In 2015, with opioid-related overdose deaths at a record high in West Virginia, the trade group for the country’s largest drug distributors hatched a plan to “turn the tide.”
The plan was not to reverse that trend, which for years had been allegedly driven by a flood of prescription painkillers shipped to the state by the trade group’s members.
Instead, they wanted reporters to stop writing about it.
The plan was detailed in a memo, sent to a senior executive at that trade group, the Healthcare Distribution Alliance, that bemoaned “imbalanced” coverage by reporters at local papers, including the Charleston Gazette, and offered strategies to “inoculate the industry” by shifting the blame to pharmacists, doctors and their patients.
That memo was filed publicly in federal court in another state in 2019, and was mentioned in opening statements of the landmark trial ongoing in Charleston. The City of Huntington and Cabell County are fighting to hold the nation’s “big three” drug distributors — McKesson, AmerisourceBergen and Cardinal Health — financially liable for the opioid epidemic.
“This is unbelievable,” Cabell County’s lawyer Paul Farrell Jr. told U.S. District Judge David Faber when summarizing the memo last month.
Farrell and his co-counsels have argued that the drug distributors were well aware that they were fueling an epidemic of opioid addiction, but were more concerned with their bottom line than restricting the flow of opioids. Meanwhile, defense attorneys have argued that drug distributors are just middlemen and that their actions did not cause the opioid crisis.
It’s not clear whether the HDA or the distributors acted on any specific advice in the memo.
But, Farrell argued, the memo illustrates the willingness of drug companies to chase profits over patient safety.
“What’s at stake? Not lives. The credibility and reputation of our industry,” Farrell said sarcastically.
Offering ‘carrots’ to spin reporters
The drug distributors were on the defensive. West Virginia had filed a lawsuit against the companies, and thanks to that litigation, sales information that the companies had tried desperately to keep secret was leaking out. Between 2007 and 2012, drug distributors shipped over 200 million doses of opioid pain medication to the state, Eric Eyre reported in the Charleston Gazette in May 2015. (Eyre is now a co-founder of Mountain State Spotlight and is reporting on this trial.)
But those numbers weren’t complete. They excluded data from the nation’s two largest distributors at the time, Cardinal Health and McKesson. And the other distributors were refusing to release “confidential” data on the number of pills sent to individual pharmacies.
Eyre was doing everything he could to get that data. And the drug distributors — through their trade group — hatched a plan to distract him.
They turned to GMMB, the powerhouse political consulting firm. The firm has helped the last three Democratic presidents win the White House and was one of the largest recipients of Democratic candidate spending in the last election cycle. But the firm also provides public relations support to large trade associations like the Healthcare Distribution Alliance and the American Beverage Association, which represents Coca Cola and Pepsi — a fact GMMB rarely advertises when promoting its public health advocacy efforts.
In a memo submitted to John Parker, HDA’s head of communications, GMMB noted that keeping the sales data private was making the distributors look bad. To counter the bad press, GMMB recommended offering Eyre a scoop: exclusive access to two “key” speakers at a closed-door summit with U.S. Sen. Joe Manchin where the drug distributors could highlight their efforts to fight opioid abuse.
This, and an “exclusive” first look at a subsequent report, would be a “carrot” to Eyre and “help expand HDMA’s relationship with him,” GMMB wrote, referring to HDA by its former acronym, which stood for Healthcare Distribution Management Association.
GMMB also recommended holding “desk-side” briefings with West Virginia reporters.
“We would include Eric Eyre in this group and would carefully prep any spokesperson in advance of speaking to him,” GMMB said in the memo.
Siobhan Bunaes, a senior vice president at GMMB, said in a statement to Mountain State Spotlight that her company had developed marketing materials for HDA in 2015 and 2016, but “was never contracted by nor did we conduct work for HDA related to opioid use.”
In that same statement, she acknowledged that GMMB had proposed the summit in response to a request from HDA for “a proposal to respond to growing concerns around opioid use.”
The proposed summit outlined in the GMMB memo appears to have never happened, and it is not clear to what extent HDA took the advice outlined by GMMB in the memo. Parker declined to comment on this story, citing the ongoing litigation.
The two organizations’ efforts to sidetrack Eyre did not work.
A little over a year later, Eyre finally obtained the data from the state Attorney General’s Office and published a pair of blockbuster stories that revealed the staggering number of pills distributors delivered to West Virginia — 433 per person over a six-year period — and the fact that both the distributors and the state had long been aware of the problem.
Those stories, coupled with the release of national data by the U.S. Drug Enforcement Administration to attorneys representing local governments across the country, led to thousands of lawsuits being filed against the distributors. Eyre ultimately won the Pulitzer Prize for his work.
A glimpse into a corporate influence campaign
Jonathan Marks, a professor of bioethics at Penn State University, said he wasn’t surprised at all by the contents of GMMB’s memo.
“This is straight out of the corporate influence playbook,” he said.
He drew parallels between drug distributors, car companies and tobacco companies that have all been involved in high-profile litigation following efforts to downplay the deadly consequences of using their products, which Marks called “deeply ethically problematic behaviors.”
Marks noted that every year these companies were able to hold off media, regulatory and legal scrutiny was another year they could enjoy incredible profits.
“We’ve created powerful structural incentives for corporations to bury problems,” he said.
Cabell County’s attorneys in the Charleston trial contracted another professor, Jakki Mohr at the University of Montana, to provide expert testimony regarding the distributors’ efforts to downplay their contributions to the opioid crisis. Mohr concluded that the companies “effectively influenced media to convey their message.”
In an email thread examined by Mohr, representatives from the “big three” distributors proposed letting “HDA take the lead” on managing the response to critical media coverage and were pleased with the results. An AmerisourceBergen executive wrote that the trade association could “say the things we can’t/won’t.”
HDA got to work. Not only did it request a proposal from GMMB, but according to Mohr’s testimony, the trade group contracted with the consultant Eric Dezenhall, who was dubbed the “pit bull of public relations” for his effectiveness, to counter the growing wave of negative press.
Dezenhall’s firm has worked extensively for the opioid industry, and successfully planted a pro-opioid story in The New York Times, according to an investigation by ProPublica. In an email to Mountain State Spotlight for this story, he wrote: “We have a 34 year history of not commenting on who our clients are or are not.”
The firm had also started a successful attack against one of the earliest media investigations into the opioid epidemic, a five-part series in the Orlando Sentinel in 2003. The reporter that conducted that investigation resigned and the paper printed a front-page correction after Dezenhall’s firm poked holes in the reporter’s analysis.
But instead of being “overblown” as executives from OxyContin maker Purdue Pharma referred to the media coverage, the story proved prescient. Over a decade later, the Columbia Journalism Review called the Sentinel’s series “right too soon.”
Clarification: HDA requested a proposal from GMMB for opioid-related PR, but never contracted the public relations firm.
Correction: A previous version of this story incorrectly stated that Dezenhall did not return a request for comment. He did comment via email, and the story has been updated.