99% of the time on the side of the risk-takers. I understand that a lot of drug companies get a bad rap, but they invest a lot in research and development and they're leading innovators. And we have the greatest healthcare system in the world because of the private sector healthcare companies that we have in America. But there are bad actors. And to the Sackler family and Purdue Pharma, let me be as clear as I can be. Mr Comer: (03:32:21) You all are bad actors, and there's no excuse for what you did. In the beginning, you could make the argument that you didn't realize that this drug, which was possibly created to prevent pain, would become addictive and create to havoc that it's created over the past decade. But you learn that and you have tried every way in the world to continue to market that product and you profited all along the way. Kentucky has one of the highest incarceration percentages in the nation per capita. Mr Comer: (03:33:05) I think it is the highest in the nation. And the overwhelming majority of people who are incarcerated in Kentucky are there because of drug problems. They've had to forfeit their assets. They have broken homes and the cost to society is immeasurable. But you all have created the same harm to society, yet you're one of the wealthiest families in America. I hope that the courts hold you accountable. I hope that the states, where you are domiciled and where you operate in the future, have a watchful eye on you. And I hope that a story like this, a story like yours never happens again. With that Madam chair, I yield back. Speaker 8: (03:33:58) I thank the gentlemen. The gentlemen, yields back. I just want to thank all of the panelists and thank the Sackler family for appearing without a subpoena. They came voluntarily. Thank you for your testimony. I want to thank all of my colleagues on both sides of the aisle for their insightful and thoughtful questions. And I can assure you, we will have future hearings to make sure as the ranking member said, that this never happened again. I want to state that it has always been this committee's mission to focus on the people directly affected by the issues we examine. Since we announced this hearing, the committee received dozens of letters and submissions from individuals and families across the country, whose lives have been affected by addiction. I asked for unanimous consent that these letters and statements be entered into the official record of the hearing so ordered. Since 1999, nearly half a million lives have been cut short by the opioid epidemic. Speaker 8: (03:35:09) Millions more have been caught in the stranglehold of addiction. Families and communities, as we have heard from my colleagues today, have been absolutely devastated. In the Sackler family's version of the story, they are totally blameless. A family caught in the wrong place at the wrong time. They have pointed a finger at so-called bad apple employees, the FDA, consulting firms and prescribers. In the past, even blamed the patients, the people suffering from opioid use disorder, which they fraudulently advertised and paid salesman to push into pharmacies into doctors and into their lives. So I'd like to say this clearly to the members of the Sackler family, the committee will not allow you to continue hiding from your part in this devastation. You have played a critical, active role in sparking and fueling the opioid epidemic. You approved and monitored dangerous marketing plans. They directed their sales representatives to focus on the highest volume prescribers and the strongest versions of addictive oxycotin. Speaker 8: (03:36:38) You targeted vulnerable populations with misleading messages. And when it began to look like your wealth could be at risk from lawsuit, you moved it out of reach, preventing the money from going to the victims of the crisis they created. We did not get all of the answers we needed from the Sackler family, but the witnesses have agreed to make additional information available to the committee and to the public. Number one, you have agreed to provide a full accounting of the shell companies owned by the Sackler family. Number two, you have agreed to make publicly available all documents in the Sackler family's possession. Let me close with this earlier, Mr. Cooper called you one of the most evil families in America. Speaker 8: (03:37:29) A lot of people agree with that. You have the ability now to mitigate at least some of the damage you caused, please stop hiding and offshoring your assets. Stop nickel and diming the negotiators. Make a massive financial contribution that these no doubt about your commitment. And finally, acknowledge your wrongdoing. The families and communities who's lives have been ruined, deserve at least that much. They have taken money out of the company, so it would be forever beyond the legal reach of the people they were harming. They are the Bernie Maydoffs of medicine. Adjourned. In closing [inaudible 00:26:27]. Without objection, all members have five legislative days within which to submit additional materials and written questions for the witnesses to answer, which will be forwarded to the witnesses for their response. I ask our witnesses to please respond as promptly as you can. This hearing is adjourned.