Thousands of lawsuits across the United States have accused a drug company owned by the billionaire Sackler family of using false claims to push highly addictive opioids on an unsuspecting nation, fuelling the deadliest drug epidemic in US history.
Yet, even as its US drugmaker collapses under the charges, another company owned by the family has used the same tactics to peddle its signature painkiller, OxyContin, in China, according to interviews with current and former employees and documents obtained by the Associated Press.
The documents and interviews indicate that representatives from the Sacklers' Chinese affiliate, Mundipharma, tell doctors that time-release painkillers like OxyContin are less addictive than other opioidsthe same pitch that Purdue Pharma, the US company owned by the family, admitted was false in court more than a decade ago.
Mundipharma has pushed ever larger doses of the drug, even as it became clear that higher doses present higher risks, and represented the drug as safe for chronic pain, according the interviews and documents.
These tactics mirror those employed by Purdue Pharma in the US, where more than 400,000 people have died of opioid overdoses and millions more became addicted.
An avalanche of litigation over the company's marketing has driven Purdue Pharma into bankruptcy in the US.
In China, Mundipharma managers have required sales representatives to copy patients' private medical records without consent, in apparent violation of Chinese law, current and former employees told AP.
Former reps also said they sometimes disguised themselves as medical staff, putting on white doctor's coats and lying about their identity to visit patients in the hospital.
As in the US, marketing material in China made claims about OxyContin's safety and effectiveness based on company-funded studies and outdated data that has been debunked.
The AP examined more than 3,300 pages of training and marketing materials used by Mundipharma staff, as well as internal company documents and videos. These files came from three independent sources and were verified by cross-checking.
AP also spoke with one current and three former OxyContin sales representatives who worked at the company last year.
Mundipharma has promoted its blockbuster product, OxyContin, in questionable ways in other countries, including Italy and Australia.
But the company has particularly high hopes for China the world's most populous nation and second largest economy where it has said it wants sales to surpass those in the US by 2025.
Though Mundipharma and Purdue are separate legal entities, both are owned by the Sackler family. Today, Mundipharma is a bargaining chip in negotiations to settle sweeping US litigation.
The Sackler family agreed to cede ownership of Purdue, but wants to keep Mundipharma for now to sell OxyContin abroad.
They have discussed eventually selling Mundipharma to fund the family's contribution to a nationwide settlement in the US.
Mundipharma said it was taking immediate action to investigate the allegations uncovered by AP.
In a statement, the company did not respond to specific allegations but said it has rigorous policies in place to ensure that our medicines are marketed responsibly and in accordance with China's strict regulatory framework governing analgesics.
In response to detailed questions, Purdue said Mundipharma is an independent entity, operating in a different country, under different laws and regulations.
Representatives of the Sackler family did not respond to detailed requests for comment.
In the United States, Purdue stopped promoting OxyContin to doctors in 2018 and got rid of its entire opioid sales staff.
Meanwhile, Mundipharma is hiring in China.
A celestial challenge
Mundipharma China was born in 1993 in a signing ceremony at the Great Hall of the People on Tiananmen Square.
Just as in the US, the Sackler family's business interests in China coincided with their philanthropy.
The month after Mundipharma's creation, the Arthur M Sackler Museum of Art and Archeology opened its doors at Peking University in Beijing.
Outside the museum is a statue dedicated to Arthur Sackler and his wife by the China Medical Tribune, a journal he helped found that now claims a readership of more than a million Chinese doctors.
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