Time for Tufts soul-searching on Purdue Pharma

Whatever probe uncovers should be released publicly

AS A FACULTY MEMBER at Tufts University School of Medicine, I, along with colleagues and many of our students, have found it embarrassing to be confronted by news reports on how our medical school and university have been taking money over a number of years from Purdue Pharmaceuticals, the family that owns the company, and related firms and/or family foundations.

The biggest worry is that the money may have unduly influenced Tufts’ teaching and research missions, or affected a professor’s public written or oral statements about the risk of opiates before the FDA or in scholarly publications.   But even if donated money only helped to credential a company and its owners, using ties to Tufts as part of a marketing campaign to fraudulently mislead both prescribers and the public about the safety of its drugs, this alone should bring great concern to us at the university.  It does not feel good to know that by accepting money from Purdue and the Sackler family, which owns the company, Tufts has helped contribute to the current-day opiate crisis and the deaths of thousands of people.

The focus on Tufts came to light this past January when Attorney General Maura Healey filed a lawsuit against individual members of the Sackler family, Purdue Pharma, and other affiliated organizations alleging that the practices used to promote products such as Purdue’s OxyContin were fraudulent and resulted in the addiction and death of hundreds of thousands of people across the country.  The federal Centers for Disease Control has estimated that from 1999 to the present 200,000 to 300,000 overdose deaths have resulted from prescription opiates, including Purdue’s Oxycontin.  That number does not include people who became addicted to these prescription pills, ultimately dying from heroin or fentanyl overdoses.

In her complaint, Healey alleges that contributions by Purdue Pharma, the Sackler family, or related entities’ to the Pain Research, Education, and Policy Program at Tufts University School of Medicine were part of an effort to legitimize the marketing of those drugs. There are allegations that Tufts allowed a Purdue executive to join the program faculty and teach about opiates in some of the graduate school courses. Healey also suggests that a key faculty member’s testimony before the Food and Drug Administration may have been influenced by ties to Purdue or the Sacklers and even the medical school curriculum on opiates may have been influenced by Purdue staff.

Reacting to the scope of the allegations—not yet proven in court—one of our medical students noted in my class last week that she feels as if she is attending a medical school that could be aptly named the “Pablo Escobar School of Medicine.”

In fairness to Tufts, university relationships with the pharma industry are not a new phenomenon or unique to Tufts. Universities, hospitals, physicians, and others have been accepting money from pharmaceutical companies for many years.  While these relationships are often defended in the name of science, innovation, or education, many analysts say the money is donated primarily for the purpose of increasing drug sales and profits.  A good part of the pharma money-giving strategy is to dole funds out to credible institutions and some research or clinical leaders as a way to get those respected people and institutions to say good things (or downplay the bad things) about the products that pharma makes.

Tufts has accepted Sackler money at least back to the early 1980s, when it took family donations and in return placed the Sackler name on its School of Graduate Biomedical Sciences and its main medical school building.  This was long before 1996, when Oxycontin was brought to the market in the US.

A key date to keep in mind is May 10, 2007. That is the date when Purdue pleaded guilty in federal court to criminal charges that the company had misled regulators, doctors, and patients about the drug’s risk of addiction and its potential for abuse. The company paid more than $600 million in fines. Presumably, any money accepted by Tufts after that date was done with the knowledge that the university was dealing with a company that had enriched itself at the expense of the lives and well-being of thousands of people.

Tufts President Anthony Monaco in late March told the university community that he had asked former US attorney Donald Stern and his law firm to conduct a review of the financial connections between the school and Purdue, the Sackler family, and related foundations.

“The review will determine if we adhered to our policies and if our policies adopted best practices with respect to academic and research integrity and conflicts of interest in accepting those funds,” Monaco wrote in a letter to the university community. “Attorney Stern will present his findings with a team of academic leaders. Together they will develop recommendations for the future which will be shared with our community. If our existing policies and controls need to be changed or strengthened, that will happen.”

Meet the Author

Paul A. Hattis

Associate professor, Tufts University Medical School
Monaco’s letter is unclear on whether he will publicly release key findings from the investigation. That feels very unsatisfactory, since I am interested in finding answers to these questions:

  1. How much money did Purdue, the Sacklers, or related entities provide to Tufts University over the years and for what purpose?
  2. How much of this money came in after the May 2007 court decision and the finding of criminal behavior leading to over $600 million in fines?
  3. The Pain Research, Education, and Policy program has had very low enrollment for a number of years, and is now being closed to new admissions. That raises the question of whether the program was continued all these years as part of some sort of quid pro quo understanding with Purdue, the Sacklers, or related entities, even though student numbers did not justify its continuation. Did that occur?
  4. What sort of conflicts review was conducted before the high-ranking Purdue employee (Dr. David Haddox) was appointed as an adjunct member to the Tufts faculty and was permitted to teach in some Pain Research, Education, and Policy courses about opioids?
  5. Healey’s complaint suggests there may have been times when Purdue employees gave input that might have affected the medical school curriculum, leading to non-evidenced-based content about opiates being taught to students—possibly in medical school classes or in clinical rotations at Tufts Medical Center. Is there any truth to any of these allegations?
  6. Were any Tufts faculty or staff the recipients or beneficiaries of any compensation, gifts, or other benefits from Purdue, the Sacklers, or related entities that Tufts University is aware of, or should have been aware of? This would include whether there was any flow of money or benefits to Tufts faculty that may have been routed through outside organizations (such as professional pain medicine societies) that the University knew or should have known could cause undue influence on faculty views about opiate use or safety.

My hope is that the facts will cast the Tufts connections with Purdue and the Sacklers in a more favorable light. But until there is a public sharing of this information, we will continue to wonder what actually did take place over the years. If only recommendations for future behavior emerge from the investigation, that will not be a satisfactory resolution – the educational equivalent of sweeping the matter under the rug.

Paul A. Hattis is an associate professor at Tufts University Medical School.