Purdue Pharma-Mass. AG

COMMONWEALTH OF MASSACHUSETTS
SUFFOLK, ss. SUPERIOR COURT

C.A. No. 1884-cv-01808 (BLS2)
)
COMMONWEALTH OF MASSACHUSETTS, )
)
v. )
)
PURDUE PHARMA L.P., PURDUE PHARMA INC.,
RICHARD SACKLER, THERESA SACKLER,
KATHE SACKLER, JONATHAN SACKLER,
)
)
) JAhj j %o
MORTIMER D.A. SACKLER, BEVERLY SACKLER, )
DAVID SACKLER, ILENE SACKLER LEFCOURT, )
PETER BOER, PAULO COSTA, CECIL PICKETT, )
RALPH SNYDERMAN, JUDITH LEWENT, CRAIG )
LANDAU, JOHN STEWART, MARK TIMNEY, )
and RUSSELL J. GASDIA )
_____________________________________________________ )
THE COMMONWEALTH’S PRE-HEARING MEMORANDUM

FOR THE HEARING SET FOR JANUARY 25, 2019
The Commonwealth respectfully submits this memorandum in advance of the hearing set
for January 25, 2019. At the last hearing, on December 21, 2018, the Court considered motions
to impound by Purdue (Purdue Pharma LP and Purdue Pharma Inc.) and by the Chief Executive
Officer defendants (John Stewart, Mark Timney, and Craig Landau) filed on December 20, 2018.
At the conclusion of that hearing, the Court:
1) ordered the Commonwealth to file an impounded, unredacted version of its Amended
Complaint as well as a redacted version for the public file;
2) provisionally granted the CEO defendants’ motion to impound information relating to
their compensation;
3) set a January 25, 2019 conference for the parties to update the Court on the status of the
parties’ efforts to resolve the issues presented by the redactions, discuss next steps, and
i
provide the public an opportunity to be heard with respect to the redactions; and
4) invited the parties to file memoranda to assist the Court in navigating remaining issues.
In advance of the hearing on January 25, the Commonwealth files this memorandum to
update the Court on the status of the redaction dispute and propose next steps for resolving the
remaining disputes within this proceeding.
I. Status of the Redaction Dispute
The parties have a shared interest in avoiding unnecessary conflicts between the federal
multi-district litigation and state proceedings and, accordingly, they have worked in good faith to
narrow the scope of the redaction dispute. On December 20, 2018, the Commonwealth notified
Purdue, pursuant to the relevant provision in the MDL Protective Order, that it challenged
Purdue’s confidentiality designations for all allegations in the Amended Complaint. Through the
process that followed, Purdue agreed to lift hundreds of redactions.
On January 10, in accordance with the MDL procedures, the Commonwealth notified
Purdue that it would challenge the remaining redactions before MDL Special Master Cathy
Yanni. On January 14, the Commonwealth submitted its challenge to Special Master Yanni for
every redaction that remains. The Commonwealth’s letter brief to Special Master Yanni is
attached hereto as Exhibit 1. Purdue asked that its letter brief to the Special Master be due
January 22, and the Special Master granted that request. The Special Master may provide a
ruling that further reduces the number of items in dispute. The Commonwealth is providing the
Special Master with a copy of this Pre-hearing Memorandum today.
On January 10 and 11, counsel for Defendants Richard Sackler and Russell Gasdia
contacted the Commonwealth regarding redactions. In the discussions that followed, they asked
the Commonwealth to maintain redactions in paragraph 370 and paragraphs 699-753 to allow
2
further time to confer.
A list of the remaining redactions and an updated version of the Amended Complaint
showing the remaining redactions are attached as Exhibit 2 and Exhibit 3.
II. Proposed Next Steps
A. Order Purdue to Produce the Documents Cited in the Amended Complaint in

this Proceeding and Set a Schedule for Proper Briefing on Impoundment
The Court-permitted, temporary impoundment has enabled the parties to engage in the
MDL Court’s procedure for narrowing discovery disputes and that process remains ongoing.
Now the Court and the parties should prepare to turn to the question of the propriety, under
Massachusetts law, of continuing to withhold from public view something that is ordinarily
considered to be a matter of public record, i.e., the remaining, redacted allegations in the
Commonwealth’s Amended Complaint.
As the Court observed during the December 21 hearing, this Court is not bound by
confidentiality designations made to facilitate discovery. Instead, as the Protective Order
submitted by the parties and entered by this Court (Kaplan, J.) on Oct. 22, 2018 states, upon a
motion to impound materials in the public record, the Court must apply the Uniform Rules of
Impoundment Procedure.1 To find good cause for impoundment, Rule 7(b) requires the Court to
“consider all relevant factors, including, but not limited to, (i) the nature of the parties and the
controversy, (ii) the type of information and the privacy interests involved, (iii) the extent of
community interest, (iv) constitutional rights, and (v) the reason(s) for the request.”
1
See Oct. 22, 2018 Protective Order, par. 12 (“[T]he Court is not bound by the designation of any material as
“Confidential” or “Highly Confidential” and any such designation shall not create any presumption that documents
so designated are entitled to confidential treatment pursuant to Mass. R. Civ. P. 26(c) or impoundment pursuant to
the Uniform Rules of Impoundment Procedure. If the Court determines that the Confidential Materials or Highly
Confidential Materials are not entitled to confidential treatment and/or does not permit the documents which contain
such Confidential Materials or Highly Confidential Materials to be filed under seal, the parties may then file those
pleadings or other documents in open court.”)
3
Impoundment is the exception rather than the rule, and denying the public access to judicial
records should be “strictly construed in favor of the general principle of publicity.” Republican
Co. v. Appeals Court, 442 Mass. 218, 223 (2004), quoting Commonwealth v. Blondin, 324 Mass.
564, 571 (1949), cert. denied, 339 U.S. 984 (1950).
In light of Purdue’s contention that documents the Commonwealth obtained pursuant to
MDL Protective Order par. 33(l) are not subject to this Court’s jurisdiction — a position in direct
conflict with Purdue’s earlier agreement that such documents “shall be governed by this [Court’s
Protective] Order”2 — the Commonwealth proposes that the Court order Purdue, by March 1, to
produce in this litigation copies of the documents cited in the Amended Complaint; and, by
March 15, to serve upon the Commonwealth a fully-supported, specific motion to impound any
allegations that Purdue seeks to withhold from the public.
With respect to the proposal that Purdue produce the documents cited in the Amended
Complaint, the burden on Purdue is low. A list of the documents cited is attached as Exhibit 4.
There are fewer than 600 documents at issue, and Purdue has already reviewed them for
privilege and produced them in the MDL and, in some instances, in other proceedings. The
relevance of the documents to the Commonwealth’s allegations is high: the reason Purdue seeks
to redact the Amended Complaint allegations is because they are based on those documents. It
would be reasonable for Purdue to produce the documents in this litigation. After Purdue
produces the documents in this litigation, there would be no federal-state complications and no
obstacle to providing the most complete public access provided by Massachusetts law. Purdue
2
See id. at par. 5 (“To the extent that a Producing Party produces discovery materials in this action that were
designated as “Confidential” or “Highly Confidential” in In re National Prescription Opiate Litigation, Case No.
17-MD-2804 (N.D. Oh.) or the Commonwealth obtains such materials pursuant to ¶ 33(l) of Case Management
Order No. 2: Protective Order (Docket No. 441) therein, those discovery materials are deemed “Confidential” or
“Highly Confidential” under this Order and shall be governed by this Order.”)
4
should produce the documents by March 1.
With respect to the proposal that Purdue properly brief its Motion to Impound, the
Commonwealth contends that Purdue has not yet filed a motion addressing the specific
information to be impounded as the Uniform Rules of Impoundment require. The
Commonwealth anticipates strenuously opposing Purdue’s motion. The Attorney General is the
Commonwealth’s lawyer, and the people of Massachusetts should be allowed to see the
allegations brought on their behalf. The Defendants’ deceptive sales tactics injured people
across the Commonwealth, and the people of Massachusetts deserve to know the truth. This
Court has the responsibility of presiding over this litigation — likely including ruling on
Defendants’ motions to dismiss the Amended Complaint that is still not fully public — and the
people should have the fullest opportunity to access this proceeding under Massachusetts law.
Purdue’s final Motion to Impound should be due March 15.
B. The CEOs’ Motion To Impound
At the last hearing, the Court granted a provisional impoundment of information
regarding the compensation of the three Defendants who have served as Purdue’s Chief
Executive Officer. The Commonwealth opposes the long-term impoundment of that
information, because the public should be allowed to assess the key facts about these
Defendants’ compensation that are relevant to, among other things, personal jurisdiction, civil
penalties and damages under Chapter 93A, and any potential settlement of the Commonwealth’s
claims. The public is entitled to know the specific facts of these Defendants’ compensation, not
merely that they were highly compensated.
Purdue currently seeks redactions in the Amended Complaint in more than 100
paragraphs and footnotes concerning payments to individual Defendants on the basis that the
5
information relates to compensation. The Commonwealth is challenging Purdue’s
confidentiality designations regarding all those allegations in the MDL.
It is possible that this Court may be called on to decide the question of impoundment of
compensation-related information for others at Purdue, beyond the three CEOs. To provide for
an orderly process, the Commonwealth suggests that the Court continue the provisional
impoundment of the CEOs’ information until this Court decides Purdue’s fully-supported,
specific motion to impound.
Dated: January 15, 2019 Respectfully submitted,

By its Attorney,
MAURA HEALEY
ATTORNEY GENERAL
Sydenham B. Alexander III, BBO #671182

Gillian Feiner, BBO # 664152
Eric M. Gold, BBO # 660393
Jeffrey Walker, BBO # 673328
Jenny Wojewoda, BBO # 674722
Assistant Attorneys General

Health Care & Fair Competition Bureau
Office of the Attorney General
One Ashburton Place
Boston, Massachusetts 02108
617-727-2200
gillian. feiner@mass. gov
6
CERTIFICATE OF SERVICE
I, Sydenham B. Alexander III, Assistant Attorney General, hereby certify that I have this
day, Tuesday, January 15, 2018, served the foregoing document upon all parties by email as well
as by mailing a copy, first class, postage prepaid to:
Timothy C. Blank, BBO # 548670

DECHERT LLP
One International Place, 40th Floor
100 Oliver Street
Boston, MA 02110-2605
timothy.blank@dechert.com
Counsel for Defendants Purdue Pharma LP and Purdue Pharma Inc.
Joan A. Lukey, BBO # 307340

CHOATE HALL & STEWART LLP
Two International Place
Boston, MA 02110
joan.lukey@choate.com
Counsel for Defendants Richard Sackler, Theresa Sackler, Kathe Sadder, Jonathan Sadder,
Mortimer D.A. Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt, Peter Boer,
Paulo Costa, Cecil Pickett, Ralph Snyderman, and Judith Lewent
James R. Carroll, BBO # 554426

Maya P. Florence, BBO # 661628
SKADDEN, ARPS, SLATE MEAGHER & FLOM LLP
500 Boylston Street
james.carroll@skadden.com
maya. florence@skadden. com
Counsel for Defendants Craig Landau, John Stewart, and Mark Timney
Juliet A. Davison, BBO # 562289

DAVISON LAW, LLC
280 Summer St., 5th Floor
Boston, MA 02210
juliet@davisonlawllc.com
porter@spplawyers.com
Counselfor Defendant Russell J. Gasdia
Assistant Attorney General
7
Exhibit 1
Massachusetts Attorney General Office’s Letter Brief

to MDL Special Master Cathy Yanni
THE COMMONWEALTH OF MASSACHUSETTS
OFFICE OF THE ATTORNEY GENERAL
ONE ASHBURTON PLACE
BOSTON, MASSACHUSETTS 02108
(617) 727-2200
(617) 727-4765 TTY
www.mass.gov/ago
January 14, 2019
Via Electronic Mail
Re: In re National Prescription Opiate Litigation, MDL No. 2804

Massachusetts Challenges to Confidentiality Designations of Purdue
Dear Special Master Yanni:
I write on behalf of the Massachusetts Attorney General’s Office (the “Massachusetts

AGO”) requesting your resolution of a dispute arising from Purdue’s position that certain
allegations contained in the Massachusetts AGO’s Amended Complaint should stay redacted in
the public file in the Massachusetts Superior Court. This request follows from the MDL Court’s
December 20, 2018 Order, directing the parties to seek guidance from the Special Masters
pursuant to the protocols set forth in the Court’s Protective Order and Protocol for State and
Federal Court Coordination for resolving confidentiality designation disputes.
I. Background
Purdue designated as Confidential and Highly Confidential millions of pages of

documents it produced in the MDL. On December 20, 2018, the Massachusetts AGO notified
Purdue it was challenging, pursuant to paragraph 52 of the MDL Protective Order, Purdue’s
confidentiality designations only as they relate to the text of the allegations in the Massachusetts
Amended Complaint, and not any other material in the underlying Purdue documents.
Counsel for the parties made sincere, good faith efforts to resolve the dispute. In emails
to the Massachusetts AGO on January 3, 9, and 10, Purdue consented to unredact several
hundred paragraphs of the Amended Complaint and to narrow the redactions in several other
paragraphs. As of the date of this letter, Purdue seeks to maintain redactions in 189 paragraphs
and footnotes in the Amended Complaint. On January 10, the Massachusetts AGO notified
Purdue that it would press its challenge to all the remaining redactions and indicated its intent to
submit a position letter to you as Special Master.
A summary of each designated item and the respective basis for Purdue’s confidentiality
claim is attached hereto as Exhibit A. A copy of the Amended Complaint with each of these 189
items highlighted is attached as Exhibit B. The highlighting in Exhibit B matches the redaction
in the Amended Complaint.
1
II. Purdue’s Bases For Redactions Are Insufficient
Case Management Order No. 2 provides that Purdue bears the burden of persuasion in
this challenge to its confidentiality designations, as if it were seeking a Protective Order pursuant
to Federal Rule of Civil Procedure 26(c). Rule 26(c) requires Purdue to demonstrate “good
cause” for maintaining the redactions. It must do so by showing, “with a particular and specific
demonstration of fact, as distinguished from stereotyped and conclusory statements” “specific
prejudice or harm [that] will result” from each disclosure. See In re Ohio Execution Protocol
Litigation, 845 F.3d 231, 236-37 (6th Cir. 2016). The bases for redactions that Purdue has
offered are insufficient to meet its burden for a host of reasons.
First, Purdue’s categorical positions are exactly the type of conclusory statements that
fall short of Rule 26(c)’s “good cause” requirement. “To demonstrate good cause, the movant
must articulate specific facts showing clearly defined and serious injury resulting from the
discovery sought and cannot rely on mere conclusory statements.” Stout v. Remetronix, Inc., 298
F.R.D. 531, 534-35 (S.D. Ohio 2014) (internal quotations and citations omitted); see also Solar X
Eyewear, LLC v. Bowyer, 2011 WL 3921615, at *3 (N.D. Ohio 2011) (“Without specific,
definitive showings of cognizable harm, [a court] has no basis to find good cause to issue a
protective order.”). Purdue has not met that burden.
Second, the facts alleged in the Amended Complaint are not trade secrets or proprietary
innovations. Instead, Purdue seeks to protect assertions its directors and officers made about
opioids, sales tactics that were not secret, and evidence of its executives’ participation in sales
and marketing. 1
Third, the business information Purdue seeks to protect is stale. “[B]usiness information
that is substantially out of date is unlikely to merit protection under Rule 26(c).” Clark v.
Prudential Ins. Co. of America, 2011 WL 1833355 at * 3) (D.N.J., 2011). Much of the
information Purdue seeks to redact is too old to merit court protection as proprietary business
information. For example, Purdue seeks redactions in 27 paragraphs that concern information
from more than ten years ago. 2
Fourth, even with regard to recent years, the business information that Purdue seeks to
conceal is obsolete because it describes practices that Purdue promised to end. For example,
Purdue seeks to redact scores of allegations about its massive opioid sales force, which Purdue
shut down last year. 3 If Purdue is considering re-starting its aggressive tactics of sending
hundreds of sales reps to promote opioids to doctors across Massachusetts and the nation, it
should say so in an affidavit. Likewise, Purdue seeks to maintain as proprietary business
information its tactics for circumventing prescription limits, getting patients on higher doses of
opioids, and keeping patients on opioids longer — harmful conduct that is not a business strategy
Purdue can enlist the Court to protect. 4
1
E.g., Ex. D, ¶¶ 177, 204, 208, 215, 221, 222, 231.
2
E.g., Ex. D, ¶¶ 177, 188, 189, 204, 215, 221, 222, 226, 227, 231, 239, 240, 242, 247, 249, 250, 251, 498, 515, 517,
520, 597, 612, fn 125, fn 143, fn 173.
3
E.g., Ex. D, ¶¶ 208, 215, 222, 249, 250, 259, 314, 315, 325, 521, 540, 612, 620, 627;
https://www.purduepharma.com/news-media/2018/02/purdue-pharma-l-p-issues-statement-on-opioid-promotion/.
4
E.g., Ex. D, ¶¶ 307, 347, 384, 404, 407, 410, 413, 532, 564, 568, 572, 597, 666, 681, 808.
2
Fifth, Purdue wrongly seeks protection for basic facts about the company’s conduct
under a sweeping claim to confidentiality for “Board of Directors Decision-Making.” 5 Members
of the Board of Directors are defendants in the Massachusetts suit. Rule 26(c) does not provide
categorical protection to facts about corporate conduct wherever the board is involved. See Wall
Industries, Inc. v. U.S., 5 Cl. Ct. 485, 485-88 (1984) (denying protective order for documents,
including board minutes, where movant’s argument amounted to “broad, vague and conclusory
generalizations.”). Corporate board materials are routinely disclosed publicly through litigation
when, as here, they are relevant to the claims. 6
Sixth, Purdue wrongly seeks to conceal information about scores of payments to its
directors and officers under the categorical assertion that “compensation” is confidential. 7 As
with directors’ minutes, however, such information is regularly disclosed as relevant evidence in
court documents. See Baxter Intern., Inc. v. Abbott Labs, 297 F. 3d 544, 547 (7th Cir. 2002)
(“[M]any litigants would like to keep confidential the salary they make…but when [facts] are
vital to claims made in litigation they must be revealed.”). The information at issue here does
not describe a business strategy or compensation system that could be used by anyone to
Purdue’s competitive disadvantage. Instead, the allegations describe individuals extracting vast
sums from misconduct that should never happen again.
Seventh, Purdue seeks to conceal information that should fairly be disclosed to contradict
inaccurate sworn statements by Purdue’s officers and directors in the Massachusetts litigation.
With the exception of Russell Gasdia, every individual defendant in the Massachusetts action
moved to dismiss the suit for lack of personal jurisdiction and made a sworn statement denying
involvement in Purdue’s marketing and sales. Richard Sackler, for example, attested that he did
not “direct any marketing, sales, or promotional activities by [Purdue] in Massachusetts.” Rule
26(c) does not allow Purdue’s leaders to say one thing publicly under oath and then ask the
assistance of a Court in withholding from the public the evidence that disproves those
statements. 8
5
E.g., Ex. D, ¶¶ 188, 189, 204, 208, 215, 221, 222, 227, 238, 240, 242, 247, 249, 250, 251, 253, 259, 265, 268-271,
291, 292, 294, 295, 305, 307, 308, 309, 310, 314-316, 322, 325, 326, 327, 334, 340, 345, 346, 347, 357, 363, 364,
389, 395, 412, 437, 458, 460, 483, 485, 494, 496, 498, 501-508, 515, 517, 521, 526, 528, 532-535, 539, 540, 554.
6
E.g. In Re Parmalat Securities Litigation, 258 F.R.D. 236, 252 (S.D.N.Y. 2009) (vague and conclusory claims of
economic and competitive harm insufficient to establish good cause for sealing corporate board minutes); Sims v.
BB&T Corp., 2018 WL 3466945 at *4 (M.D.N.C. 2018) (declining to seal relevant board minutes based on
conclusory statements of harm or citations to cases with distinguishable circumstances); City of Greenville, IL v.
Syngenta Crop Protection, Inc., 2013 WL 1164788, at *4 (S.D. Illinois, 2013)(declining to seal corporate board
minutes that did not “contain sufficient indicia of confidentiality [or] reveal confidential strategies that [were]
commercially relevant … such that disclosure would likely subject the defendants to a risk of harm.”); Bovie
Medical Corp. v. Livneh, 2010 WL 4117635, at *3 (M.D. Florida, 2010)(Defendants failed to show good cause to
overcome common law right of access to board minutes filed in court); and Byrnes v. Empire Blue Cross Blue
Shield, 2000 WL 60221, at *5 (S.D.N.Y., 2000)(probative value of board minutes outweighed any potential chilling
effect of disclosure on corporate decision-making).
7
E.g., Ex. D, ¶¶ 200, 238, 239, 242, 247, 259, 265, 303, 317, 320, 322, 324, 327, 336, 340, 357, 362, 363, 365.
8
E.g., Ex. D, ¶¶ 208, 215, 221, 222, 226, 231, 240, 250, 253, 268, 269, 270, 271, 307, 308, 309, 310, 314, 315, 325,
364, 369, 370, 384, 389, 395, 412, 458, 460, 485, 494, 502, 503, 508, 521, 526, 532, 533, 534, 535, 539, 540, 554,
566, 571, 572, 597, 612, 620, 627, 629, 631, 639, 664, 666, 676, 682, 759, 764, 808, 817, 819, 828.
3
Eighth, Purdue wrongly seeks to conceal behind a protective order allegations of the
Massachusetts AGO on the basis that they are not supported by the documents produced in the
MDL, or are “misleading” or “mischaracterizations.” 9 That assertion is not a basis for
confidentiality. Purdue is free to deny the allegations that the Attorney General of Massachusetts
has made; it cannot use Rule 26(c) to hide them.
Ninth, the disclosure sought by the Massachusetts AGO is narrowly tailored. The AGO
has not sought blanket de-designations of the underlying documents. The AGO seeks to disclose
only the text of allegations that it has made in its filed Amended Complaint.
Finally, Purdue seeks to conceal information of great public interest. The Attorney
General is the Commonwealth’s lawyer, and the people of Massachusetts should see the
allegations brought in their name. Revealing the truth about Purdue’s misconduct is important to
achieve justice and make sure deception like Purdue’s never happens again. As an Ohio court
held when denying a similar request for a protective order:
“[T]his motion for a protective order has more to do with other litigation
and bad publicity than with what the court finds to be but vague and
conclusory allegations of competitively sensitive documents. The court
‘must consider the need for public dissemination, in order to alert other
consumers to potential dangers posed by the product.’ If the sharing of
discovery can possibly save lives and stop injuries such as occurred here
by forcing this defendant to act, then no protective order should prohibit
it. As pointed out in plaintiff’s brief in opposition: ‘The analogous
question to be asked here is whether the documents produced in the Ford
Pinto Fuel tank cases should have been kept from the public.’ The
answer there, as here, must be a resounding ‘No.’”
Koval v. Gen. Motors Corp., 62 Ohio Misc. 2d 694, 699 (1990) (internal citation omitted).
For the forgoing reasons, the Massachusetts AGO respectfully request that its challenge
to the 189 confidentiality designations be granted. If Purdue provides more detailed and specific
support for its positions, the Massachusetts AGO respectfully requests the opportunity to
respond.
Thank you for your attention in this matter.
Respectfully submitted,
Gillian Feiner
Chief, False Claims Division
9
E.g., Ex. D, ¶¶ 177, 226, 231, 256, 311, 312, 369, 370, 416, 490.
4
Exhibit 2
List Of Remaining Redactions As Of January 15, 2019

Commonwealth v. Purdue Pharma, et al., C.A. No. 1884‐cv‐01808 (BLS2)
Redactions Remaining In the Commonwealth’s Amended Complaint As Of 1/15/2019
Paragraph
Defendents' Basis for Confidentiality
Number
Key Charts and
Illustrations Compensation Information, Trade Secret/Confidential Business Negotiations
177 Mischaracterization of underlying document
188 Board of Directors Decision‐Making
200 Compensation Information
fn. 125 Board of Directors Decision‐Making
226 Mischaracterization of underlying document
fn. 143 Mischaracterization of documents; irrelevant
231 Mischaracterization of underlying document; irrelevant
238 Board of Directors Decision‐Making; Compensation Information
256 Mischaracterization of underlying documents
269 Board of Directors Decision‐Making; Confidential Proprietary Study
fn. 212 Confidential Proprietary presentation
291 Board of Directors Decision‐Making; Confidential Proprietary Study
fn. 260 Proprietary confidential study
Page 1
Paragraph
Number
311 Misleading citation
312 Misleading citation
369 Misleading citation; irrelevant
370 Misleading citation; irrelevant; Richard Sackler
384 Proprietary confidential internal study
404 Proprietary confidential study
Page 2
Paragraph
Number
412 Proprietary confidential study; Board of Directors Decision‐Making
445 Trade Secret/Confidential Business Negotiations
fn. 535 Trade Secret/Confidential Business Negotiations
Page 3
Paragraph
Number
528 Board of Directors Decision‐Making; proprietary confidential study
fn. 642 Board Deliberative Process
666 Proprietary confidential internal studies
699‐753 Russell Gasdia
Require additional information and discussion before we can consent to
746
unredaction.
Page 4
Paragraph
Number
fn. 990 Compensation Information
Page 5
Exhibit 3
Amended Complaint Showing Remaining Redactions As Of January 15, 2019

SUFFOLK, ss. SUPERIOR COURT

C.A. No. 1884-cv-01808 (BLS2)
)
COMMONWEALTH OF MASSACHUSETTS, )
) FIRST AMENDED
v. ) COMPLAINT
) AND JURY DEMAND
PURDUE PHARMA L.P., PURDUE PHARMA INC., )
RICHARD SACKLER, THERESA SACKLER, )
KATHE SACKLER, JONATHAN SACKLER, )
MORTIMER D.A. SACKLER, BEVERLY SACKLER, )
DAVID SACKLER, ILENE SACKLER LEFCOURT, )
PETER BOER, PAULO COSTA, CECIL PICKETT, )
RALPH SNYDERMAN, filDITH LEWENT, CRAIG )
LANDAU, JOHN STEWART, MARK TIMNEY, )
and RUSSELL J. GASDIA )
_________________ )
REDACTED VERSION
Annotated To Show Redactions Remaining As Of January 15, 2019

I. INTRODUCTION
1. Dangerous opioid drugs are killing people across Massachusetts. Prescription
medicines, which are supposed to protect our health, are instead ruining people’s lives. Every
community in our Commonwealth suffers from the epidemic of addiction and death.
2. Purdue Pharma created the epidemic and profited from it through a web of illegal
deceit. First, Purdue deceived Massachusetts doctors and patients to get more and more people
on its dangerous drugs. Second, Purdue misled them to use higher and more dangerous doses.
Third, Purdue deceived them to stay on its drugs for longer and more harmful periods of time.
All the while, Purdue peddled falsehoods to keep patients away from safer alternatives. Even
when Purdue knew people in Massachusetts were addicted and dying, Purdue treated doctors and
their patients as targets to sell more drugs. At the top of Purdue, a small group of executives led
the deception and pocketed millions of dollars.
3. On behalf of the Commonwealth, the Attorney General asks the Court to end
Purdue’s illegal conduct and make Purdue and its culpable executives pay for the harm they
inflicted in our state.
II. PARTIES
4. The plaintiff is Attorney General Maura Healey, who brings this action in the
public interest in the name of the Commonwealth of Massachusetts.
5. The defendants are two companies and seventeen individuals who engaged in a
deadly, deceptive scheme to sell opioids in Massachusetts. This Amended Complaint addresses
the bases for jurisdiction and liability as to each of the nineteen defendants, arising from their
decade-long course of misconduct in Massachusetts that involved hundreds of deaths, hundreds
of thousands of unlawful acts, and hundreds of millions of dollars.
2
6. Defendant Purdue Pharma Inc. is a drug company incorporated in New York with
its principal place of business in Connecticut. It is the general partner of Defendant Purdue
Pharma L.P., a limited partnership established in Delaware with its principal place of business in
Connecticut. This Complaint refers to Purdue Pharma Inc. and Purdue Pharma L.P. collectively
as “Purdue.”
7. The seventeen individual defendants are current and former directors and officers
of Purdue Pharma Inc. In Massachusetts, directors, officers, and employees of corporations are
not immune from jurisdiction or liability when they break the law. Instead, every individual is
accountable for his or her actions. 1
8. Defendants Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler
Lefcourt, Jonathan Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler controlled
Purdue’s misconduct. Each of them took a seat on the Board of Directors of Purdue Pharma Inc.
Together, they always held the controlling majority of the Board, which gave them full power
over both Purdue Pharma Inc. and Purdue Pharma L.P. They directed deceptive sales and
marketing practices deep within Purdue, sending hundreds of orders to executives and line
employees. From the money that Purdue collected selling opioids, they paid themselves and
their family billions of dollars.
9. Defendants Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa, and Ralph
Snyderman took seats on the Board and knowingly advanced the Sacklers’ scheme.
1
E.g., Kleinerman v. Morse, 26 Mass. App. Ct. 819 (1989); Hongyu Luo v. Tao Ceramics, 32 Mass. L. Rptr. 134
(Mass. Sup. Ct. 2014); Rissman, Hendricks & Oliverio v. MIV Therapeutics, 901 F. Supp. 2d 255 (D. Mass. 2012);
Trans National Travel v. Sun Pacific Intern., 10 F. Supp. 2d 79 (D. Mass. 1998); Yankee Group v. Yamashita, 678 F.
Supp. 20 (D. Mass. 1988); Johnson Creative Arts v. Wool Masters, 573 F. Supp. 1106 (D. Mass. 1983). “The
question of personal jurisdiction over an individual, therefore, rests on whether there is an independent basis for
jurisdiction based on an individual’s actions, regardless of the capacity in which those actions were taken.”
Rissman, 901 F. Supp. 2d at 263. A defendant’s “status as a corporate officer and director does not insulate him
from personal jurisdiction.” Id. at 264.
3
10. Defendants John Stewart, Mark Timney, and Craig Landau each directed
Purdue’s deception as CEO of Purdue Pharma Inc. and Purdue Pharma L.P. Defendant Russell
Gasdia carried out the misconduct as Vice President of Sales and Marketing.
11. Beverly Sackler, Jonathan Sackler, Kathe Sackler, Paulo Costa, Mark Timney,
and Craig Landau reside in Connecticut. David Sackler, Ilene Sackler Lefcourt, and Mortimer
Sackler reside in New York. Richard Sackler, Peter Boer, and John Stewart reside in Florida.
Judith Lewent and Cecil Pickett reside in New Jersey. Ralph Snyderman resides in North
Carolina. Theresa Sackler resides in the United Kingdom. Russell Gasdia resides in
Massachusetts.
12. The Court has jurisdiction over all the defendants for the reasons set forth on
pages 51-269 below.
III. OUTLINE OF THE COMPLAINT
13. On May 15, 2007, this Court entered Judgment (“2007 Judgment”) to prohibit
Purdue’s deceptive conduct in the sale of opioids. This suit addresses Purdue’s misconduct since
that 2007 Judgment.
14. The Complaint begins with the story of Purdue’s misconduct in Massachusetts
(pages 1-51). The Complaint then explains how each individual defendant broke the law (pages
52-256). Sections addressing jurisdiction, the counts, prayers for relief, and the jury demand
then follow, as outlined in the following Table of Contents.
4
TABLE OF CONTENTS
I. INTRODUCTION ....................................................................................................................2
II. PARTIES ...............................................................................................................................2
III. OUTLINE OF THE COMPLAINT ...........................................................................................4
IV. PURDUE’S DRUGS KILL HUNDREDS OF PEOPLE IN MASSACHUSETTS ..............................7
V. PURDUE TARGETED MASSACHUSETTS WITH ITS UNFAIR AND DECEPTIVE SALES

CAMPAIGN .........................................................................................................................11
VI. PURDUE DECEIVED DOCTORS AND PATIENTS TO GET MORE PEOPLE ON

DANGEROUS DRUGS, AT HIGHER DOSES, FOR LONGER PERIODS ..................................14
A. More People ........................................................................................................... 14
B. Higher Doses .......................................................................................................... 22
C. Longer Periods....................................................................................................... 28
VII. PURDUE PEDDLED FALSEHOODS TO KEEP PATIENTS AWAY FROM SAFER

ALTERNATIVES ..................................................................................................................34
VIII. PURDUE TARGETED DOCTORS WHO PRESCRIBED THE MOST DRUGS, EVEN WHEN
THEY WROTE ILLEGITIMATE PRESCRIPTIONS AND THEIR PATIENTS DIED ..................39
IX. PURDUE PHARMA INC. AND PURDUE PHARMA L.P. ARE BOTH RESPONSIBLE FOR
THE DEADLY MISCONDUCT ..............................................................................................51
X. THE INDIVIDUAL DEFENDANTS LED PURDUE’S MISCONDUCT ........................................52
A. Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt,

Jonathan Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler ... 54
B. Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa

and Ralph Snyderman ........................................................................................ 173
C. John Stewart, Russell Gasdia, Mark Timney, and Craig Landau ................. 197
XI. DISCOVERY RULE AND TOLLING ....................................................................................257
XII. JURISDICTION AND VENUE ..............................................................................................258
XIII. CAUSES OF ACTION .........................................................................................................270
XIV. PRAYER FOR RELIEF .......................................................................................................273
XV. JURY DEMAND .................................................................................................................274
5
KEY CHARTS AND ILLUSTRATIONS
Opioid Deaths in Massachusetts ..................................................................................................7
Purdue Targeted Massachusetts ...................................................................................................11
Do You Have Patients Like Pam? ...............................................................................................21
Purdue Promotions for Higher Doses ..........................................................................................23
Impact of Changes in Dose Mix ..................................................................................................25
Keeping Patients on Opioids Longer Kills Them ........................................................................29
There Is a Direct Relationship Between OxyContin Length of Therapy and Dose.....................31
Purdue Sales Rep Visits to One Massachusetts Doctor ...............................................................43
The Sacklers Ordered Purdue to Hire Hundreds of Sales Reps ...................................................67
Purdue Board Minutes of February 2008.....................................................................................72
Massachusetts Communities Targeted in Purdue’s 2008 Sales Force Expansion .......................73
The Sacklers ......................................................................79
The Sacklers Required Each Sales Rep to Visit 7 Prescribers per Day .......................................99
The Sacklers Required Sales Reps to Visit Prescribers Thousands of Times .............................100
Map of the Abuse Environment ...................................................................................................114
Richard Sackler into the Field with Sales Reps ...........................................................................120
True Physician Example: Wareham, Massachusetts ...................................................................140
Project ...................................................................................152
Purdue .............................................................163
Critical Shifts in the National Discussion ....................................................................................164
Sales Rep Districts for 2018 ........................................................................................................170
Planned Actions to Sell Higher Doses .........................................................................................215

6
IV. PURDUE’S DRUGS KILL HUNDREDS OF PEOPLE IN MASSACHUSETTS
15. Opioids are killing people all around us. More than 11,000 people died from
opioid-related overdoses in the past decade in Massachusetts — more than everyone killed in car
accidents and murders combined. The people of Massachusetts also survived more than 100,000
overdoses that were not fatal, but still devastating. This crisis is not natural or normal. Drug
companies, particularly Purdue, created this tragedy by deceiving doctors and patients about their
dangerous drugs.
Opioid Deaths in Massachusetts

2155
1977
1768
1352
961
742
638 656
622
560
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
AGO graph from Massachusetts Department of Public Health data
7
16. Opioids are dangerous narcotics that can be deadly, because they can cause
patients to stop breathing and suffocate.
17. Opioids are also highly addictive. Patients using opioids for more than a few days
can experience severe withdrawal symptoms if they stop taking the drugs, including: anxiety,
insomnia, pain, blurry vision, rapid heartbeat, chills, panic attacks, nausea, vomiting, and
tremors. Withdrawal can last so long and be so painful that it is difficult to stop taking opioids.
18. Putting patients on opioids puts them at risk. Patients who take opioids at higher
doses and for longer periods face higher and higher risk of addiction and death. Compared to our
general population, Massachusetts patients who were prescribed opioids for more than a year
were 51 times more likely to die of an opioid-related overdose.
19. Purdue took advantage of addiction to make money. For decades, physicians had
reserved opioids for treating severe short-term pain, or for patients near the end of life. But the
tradition of limiting opioids to short-term treatment ended after Purdue introduced OxyContin
and began marketing it and other opioids with deceptive claims.
20. OxyContin’s sole active ingredient is oxycodone, a molecule nearly identical to
heroin. Purdue later introduced another dangerous drug, Butrans, which releases opioids into the
body from a skin patch. Then Purdue introduced Hysingla, which contains yet another opioid.
Almost all of Purdue’s business is selling opioids.
21. Since May 2007, Purdue has sold more than 70,000,000 doses of opioids in
Massachusetts. Purdue collected revenue of more than $500,000,000 from Massachusetts sales.
For Purdue, the Massachusetts prescriptions were a gold mine.
8
22. For patients, it was a massacre. Hundreds of patients who took Purdue’s opioids
in Massachusetts became addicted and died. An investigation by the Massachusetts Attorney
General found that, since 2009, 671 people who filled prescriptions for Purdue opioids in
Massachusetts subsequently died of opioid-related overdoses.
23. The people we lost worked as firefighters, homemakers, carpenters, truck drivers,
nurses, hairdressers, fishermen, waitresses, students, mechanics, cooks, electricians, ironworkers,
social workers, accountants, artists, lab technicians, and bartenders. They lived and died in every
part of our state. The oldest died at age 87. The youngest started taking Purdue’s opioids at 16
and died when he was 18 years old.
24. Purdue’s deception also imposed lasting hardship on the people who lost their
loved ones. Because of Purdue’s dishonesty, too many children in Massachusetts lost their
parents. Too many parents in Massachusetts buried their children. Too many grandparents in
Massachusetts are raising their grandchildren.
25. Patients who survive addiction need lengthy, difficult, and expensive treatment.
People who are addicted to opioids are often unable to work. The addiction of parents can force
their children into foster care. Babies are born addicted to opioids, because they are exposed to
the drugs in the womb.
26. Purdue’s misconduct has imposed heavy costs on the people of Massachusetts and
on the Commonwealth. Intensive care for a newborn who has been harmed by opioids can cost
$200,000, even before the baby comes home from the hospital. The injuries from addiction and
overdose are staggering. For example, the White House Council of Economic Advisers
determined that a middle estimate of the cost of each death from opioid overdose is $9.6 million.
By that methodology, the 671 deaths that the Attorney General has already identified in
9
Massachusetts total more than $6 billion.
27. To profit from its dangerous drugs, Purdue engaged in a deadly and illegal
scheme to deceive doctors and patients. First, Purdue deceived Massachusetts doctors and
patients to get more people on its dangerous drugs. Purdue targeted vulnerable people who could
be introduced to its opioids, including elderly patients, veterans, and people who had never taken
opioids before. Second, Purdue misled them to take higher and more dangerous doses. Third,
Purdue deceived them to stay on its drugs for longer and more harmful periods of time.
28. All the while, Purdue peddled falsehoods to keep patients away from safer
alternatives. Even when Purdue knew people in Massachusetts were addicted and dying, Purdue
treated doctors and patients as “targets” to sell more drugs.
29. Each part of the scheme earned Purdue more money from Massachusetts opioid
sales and caused more addiction and death here in our Commonwealth. And each defendant
participated in and profited from the scheme in Massachusetts, as set forth below.
10
V. PURDUE TARGETED MASSACHUSETTS WITH ITS UNFAIR AND
DECEPTIVE SALES CAMPAIGN
30. Hundreds of Massachusetts patients died after taking Purdue’s drugs because
Purdue targeted Massachusetts with a massive deceptive sales campaign.
31. Purdue’s most powerful tool of deception was sending sales representatives to
promote opioids to Massachusetts doctors, nurses, and pharmacists face to face. During sales
visits, Purdue reps made false and misleading claims directly to the professionals who care for
Massachusetts patients. Purdue assigned reps to specific territories in Massachusetts and gave
them lists of Massachusetts doctors to visit. Purdue targeted doctors, nurses, and pharmacists in
every part of our Commonwealth. The map below shows Massachusetts communities where
Purdue promoted opioids since 2007. Each dot represents a city or town where Purdue sales reps
promoted opioids in Massachusetts.
Purdue Targeted Massachusetts
11
32. Since the 2007 Judgment, Purdue sales reps visited Massachusetts prescribers and
pharmacists more than 150,000 times. A list of the exact date, location, sales rep, and “target”
of each sales visit is attached as Exhibit 1.
33. Each of these in-person sales visits cost Purdue money — on average more than
$200 per visit. But Purdue made that money back many times over, because it convinced doctors
to prescribe its addictive drugs. When Purdue identified a doctor as a profitable target, Purdue
visited the doctor frequently: often weekly, sometimes almost every day. Purdue salespeople
asked doctors to list specific patients they were scheduled to see and pressed the doctors to
commit to put the patients on Purdue opioids. By the time a patient walked into a clinic, the
doctor, in Purdue’s words, had already “guaranteed” that he would prescribe Purdue’s drugs.
Purdue rewarded high-prescribing doctors with coffee, ice cream, catered lunches, and cash.
Purdue has given meals, money, or other gifts to more than 2,000 Massachusetts prescribers.
34. Purdue judged its sales reps by how many opioids they got doctors to prescribe.
Sales reps who generated the most prescriptions won bonuses and prizes. Reps who failed to get
enough Massachusetts patients on opioids were placed on probation, put on performance
improvement plans, and fired.
35. Purdue used face-to-face sales visits to conceal its deception by trying to avoid
witnesses or a paper trail. When one sales rep made the mistake of writing down in an email her
sales pitch to a doctor, Purdue’s Vice President of Sales Russell Gasdia ordered: “Fire her now!”
Purdue’s leaders did not want a record of their behavior because they knew they were breaking
the law.
36. Purdue reinforced its sales visits with dozens of other deceptive tactics aimed at
Massachusetts. Purdue wrote deceptive pamphlets and mailed them to doctors in Massachusetts.
12
Purdue streamed videos to Massachusetts doctors on its OxyContin Physicians Television
Network. Purdue hired the most prolific opioid prescribers in Massachusetts as spokesmen to
promote its drugs to other doctors. Purdue funded the Massachusetts General Hospital Purdue
Pharma Pain Program and an entire degree program at Tufts University to influence
Massachusetts doctors to use its drugs.
37. Purdue used all these deceptive tactics to collect money in Massachusetts, by
getting more Massachusetts patients on opioids, at higher doses, for longer periods of time.
13
VI. PURDUE DECEIVED DOCTORS AND PATIENTS TO GET MORE PEOPLE ON
DANGEROUS DRUGS, AT HIGHER DOSES, FOR LONGER PERIODS
A. Purdue Deceived Doctors and Patients to Get More and More People on Its
Dangerous Drugs
(i) Deception About Addiction
38. Purdue always knew that its opioids carry grave risks of addiction and death.
Instead of being honest about these risks, Purdue obscured them, including by falsely stating and
implying that “appropriate” patients won’t get addicted.
39. In a pamphlet for doctors, Providing Relief, Preventing Abuse: A Reference Guide
To Controlled Substance Prescribing Practices, Purdue wrote that addiction “is not caused by
drugs.” Instead, Purdue assured doctors that addiction happens when the wrong patients get
drugs and abuse them: “it is triggered in a susceptible individual by exposure to drugs, most
commonly through abuse.” 2
40. Purdue promoted its opioids to Massachusetts patients with marketing that was
designed to obscure the risk of addiction and even the fact that Purdue was behind the campaign.
Purdue created a website, In The Face of Pain, that promoted pain treatment by urging patients
to “overcome” their “concerns about addiction.” Testimonials on the website that were
presented as personal stories were in fact by Purdue consultants, whom Purdue had paid tens of
thousands of dollars to promote its drugs. 3
2
Providing Relief, Preventing Abuse (2008), pg. 12, PTN000003587.
3
2011-10-24 website capture, In the Face of Pain, PVT0033890–891.
14
41. Another Purdue publication, the Resource Guide for People with Pain, falsely
assured patients and doctors that opioid medications are not addictive:
“Many people living with pain and even some healthcare

providers believe that opioid medications are addictive. The truth
is that when properly prescribed by a healthcare professional and
taken as directed, these medications give relief – not a ‘high.’” 4
Purdue falsely denied the risk of addiction, falsely implied that addiction requires patients to get
“high,” and falsely promised that patients would not become addicted if they took opioids as
prescribed.
42. Purdue funded and distributed many more publications that were similarly
misleading. Exit Wounds: A Survival Guide to Pain Management for Returning Veterans and
Their Families misleadingly claimed: “Long experience with opioids shows that people who are
not predisposed to addiction are unlikely to become addicted to opioid pain medications.” 5
43. Opioid Prescribing: Clinical Tools and Risk Management Strategies told doctors
that “addiction is rare in patients who become physiologically dependent on opioids while using
them for pain control.” 6
44. Responsible Opioid Prescribing told doctors that only “a small minority of people
seeking treatment may not be reliable or trustworthy” and not suitable for addictive opioid
drugs. 7
45. Over and over, Purdue told Massachusetts doctors and pharmacists that they could
give opioids to “trusted” patients without risk of addiction, even though that was false. To
promote its drugs, Purdue pushed the myth that addiction is a character flaw, and “trustworthy”
4
Resource Guide for People with Pain (2009), pg. 8, PVT0037321.
5
Exit Wounds (2009), pg. 107, PTN000023114.
6
Opioid Prescribing: Clinical Tools and Risk Management Strategies (2009), pg. 12, PWG000242087.
7
Responsible Opioid Prescribing (2007), pg. 11, #448.1.
15
people don’t get addicted to drugs.
46. A Purdue sales rep reported meeting with a Massachusetts pharmacist who said
local doctors were reluctant to prescribe OxyContin. The Purdue rep pushed the pharmacist to
get “older, trustworthy customers” on opioids:
“Made a case to her for those older, trustworthy customers that

she knows well and committed her to step in and call the doctors.
Said she would.”
47. Purdue managers praised Massachusetts sales reps for pitching doctors on the idea
that prescribing to “trustworthy” patients was safe. A sales rep reported that one doctor: “let me
know that she will Rx OxyContin when the pts [patients] has chronic pain and are trustworthy.”
The rep added that he would “Follow up with Dr and ask what pts does she consider ‘trust
worthy?’” A Purdue district manager responded: “Great follow up question on what patients
does he consider trustworthy.”
48. Purdue knew better. Blaming victims for being “untrustworthy” was another way
to lie about Purdue’s addictive drugs.
(ii) Deception to Get Vulnerable Patients on Opioids
49. Pushing opioids for “trustworthy” patients was only one of Purdue’s methods for
getting more people on drugs. To expand the market for opioids, Purdue also trained sales reps
to target vulnerable populations and encourage doctors to put them on opioids, without
disclosing the risks. In Massachusetts, Purdue deceptively promoted opioids for elderly patients,
veterans, patients who had never taken opioids, and patients with osteoarthritis — putting
thousands more patients at risk.
Elderly Patients
50. Purdue knew that prescribing opioids to elderly patients increases their risk of
death. Elderly patients are at greater risk of dangerous interactions between drugs. They are also
16
at greater risk of respiratory depression — in which patients suffocate and die. But Purdue saw
the opportunity to earn millions of dollars by getting elderly patients on opioids because the
public would pay through Medicare. Purdue’s internal documents show that it targeted “Patients
over the age of 65 as more Medicare Part D coverage is achieved.” 8
51. Purdue disregarded and obscured the risks to elderly patients in its deceptive sales
campaign. Purdue reps asked doctors to identify elderly patients and then solicited commitments
from the doctors to give them Purdue opioids. In Massachusetts, a Purdue supervisor coached
sales reps to “Keep the focus on the geriatric patients” and follow Purdue’s “geriatric strategy.”
52. Purdue trained its reps to show doctors charts emphasizing Medicare coverage for
its opioids and use profiles of fake elderly patients, complete with staged photographs, to
convince doctors to prescribe opioids. As a Massachusetts sales rep observed, a fake patient
profile “brings the heart into it” and helps get the doctor to say: “Yes, they need this
medication.”
53. Purdue even made the false claim that elderly patients were especially likely to
benefit from opioids. A rep reported to Purdue that she told a Massachusetts doctor that putting
elderly patients on opioids would improve safety and quality of life by addressing “the need for
sleep for elderly, increased risk for falls if they need to get up at night--take a pill, get glass,
move across a dark room--and the potential impact that could have on healing and mobility.” In
fact, elderly patients taking opioids have increased risks of falling and breaking bones.
Veterans
54. Purdue also targeted veterans with its deceptive claims that they should take
opioids. Like the elderly, many veterans’ prescriptions are paid for by the public, providing
8
2015-01-28 Pain Products Presentation, pg. 12, PVT0029495.
17
another source of revenue when Purdue got veterans on its drugs. Records of sales meetings in
Massachusetts show that Purdue reps emphasized insurance coverage by the veterans’ Tricare
program more than 500 times.
55. To target veterans, Purdue funded a book, Exit Wounds, which was packaged as
the story of a wounded veteran but was really part of Purdue’s deceptive marketing campaign.
The book repeated Purdue’s lie that patients would not become addicted to opioids:
“The pain-relieving properties of opioids are unsurpassed; they

are today considered the ‘gold standard’ of pain medications, and
so are often the main medications used in the treatment of chronic
pain. Yet, despite their great benefits, opioids are underused. For
a number of reasons, healthcare providers may be afraid to
prescribe them, and patients may be afraid to take them. At the
core of this wariness is the fear of addiction, so I want to tackle
this issue head-on … Long experience with opioids shows that
people who are not predisposed to addiction are unlikely to
become addicted to opioid pain medications.” 9
56. Purdue held special events to encourage doctors to prescribe opioids to veterans: 10
Purdue flyer from 2011
57. Purdue’s campaign to target veterans had a terrible cost. Compared to non-
veterans, Massachusetts veterans are three times more likely to die from opioid overdose.
Opioid-Naive Patients
58. Purdue also targeted patients who were not already taking opioids, described in
9
Exit Wounds (2009), pgs. 106-107, PTN000023114.
10
2011 flyer, PTN000003864.
18
the field as “opioid-naive.” Purdue unfairly and deceptively marketed its drugs as appropriate
treatments for opioid-naive patients, without disclosing that they face even higher risks of
overdose and death.
59. Purdue trained its sales reps to promote its drugs specifically for opioid-naive
patients. In training calls, Purdue managers instructed:
• “Your opportunity here is with the naive community, let’s use the
naive trial to make your case.”
• “You created an epiphany with the doctor today (potentially) by

reviewing the opiate naive patient profile. What made him more
pat to write for this patient, being an amiable doctor, is the fact
that he would not have to talk patients out of their short acting
[opioids].”
• “This was an example of what a good call looks like … [Dr.] was
particularly interested in the RM case study of Marjorie, which
generated a robust discussion of opioid naive patients …”
60. A sales script prompted sales reps to ask: “Would you consider OxyContin for an
opioid-naive patient?” Another Purdue script read: 11
Purdue sales script from 2011
61. Purdue also promoted its drugs for opioid-naive patients using the deceptive term
“first line opioid.” “First line” is a medical term for the preferred first step in treating a patient.
Opioids are not an appropriate first line therapy. Nevertheless, Purdue’s internal documents and
testimony from sales reps shows that Purdue repeatedly promoted OxyContin as “first line” —
“the first thing they would take to treat pain.”
11
OxyContin sales script, pg. 10, PWG000334238.
19
62. Purdue also found vulnerable opioid-naive patients by targeting prescribers with
the least training in the risks of opioids. Purdue determined that nurse practitioners, physician
assistants, and primary care doctors were especially responsive to sales reps, so it targeted them
to sell more drugs.
Osteoarthritis
63. Purdue also targeted new patients with the deceptive claim that its opioids should
be used to treat the most common form of arthritis, osteoarthritis. Purdue decided osteoarthritis
would be a money-maker because it is widespread. Purdue’s documents emphasize that more
than 20 million Americans have osteoarthritis, including most people over 75.
64. Opioids are not approved to treat osteoarthritis. Purdue conducted a single study
on osteoarthritis for Butrans, and it failed. Purdue admitted in internal documents that its opioids
“are not indicated for a specific disease” and “it is very important that you never suggest to your
HCP [health care professional] that OxyContin is indicated for the treatment of a specific disease
state such as Rheumatoid Arthritis or Osteoarthritis.”
65. Nevertheless, to meet its business goals, Purdue trained its Massachusetts sales
reps to mislead doctors by promoting opioids for osteoarthritis without disclosing Purdue’s failed
trial. Purdue even measured how often it targeted osteoarthritis patients. A Purdue marketing
presentation concluded that its sales reps were “identifying appropriate patients” because
osteoarthritis was specifically mentioned during 35% of sales visits.
66. Purdue also directed Massachusetts sales reps to use marketing materials that
highlight patients with osteoarthritis, even though Purdue drugs were never indicated for that
disease and Purdue’s Butrans trial had failed.
20
Purdue opioid promotion from 2015 12
12
2015 Butrans Patient Identification and Initiation Guide, pg. 16, PWG000080076.
21
B. Purdue Deceived Doctors and Patients to Use Higher and Higher Doses
67. For patients, taking higher doses of opioids increases the risk of addiction and
death. But for Purdue, higher doses mean higher profits. So Purdue deceived doctors and
patients to get people on higher and higher doses.
68. Purdue earns more money every time a patient moves to a higher dose. For
example, Purdue’s 2015 prices increased dramatically as patients move to higher doses:
OxyContin Prices
bottle of 100 tablets (10 mg) $269.17
bottle of 100 tablets (60 mg) $1,217.22
bottle of 100 tablets (80 mg) $1,500.18
A patient taking the lowest dose pill twice a day for a week earns Purdue $38. But if the patient
instead takes the highest dose, Purdue collects $210 — an increase of 450%.
69. To get that revenue, Purdue designed its sales tactics to increase doses. Purdue
created a campaign for OxyContin around the slogan, Individualize The Dose, because Purdue
determined that it would Increase The Dose. Purdue’s CEO prepared a presentation to the Board
of Directors explaining that Purdue would use Individualize The Dose to sell more of its highest
doses. When Purdue decided to refresh the campaign with a new slogan, it hired consultants to
study what would increase doses the most.
70. Purdue trained its sales reps that increasing a patient’s dose (“titration”) was a key
move when making sales. Purdue’s graphics show the one-way path of increasing doses that
Purdue pushed doctors and patients to follow:
22
Purdue opioid promotion from 2008
Purdue opioid promotion from 2013 13
13
2008-04 OxyContin Conversion/Titration Guide, pg. 14, PPLP003276594; 2013-12 Butrans core visual aid, pg.
20, PWG000076579.
23
71. Purdue tracked whether its sales reps were getting patients on higher doses and
warned staff when doses were not increasing enough: “Titration up to higher strengths,
especially the 40mg and 80mg strengths, is declining.” Purdue required its sales reps to
“practice verbalizing the titration message” to get patients’ doses up. 14
72. Purdue knew its promotion drove patients to higher doses. Purdue’s internal
analysis “found that there is greater loss in the 60mg and 80mg strengths (compared to other
strengths) when we don’t make primary sales calls.” 15 Purdue’s business plans emphasized that
“OxyContin is promotionally sensitive, specifically with the higher doses, and recent research
findings reinforce the value of sales calls.” In 2014, when public health experts tried to save
patients’ lives by warning against high doses of opioids, Purdue pursued a “strategic initiative”
to fight back and “maintain 2013 dose mix.” 16
73. Purdue encouraged Massachusetts doctors to prescribe high doses and did not tell
doctors, or even its own sales reps, that higher doses carry heightened risk of addiction,
overdose, and death. A Massachusetts sales rep testified:
Q: Are you aware of any risks in titrating to a higher dose with

OxyContin?
A. No.
74. Purdue’s deception about the risk of higher doses was deliberate. Purdue claimed
that “dose was not a risk factor for opioid overdose,” even while it admitted in internal
documents that it was “very likely” that patients face “dose-related overdose risk.” 17
14
2013-08-19 OxyContin “Initiation, Conversion, and Titration” workshop, PWG000197629.
15
2013-08-19 OxyContin “Initiation, Conversion, and Titration” workshop, PWG000197635; 2013-09-23
OxyContin marketing plan, PWG000062680.
16
2013-09-23 OxyContin marketing plan, pgs. 35, 57, PWG000062688, -710.
17
2013-08-27 Opioid dosage data press release, PWG000216270; 2012-10-01 internal Purdue analysis, pg. 22,
PWG000226041.
24
75. Purdue analyzed, down to the last dollar, how much of its profit depended on
patients taking higher doses of opioids. In the slide below, Purdue reminded staff that a shift to
lower doses, which reduces the danger to patients, would be bad for Purdue’s bottom line. 18
Purdue internal strategy presentation from 2012
76. When the U.S. Centers for Disease Control issued a national warning against the
highest and most dangerous doses of opioids, Purdue studied prescription data to calculate how
much profit it would lose if doctors followed the CDC’s advice. Purdue determined that the
amount at stake in Massachusetts was $23,964,122 — that was the extra revenue that Purdue was
getting from the most dangerous doses of opioids, every year, in Massachusetts alone. 19
18
2012-08-14 OxyContin ACAM Presentation, slide 28, PWG00062610.
19
2016-04-13 April Board meeting Commercial Update, slide 74, PPLPC016000286167.
25
Responding to Addiction by Increasing the Dose
77. When patients showed signs of addiction to Purdue’s opioids, Purdue urged
doctors to respond by increasing the opioid dose. To convince doctors to increase the dose for
addicted patients, Purdue peddled the false notion that patients suffered from “pseudoaddiction.”
78. A Purdue presentation for doctors titled Medication Therapy Management recited
what had been the consensus view for decades: “Many medical students are taught that if opioids
are prescribed in high doses or for a prolonged time, the patient will become an addict.” Purdue
then assured doctors that this traditional concern about addiction was wrong — that patients
instead suffer from “pseudoaddiction” because “opioids are frequently prescribed in doses that
are inadequate.” 20
79. A Purdue pamphlet titled Clinical Issues in Opioid Prescribing urged doctors to
look for pseudoaddiction:
“A term which has been used to describe patient behaviors that

may occur when pain is undertreated. Patients with unrelieved
pain may become focused on obtaining medications, may ‘clock
watch,” and may otherwise seem inappropriately “drug-seeking.’
Even such behaviors as illicit drug use and deception can occur in
the patient’s efforts to obtain relief. Pseudoaddiction can be
distinguished from true addiction in that the behaviors resolve
when the pain is effectively treated.”
Purdue again urged doctors to prescribe higher doses, stating that opioids “are frequently
underdosed - or even withheld due to a widespread lack of information … about their use among
healthcare professionals.” 21
80. In another pamphlet, Providing Relief, Preventing Abuse: A Reference Guide To
Controlled Substances Prescribing Practices, Purdue admonished doctors that “[u]ndertreatment
20
2007-11 Medication Therapy Management: Opportunities For Improving Pain Care, slide 31, PTN000006105.
21
Clinical Issues in Opioid Prescribing (2008), pgs. 1-3, PWG0000058054-055.
26
of pain is a serious problem” and “pain should be treated aggressively.” Purdue stated: “Facts
About Addiction: ‘Misunderstanding of addiction and mislabeling of patients as addicts result in
unnecessary withholding of opioid medications.’” 22
81. Purdue released a second edition of Providing Relief, Preventing Abuse, which
continued to urge higher doses, and added a new deception about the scientific “literature”:
“The term pseudoaddiction has emerged in the literature to

describe the inaccurate interpretation of [drug-seeking] behaviors
in patients who have pain that has not been effectively treated.” 23
The revised pamphlet failed to disclose that none of the “literature” it cited included scientific or
medical evidence supporting pseudoaddiction as a diagnosis separate from addiction. Nor did it
disclose that all of the cited “literature” was linked to organizations and doctors paid by Purdue.
82. Purdue also urged doctors to prescribe higher doses in a Purdue-sponsored book,
Responsible Opioid Prescribing, which again suggested that patients who appear to be addicted
were instead “receiving an inadequate dose” and needed more drugs. 24
83. Purdue knew its campaign to push higher doses of opioids was wrong. Doctors
on Purdue’s payroll admitted in writing that pseudoaddiction was used to describe “behaviors
that are clearly characterized as drug abuse” and put Purdue at risk of “ignoring” addiction and
“sanctioning abuse.” But Purdue nevertheless urged doctors to respond to signs of addiction by
prescribing higher doses of Purdue’s drugs.
22
Providing Relief, Preventing Abuse (2008), pgs. 4, 6, PTN00003569-570.
23
Providing Relief, Preventing Abuse (2nd ed. 2011), pg. 9, PTN00003555.
24
Responsible Opioid Prescribing (2011), pg. 90, Bates no. #729.1.
27
C. Purdue Deceived Doctors and Patients to Stay on Its Drugs Longer and Longer
84. Just as Purdue made more money by pushing patients to higher doses, Purdue
increased its profits by keeping patients on drugs for longer periods of time. Long-term opioid
use causes addiction and death. But for Purdue, keeping patients on drugs longer meant more
profits. So Purdue deceived doctors and patients to stay on its drugs longer.
85. According to Purdue’s 2015 price list, a patient taking Purdue’s 80mg OxyContin
pill twice a day for a week earned Purdue $210. If that same patient could be kept on the drug
for a year, Purdue collected far more money: $10,959. 25
86. Purdue’s profit came at a terrible human cost. The Massachusetts Department of
Public Health studied more than a million real Massachusetts patients during the years of
Purdue’s misconduct and found that staying on prescription opioids longer dangerously increases
the risk of overdose death. Compared to the general population, a patient who receives three
months of prescribed opioids is 30 times more likely to overdose and die. A patient who stays
on prescription opioids for 6-11 months is 46 times more likely to die. And a patient who stays
on prescription opioids for a year — like the example that earns Purdue $10,959 — is 51 times
more likely to die. 26
25
2015-01-12 Price Increase Notification, PWG000045843.
26
2017-08 Assessment of Opioid-Related Overdoses in Massachusetts 2011-2015, available at
https://www.mass.gov/files/documents/2017/08/31/data-brief-chapter-55-aug-2017.pdf.
28
Keeping Patients On Opioids Longer Kills Them
Opioid-related overdose deaths per 100,000 people in a study of
1.1 million Massachusetts patients prescribed opioids in 2011
51x
600 46x
deaths
500
deaths
400
deaths
30x
300
deaths
200
deaths
100
deaths
0
General Population 3 to 5 months 6 to 11 months 12 months
of opioids of opioids of opioids
AGO graph from Massachusetts Department of Public Health data
29
87. Even compared to the most famous deadly and addictive products, these are
extraordinary effects. Smoking increases the chance of lung cancer death by less than 51 times.
88. By getting patients addicted, Purdue greatly increased the patients’ risk of harm
from many drugs in the opioid class — including, heroin, fentanyl, and generic oxycodone —
which share the same addictive chemistry as Purdue opioids.
89. To get patients to take that awful risk, Purdue deceived doctors into keeping
patients on opioids for longer and longer periods of time. Purdue gave its salespeople explicit
instructions to “extend average treatment duration.” 27 Purdue’s business plans valued patients
by how long they could be kept on Purdue’s opioids and targeted patients who could be kept on
opioids for more than a year. 28 To “drive sales and profitability,” Purdue deliberately worked to
keep patients on its opioids longer. 29
90. Purdue secretly determined that pushing patients to higher doses would keep them
on opioids longer. Purdue developed tactics specifically to keep patients hooked on opioids
longer, which it called by the euphemism: “Improving the Length Of Therapy” — sometimes
abbreviated as “LOT” or “LoT.” 30 Purdue taught its employees that there is “a direct
relationship” between getting patients on higher doses and keeping them on Purdue’s opioids
longer. 31
27
2011-10-18 OxyContin Level 300 Training, slide 49, PVT0050183.
28
2012-04-27 Marketing Welcome, slides 48-49, PVT0007742-743.
29
2012-02-15 10-Year Plan, slides 31-33, PWG000164238-240
30
2013-07 Sales & Marketing Opioid Market Overview, slide 35, PWG000163716.
31
2012-08-14 OxyContin marketing plan, slide 25, PWG000062607.
30
91. Purdue’s internal marketing plan showed a graph that broke down exactly how
getting patients on higher doses of opioids would get more patients to stay on drugs longer:
Purdue’s sales reps promoted higher doses, but they did not tell doctors and patients that the
higher doses were a scheme to trap patients on Purdue’s drugs.
92. To “extend average treatment duration,” Purdue deceptively claimed that patients’
becoming dependent on its drugs was not dangerous or deadly, but “normal.” Purdue taught
doctors that: “Healthcare professionals should recognize that tolerance and physical dependence
are normal consequences of sustained use of opioid analgesics and are not the same as
addiction.” 32 Purdue deceptively claimed that physical dependence on its opioids was “a normal
physiologic response,” “an expected occurrence,” and no more dangerous than “many classes of
32
2009-11 FACETS, slide 9, PTN000006436.
31
medications” that are not addictive, including drugs used to treat high blood pressure. 33 Purdue
set as one of its “key messages” that “data support the use of opioids beyond 90 days and
maintained through 52 weeks.” 34
93. One of Purdue’s most powerful tactics to keep patients on opioids longer was an
opioid savings card that gave patients discounts on their first prescriptions. Discounts could
have cut Purdue’s revenue if patients took opioids for a short time. But Purdue’s internal 10-
year plan highlighted its discovery that opioid savings cards kept patients on opioids longer:
“more patients remain on OxyContin after 90 days.” 35 Purdue determined that opioid savings
cards worked like the teaser rate on a long-term and very high-stakes mortgage. According to
Purdue’s internal analysis, the savings cards had the highest “return on investment” in the entire
“OxyContin Marketing Mix.” The return on investment for Purdue was 4.28, so that every
$1,000,000 Purdue gave away in savings came back to Purdue as $4,280,000 in revenue because
patients stayed on dangerous opioids longer. 36
33
Is It Pain (2011), slide 6, PTN000007194.
34
2013-07 Publication Plan for Long-Term Opioid Therapy for Chronic Non-Cancer Pain, pg. 3, PWG000323550.
35
2012-02-15 10-Year Plan, slide 33, PWG000164240.
36
2012-11-01 Board report, pg. 31, PWG000414917.
32
Purdue internal strategy presentation from 2011 37
94. Keeping more patients on opioids for longer than 90 days was one of Purdue’s
“2011 Highlights.” 38 Purdue’s directors and CEO were briefed specifically on “emails targeted
towards HCPs [healthcare professionals] practicing in Massachusetts” to push opioid savings
cards. 39 But it was a public health disaster. The Massachusetts Department of Public Health
found that patients who stayed on prescription opioids for more than 90 days were thirty times
more likely to die of an overdose.
95. Purdue aimed to “drive” patients to higher doses and longer periods on drugs so
forcefully that it could control how many kilograms of opioids were taken within 2%: 40
37
2011-12-06 Manager’s Meeting Presentation, slide 13, PWG003840379.
38
2012-02-15 10-Year Plan, slide 33, PWG000164240.
39
40
2012-08-14 OxyContin marketing plan, slide 23, PWG000062605.
33
96. When Purdue’s sales reps talked with doctors about how to dose its drugs, and
when Purdue sent opioid savings cards to patients, Purdue did not disclose that higher doses and
savings were designed to keep patients on its drugs longer. Purdue did not disclose that its
promotion to doctors was designed to drive the amount of drugs consumed by Massachusetts
patients to within 2% of its desired profit. Purdue did not disclose that its business target would
cause many more patients to get addicted and die.
97. Purdue’s campaign to “extend average treatment duration” succeeded. A national
study of tens of thousands of medical and pharmacy claims records published in the Journal of
General Internal Medicine found that two-thirds of patients who took opioids for 90 days were
still taking opioids five years later. 41
VII. PURDUE PEDDLED FALSEHOODS TO KEEP PATIENTS AWAY FROM

SAFER ALTERNATIVES
98. Purdue not only lit the fire that killed so many patients; it also tried to block the
exits that patients could have used to escape. Purdue peddled a series of falsehoods to push
patients away from safer drugs and toward its opioids.
99. Purdue had no justification to steer patients away from safer alternatives, and it
knew it. Purdue’s internal documents admit that it “cannot represent or suggest” that its drugs
are “safer” or “more effective” or make “any other sort of comparative claim,” because it had no
drugs with the evidence required for such a claim. In its internal documents, Purdue admitted
41
Martin et al., Long-term chronic opioid therapy discontinuation rates from the TROUP study. J Gen Intern Med.
2011;26(12):1450-7. Summarized in Purdue’s files on pg. 15, PWG000226034.
34
that “making comparative statements of our product versus a competitor’s product is never
appropriate.” 42
Purdue internal presentation from 2011
But Purdue went ahead and made deceptive claims to steer patients away from alternatives.
Deception about Tylenol and Ibuprofen
100. Purdue made deceptive claims about research by its own employees, designed to
“highlight” the risks of non-opioid drugs. Purdue deceptively compared the risks of high doses
of acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs, such as aspirin and
ibuprofen) with its claim that opioids have “no ceiling dose,” to falsely contend that opioids were
safer, even though high doses of opioids pose grave risk of addiction and death.
42
2011-10 Guidelines on Product Promotion: Comparative Claims Workshop, slide 12, PWG000190160.
35
101. Purdue paid for deceptive propaganda by groups designed to appear independent
from Purdue, promoting the message that NSAIDs and Tylenol have “life-threatening” side
effects, but opioids are “the gold standard of pain medications.” 43
102. Purdue funded “switch research” to “understand what triggers prescribers to
switch patients” from safer NSAIDs to more dangerous opioids. Purdue hired consultants to
study how to make doctors “more comfortable” about opioids and “more cautious” about non-
addictive drugs like ibuprofen. 44
Deception about Lower-Dose Opioids
103. Just as Purdue deceptively steered patients away from ibuprofen and Tylenol,
Purdue also deceived patients and doctors by claiming that Purdue’s high-dose, extended-release
opioids were superior to lower-dose, immediate-release opioids that had been used for decades
before the epidemic.
104. In fact, Purdue’s opioids (sometimes called ER/LA or extended release/long
acting) are extraordinarily dangerous. The CDC found, based on published research, that there is
“a higher risk for overdose among patients initiating treatment with ER/LA opioids than among
those initiating treatment with immediate-release opioids.” The CDC “did not find evidence that
continuous, time-scheduled use of ER/LA opioids is more effective or safer than intermittent use
of immediate-release opioids or that time-scheduled use of ER/LA opioids reduces risks for
opioid misuse or addiction.” 45
105. Nonetheless, Purdue deceptively claimed that its opioids provided more effective
pain relief than traditional immediate-release opioids (sometimes called IROs). Purdue sale reps
43
2009 Exit Wounds, pg. 104-106, PTN000023113-114.
44
2016-02 NSAID to ERO Switch Research Final Report, slides 3, 16, PWG000072028, -041.
45
CDC Guideline for Prescribing Opioids for Chronic Pain (2016), available at
https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.
36
admitted under oath that they told Massachusetts doctors that OxyContin provides more
consistent pain relief with fewer peaks and troughs than IROs. Purdue records show that the
sales reps repeatedly claimed that OxyContin’s “steady state is better than peak and trough w/
[IROs].” Purdue claimed that OxyContin provides a “full tank of gas,” but immediate-release
opioids require “stopping at each exit to refuel.” Purdue bolstered these misrepresentations with
marketing materials that misrepresented data to indicate that Purdue drugs provided more
consistent pain relief than more frequently dosed, lower-dose opioids.
Deception about Quality of Life
106. Purdue also steered patients away from safer alternatives with the false claim that
its opioids improve patients’ “quality of life.” Purdue’s internal documents admit that “Purdue
has no clinical studies or other substantial evidence demonstrating that a Purdue Product will
improve the quality of a person’s life.” Nevertheless, Purdue sales reps repeatedly claimed that
its opioids improve quality of life. A Purdue sales rep noted the need to follow-up with a
Massachusetts doctor to “get commitment from him that he is definitely going to improve the
quality of life for the [rheumatoid arthritis patient] he has.” Purdue also devised and funded
third-party publications to say that opioids give patients the “quality of life we deserve.” 46
Deception about Risk of Abuse
107. Purdue also steered patients away from safer alternatives with false claims that its
opioids had less risk of abuse. As more people died of addiction and overdose, Purdue created
tamper-resistant versions of its drugs to be harder to crush. The FDA found that the changes had
no effect on the most common way that the Purdue’s pills were taken and abused: by swallowing
them. “The tamper-resistant properties will have no effect on abuse by the oral route (the most
46
Treatment Options: A Guide for People Living with Pain, pg. 15, PWG000243995.
37
common mode of abuse).” 47 Despite that warning, Purdue deceptively marketed its opioids in a
manner falsely implying they stop abuse — and even prevent addiction.
108. Purdue also paid for and promoted articles which stated or implied that its tamper-
resistant drugs were safe. For example, in 2014, Purdue placed three articles in The Atlantic as
sponsored content, including one titled Take My Pain Away ... A Physician's Perspective of
Prescription Opioids and Pain Management by Dr. Gerald Aronoff. That article calls the
tamper-resistant formulations “safer alternatives” and encourages physicians to “embrace these
additional choices, rather than decide to leave opioid prescribing.” 48
109. Purdue further created an unbranded marketing initiative, Opioids with Abuse
Deterrent Properties, to encourage prescribers to switch to Purdue opioids. The initiative
included a website, ads in medical journals, medical education events touting the benefits of the
tamper-resistant drugs, and payments to doctors to promote Purdue opioids. 49
110. Purdue’s deceptive marketing convinced doctors of the falsehood that Purdue
drugs are less addictive. In a national survey, conducted by the Johns Hopkins Bloomberg
School of Public Health, almost half of doctors believed that tamper-resistant opioids were less
addictive than other opioids, when in fact they are equally addictive. 50
111. In addition to visiting Massachusetts prescribers and pharmacists more than
150,000 times, Purdue distributed in Massachusetts thousands of copies of its deceptive
publications, including Providing Relief, Preventing Abuse; the Resource Guide for People with
Pain; Exit Wounds; Opioid Prescribing: Clinical Tools and Risk Management Strategies;
47
2009-12-30 New Drug Application 22-272, OxyContin, Division Director Summary Review for Regulatory
Action, pg. 7, available at https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/022272s000MedR.pdf.
48
2014-11-14 Take my Pain Away … A Physician’s Perspective of Prescription Opioids and Pain Management,
pg. 6, PWG000214681.
49
Introducing Opioids with Abuse-Deterrent Properties (OADP), PVT0024614.
50
2015-06-23 Many Doctors Misunderstand Key Facets of Opioid Abuse, https://www.jhsph.edu/news/news-
releases/2015/survey-many-doctors-misunderstand-key-facets-of-opioid-abuse html.
38
Responsible Opioid Prescribing; and Clinical Issues in Opioid Prescribing. Purdue’s In The
Face of Pain website was viewed in Massachusetts more than 11,700 times.
VIII. PURDUE TARGETED DOCTORS WHO PRESCRIBED THE MOST DRUGS,

EVEN WHEN THEY WROTE ILLEGITIMATE PRESCRIPTIONS AND THEIR
PATIENTS DIED
112. Purdue pushed Massachusetts doctors to prescribe more and more opioids,
because high-prescribing doctors earned Purdue millions of dollars. To make sure doctors
prescribed more opioids, Purdue tracked Massachusetts doctors’ prescriptions, visited their
offices, bought them meals, and asked them to put specific patients on Purdue drugs.
113. Purdue selected doctors for target lists based on its estimates of which doctors
could be influenced to increase opioid prescriptions the most. Purdue managers told reps to visit
most often the doctors who were most likely to change their prescribing to benefit Purdue.
114. In Massachusetts, sales reps visited Purdue’s 100 top targets an average of more
than 200 times each. Those visits cost Purdue more than $40,000 for each doctor. Purdue did
not spend $40,000 per doctor so sales reps could watch doctors write prescriptions that they were
already going to write anyway. Instead, Purdue paid to lobby these doctors because Purdue
knew its reps would convince them to put more patients on opioids, at higher doses, for longer
periods. Those extra prescriptions paid back Purdue’s investment many times over.
115. Those extra prescriptions led Massachusetts patients to become addicted,
overdose, and die. Just as taking opioids increases risks to a patient, meeting with Purdue sales
reps increases the risk that a doctor will write dangerous prescriptions. Some of Purdue’s top
targets in Massachusetts lost their medical licenses because of their dangerous prescribing.
Some went to prison. Most of Purdue’s 100 top targets in Massachusetts prescribed Purdue
opioids to patients who overdosed and died.
116. That disaster is not the normal effect of practicing medicine. It is not the
39
appropriate result of treating patients in pain. It is the consequence of Purdue breaking the law.
Compared to Massachusetts doctors and nurses who prescribed Purdue opioids without lobbying
from sales reps, Purdue’s top targets wrote far more dangerous prescriptions. Purdue’s top
targets prescribed Purdue opioids to more of their patients, at higher doses, and for longer
periods of time. Compared to Massachusetts doctors and nurses who prescribed Purdue opioids
without seeing reps, Purdue’s top targets were at least ten times more likely to prescribe Purdue
opioids to patients who overdosed and died.
North Andover, MA
117. From 2008 until he lost his medical license in 2012, Purdue’s top prescriber in
Massachusetts was Dr. Walter Jacobs in North Andover. 51 He practiced alone. He often worked
only three days a week. Nevertheless, in five years, he prescribed more than 347,000 pills of
Purdue opioids.
118. Purdue knew Jacobs’s practice inside and out. Purdue sales reps visited him more
than a hundred times. Purdue pushed Jacobs to keep up a high rate of prescriptions – to keep
writing “new scripts” – and to get patients on higher doses. Purdue’s sales rep recorded his goal
to “get Dr Jacobs to write more of the intermediate strengths.” The doctor complied. He
prescribed tens of thousands of Purdue’s intermediate strength pills. He also prescribed more
than 200,000 of Purdue’s highest strength 80mg OxyContin — the pill that is the most dangerous
and the most profitable.
119. Based on its marketing research showing that opioid savings cards kept patients
on opioids longer, Purdue urged Jacobs to distribute savings cards. Purdue asked him to have his
patients travel to New Hampshire to fill prescriptions because opioid savings cards were illegal
51
Monthly prescription data by prescriber, PWG003984534.
40
in Massachusetts until 2012. 52
120. Purdue’s sales rep reported to the company that Jacobs “believes in Oxycontin”
and “continues to switch patients from other medications to Oxycontin.” A few weeks later,
Purdue gave Jacobs a contract worth more than $50,000 to give speeches to other doctors to
promote Purdue opioids. Purdue ended up paying him more than $80,000 — more than any
other doctor in Massachusetts.
121. As Purdue’s top paid consultant in Massachusetts, Jacobs exemplified Purdue’s
strategy of getting patients on higher doses and keeping them on opioids for longer periods of
time. For one patient, he prescribed OxyContin for more than two years, at a rate of sixteen
80mg pills per day. For another patient, Jacobs prescribed OxyContin for more than two years
— at a rate of twenty-four 80mg pills per day. When he lost his medical license, Jacobs
admitted that he continuously prescribed narcotics to patients, ignored the risk of substance
abuse, and kept prescribing narcotics even after his patients overdosed.
122. Purdue paid Jacobs to get more people on addictive opioids, at higher doses, for
longer periods of time. By the time Jacobs lost his license, he had prescribed enough opioids for
Purdue to collect more than $3 million. 53
52
Jacobs’ patients filled dozens of OxyContin prescriptions using savings cards at out-of-state pharmacies. Purdue
reps asked other Massachusetts doctors to do the same thing, and their patients used savings cards that were banned
in Massachusetts to buy more than 40,000 pills of OxyContin in neighboring states. PWG004285076.
53
The revenue allegations in paragraphs 122, 124, 127, 133, 134, 139, 143, and 153 are estimated based on prices
and prescription data.
41
Fitchburg and Waltham, MA
123. Another of Purdue’s high-value targets practiced in Fitchburg and Waltham. 54
Since 2008, Purdue sales reps visited him more than a hundred times. The Purdue reps
encouraged the doctor to prescribe opioids to elderly patients, by emphasizing coverage on
Medicare, and they asked him to find opioid-naive patients who could start taking opioids for the
first time. The doctor gave Purdue what it wanted: when Purdue launched its Butrans opioid, the
salesperson reported that the doctor was “looking for an opioid naive patient to start Butrans on.”
A few weeks later, the sales representative reported to Purdue that “Butrans is his new go to
product.” The next month, Purdue rewarded the doctor with a contract worth up to $48,000.
124. For years, Purdue paid the Fitchburg doctor tens of thousands of dollars to
promote its opioids. And he delivered for Purdue. Since 2008, he prescribed more than 250,000
pills of Purdue opioids — enough to give Purdue more than $1.5 million.
54
This Complaint does not identify by name the doctors in paragraphs 123-127 because they are not defendants in
this suit and are still practicing medicine. The doctors named in paragraphs 117-122, 128-153, and 310-313 no
longer hold medical licenses in Massachusetts.
42
Fall River, MA
125. In Bristol County, Purdue targeted a doctor in Fall River. Since 2008, Purdue
sales reps visited this doctor more than six hundred times. In 2015, Purdue’s rep was in his
office almost every workday:
Purdue Sales Rep Visits to One Massachusetts Doctor
AGO graphic summarizing Purdue internal sales records
126. Purdue repeatedly asked the Fall River doctor to “commit” to prescribing its
opioids, and he agreed over and over, day by day. For example, during the week of April 6-10,
2015: Purdue’s rep met the doctor at his office on Monday to discuss patients who would be
coming in that day. On Tuesday, the salesperson met with the doctor again and confirmed that
43
the doctor had put the patients on Purdue opioids. On Wednesday, Purdue’s salesperson came to
the doctor’s office again to discuss more patients. And again on Thursday. And again on Friday.
On the following Monday, the Purdue rep came back to talk with the doctor again.
127. The Fall River doctor told Purdue that he “loves the idea” of Purdue’s Butrans
opioid and was putting “more and more” patients on Purdue’s OxyContin. The next month,
Purdue gave the doctor a consulting contract worth up to $48,000 to promote Purdue opioids.
Purdue ended up paying him more than $50,000. In turn, the doctor prescribed more than
180,000 pills of Purdue opioids — enough for Purdue to collect more than $1.4 million.
Hyannis, MA
128. On Cape Cod, Purdue targeted Dr. Conrad Benoit. From 2008 until May 2016,
Purdue sales reps met with Benoit more than 90 times.
129. By 2012, Purdue knew or should have known that Benoit was engaged in
problematic prescribing practices, keeping patients on opioids for extended periods without
proper medical exams. Purdue’s rep met with the doctor and recorded: “he said that he does just
refill meds out of ease of refilling given challenge with time in exam.” At the next sales visit
two weeks later, Purdue encouraged the doctor to prescribe more refills of its opioids.
130. Purdue’s district manager went along on sales visits to coach the sales rep. In a
written evaluation, the manager praised the rep for her control over the doctor: “Very good close
and taking control of the call … [he] can get off topic, but you snapped fingers and said ‘Dr. I
need you focused.’ He smiled and paid attention. Wow.” The purpose of the in-person sales
visits was to drive the doctors to prescribe.
131. In 2015, even after Purdue’s sales rep reported “a huge concern with the issue of
narcotics in the cape,” Purdue continued to target Benoit, calling on him 27 times through 2015
44
and into 2016 and making particular note of efforts to promote Hysingla and OxyContin. In
February 2016, Purdue’s sales rep logged a “Report Of Concern” when a newspaper reported on
Benoit’s excessive opioid prescribing and police found a patient with 420 pills. Purdue kept
promoting opioids to the doctor anyway.
132. When the Board of Registration in Medicine suspended Benoit’s medical license
on May 5, 2016, Purdue was still urging him to prescribe its drugs. Purdue last attempted to
promote opioids to Benoit on May 10, 2016, five days after his suspension.
133. Since 2008, Benoit had prescribed more than 34,000 pills of Purdue opioids — so
Purdue collected more than $250,000.
Brockton, MA
134. In Plymouth County, Purdue targeted Dr. Yoon Choi. Purdue promoted its
opioids to Choi for a decade, from at least 2006 until July 2016, calling on him more than 200
times. In 2012 and 2014, Purdue salespeople reported concerns about Choi’s prescribing
behavior. Both times, Purdue advised the sales reps they could continue promoting opioids to
him. In 2017, the Massachusetts Board of Registration in Medicine suspended Choi’s license
after concluding he had committed negligence on multiple occasions, including in connection
with two patients – a mother and son – who both overdosed on opioids and died. By the time the
authorities stopped him, Choi had prescribed more than 108,000 pills of Purdue opioids —
enough to give Purdue more than $750,000.
Ludlow, MA
135. In Hampden County, Purdue targeted Dr. Fernando Jayma. Purdue promoted its
opioids to Jayma from at least 2009 until in or around November 2013. Purdue’s notes starting
in 2010 are replete with red flags. In June 2010, Jayma told a Purdue sales rep that many of his
45
patients had failed drug screens and doctor shopped. In August 2011, Jayma told Purdue that he
wrote six months’ worth of prescriptions at a time and patients just came in and picked them up.
In October 2011, Jayma told Purdue that an insurer was denying his OxyContin prescriptions.
But, from Purdue’s perspective, all was well. After a 2012 meeting with Jayma, the Purdue
representative reported: “he has written 5 new OxyContin scripts this week,” and “most are
converting over to 40mg or higher.”
136. In January 2013, a Purdue sales representative noted, to praise from her
supervisor, that Jayma was taking opioid patients that other practices were turning away. In May
2013, Purdue’s rep reported that Jayma was seeing a lot of patients from a doctor who had been
arrested for improper prescribing and had his license seized.
137. Purdue kept promoting its opioids to Jayma until a new sales rep was assigned to
his account and reported overwhelming signs of “inappropriate prescribing”:
“Upon entering office it did not appear to be the typical internal

med/general medicine practice. All patients appeared to be there for
pain management and no other health concerns … While in the
office the police had arrived because there had been 2 prescription
pads stolen by a girlfriend of a patient. She tried to fill rx at local
Stop and Shop and was turned down. [The medical assistant]
further stated that they do see out of state patients and do not take
drivers licenses and insurance card at time of check in. She stated
that Rite Aid pharmacy as a corporation will not fill any of dr.’s
Rx's. Many other local pharmacies require additional information”
138. On November 26, 2013, Purdue finally told its sales reps to stop promoting
opioids to Jayma. Within six months, Jayma’s prescriptions of Purdue opioids fell by 99%. In
the summer of 2014, when Jayma was no longer valuable to Purdue, Purdue reported him to the
DEA.
139. Jayma was convicted of illegally prescribing controlled substances, and was
sentenced to two-and-a-half years in the house of correction. But Purdue got what it wanted.
46
Since 2008, Jayma prescribed more than 68,000 pills of Purdue opioids — so Purdue took in
more than $400,000.
Stoneham, MA
140. Another of Purdue’s high-value targets was Dr. Ellen Malsky in Stoneham.
Purdue promoted its opioids to Malsky from at least 2006 until April 2011. Purdue’s records
show that red flags about her prescribing became apparent at least as early as March 2006, when
Purdue’s sales rep recorded a note that Malsky “has issues with legal use of prescribing,” and
again, in May 2007, when Malsky raised concerns about attracting too much attention to her
prescribing.
141. In December 2009, Purdue’s sales rep noted that a patient of Malsky died from an
overdose. Three months later, the Purdue representative recorded that Malsky “lost her
affiliation with BCBS - however, 75% of those patients switched to other plans in order to stay in
her practice; BCBS said she was writing too many opioids as an Internal Medicine doctor[.]”
Meanwhile, Purdue kept asking Malsky to prescribe more of its drugs.
142. On September 29, 2010, Malsky told Purdue’s sales rep she planned to close her
practice “because of pressure from the MA board to write less opioids.” Purdue continued
promoting its opioids to Malsky until the bitter end, when the sales rep showed up at her practice
to find it closed in April 2011. On April 22, 2011, Purdue finally told its sales reps to stop
promoting opioids to Malsky because she had surrendered her medical license.
143. Purdue already had its money in the bank. Since 2008, Malsky prescribed more
than 114,000 pills of Purdue opioids — enough to give Purdue hundreds of thousands of dollars.
47
Holbrook, Weymouth, Winchester and Worcester, MA
144. As a final example, Purdue targeted Dr. Fathalla Mashali, who ran pain clinics in
Holbrook, Weymouth, Winchester, Worcester, and Rhode Island. Purdue promoted its opioids
to Mashali from at least May 2009 until June 2013, calling on him more than 150 times.
145. Purdue should have been aware of red flags from the beginning. At a promotional
visit in May 2010, the Purdue rep learned that Mashali had inherited the patients from a doctor
who lost his license for improper opioid prescribing. Purdue recorded: “Dr. Mashali appears to
be a very good new target.”
146. Mashali went along with every part of Purdue’s scheme. Purdue wanted patients
to take its opioids instead of traditional lower-dose, shorter-acting “SA” drugs; Mashali told
Purdue that he would “focus on switching pts from SA meds to Butrans and OxyContin where
appropriate.” Purdue promoted OxyContin as a “first line” treatment for opioid-naïve patients;
Mashali told Purdue’s sales rep he “will Rx OxyContin first line when possible” and would
prescribe OxyContin “more than any other branded medication.” At his next sales visit, the
Purdue rep asked Mashali to continue prescribing OxyContin first line.
147. Purdue’s rep met with Mashali, “introduced” Butrans, and asked the doctor “to
start pts on Butrans today.” Mashali immediately agreed that the opioid would be “great” for
“opioid naïve patients.” Five days later, at his next sales visit, Mashali told Purdue that he had
already prescribed Butrans 10-15 times and, in the next week, prescribed Butrans 30 more times.
148. During another sales meeting, Mashali told Purdue that he was seeing 70 patients
the next day and “guaranteed” that he would put some on Purdue’s opioids. Later, Purdue’s rep
reported: “Dr. let me know he will continue to find more patients for” Purdue opioids. Later, the
rep wrote that Mashali was “seeing 40 new patients each week” and “starting new patients on
48
Butrans every day.” Purdue kept encouraging Mashali to prescribe its drugs. The manager
overseeing all Purdue reps in the Boston area visited Mashali and got him to agree to write to
Massachusetts insurance companies to ask for more generous coverage of Purdue opioids.
149. Finally, in January 2012, a sales rep sent Purdue a “Report Of Concern,” because
she heard that the DEA was investigating Mashali’s office in Rhode Island. In February, Purdue
emailed its sales reps that, “pending the outcome of any investigation of the Rhode Island
office,” they should not meet with Mashali in Rhode Island, but they could continue calling on
him in Massachusetts. Purdue’s records show that its sales reps continued to meet with Mashali
at both his Rhode Island and Massachusetts offices. A few days later, the sales rep filed a second
Report Of Concern, stating that insurance companies had cut off Mashali and he required
patients to pay him $300 in cash. Purdue still did not instruct its reps to stop promoting opioids
to him.
150. More than a year after that, in June 2013, Purdue’s sales rep noted that she visited
Mashali’s office “to follow up on the rumor I heard about him losing his license.” The doctor’s
staff gave her “a letter that is on the front door,” announcing that Mashali was taking his patients
off opioids. In an email, Purdue’s sales manager worried about the bottom line: “Dr. Mashali is
the largest prescriber of OxyContin in the District and most likely the Region.” He was cutting
back on OxyContin “because of so much scrutiny he’s under.” The sales reps were “nervous of
what it would do to their business.”
49
151. The Massachusetts-based sales rep wrote:
“on several occasions recently when calling on his office patients

are literally lined out the door. I have spoken with this staff and
some of these patients are waiting up to 4-5 hours before being
seen by Dr Mashali . In addition, approximately 3 months ago he
is no longer taking [Blue Cross Blue Shield] of MA. Dr Mashali
claims it is because BCBS of MA, I could never get a straight
answer. I suspect it could be for other reasons…. BCBS is not
comfortable with the way he is practicing and trying to get
reimbursement. Dr Mashali did state for many office visits he is
now making patients pay cash for their office visits…Based on my
observations and gut feeling including comments from other pain
physicians in the area, lately there appears to be too many red
flags with Dr Mashali.”
The Rhode Island-based sales rep replied:
“I agree…. My office has patients bringing their own ‘beach type’

folding chairs to sit on because at any given time, he can have 35
or more patients waiting only for him. All of his PA’s have quit.
He has patients scheduled at 9:30 am and he doesn’t usually come
‘sauntering’ in until noon. He has changed his practice name yet
again…3rd time in about 1 year. I even had one of his nurses tell
me last visit that she has witnessed him deleting electronic records
for certain patients…which makes her very uncomfortable. I’ve
already reported him to Purdue several times.”
152. About a month later, on July 31, 2013, Purdue finally told its reps to stop
promoting opioids to Mashali. The Rhode Island Board of Medicine revoked his license, finding
that he was “an immediate threat to the health, welfare and safety of the public.”
153. Seventeen patients who were prescribed Purdue opioids by Mashali died of opioid
overdoses. Mashali was sentenced to eight years in prison for 27 counts of health care fraud.
But Purdue profited. Since 2008, Mashali prescribed more than 367,000 pills of Purdue opioids
— so Purdue collected nearly $2 million.
50
IX. PURDUE PHARMA INC. AND PURDUE PHARMA L.P. ARE BOTH
RESPONSIBLE FOR THE DEADLY MISCONDUCT
154. Purdue Pharma Inc. and Purdue Pharma L.P. acted together to carry out all of the
misconduct alleged in this Complaint.
155. According to its official corporate documents, Purdue Pharma Inc.’s purpose is
manufacturing, sales, distribution, and research and development with respect to pharmaceutical,
toiletry, chemical and cosmetic products, directly or as the general partner of a partnership
engaged in those activities. That is the conduct at issue in this suit.
156. Purdue Pharma Inc. controlled Purdue Pharma L.P. as its general partner and is
liable for the misconduct of the partnership as a matter of law. Purdue Pharma Inc. is also the
general partner of Purdue Holdings L.P., which holds the sole limited partnership interest in
Purdue Pharma L.P.
157. Purdue Pharma L.P. employed the sales reps and paid the doctors to promote
Purdue’s drugs. That is a key element of the conduct at issue in this suit.
158. Purdue Pharma Inc. and Purdue Pharma L.P. shared the same physical offices, the
same CEO, and many of the same officers.
51
X. THE INDIVIDUAL DEFENDANTS LED PURDUE’S MISCONDUCT
159. This section of the Complaint identifies the individuals who are personally
responsible for Purdue’s illegal scheme. Massachusetts law against unfair and deceptive conduct
in commerce applies to individuals regardless of whether they are officers, directors, or
employees. Holding individuals personally liable for their misconduct does not require piercing
a corporate veil. Individuals are personally liable if: (a) they participated in the misconduct; or
(b) they knew about the misconduct and failed to stop it; or (c) they should have known about the
misconduct and they failed to stop it. 55 In this case, the individual defendants made the decisions
to break the law; they controlled the unfair and deceptive conduct; and they personally collected
many millions of dollars from the deception.
Summary Of The Individuals’ Misconduct
160. The individual defendants were the chief architects and beneficiaries of Purdue’s
deception. In summary:
161. The individual defendants controlled the misconduct described in paragraphs 1-
158 above.
162. Each individual defendant knowingly and intentionally sent sales representatives
to promote opioids to prescribers in Massachusetts thousands of times.
163. Each individual defendant knew and intended that the sales reps in Massachusetts
would unfairly and deceptively promote opioid sales that are risky for patients, including by:
55
See Thermoplastic Elastomers, Inc. v. McKenna, No. 002018B, 2002 WL 968859, at *4 (Mass. Super. Feb. 5,
2002) (“A corporate officer may be held personally liable for his “participation in unfair and deceptive practices.”),
citing Nader v. Citron, 372 Mass. 96, 103 (1977); Community Builders, Inc. v. Indian Motorcycle Associates,
Inc., 44 Mass. App. Ct. 537, 560 (1998). See also Townsends, Inc. v. Beaupre, 47 Mass. App. Ct. 747, 751 (1999)
(“A corporate officer is personally liable for a tort committed by the corporation that employs him, if he personally
participated in the tort by, for example, directing, controlling, approving, or ratifying the act that injured the
aggrieved party.”; “It is not necessary in all instances, however, to pierce the corporate veil in order to hold a
corporate officer liable for a corporation's torts.”).
52
• falsely blaming the dangers of opioids on patients instead of the addictive drugs;
• pushing opioids for elderly patients, without disclosing the higher risks;
• pushing opioids for patients who had never taken them before, without disclosing the
higher risks;
• pushing opioids as substitutes for safer medications, with improper comparative

claims;
• falsely assuring doctors and patients that reformulated OxyContin was safe;
• pushing doctors and patients to use higher doses of opioids, without disclosing the
higher risks;
• pushing doctors and patients to use opioids for longer periods of time, without
disclosing the higher risks; and
• pushing opioid prescriptions by doctors that Purdue knew were writing dangerous
prescriptions.
164. Each individual defendant knew and intended that the sales reps would not tell
Massachusetts doctors and patients the truth about Purdue’s opioids. Indeed, they knew and
intended these unfair and deceptive tactics achieved their purpose by concealing the truth.
165. Each individual defendant knew and intended that prescribers, pharmacists, and
patients in Massachusetts would rely on Purdue’s deceptive sales campaign to prescribe,
dispense, and take Purdue opioids. Securing that reliance was the purpose of the sales campaign.
166. Each individual defendant knew and intended that staff reporting to them would
pay top prescribers tens of thousands of dollars to encourage other doctors to write dangerous
prescriptions in Massachusetts.
167. Each individual defendant knew and intended that staff reporting to them would
reinforce these misleading acts through thousands of additional acts in Massachusetts, including
by sending deceptive publications to Massachusetts doctors and deceptively promoting Purdue
opioids at Boston University, Massachusetts General Hospital, the Massachusetts College of
53
Pharmacy, Northeastern University, and the Sackler School at Tufts University.
168. Each individual defendant knowingly and intentionally took money from
Purdue’s deceptive business in Massachusetts.
169. Each individual defendant knowingly and intentionally sought to conceal his or
her misconduct.
A. Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt,

Jonathan Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler
170. Eight people in a single family made the choices that caused much of the opioid
epidemic. The Sackler family owns Purdue, and they always held a majority of the seats on its
Board. Because they controlled their own privately held drug company, the Sacklers had the
power to decide how addictive narcotics were sold. They hired hundreds of workers to carry out
their wishes, and they fired those who didn’t sell enough drugs. They got more patients on
opioids, at higher doses, for longer, than ever before. They paid themselves billions of dollars.
They are responsible for addiction, overdose, and death that damaged millions of lives. They
should be held accountable now.
The Sacklers’ Misconduct Leading To The 2007 Judgment
171. The misconduct of Richard, Beverly, Ilene, Jonathan, Kathe, Mortimer, and
Theresa Sackler was particularly unfair, deceptive, unreasonable, and unlawful because they
already had been given a second chance. From the 1990s until 2007, they directed a decade of
misconduct, which led to criminal convictions, a judgment of this Court, and commitments that
Purdue would not deceive doctors and patients again. That background confirms that their
misconduct since 2007 was knowing and intentional.
172. The Sackler family’s first drug company was the Purdue Frederick Company,
which they bought in 1952. In 1990, they created Purdue Pharma Inc. and Purdue Pharma L.P.
54
Richard, Beverly, Ilene, Jonathan, Kathe, Mortimer, and Theresa Sackler took seats on the
Board. 56 For events before July 2012, this Complaint uses “the Sacklers” to refer to them.
David Sackler joined the Board in July 2012. 57 From that time forward, “the Sacklers” includes
him as well.
173. The Sacklers always insisted that their family control Purdue. From 1990 until
today, their family always held the majority of seats on the Board. In 1994, Jonathan Sackler
issued a memorandum to Purdue staff requiring that the Sacklers should receive “all Quarterly
Reports and any other reports directed to the Board.” 58
174. Purdue launched OxyContin in 1996. It became one of the deadliest drugs of all
time. 59 The FDA scientist who evaluated OxyContin wrote in his original review: “Care should
be taken to limit competitive promotion.” 60 The Sacklers did not agree. From the beginning, the
Sacklers viewed limits on opioids as an obstacle to greater profits. To make more money, the
Sacklers considered whether they could sell OxyContin in some countries as an uncontrolled
drug. Staff reported to Richard Sackler that selling OxyContin as “non-narcotic,” without the
safeguards that protect patients from addictive drugs, would provide “a vast increase of the
market potential.” 61 The inventor of OxyContin, Robert Kaiko, wrote to Richard to oppose this
dangerous idea. Kaiko wrote that he was “very concerned” about the danger of selling
56
Purdue Pharma Inc.’s 1991 filings with the Secretary of State of Connecticut state that it was incorporated in New
York on October 2, 1990. Richard, Ilene, Jonathan, and Kathe Sackler are all listed as directors on the earliest
(1991) report. Beverly, Mortimer, and Theresa all appear on the 1995 report.
57
David Sackler affidavit.
58
1994-04-28 memo from Jonathan Sackler, PDD1701827936.
59
See, e.g., 2016-03-15 telebriefing by CDC Director Tom Frieden (“We know of no other medication that’s
routinely used for a nonfatal condition that kills patients so frequently … those who got the highest doses of opioids,
more than 200 MMEs per day had a 1 in 32 chance of dying in just 21/2 years … almost all the opioids on the
market are just as addictive as heroin.), available at https://www.cdc.gov/media/releases/2016/t0315-prescribing-
opioids-guidelines html.
60
1995-10 Overall Conclusion to 1995 FDA review, Curtis Wright, #785793.1.
61
1997-02-27 email from Walter Wimmer, PDD1701346000.
55
OxyContin without strict controls. Kaiko warned: “I don’t believe we have a sufficiently strong
case to argue that OxyContin has minimal or no abuse liability.” To the contrary, Kaiko wrote,
“oxycodone containing products are still among the most abused opioids in the U.S.” Kaiko
predicted: “If OxyContin is uncontrolled, … it is highly likely that it will eventually be
abused.” 62 Richard responded: “How substantially would it improve your sales?” 63
175. At the OxyContin launch party, Richard Sackler spoke as the Senior Vice
President responsible for sales. He asked the audience to imagine a series of natural disasters: an
earthquake, a volcanic eruption, a hurricane, and a blizzard. He said: “the launch of OxyContin
Tablets will be followed by a blizzard of prescriptions that will bury the competition. The
prescription blizzard will be so deep, dense, and white….” 64 Over the next twenty years, the
Sacklers made Richard’s boast come true. They created a manmade disaster. Their blizzard of
dangerous prescriptions buried children and parents and grandparents across Massachusetts, and
the burials continue.
176. From the beginning, the Sacklers were behind Purdue’s decision to deceive
doctors and patients. In 1997, Richard Sackler, Kathe Sackler, and other Purdue executives
determined — and recorded in secret internal correspondence — that doctors had the crucial
misconception that OxyContin was weaker than morphine, which led them to prescribe
OxyContin much more often, even as a substitute for Tylenol. 65 In fact, OxyContin is more
62
1997-02-27 email from Robert Kaiko, PDD1701345999.
63
1997-03-02 email from Richard Sackler, PDD1701345999.
64
PKY180280951.
65
1997-06-12 email from Richard Sackler, PDD8801141848 (Staff reported: “Since oxycodone is perceived as
being a ‘weaker’ opioid than morphine, it has resulted in OxyContin being used much earlier for non-cancer pain.
Physicians are positioning this product where Percocet, hydrocodone, and Tylenol with Codeine have been
traditionally used. Since the non-cancer pain market is much greater than the cancer pain market, it is important that
we allow this product to be positioned where it currently is in the physician’s mind.” Richard Sackler replied: “I
think you have this issue well in hand. If there are developments, please let me know.”); 1997-05-28 email from
Richard Sackler PDD1508224773; 1997-04-23 email from Richard Sackler, PDD1701801141.
56
potent than morphine. Richard directed Purdue staff not to tell doctors the truth, because the
truth could reduce OxyContin sales. 66
177. From the start, the Sacklers were also the driving force behind Purdue’s strategy
to push opioids .” In 1998, Richard
Sackler
. 67
178. Most of all, the Sacklers cared about money. Millions of dollars were not enough.
They wanted billions. They cared more about money than about patients, or their employees, or
the truth. In 1999, when employee Michael Friedman reported to Richard Sackler that Purdue
was making more than $20,000,000 per week, Richard replied immediately, at midnight, that the
sales were “not so great.” “After all, if we are to do 900M this year, we should be running at
75M/month. So it looks like this month could be 80 or 90M. Blah, humbug. Yawn. Where was
I?” 68
179. In 1999, Richard Sackler became the CEO of Purdue. 69 Jonathan, Kathe, and
Mortimer were Vice Presidents. 70 The company hired hundreds of sales representatives and
taught them false claims to use to sell drugs. 71 Purdue managers tested the sales reps on the most
important false statements during training at company headquarters. On the crucial issue of
addiction, which would damage so many lives, Purdue trained its sales reps to deceive doctors
that the risk of addiction was “less than one percent.” 72 Purdue mailed thousands of doctors
66
1997-06-12 email from Richard Sackler, PDD8801141848; 1997-05-28 email from Richard Sackler
PDD1508224773; 1997-04-23 email from Richard Sackler, PDD1701801141.
67
68
1999-06-17 email from Michael Friedman, #228728.1.
69
[intentionally left blank]
70
2000-03-26, Peter Healy, Opening the Medicine Chest: Purdue Pharma prepares to raise its profile, #24865.1.
71
2003-12-23 GAO Report, pg. 19, PKY183266843 (increase from 771 reps in 1999 to 1,066 in 2001).
72
Barry Meier, Pain Killer (1 ed. 2003) at 99.
57
promotional videos with that same false claim:
“There’s no question that our best, strongest pain medicines are the
opioids. But these are the same drugs that have a reputation for
causing addiction and other terrible things. Now, in fact, the rate
of addiction amongst pain patients who are treated by doctors is
much less than one percent. They don’t wear out, they go on
working, they do not have serious medical side effects.” 73
A sales representative told a reporter: “We were directed to lie. Why mince words about it?
Greed took hold and overruled everything. They saw that potential for billions of dollars and
just went after it.” 74
180. In 2000, the Sacklers were warned that a reporter was “sniffing about the
OxyContin abuse story.” 75 The Sackler family put the threat on the agenda for the next Board
meeting and began covering their tracks. They planned a response that “deflects attention away
from the company owners.” 76
181. In January 2001, Richard Sackler received a plea for help from a Purdue sales
representative. The sales rep described a community meeting at a local high school, organized
by mothers whose children overdosed on OxyContin and died. “Statements were made that
OxyContin sales were at the expense of dead children and the only difference between heroin
and OxyContin is that you can get OxyContin from a doctor.” 77
182. The next month, a federal prosecutor reported 59 deaths from OxyContin in a
single state. 78 The Sacklers knew that the reports underestimated the destruction. Richard
73
“I Got My Life Back” video, transcript, PDD9521403504.
74
2017-10-16, Christopher Glazek, “The Secretive Family Making Billions From The Opioid Crisis,” Esquire
Magazine (quoting Purdue sales representative Shelby Sherman).
75
2000-11-30 email from Michael Friedman, PDD1706196247.
76
2000-12-01 email from Mortimer D. Sackler, PDD1706196246. Defendant Mortimer Sackler’s father, the late
Mortimer D. Sackler, was also involved in Purdue Pharma during his lifetime.
77
2001-01-26 email from Joseph Coggins, #171855.1.
78
2001-02-08 email from Mortimer Sacker, PDD8801151727.
58
Sackler wrote to Purdue executives: “This is not too bad. It could have been far worse.” 79 The
next week, on February 14, a mother wrote a letter to Purdue: 80
“My son was only 28 years old when he died from Oxycontin on
New Year’s Day. We all miss him very much, his wife especially
on Valentines’ Day. Why would a company make a product that
strong (80 and 160 mg) when they know they will kill young
people? My son had a bad back and could have taken Motrin but
his Dr. started him on Vicodin, then Oxycontin then Oxycontin
SR. Now he is dead!”
A Purdue staff member noted: “I see a liability issue here. Any suggestions?” 81
183. That same month, Richard Sackler wrote down his solution to the overwhelming
evidence of overdose and death: blame and stigmatize people who become addicted to opioids.
Sackler wrote in a confidential email: “we have to hammer on the abusers in every way possible.
They are the culprits and the problem. They are reckless criminals.” 82 Richard followed that
strategy for the rest of his career: collect millions from selling addictive drugs, and blame the
terrible consequences on the people who became addicted. By their misconduct, the Sacklers
have hammered Massachusetts families in every way possible. And the stigma they used as a
weapon made the crisis worse.
184. Not long after the mother’s February 14 letter, the Sacklers achieved a long-
sought goal: the front page of the New York Times reported that “OxyContin’s sales have hit $1
billion, more than even Viagra’s.” The same article noted that “OxyContin has been a factor in
the deaths of at least 120 people, and medical examiners are still counting.” 83
185. When Time magazine published an article about OxyContin deaths in New
England, Purdue employees told Richard Sackler they were concerned. Richard responded with
79
80
2001-02-14 email to Robin Hogen, #3072810.1.
81
2001-02-14 email from James Heins, #3072810.1.
82
83
2001-03-05 article in New York Times, PDD9316101737.
59
a message to his staff. He wrote that Time’s coverage of people who lost their lives to
OxyContin was not “balanced,” and the deaths were the fault of “the drug addicts,” instead of
Purdue. “We intend to stay the course and speak out for people in pain – who far outnumber the
drug addicts abusing our product.” 84
186. That spring, Purdue executives met with the U.S. Drug Enforcement Agency
(“DEA”). A senior DEA official sat across from Richard Sackler. Before the meeting ended,
she leaned over the table and told Richard: “People are dying. Do you understand that?” 85
187. As Purdue kept pushing opioids and people kept dying, the company was
engulfed in a wave of investigations by state attorneys general, the DEA, and the U.S.
Department of Justice. In 2003, Richard Sackler left his position as President of Purdue. After a
few more years of investigation, Jonathan, Kathe, and Mortimer Sackler resigned from their
positions as Vice Presidents. 86 But those moves were for show. The Sacklers kept control of
the company. Their family owned Purdue. They controlled the Board. They paid themselves
the profits. And, as alleged in detail below, they continued to direct Purdue’s deceptive
marketing campaign.
188. By 2006, prosecutors found damning evidence that Purdue intentionally deceived
doctors and patients about its opioids. The Sacklers
. The Sacklers also
84
2001-01-08 letter from Richard Sackler, PDD1501720041.
85
2001 meeting described in Pain Killer: A “Wonder” Drug’s Trail of Addiction and Death by Barry Meier, pg. 158
(2003). The DEA official was Laura Nagel, head of the DEA Office of Diversion Control.
86
2018-09-05 declaration of Jonathan Sackler; 2018-09-08 declaration of Kathe Sackler; 2018-09-06 declaration of
Mortimer Sackler.
60
. 87
189. In May 2007, the Sacklers
. The Purdue Frederick Company confessed to a felony and effectively went out of
business. 88 The Sacklers continued their opioid business in two other companies: Purdue
Pharma Inc. and Purdue Pharma L.P.
190. The Sacklers voted to admit in an Agreed Statement Of Facts that, for more than
six years, supervisors and employees intentionally deceived doctors about OxyContin:
“Beginning on or about December 12, 1995, and continuing until on or about June 30, 2000,
certain Purdue supervisors and employees, with the intent to defraud or mislead, marketed and
promoted OxyContin as less addictive, less subject to abuse and diversion, and less likely to
cause tolerance and withdrawal than other pain medications.” 89
191. To remove any doubt, the Sacklers voted to enter into a plea agreement that
stated: “Purdue is pleading guilty as described above because Purdue is in fact guilty.” 90 Those
intentional violations of the law happened while Richard Sackler was CEO; Jonathan, Kathe, and
Mortimer were Vice Presidents; and Richard, Jonathan, Kathe, Mortimer, Ilene, Beverly, and
Theresa Sackler were all on the Board.
192. The Sacklers also voted for Purdue to enter a Corporate Integrity Agreement with
the U.S. government. The agreement required the Sacklers to ensure that Purdue did not deceive
87
2006-10-25 Board minutes, PKY183307486; 2006-10-25 agreement, PPLP004031281.
88
2007-05-03 Board minutes, PKY183307494.
89
2007-05-09 Agreed Statement of Facts, paragraph 20, available at
https://www.documentcloud.org/documents/279028-purdue-guilty-plea.
90
2007-05-09 Plea Agreement.
61
doctors and patients again. The Sacklers promised to comply with rules that prohibit deception
about Purdue opioids. They were required to complete hours of training to ensure that they
understood the rules. They were required to report any deception. Richard, Beverly, Ilene,
Jonathan, Kathe, Mortimer, and Theresa Sackler each certified in writing to the government that
he or she had read and understood the rules and would obey them. 91
193. Finally, the Sacklers voted to enter into a Consent Judgment in this Court (“2007
Judgment”). The 2007 Judgment ordered that Purdue “shall not make any written or oral claim
that is false, misleading, or deceptive” in the promotion or marketing of OxyContin. The
judgment further required that Purdue provide fair balance regarding risks and benefits in all
promotion of OxyContin. That judgment required fair balance about the risks of taking higher
doses for longer periods and the risks of addiction, overdose, and death. 92
194. The 2007 Judgment further required that Purdue establish and follow an abuse
and diversion detection program to identify high-prescribing doctors who show signs of
inappropriate prescribing, stop promoting drugs to them, and report them to the authorities:
“Upon identification of potential abuse or diversion,” Purdue must

conduct an inquiry and take appropriate action, “which may
include ceasing to promote Purdue products to the particular
Health Care Professional, providing further education to the Health
Care Professional about appropriate use of opioids, or providing
notice of such potential abuse or diversion to appropriate medical,
regulatory or law enforcement authorities.” 93
195. The 2007 Judgment and related agreements should have ended the Sacklers’
misconduct for good. Instead, the Sacklers decided to break the law again and again, expanding
91
2007-05-09 Plea Agreement; 2007-05-04 Associate General Counsel’s Certificate, PDD1712900054.
92
2007-05-15 Consent Judgment, Commonwealth v. Purdue Pharma L.P. et al., No. 07-1967(B), Mass. Super. Ct.
93
2007-05-15 Consent Judgment, Commonwealth v. Purdue Pharma L.P. et al., No. 07-1967(B), Mass. Super. Ct.
62
their deceptive sales campaign to make more money from more patients on more dangerous
doses of opioids.
The Sacklers’ Misconduct From The 2007 Judgment Until Today
196. From the 2007 Judgment to 2018, the Sackler controlled Purdue’s deceptive sales
campaign. They directed the company to hire hundreds more sales reps to visit doctors
thousands more times. They insisted that sales reps repeatedly visit the most prolific prescribers.
They directed reps to encourage doctors to prescribe more of the highest doses of opioids. They
studied unlawful tactics to keep patients on opioids longer and then ordered staff to use them.
They asked for detailed reports about doctors suspected of misconduct, how much money Purdue
made from them, and how few of them Purdue had reported to the authorities. They sometimes
demanded more detail than anyone else in the entire company, so staff had to create special
reports just for them. Richard Sackler even went into the field to promote opioids to doctors and
supervise reps face to face.
197. The Sacklers’ micromanagement was so intrusive that staff begged for relief. The
VP of Sales and Marketing wrote to the CEO:
“Anything you can do to reduce the direct contact of Richard into

the organization is appreciated.” 94
198. The Sacklers’ directions shot through the company with dangerous force. When
the Sacklers berated sales managers, the managers turned around and fired straight at reps in the
field. When Richard Sackler wrote to managers, “This is bad,” 95 to criticize the sales of
Purdue’s Butrans opioid, the managers in turn drafted a warning for employees:
94
2012-02-07 email from Russell Gasdia, PPLPC012000368569.
95
2012-02-07 email from Richard Sackler, PPLPC012000368430.
63
“Just today, Dr. Richard sent another email, ‘This is bad,’ referring
to current Butrans trends. I am quite sure that Dr. Richard would
not be sympathetic to the plight of the Boston District.” 96
The manager then threatened to fire every sales rep in the Boston district:
“I am much closer to dismissing the entire district than agreeing

that they deserve a pass for poor market conditions.” 97
199. The Sacklers took special interest in promoting Purdue’s opioids in
Massachusetts. The Sacklers decided to spend millions of dollars to establish the Massachusetts
General Hospital Purdue Pharma Pain Program. Similarly, the Sacklers and Purdue pursued an
intense relationship with Tufts University, which named its School of Biomedical Sciences as the
Sackler School of Graduate Biomedical Sciences, and created an entire degree program, the
Master of Science in Pain Research, Education, and Policy, funded by Purdue. The Tufts
program is also home of an annual Sackler Lecture, which Purdue sales managers arranged for
Purdue sales reps to attend. 98 The Sacklers also tracked Purdue initiatives to promote opioids at
Boston University, Northeastern University, and the Massachusetts College of Pharmacy.
200. The Sacklers cared most of all about money. From 2007 to 2018,
. .
201. As detailed below, the Sacklers’ misconduct continued from the 2007 convictions
through 2018.
96
2012-02-07 email from Windell Fisher, PPLPC012000368500.
97
98
2007-03-30 emails from Russell Gasdia and Windell Fisher, PPLPC012000137174; PPLPC012000137178.
64
   2007   
202. In July 2007, staff told the Sacklers that more than 5,000 cases of adverse events
had been reported to Purdue in just the first three months of 2007. Staff also told the Sacklers
that Purdue received 572 Reports of Concern about abuse and diversion of Purdue opioids during
Q2 2007 — including several reports in Massachusetts. Staff reported to the Sacklers that they
completed only 21 field inquiries in response. Staff also told the Sacklers that they received
more than 100 calls to Purdue’s compliance hotline during the quarter, which was a “significant
increase,” but Purdue did not report any of the hotline calls or Reports of Concern to the FDA,
DEA, Department of Justice, or state authorities. 99
203. Purdue’s self-interested failure to report abuse and diversion would continue,
quarter after quarter, even though the 2007 Judgment required Purdue to report “potential abuse
or diversion to appropriate medical, regulatory or law enforcement authorities.” Instead of
reporting dangerous prescribers, or even directing sales reps to stop visiting them, the Sacklers
chose to keep pushing opioids to whoever prescribed the most. 100
204. Staff also reported to the Sacklers that they continued to mail out thousands of
deceptive marketing materials, including 12,528 publications in the first half of 2007. The single
most-distributed material was volume #1 of Purdue’s “Focused and Customized Education Topic
Selections in Pain Management” (FACETS). 101 In FACETS, Purdue falsely instructed doctors
and patients that physical dependence on opioids is not dangerous and instead improves patients’
“quality of life” — . In the same
material, Purdue also falsely told doctors and patients that signs of addiction are actually
99
2007-07-15 Board report, pgs. 33, 41, 54, PWG000300817, -825, -838.
100
For example, the Massachusetts prescribers described in paragraphs 112–153.
101
65
“pseudoaddiction,” and that doctors should respond by prescribing more opioids. 102 Staff told
the Sacklers that another of the publications they had sent most often to doctors was
“Complexities in Caring for People in Pain.” 103 In it, Purdue repeated again its false claim that
warning signs of addiction are really “pseudoaddiction” that should be treated with more
opioids. 104
205. Purdue sent both of those misleading publications to doctors in Massachusetts. 105
206. At the same time, staff also reported to the Sacklers that Purdue was making more
money than expected. A few months earlier, they had projected a profit of $407,000,000; now
they expected more than $600,000,000. 106
207. Staff reported to the Sacklers that “sales effort” was a key reason that profits were
high. 107 Staff told the Sacklers that Purdue employed 301 sales reps to promote opioids and that
sales reps were the largest group of Purdue employees by far. In comparison, Purdue employed
only 34 people in drug discovery. 108
102
2007-08 FACETS Vol. 1, pgs. 51-53, PTN000004691-693.
103
104
2007 Complexities of Caring for People in Pain, pg. 2, PTN000016806.
105
2010-08-26 Medical Education Materials for HCPs, PWG000247083, PWG000247084.
106
107
108
66
208. From the 2007 convictions until today, the Sacklers
. 109
700
600
500
Number of sales reps
400
300
200
100
AGO graphic based on Purdue documents
109
2007-07-15 Board report, pg. 52, PWG000300836; 2007-10-15 Board report, pg. 58, PPLPC012000157459;
2008-01-15 Board report, pg. 22, PDD8901733995; 2008-10-15 Board report, pg. 26, PDD9316101027; 2009-04-16
Board report, pg. 28, PDD9316100624; 2009-07-30 Board report, pg. 19, PPLPC012000233249; 2009-10-22 Board
67
209. The impact of Purdue’s sales reps in Massachusetts was direct and profound.
From the 2007 felony conviction until 2018, Purdue sales reps visited Massachusetts prescribers
and pharmacists more than 150,000 times. 111
210. In August, Mr. Udell was still serving as Purdue’s top lawyer, even after his
criminal conviction. He wrote to Richard, Ilene, Jonathan, Kathe, Mortimer, and Theresa
Sackler: “Over the last week there have been numerous news stories across the nation reporting
on the Associated Press’s analysis of DEA data showing very large increases in the use of
opioids analgesics (particularly OxyContin) between the years 1997 and 2005. Many of these
articles have suggested that this increase is a negative development suggesting overpromotion
and increasing abuse and diversion of these products.” 112
211. In October, staff told the Sacklers that Purdue received 284 Reports of Concern
about abuse and diversion of Purdue’s opioids in Q3 2007, and they conducted only 46 field
inquiries in response. Staff reported to the Sacklers that they received 39 tips to Purdue’s
compliance hotline during the quarter, but Purdue did not report any of them to the authorities. 113
212. Several of the troubling reports came from Massachusetts. The Reports of
report, pg. 21, PDD9316101599; 2010-02-01 Board report, pg. 4, PPLPC012000252778; 2010-04-21 Board report,
pg. 20, PWG000423159; 2010-07-27 Board report, pg. 27, PWG000422503; 2010-10-25 Board report, pg. 26,
PWG000421990; 2011-01-24 Board report, pg. 35, PWG000421582; 2011-05-02 Board report, pg. 36,
PPLPC012000322461; 2011-08-03 Board report, pg. 42, PWG000420354; 2011-11-09 Board report, pg. 41,
PWG000419343; 2012-01-25 Board report, pg. 48, PPLPC012000362291; 2012-04-30 Board report, pg. 33,
PPLPC012000374823; 2012-07-23 Board report, pg. 44, PPLPC012000387112; 2012-11-01 Board report, pg. 54,
PWG000414940; 2013-01-28 Board report, pg. 56, PPLPC012000407182; 2013-05-13 Board report, pg. 62,
PPLP004367601; 2013-07-23 Board report, pg. 59, PPLPC012000433446; 2013-11-01 Board report, pg. 55,
PPLPC002000186965; 2014-02-04 Board report, pg. 47, PPLPC002000181081; 2015-04-30 Sales & Promotion
strategic plan, slide 9, PPLPC031001334002; 2015-10-15 commercial budget review, slide 28,
PPLPC031001379856; 2016-05-11 10 year plan Sales and Promotions expenses, slide 3, PPLPC031001437901;
2016-10-11 commercial budget proposal, slide 12, PPLPC011000123475; 2017-06-22 executive committee pre-
read, slide 28, PPLPC011000153311 ; 2017-03-23 executive committee pre-read, slide 26, PPLPC011000139412;
2017-06-22 executive committee pre-read, slide 28, PPLPC011000153311; 2017-11 Board budget, slide 51,
PPLPC016000323215; 2017-11 Board budget, slide 51, PPLPC016000323215; 2018-02-07 email from Craig
Landau, PPLPC016000325614.
111
Exhibit 1
112
2007-08-30 email from Howard Udell, PPLPC012000153272.
113
2007-10-15 Board report, pgs. 36, 60, PPLPC012000157437, -461.
68
Concern included a doctor targeted by Purdue in Needham, Massachusetts. Purdue sales reps
visited him to promote opioids 19 times, until the police arrived with a warrant and his license
was suspended for improper prescribing of pain medications. Eight of his patients died. 114
213. Staff told the Sacklers that Purdue had hired more sales reps and now employed
304. They also reported to the Sacklers that Purdue was succeeding at promoting its highest
doses of opioids: “OxyContin 80mg is at Rx levels not seen in over 2 years.” 115
214. In preparation for an upcoming Board meeting, Richard Sackler instructed staff to
give him the spreadsheets underlying their sales analysis, so that he could do his own
calculations. 116 The spreadsheets showed that, in 2007, Purdue expected to collect more than
half its total revenue from sales of 80mg OxyContin — its most powerful, most profitable, and
most dangerous pill. 117
215. In November, the Sacklers
The Sacklers
. 118 Every time the Sacklers
114
2007-06-21 Purdue News Summary, PMA000283587; Exhibit 1.
115
116
117
2007-10-28 attachment to email from Edward Mahony, PPLPC012000159170.
118
2007-11-01 Board minutes, PKY183212603-06; 2008 budget submission, pg. 20, PDD9273201033.
69
   2008   
216. In January 2008, staff told the Sacklers that Purdue still employed 304 sales reps
and they were succeeding at the goal of promoting higher doses of opioids: “OxyContin 80mg
continues to grow.” Staff told the Sacklers that, in 2007, Purdue’s net sales were just over $1
billion, almost “DOUBLE” what the company had planned. OxyContin was more than 90% of
those sales. 119
217. Staff also told the Sacklers that Purdue received 689 Reports of Concern about
abuse and diversion of Purdue’s opioids in Q4 2007, and they conducted only 21 field inquiries
in response. Staff also reported to the Sacklers that they received 83 tips to Purdue’s compliance
hotline during the quarter, but Purdue did not report any of them to the authorities. 120
218. Staff also told the Sacklers that they promoted Purdue opioids at the
Massachusetts General Hospital Purdue Pharma Pain Program in Boston on November 1 and at
a Tufts University course on opioid laws and policies in Boston on October 31. 121
219. The Sacklers wanted more details on tactics for pushing sales. Richard Sackler
wrote to Russell Gasdia, Vice President of Sales and Marketing (hereinafter “Sales VP”),
demanding information about Purdue’s opioid savings cards. Richard asked Gasdia how long
the opioid savings cards lasted, how much savings they offered a patient, and whether there had
been any changes since he had last been briefed on the opioid savings card scheme. Richard sent
Gasdia a detailed hypothetical scenario to make sure he understood the sales tactic down to the
119
2008-01-15 Board report, pgs. 4, 22, 24, PDD8901733977, -995, -997.
120
2008-01-15 Board report, pg. 16, 24, PDD8901733989, -997.
121
2008-01-15 Board report, pg. 16, PDD8901733989.
70
smallest details. 122 Staff followed up with a presentation about opioid savings cards to the
Sacklers at the next Board meeting. 123
220. Meanwhile, when staff proposed a plan to get pharmacies to increase their
inventory of OxyContin from 2 bottles to 3 bottles, Richard Sackler demanded to know why they
couldn’t get up to 4 bottles or more. 124
221. The Sacklers didn’t only sweat the small stuff.
. At Purdue, hiring more sales reps was not a
matter for middle management. Selling opioids door-to-door, in visits to doctor’s offices and
hospitals, was the core business of the company. The Sacklers themselves made the decisions
122
2008-01-30 emails from Richard Sackler, PPLPC012000168321-322.
123
2008-02-09 email from John Stewart, PPLPC012000170262 (opioid savings cards “were singled-out for
presentation since they are an extraordinary item in the budget and there is good data showing a positive impact on
OxyContin utilization”).
124
71
222. In February, the Sacklers
.” 125
223. The Sacklers knew and intended that, because of their orders, more sales reps
would promote opioids to prescribers in Massachusetts. In preparation for the Sacklers’ vote,
staff told them that adding 100 sales reps would allow Purdue to make 12,000 more sales visits
to prescribers every month. 126
125
1998-04-27 Board minutes, #618527.1; 2007-04-26 Board minutes, PPLP004415274.

126
2007-10-26 Sales & Marketing presentation, PPLPC012000159022.
72
224. From 2008 to the present, sales reps hired in the 2008 expansion promoted Purdue
opioids to Massachusetts prescribers more than 13,000 times, including in:
Athol, Dudley, Mashpee, Rehoboth, Teaticket,

Auburn, Easton, Middleborough, Rutland, Uxbridge,
Barre, Edgartown, Millbury, Sagamore Beach, Vineyard Haven,
Bourne, Fairhaven, Nantucket, Sandwich, Ware,
Brewster, Fall River, New Bedford, Seekonk, Wareham,
Bridgewater, Falmouth, North Dighton, Shrewsbury, Webster,
Brimfield, Gardner, Northborough, Somerset, West Boylston,
Brockton, Harwich, Norton, South Dennis, Westborough,
Brookfield, Holden, Oak Bluffs, Southbridge, Westport,
Centerville, Hyannis, Orange, Spencer, Whitinsville,
Charlton, Lakeville, Orleans, Sterling, Whitman,
Chatham, Lancaster, Osterville, Sturbridge, Winchendon,
Clinton, Leicester, Oxford, Sutton, Worcester, and
Cotuit, Mansfield, Palmer, Swansea, Yarmouth Port.
Dartmouth, Marlborough, Raynham, Taunton,
Massachusetts Communities Targeted in

Purdue’s 2008 Sales Force Expansion
73
225. Purdue managers determined that two sales reps hired in the 2008 expansion
generated so many additional opioid prescriptions in Massachusetts that they were among
Purdue’s top performers. The company rewarded them with bonuses and all-expense-paid trips
to tropical islands and used them as examples to motivate other reps to sell more opioids. 127
226. The Sacklers also knew and intended that the sales reps would push higher doses
of Purdue’s opioids. That same month, Richard Sackler
.” 128
. The Sacklers knew higher doses
put patients at higher risk. As far back as the 1990s, Jonathan and Kathe Sackler
.” 129
227. On Valentine’s Day, the Sacklers
. 130
228. By 2008, Purdue was working on a crush-proof reformulation of OxyContin to
extend Purdue’s patent monopoly. 131 The Sacklers learned that another company was planning
clinical research to test whether crush-proof opioids are safer for patients. 132 Mortimer Sackler
suggested that Purdue conduct similar studies to find out whether reformulated OxyContin was
really safer before selling it to millions of patients. He wrote to Richard Sackler: “Purdue should
be leading the charge on this type of research and should be generating the research to support
127
2018-02-18 deposition of Catherine Yates Sypek pg. 120; 2018-03-01 deposition of Timothy Quinn pg. 99.
128
2008-02-13 email from Richard Sackler, PPLPC012000170948-949.
129
1997-03-12 memo from John Stewart, PDD1701785443.
130
131
2007-10-26 Sales & Marketing presentation, pg. 2, PPLPC012000159022.
132
2008-02-07 email from Robert Kaiko, PPLPC013000244844.
74
our formulation. Why are we playing catch up …? Shouldn’t we have studies like this …?” 133
The Sacklers decided not to do the research because they wanted the profits from a new product,
regardless of whether the deaths continued. Richard didn’t want a paper trail, so he instructed
Mortimer to call him, and CEO John Stewart met with his staff to plan how to phrase a carefully
worded reply. 134 Later that month, Stewart wrote to Richard that reformulating OxyContin “will
not stop patients from the simple act of taking too many pills.” 135
229. Meanwhile, staff gave Jonathan, Kathe, Mortimer and Richard Sackler projections
indicating that OxyContin sales could plateau. 136 Mortimer demanded answers to a series of
questions about why sales would not grow. 137 Richard chimed in at 8:30 p.m. to instruct the staff
to find answers “before tomorrow.” 138 Staff emailed among themselves about how the Sacklers’
demands were unrealistic and harmful and then decided it was safer to discuss the problem by
phone. 139
133
2008-02-12 email from Mortimer Sackler, PPLPC013000244843-844.
134
2008-02-12 email from Richard Sackler, PPLPC013000244843 (“My sentiments exactly the first time I read it.
But you should read it again. If you do and ask yourself what it means, I think you may come to a very different
conclusion, as I now have … We should talk about it. Give me a call at home.”); 2008-02-13 email from John
Stewart, PPLPC013000244843.
135
2008-02-22 email from John Stewart, PPLPC012000172201. Five years later, Purdue published two studies
about the crush-proof formulation. Neither concluded the crush-proof tablets lowered the risks of addiction,
overdose and death associated with OxyContin use. One was a single-session research study conducted by three
full-time Purdue employees and a paid Purdue consultant to assess “the attractiveness” of the crush-proof tablets to
recreational drug users. Thirty recreational opioid users were interviewed by two researchers. “This study did not
include safety, pharmacokinetic, or efficacy evaluations, and no drugs were administered.” Participants’ answers to
“open-ended questions” indicated that the crush-proof tablets “might be less attractive to recreational opioid
abusers” than original OxyContin. The study concluded that “among the available opioid products that we included
in this study, recreational opioid users judged [crush-proof OxyContin tablets] to be the least attractive, the least
valuable and the least desirable, with the least likelihood for tampering and the lowest street value.”
PTN000002031-2034. In the second study, by the same Purdue authors, 29 volunteers snorted OxyContin (original
and crush-proof), oxycodone, and a placebo over a seven-day treatment phase and rated the drugs. The study
concluded that “reformulated OxyContin has a reduced abuse potential compared to the original formulation upon
intranasal administration.” PTN000002031, -2044. Purdue amended its OxyContin label to reference these studies
in 2013.
136
2008-02-26 email from Edward Mahony, PPLPC012000172585; attachment PPLPC012000172587.
137
2008-02-26 email from Mortimer Sackler, PPLPC12000172674.
138
139
2008-02-26 email from John Stewart, PPLPC012000172677.
75
230. In March, Richard Sackler dug into Purdue’s strategy for selling more
OxyContin. He directed sales and marketing staff to turn over thousands of pieces of data about
sales trends, including data to distinguish the kilograms of active drug from the number of
prescriptions, so he could analyze higher doses. 140 Staff delivered the data early Sunday
morning; Richard responded with detailed instructions for new data that he wanted that same
day. 141 An employee sent Richard the additional data only a few hours later and pleaded with
Richard: “I have done as much as I can.” The employee explained that he needed to attend to
family visiting from out of town. 142 Richard responded by calling him at home, insisting that the
sales forecast was too low, and threatening that he would have the Board reject it. 143 On
Monday, staff emailed among themselves to prepare for meeting with Richard, highlighting that
Richard was looking for results that could only be achieved by hiring more sales reps.
Meanwhile, Richard met with John Stewart to discuss his analysis of the weekend’s data and
new graphs Richard had made. 144
231. Sales VP Russell Gasdia was struggling to handle the pressure. When Richard
Sackler sent Gasdia
140
2008-03-09 email from David Rosen, PPLPC012000174478.
141
142
143
2008-02-17 email from Mike Innaurato, PPLPC012000171496.
2008-02-17 email from Richard Sackler, PPLPC012000171511. See also 2008-11-02 email from Mike Innaurato,
PPLPC019000241631.
144
2008-03-10 emails from David Rosen and John Stewart, PPLPC012000174476.
76
“
” 145
232. Richard Sackler did not back off. Instead, he pushed staff to sell more of the
highest doses of opioids and get more pills in each prescription. That same Saturday night,
Richard sent Gasdia yet another set of instructions, directing him to identify tactics for
“exceeding 2007 Rx numbers on an adjusted basis (adjusted for strength and average number of
tablets per Rx).” 146 The very next day, Gasdia was writing up plans for how adding sales reps,
opioid savings cards, and promoting more intermediate doses of OxyContin could help increase
sales. 147
233. Richard Sackler followed through on his weekend threat that he would have the
Board reject the sales plan. Two days later, Richard circulated his own sales analysis to the
Board, ordered the Secretary to “put this high in the Board agenda,” and proposed that he and
Mortimer Sackler oversee a redo of the annual plan as well as the 5-year plan for Purdue’s
opioids. 148
234. At the same time, Jonathan, Kathe, and Mortimer Sackler were also pushing staff
about sales. Staff told those three Sacklers that they would use opioid savings cards to meet the
challenge of keeping OxyContin scripts at the same level in 2008 as in 2007, “in spite of all the
pressures.” 149 Kathe demanded that staff identify the “pressures” and provide “quantification of
their negative impact on projected sales.” 150
145
146
147
148
149
2008-03-09 email from Edward Mahony, PPLPC012000175155-156.
150
2008-03-11 email from Kathe Sackler, PPLPC012000175155.
77
235. In April, staff told the Sacklers that Purdue employed 304 sales reps. Staff
reported to the Sacklers that the reps had obtained data showing which pharmacies stocked
higher strengths of OxyContin, which helped them convince area doctors to prescribe the highest
doses. Staff also told the Sacklers that Purdue received 853 Reports of Concern about abuse and
diversion of Purdue opioids in Q1 2008, and they had conducted only 17 field inquiries in
response. Staff also reported to the Sacklers that they received 83 tips to Purdue’s compliance
hotline during the quarter, but did not report any of them to the authorities. 151
236. Staff also told the Sacklers that they promoted Purdue’s opioids at Tufts Health
Care Institute’s program on Opioid Risk Management in Boston on March 27. 152
237. On April 18, Richard Sackler sent Kathe, Ilene, David, Jonathan, and Mortimer
Sackler a secret memo about how to keep money flowing to their family. Richard wrote that
Purdue’s business posed a “dangerous concentration of risk.” After the criminal investigations
that almost reached the Sacklers, Richard wrote that it was crucial to install a CEO who would be
loyal to the family: “People who will shift their loyalties rapidly under stress and temptation can
become a liability from the owners’ viewpoint.” Richard recommended John Stewart for CEO
because of his loyalty. Richard also proposed that the family should either sell Purdue in 2008
or, if they could not find a buyer, milk the profits out of the business and “distribute more free
cash flow” to themselves. 153
151
2008-03-15 Board report, pgs. 17, 23, 24, 27, PDD8901724450, -456, -457, -460.
152
153
2008-04-18 email and attached memo from Richard Sackler, PDD9316300629-631.
78
238. That month, the Sacklers .
From the 2007 convictions until 2018, the Sacklers
. 154
AGO graphic based on Purdue’s internal Board documents

239. When the Sacklers directed Purdue to pay their family, they knew and intended
that they were paying themselves from opioid sales in Massachusetts. Purdue and the Sacklers
tracked revenue from Massachusetts. For example, when the U.S. Centers for Disease Control
154
2008-04-18 Board minutes, PKY183212631-633; 2008-06-27 Board minutes, PKY183212647; 2008-09-25
Board minutes, PKY183212654; 2008-11-06 Board minutes, PKY183212662; 2009-03-05 Board minutes,
PKY183212705; 2009-06-26 Board minutes, PKY183212742; 2009-09-23 Board minutes, PKY183212772; 2010-
02-04 Board minutes, PKY183212818; 2010-04-01 Board minutes, PKY183212829; 2010-09-10 Board minutes,
PKY183212844; 2010-12-02 Board minutes, PKY183212869-70; 2011-04-06 Board minutes, PKY183212896-97;
2011-06-24 Board minutes, PKY183212924-25; 2011-09-01 Board minutes, PKY183212927-28; 2012-07-27 Board
report, pg. 44, PPLP004367403; 2012-03-05 email from Edward Mahony, PPLPC012000368627; 2013-11-01
Board report, pg. 3, PPLPC002000186913; 2014-12-03 November flash report, slide 8, PPLPC016000266403;
2015-06-05 mid-year strategic review, slide 55, PPLPC011000036000; 2017-09-14 10 year plan spreadsheet, page
“CF – Internal,” PPLPC021000904588.
79
warned that high doses of opioids endanger patients, staff reported to the Sacklers that
Massachusetts prescriptions of Purdue’s highest doses provided $23,964,122 per year, or 2.8% of
Purdue’s high-dose sales. 155 Similarly, prescription data on over 500,000 individual prescribers
that Purdue tracked from 2007 to 2017 confirm that Massachusetts constituted approximately
2.8% of Purdue sales. 156 Since May 15, 2007, the Sacklers
. 157
240. On April 18, the Sacklers
. 158 Then, Richard Sackler sent Sales VP Russell Gasdia a series of
questions about Purdue’s efforts to get patients to take higher doses and stay on opioids for
longer times. Richard wanted to know: how many Purdue patients had insurance that would let
them take unlimited quantities of Purdue opioids; how many patients were limited to 60 tablets
per month; and how many patients had any limit on the number of tablets or dose or number of
tablets per day. He demanded that sales staff be assigned to answer his questions “by tomorrow
morning.” 159 When the sales staff pleaded for a few more hours to collect the data, Richard
agreed to give them until the end of the day. 160
241. In May, staff sent the Sacklers more ideas about ways to promote Purdue’s
opioids. The proposal matched the Sacklers’ own plan, which Richard had written out as CEO:
deflect blame from Purdue’s addictive drugs by stigmatizing people who become addicted.
“KEY MESSAGES THAT WORK” included this dangerous lie: “It’s not addiction, it’s abuse.
155
2016-04-13 Q1 2016 Commercial Update, slide 74, PPLPC016000286167.
156
Purdue Drug Units Dispensed by HCP, Product, and Strength, PWG003984518–45.
157
2.8% of $4,000,000,000 is $112,000,000.
158
2008-04-18 Board minutes, PKY183212634-37.
159
160
80
It’s about personal responsibility.” 161
242. In June, the Sacklers
. On the same day, the Sacklers . 162
243. Meanwhile, Richard Sackler asked sales staff for more information about
Purdue’s opioid savings cards. 163 Staff reported to Richard, Jonathan, Kathe, and Mortimer
Sackler that 67,951 patients had used Purdue’s opioid savings cards, and that the cards provided
a discount on a patient’s first five prescriptions. 164
244. After five prescriptions, many patients would face significant withdrawal
symptoms if they tried to stop taking opioids. Staff told Richard, Jonathan, Kathe, and Mortimer
Sackler that 27% of patients (more than 18,000 people) had used the cards for all five
prescriptions. 165
245. In July, Purdue’s Fleet Department reported to the Sacklers that Purdue had
bought one hundred new Pontiac Vibes for the expanded sales force. Staff also told the Sacklers
that Purdue received 890 Reports of Concern regarding abuse and diversion of Purdue’s opioids
in Q2 2008 and had conducted only 25 field inquiries in response. Staff reported to the Sacklers
that they received 93 tips to Purdue’s compliance hotline during the quarter, but did not report
161
2008-05-16 email from Pamela Taylor, PPLPC012000183254; 2008-04-16 Executive Committee notes,
PPLPC012000183256; 2008-04-16 presentation by Luntz, Maslansky Strategic Research, PPLPC012000183259.
162
163
164
2008-06-16 email from Russell Gasdia, PPLPC012000186394-395.
165
81
any of them to the authorities. 166
246. Staff also told the Sacklers that they promoted Purdue opioids in Massachusetts in
a presentation titled “The Assessment and Management of Chronic Pain with an Emphasis on the
Appropriate Use of Opioid Analgesics” at Tufts University on April 25 and a presentation titled
“The Role of Urine Drug and other Biofluid Assays in Pain Management,” at the Tufts Health
Care Institute on June 26 and 27. 167 Convincing Massachusetts doctors that Purdue opioids were
the best way to manage chronic pain and that urine tests protected patients from addiction were
both part of Purdue’s unfair and deceptive scheme.
247. In September, the Sacklers . 168
248. In October, staff told the Sacklers that surveillance data monitored by Purdue
indicated a “wide geographic dispersion” of abuse and diversion of OxyContin “throughout the
United States.” Staff told the Sacklers that “availability of the product” and “prescribing
practices” were key factors driving abuse and diversion of OxyContin.” On the same day, staff
told the Sacklers that Purdue had begun a new “Toppers Club sales contest” for sales reps to win
bonuses, based on how much a rep increased OxyContin use in her territory and how much the
rep increased the broader prescribing of opioids — the same “availability of product” and
“prescribing practices” factors that worsen the risk of diversion and abuse. In the same report,
staff told the Sacklers that they received 163 tips to Purdue’s compliance hotline during Q3
2008, but did not report any of them to the authorities. 169
249. Staff also told the Sacklers
166
2008-07-15 Board report, pgs. 21, 28, 30, PPLP004367317, -324, -326.
167
2008-07-15 Board report, pg. 21, PPLP004367317.
168
169
2008-10-15 Board report, pgs. 19, 24, 28, PDD9316101020, -025, 029.
82
Purdue now employed 414 sales reps. 170 The Sacklers’ decision to expand the
sales force caused the effect they intended in Massachusetts. During Q3 2008, the number of
sales visits to Massachusetts prescribers increased by 20% to more than 1,800. 171
250. In November, the Sacklers . Purdue’s
2009 budget identified expanding the sales force as the #1 sales and marketing objective. 172 The
Sacklers . 173 Staff told the Sacklers that their decision
would pay an average sales rep salary of $89,708 and bonus of $43,470, and the sales reps would
visit prescribers 518,359 times. 174
251. That same month, the Sacklers . 175
. 176
, the Sacklers
   2009   
252. In February 2009, Kathe Sackler instructed staff to report on Purdue’s grants and
donations. Staff reported that Purdue was spending $500,000 at Massachusetts General Hospital,
$185,000 at Tufts University, and $6,000 at the Massachusetts College of Pharmacy. 177
253. In March, the Sacklers
. The
170
171
Exhibit 1. 20% increase from Q3 2007.
172
2008-11 budget submission, pg. 10, PPLP004401590.
173
2008-11-06 Board minutes, PKY183212663, 66; 2008-11 budget submission, PDD9273201117 (
).
174
2008-11 budget submission, pg. 104-106, PDD9273201186-88.
175
176
177
2009-02-17 email from Brad Griffin, PPLPC012000213086, and attachment, PPLPC012000213088.
83
Sacklers . On the same day, the
Sacklers voted . 178
254. In April, staff told the Sacklers that Purdue employed 412 sales reps and had
made dramatic progress promoting higher doses: “for the first time since January 2008,
OxyContin 80mg strength tablets exceeded the 40mg strength.” 179 The Sacklers had a detailed
conversation with Sales VP Russell Gasdia about the staffing of the sales force, how many sales
reps the company should employ, and how many prescribers each rep would visit each year. 180
The Sacklers told sales executives to hire a new staff member who would contact prescribers
electronically and would promote Purdue opioids through the deceptive website Partners
Against Pain. 181
255. Staff told the Sacklers that they received 122 tips to Purdue’s compliance hotline
during Q1 2009, and revealed one of them to an outside monitor. Staff reported to the Sacklers
that the compliance problems included improper use of OxyContin marketing materials and
opioid savings cards. 182
256. In May, staff told the Sacklers
. 183 Because sales reps
lobbying doctors poses a high risk of misconduct (no witnesses, and the rep is paid to increase
opioid sales), the United States required that Purdue managers supervise sales reps in person at
least 5 days each year. 184 Purdue management disregarded that obligation
178
179
2009-04-16 Board report, pgs. 5, 28, PDD9316100601, -624.
180
181
182
2009-04-16 Board report, pgs. 24-25, PDD9316304336-337.
183
2009-05-08 corporate compliance quarterly report to the Board 1Q09, slide 6, PPLPC029000274906.
184
Purdue Corporate Integrity Agreement section III.K.
84
. 185 Even though Purdue
. 186
257. Staff also told the Sacklers that they were awaiting new regulations for drug
marketing in Massachusetts. 187
258. In June, Richard Sackler asked sales staff how a competing drug company had
increased sales: “What is happening???” 188 Staff replied that it was all about sales reps:
“They have 500 reps actively promoting to top decile MDs …

Their messaging is ‘we are not OxyContin,’ alluding to not having
the ‘baggage’ that comes with OxyContin.
Interestingly, their share is highest with MDs we have not called

on due to our downsizing and up until last year, having half as
many reps. Where we are competing head to head, we decrease
their share by about 50%.” 189
259. A few days later, staff reported to the Sacklers that Purdue had expanded its sales
force at the Board’s direction: “As approved in the 2009 Budget, 50 New Sales Territories have
been created.” Staff told the Sacklers the expansion was focused on the most prolific opioid
prescribers, because “there are a significant number of the top prescribers” that Purdue had not
been able to visit with its smaller force of sales reps. 190 Later that month, the Sacklers
. 191
185
2009-05-08 corporate compliance quarterly report to the Board 1Q09, slide 6, PPLPC029000274906
(“Compliance was not monitoring against the ‘five full days’ requirement”).
186
2009-07-30 Board report, pg. 16, PPLPC012000233246.
187
2009-05-08 corporate compliance quarterly report to the Board 1Q09, slide 14, PPLPC019000275103.
188
189
190
PPLPC012000226606.
191
85
260. In July, staff told the Sacklers that Purdue employed 429 sales reps. 192 Richard
Sackler told staff that he was not satisfied with OxyContin sales and demanded a plan to “boost”
them. He asked for the topic to be added to the agenda for the Board. 193
261. In August, Richard Sackler convened a meeting of Board members and staff
about “all the efforts Sales and Marketing is doing and planning to do to reverse the decline in
OxyContin tablets market.” He emphasized that $200,000,000 in profit was at stake. 194 At the
meeting, staff told the Sacklers that the 80mg OxyContin pill was far-and-away Purdue’s best
performing drug. Purdue sold many more kilograms of active ingredient in the 80mg dose than
any other dose (about 1,000 kilograms: literally a ton of oxycodone). 195
262. Staff also reported to the Sacklers about their newest OxyContin sales campaign,
with the slogan: Options. 196 The Options campaign set the pattern that Purdue would follow for
years: pushing doctors and patients up the ladder to higher doses. To make it easy for sales reps
to promote higher doses, the campaign materials emphasized the “range of tablet strengths,”
provided a picture of each dose, and said: “You can adjust your patient’s dose every 1 to 2 days.”
Staff told the Sacklers that they would advertise the Options campaign in medical journals
reaching 245,000 doctors. 197
192
193
194
2009-08-12 email from Richard Sackler, PPLPC012000234970-971; see also 2009-08-10 email from John
Stewart, PPLPC012000234801 (“Richard has asked me about this at least 5 times over the past few weeks”).
195
2009-08-19 Board slides, slide 7, PPLPC012000235543.
196
197
2009-08-19 Board slides, slides 12, 16, PPLPC012000235543; Options marketing materials, PMA000189015.
86
Purdue’s 2009 marketing campaign ‘Options’
263. Staff also reported to the Sacklers that more than 160,000 patients had used
Purdue’s opioid savings cards, more than doubling the result reported to the Sacklers the summer
before. 198 Staff also told the Sacklers that they would advertise OxyContin using a special
television network: thousands of doctors would be given free digital video recorders for their
home televisions, in exchange for watching advertisements for drugs. 199
198
2009-08-19 Board slides, slide 12, PPLPC012000235543. Compare with 67,951 in June 2008. 2008-06-16
email from Russell Gasdia, PPLPC012000186394.
199
2009-08-19 Board slides, slide 19, PPLPC012000235543. Purdue spent approximately $100 for each doctor who
watched the advertisement, but it made the money back when the doctors prescribed Purdue’s opioids. 2009-04-27
email from Lindsay Wolf, PPLPC012000221091.
87
264. Immediately after meeting with sales staff, Richard Sackler asked for the raw data
underlying their presentation. When staff had not responded within five minutes, he asked
again. 200
265. In September, the Sacklers . 201 But
Mortimer Sackler was concerned that staff were not selling Purdue’s opioids aggressively
enough. He demanded to know why staff predicted a decline in OxyContin sales when he
believed the market should grow. 202
266. In October, staff told the Sacklers that Purdue had expanded its sales force by 50
territories and now employed 475 sales reps. 203 Richard Sackler directed staff to send him
weekly reports on OxyContin sales. 204 No one in the company received reports that often, so
staff were not sure how to reply. 205 Staff considered telling Richard that there were no weekly
reports, but they decided to make a new report just for him instead. 206 The CEO also instructed
the Sales Department to report to the Sacklers with more explanation about its activities. 207
267. That same month, the Sacklers and staff discussed federal sunshine legislation
that would create a public database to disclose drug companies’ payments to doctors. Purdue
was paying many doctors to promote its opioids — including doctors in Massachusetts — but the
200
2009-08-19 emails from Richard Sackler, PPLPC023000236021-022.
201
202
2009-09-28 email from Mortimer Sackler, PPLPC012000240032
203
204
2009-10-08 email from Richard Sackler, PPLPC012000241516; see also PDD9316309168.
205
2009-10-08 email from Robert Barmore, PPLPC012000241515; see also PPLPC022000283453.
206
2009-10-08 email from David Rosen, PPLPC012000241515 (“Hi, guys … Someone needs to alert Dr. Richard
that we no longer do a weekly report. Can either one of you help …); 2009-10-08 email from Dipti Jinwala,
PPLPC012000241526 (“we have not been providing the OxyContin weekly report since May 09”); 2009-10-08
email from Richard Sackler, PPLPC012000241586 (“I’d like to have the weekly updates.”); 2009-10-08 email from
David Rosen, PPLPC012000241586 (“If we do as dr. richard requests, we will be adding work and providing him
near worthless data”); 2009-10-08 email from Russell Gasdia, PPLPC012000241586 (“Tell her not to respond.”);
2009-10-08 email from John Stewart, PPLPC012000241647; 2009-10-09 email from Rob Barmore,
PPLPC022000283690 (“For the record, my concerns regarding workload and being able to meet demands of all the
reporting, primary research, ad hocs while maintaining quality and reasonable levels of group morale remain.”).
207
88
payments could often be kept secret. Some of the Sacklers were concerned that doctors would
be “much less willing” to work for Purdue if the payments were disclosed. 208
268. In November, the Sacklers
. Kathe and Richard Sackler . 209
. 210
269. , Kathe and Richard Sackler
. 211 The report
. 212
270. , Richard Sackler
?” , staff reported to all the Sacklers
208
209
2009-11-03 Board minutes, PKY183212802-804; 2009-11 budget submission, pg. 12, PDD9273201222.
210
2009-11-20 Board minutes, PKY183212814; 2009-11-25 Board minutes, PKY183212815.
211
2009-11-02 budget presentation, PPLPC012000249328; 2009-12-22 email from Edward Mahony,
PPLPC012000249327 (“ ”).
212
2009-10-26 steering committee meeting presentation by , slide 19, PPLPC018000346294.
89
. 213 These were all improper, unfair, and deceptive claims that
Purdue had admitted were prohibited.
271. Richard Sackler
. Staff responded to all the Sacklers
. 214
272. In December, Kathe and Richard Sackler met with sales staff to review plans for
2010. Staff warned the two Sacklers that, although OxyContin sales were at record-breaking
levels (nearly $3 billion per year), the decade-long rise in the total kilograms of oxycodone
prescribed in America was beginning to flatten. 215 Higher doses contain more of that active
ingredient and are more profitable to Purdue.
  
The Massachusetts General Hospital Purdue Pharma Pain Program
  
273. In 2009, the Sacklers decided to renew Purdue’s commitment to spend $3,000,000
in Massachusetts to fund the Massachusetts General Hospital Purdue Pharma Pain Program. 216
274. The Sacklers had chosen to launch the Massachusetts General Hospital Purdue
Pharma Pain Program in 2002 after due diligence, including review of OxyContin sales data,
led staff to conclude that it would help Purdue sell more opioids in Massachusetts. 217 Staff
commented positively on “MGH’s commitment to OxyContin,” citing OxyContin’s 63.1%
market share in MGH’s zip code and the fact that “MGH also has a hospital owned pharmacy
213
2009-11-02 budget presentation, PPLPC012000249329.
214
215
2009-12-03 email from Mike Innaurato, PPLPC012000247640, attachment PPLPC012000247642.
216
2009-07-09 email from David Haddox, PPLPC023000228146; Health Policy Memorandum from David Haddox,
PPLPC023000228147 at 48.
217
2001-11-14 email from James Lang, PPLPC012000041068; 2001-11-16 email from Phil Cramer,
PPLPC014000021900.
90
which conservatively generates $25,000 per month in OxyContin sales.” 218 Staff also noted:
“MD accessibility is great … they come to us with any questions,

and allow us to see them when we need to.” 219
“Partner’s Healthcare Group is MGH’s arm all around Boston –

MGH has significant impact on these members (mostly primary
care). MGH also has significant influence through most of New
England, simply because they are MGH.” 220
275. The agreement establishing the program gave Purdue the right to influence
education of doctors in Massachusetts by proposing “areas where education in the field of pain is
needed” and “curriculum which might meet such needs.” Purdue was also entitled to appoint a
voting member of the Educational Program Committee and an advisor to the program’s
Oversight Board. 221
276. When the Massachusetts General Hospital Purdue Pharma Pain Program
launched, Purdue made sure that Boston area sales reps and the Sacklers were poised to lever the
partnership to Purdue’s advantage. 222 Purdue staff planned a symposium and reception at the
hospital’s famous “Ether Dome” for which Purdue selected the speakers. 223 Purdue staff also
prepared a guest list, including “key politicians,” who could influence policy in Massachusetts,
and “managed care administrators,” who could decide whether Massachusetts insurance plans
encouraged the use of Purdue’s opioids. 224
277. Although staff acknowledged that reactions to the launch had not all been positive
— one medical journal threatened not to publish research that came out of the program because
218
2001-11-19 email from Dan Doucette, PPLPC012000041222.
219
220
2001-11-19 email from James Lang, PPLPC012000041198.
221
The Massachusetts General Hospital and Harvard Medical School Fund Agreement with Purdue Pharma L.P.
Dated as of March 5, 2003, PPLPC021000425373-378.
222
2002-02-04 email from Windell Fisher, PPLPC024000063880; 2002-02-06 email from Robert Reder,
PPLPC026000007351.
223
224
2002-03-21 email from Merle Spiegel, PPLPC023000014497.
91
of the conflict of interest — staff told the Sacklers that funding the program was a valuable way
to exert influence in Massachusetts. Staff told the Sacklers that the Massachusetts General
Hospital Purdue Pharma Pain Program gave Purdue name recognition among medical students,
residents, and the public, as well as political protection against efforts to address the opioid
crisis. 225 Staff told the Sacklers:
“There has been a great deal of legislative activity/debate in

Massachusetts around the issues of whether or not OxyContin
tablets should remain available to persons in the Commonwealth.
Some legislators have suggested that the product should be
classified as a banned substance under the Commonwealth’s
controlled substances regulation – in the same class as heroin and
LSD – by introducing a total of five bills to this end …
I fear that a termination of support might fuel the efforts of those

already hostile to us, or reduce the willingness of those who have
supported our positions to continue to do so.” 226
278. In late 2010 or early 2011, the Sacklers voted to continue funding the
Massachusetts General Hospital Purdue Pharma Pain Program. 227 The Sacklers sent CEO John
Stewart to Boston to network with MGH doctors who could prescribe opioids in
Massachusetts. 228 Purdue paid MGH the full $3,000,000. 229 The Sacklers knew and intended
that their sponsorship of the Massachusetts General Hospital Purdue Pharma Pain Program
would contribute to their deceptive promotion of opioids in Massachusetts.
225
2009-07-09 memorandum from David Haddox, PPLPC023000228147-153.
226
2009-07-09 memorandum from David Haddox, PPLPC023000228149.
227
2011-11-14 memorandum to the Oversight Board, PPLPC021000425379.
228
2010-12-03 email from Paul Coplan, PPLPC017000258652.
229
2014-05-29 email from Bert Weinstein, PPLPC020000797947,
.”
92
  
The Sacklers, Purdue, and Tufts University
  
279. Massachusetts General Hospital was not the only place where the Sacklers
cultivated influence over Massachusetts doctors. The Sackler family had long sent money to
Tufts, a leading university, including a renowned medical school. In 1980, three Sackler
brothers, through a very large payment, established the Sackler School of Graduate Biomedical
Sciences. Later, in 1999, the Sackler family made a more targeted gift, establishing Tufts
Masters of Science in Pain Research, Education, and Policy (“MSPREP Program”). 230 Kathe
Sackler co-presided over the decision to fund the MSPREP Program. 231 Richard Sackler
attended the launch symposium in Boston and paid Tufts hundreds of thousands of dollars. 232
Purdue also sponsored the annual Sackler Lecture at Tufts on a topic in pain medicine. 233 For
many years, Richard took a seat on the board of the Tufts University School of Medicine.
280. The Sacklers got a lot for their money. The MSPREP Program bought Purdue
name recognition, goodwill in the local and medical communities, and access to doctors at
Massachusetts hospitals like Brigham and Women’s. 234 Purdue got to control research on the
treatment of pain coming out of a prominent and respected institution of learning. 235 Staff told
the Sacklers that Purdue employees regularly taught a Tufts seminar about opioids in
Massachusetts as part of the MSPREP Program. 236 Staff sent the Sacklers a report showing that
Tufts and its affiliated teaching hospital helped Purdue develop a publication for patients
230
1999-07-10 email from Richard Sackler, #212166.1; memorandum dated May 7, 2000, PPLPC013000048630.
231
1999-07-07 attendance list for the Meeting to discuss funding, PPLPC013000029936.
232
1999-10-13 email from Richard Sackler, #436363.1; 1999-03-11 Board decision, PDD1706191717.
233
2007-03-29 email from David Haddox, PPLPC012000137085.
234
See, e.g., 2016-10-04 email from Srdjan Nedeljkovic, PPLPC022000968264.
235
2002-07-31 email from David Haddox, #3065539.1.
236
93
entitled, “Taking Control of Your Pain.” 237 The MSPREP Program was such a success for
Purdue’s business that the company considered it a model for influencing teaching hospitals and
medical schools. 238
281. A May 2000 Tufts site visit memorandum from Purdue staff, sent to Richard
Sackler and others, listed many of the lasting benefits of the relationship Purdue had with Tufts.
The purposes of the visit were, in part: to address a complaint the Sacklers had about the
prominence and placement of the Purdue logo on the Tufts MSPREP materials; to “explore ways
in which PPLP [Purdue Pharma L.P.] can contribute academically to the curriculum of the
MSPREP Program;” and to find opportunities for Purdue to influence the work of Tufts in the
Massachusetts medical marketplace and beyond. 239
282. In a tour of Tufts Medical Center in Boston, Purdue and Tufts employees
“discussed ways in which they could better coordinate their activities… to raise consciousness of
better pain control,” presented doctors with metrics developed by Purdue for “studies of
analgesics that go beyond an acute observation,” and discussed curriculum for training
physicians. Purdue staff met with a Tufts nurse who was recruiting patients for a Purdue clinical
project, toured the project lab, and discussed a research protocol that Purdue helped to write.
Purdue staff told Tufts that “one way in which the Program could function better from the PPLP
[Purdue Pharma LP] perspective was to have a designated contact person … to coordinate
requests for preceptorships of PPLP employees.” Tufts said that Purdue employees were
welcome at its Boston-based medical school and its affiliated hospital in Western
237
2000 Budget Submission, pg. 58, PDD1701809250.
238
2000-05-30 email from Robert Kaiko, PPLPC013000048629; 2000-05-07 memorandum, PPLPC013000048630-
634.
239
2000-05-07 memorandum, PPLPC013000048630.
94
Massachusetts. 240
283. Purdue also obtained an agreement from Tufts to sponsor programs “in response
to the situation in Maine.” 241 Around the time of that visit, Purdue and the Sacklers knew of
damning reports of addiction and overdose in Maine caused by Purdue’s opioids. 242 Tufts ran a
residency program for family practice physicians and agreed to help Purdue find doctors to
attend an event where Purdue could defend its reputation. 243
284. Richard Sackler communicated with the Director of the MSPREP Program,
encouraged him to visit Purdue’s offices, and offered to send Purdue marketing staff to visit him
in Boston. 244 The MSPREP steering committee went to Purdue headquarters in 2009 to learn
what Purdue would like to see in the MSPREP Program. 245
285. Purdue regularly sent staff to Tufts, including in the years 2007, 2010, 2013,
2015, and 2017. 246 Tufts promoted a Purdue employee to Adjunct Associate Professor in
2011. 247 The Director of the MSPREP Program provided comments favorable to Purdue at FDA
meetings in 2012 and 2013, and Purdue staff tracked it all in a grid. 248 Richard Sackler arranged
for a Tufts professor to meet with Purdue staff in 2012. 249 In 2014, Purdue’s medical liaison
staff succeeded in getting two Purdue unbranded curricula approved for teaching to Tufts
students — future residents, fellows, and clinicians. Purdue’s New England accounts team
240
2000-05-07 memorandum, PPLPC013000048630-634.
241
242
243
244
2000-05-30 email from Robert Kaiko, PPLPC013000048629; 2004-08-18 email from David Haddox, #381773.1.
245
2009-10-09 email from Kristi Dover, PPLPC017000177863.
246
2007-03-29 email from David Haddox, PPLPC012000137085; 2010-08-27 email from David Haddox,
PPLPC019000417292; 2013-01-29 email from David Haddox, PPLPC020000649740; 2015-10-27 email to David
Haddox, PPLPC022000894451; 2017-01-19 email from David Haddox, PPLPC011000133242. Purdue staff taught
a seminar via videoconference in 2016. 2016-10-04 email to David Haddox, PPLPC022000968264.
247
248
2013-01-16 email from Pamela Bennett, PPLPC017000434836.
249
95
congratulated them for “penetrating this account.” 250
286. The marketing benefits that the Sacklers reaped from Tufts were so great that they
offered to send Purdue’s CEO to Massachusetts to sustain the courtship. As recently as
November 2017, CEO Craig Landau wrote to Tufts’ President to promote Purdue’s contentions
about opioids and offer to meet. 251
287. The Sacklers’ high-profile involvement at the Massachusetts General Hospital
and Tufts University was part of their misconduct. These marquee projects also confirm the
obvious truth that the Sacklers knew and intended that Purdue promoted opioids in
Massachusetts.
   2010   
288. In January 2010, Richard Sackler started the year by asking sales staff for new
customized reports. 252 Staff complained to each other until Sales VP Russell Gasdia asked CEO
John Stewart to intervene: “Can you help with this? It seems like every week we get one off
requests from Dr. Richard.” 253 Neither Stewart nor anyone else could keep Richard out of
sales. 254 Days later, Richard was writing to the sales employee on Saturday morning, ordering
that his need to review the sales plan was “urgent” and should be satisfied “this weekend.” 255
289. In February, Purdue’s Sales and Marketing Department told the Sacklers that a
key objective for 2010 would be to “Meet or exceed total prescriber call targets of 545,000”
250
2014-04-09 email from Thomas Currier, PPLPC022000712807.
251
2017-11-13 letter from Craig Landau, PPLPC021000912691.
252
253
254
2010-01-08 email from John Stewart, PPLPC023000259669 (“PS You are not alone in receiving requests for
extraordinary analyses and reports.”).
255
2010-01-16, email from Richard Sackler, PPLPC023000260293.
96
visits to prescribers to promote Purdue opioids. For the next four years or more, a key objective
for the sales employees was to meet a quota of sales visits, and the Sacklers tracked their
performance. The target rose from 545,000 prescriber visits in 2010, to 712,000 visits in 2011,
752,417 visits in 2012, and 744,777 visits in 2013. 256
290. To achieve the target for sales visits, staff told the Sacklers that another sales
force expansion ordered by the Board had been implemented and Purdue employed 490 sales
reps. 257 That expansion was having the intended effect in Massachusetts. During Q4 2009,
Purdue reps visited Massachusetts prescribers more than 2,800 times, a 25% increase over the
same quarter the year before. 258
. 259
.”
. 260 In fact, becoming addicted to
opioids makes patients more stressed, more isolated, and less likely to survive.
292. The Sacklers
. 261
256
2010-02-01 Board report, pg. 23, PPLPC012000252797; 2011-05-02 Board report, pg. 3, PPLPC012000322428;
2012-04-30 Board report, pg. 3, PPLPC012000374793; 2013-05-13 Board report, pg. 7, PPLP004367546.
257
258
Exhibit 1.
259
PPLPC012000257446.
260
2009-09-11 presentation, PPLPC023000239858, slide 22.
261
97
293. In March, Richard Sackler instructed sales staff to send him monthly reports on
sales of OxyContin and its competitors. They complied within ten minutes. 262 The report
showed that Purdue was selling more pills of its 80mg OxyContin (the highest dose) than any
other dose, and that the highest dose pills were responsible for the greatest share of Purdue’s
revenue by far. 263
294. Staff also told
. 264 Deceptively promoting opioids for opioid-naive patients who had not taken them
before was one of the ways Purdue put patients at risk.
295. In April, the Sacklers . 265
296. Meanwhile, staff told the Sacklers that they were pushing back against the
“threat” of public health rules that would limit high doses of opioids. They told the Sacklers that
Purdue would oppose precautions that asked doctors to consult with specialists before
prescribing the highest doses. 266
297. In Massachusetts, Purdue was pushing high doses with great success. At that
moment, Purdue’s top-paid physician spokesman in Massachusetts, Walter Jacobs, had a patient
on twenty-four pills of 80mg OxyContin per day — almost a hundred times more drug that the
starting dose on the label. For all of 2010, 73% of the OxyContin pills that Jacobs prescribed
were the highest-dose 80mg pills. Purdue paid Jacobs to give presentations to other doctors so
that his dangerous prescribing practices would spread.
262
2010-03-15 emails from Richard Sackler and Mike Innaurato, PPLPC012000262889.
263
2010-03-11 January 2010 OxyContin monthly report, slides 10, 15, PPLPC012000262892.
264
2010-03-17 Executive Committee notes, PPLPC012000267960.
265
266
98
  
The Sacklers’ Control of Sales Visits
  
298. That same month (April 2010), staff gave the Sacklers one of many detailed
reports on sales reps’ visits to prescribers. As with every reference to “the Sacklers” before July
2012, that includes Beverly, Ilene, Jonathan, Kathe, Mortimer, Richard, and Theresa Sackler.
299. The Sacklers required each rep to visit an average of 7.5 prescribers per day. In
April 2010, staff reported that they were falling short. During Q1 2010, reps had averaged only
7.0 visits per day. 267 Staff promised to try harder. The Sacklers continued to set a target for
daily sales visits for every sales rep, and they tracked the results, quarter by quarter, for at least
the next four years. The results were always close to 7 visits per day.
The Sacklers Required Each Sales Rep to

Visit 7 Prescribers per Day
7
reported to the Sacklers
6
Daily visits per rep
267
99
300. The Sacklers also set targets for the total number of sales visits by the entire sales
force per quarter — huge numbers that were always more than a hundred thousand visits.
Meeting those targets was a top priority for the entire company. For Q1 2010, the target was to
visit prescribers 127,376 times. Staff told the Sacklers that Purdue employed 489 sales reps and
that, during Q1 2010, they achieved the goal. 268 As with the daily visits per rep, the Sacklers
tracked the total number of sales visits per quarter, every quarter, for at least the next four years.
The Sacklers Required Sales Reps to

Visit Prescribers Thousands of Times
180,000
160,000
Total sales visits reported to the Sacklers
140,000
each quarter from 2010 to 2014
120,000
100,000
80,000
60,000
40,000
20,000
268
2010-04-21 Board report, pgs. 4, 20, PWG000423143, -159. They exceeded the goal and visited prescribers
133,561 times.
100
301. During every quarter, sales reps visited prescribers in Massachusetts. Indeed,
they visited every month, every week, and almost every day. During Q1 2010, Purdue sales reps
visited Massachusetts prescribers more than 2,700 times. 269
302. The Sacklers also tracked the cost of the sales visits. In April 2010, staff reported
to the Sacklers that each visit to a prescriber cost Purdue $219, and they were working to lower
the cost to a target of $201. 270 For the people of Massachusetts, the costs were far higher.
  
303. In June 2010, staff gave the Sacklers an updated 10-year plan for growing
Purdue’s opioid sales.
. Beginning on page one, staff emphasized
that selling as many opioids as the Sacklers wanted “will require significant salesforce support”
so the plan detailed the “optimization” of sales visits and the number of reps they would require.
Sales VP Gasdia wrote to the Sacklers that they planned for each rep to visit prescribers 1,540
times per year, so that 500 reps could make 770,000 visits at a cost of $212 per visit. He
proposed to grow the sales force to 1,050 sales reps by 2015. To reach the Sacklers’
expectations, Gasdia projected that Purdue would convince doctors to switch patients from
Tylenol to Purdue’s soon-to-be-released Butrans opioid, and Butrans would become a billion-
dollar drug. 271
304. In July, Richard Sackler emailed staff just before the July 4th holiday weekend to
demand more details about sales and marketing. Richard directed them to send to the Board
plans for “the marketing program” and “the sales program,” with instructions to “get this out
269
Exhibit 1.
270
271
2010-06-24 Purdue Pharma 2010 10-Year Plan, pgs. 1-15, Key Assumptions pg. 6, PPLPC012000277155-169, -
217.
101
before the weekend.” 272 A despondent staff member wrote to the CEO: “Are you expecting us to
provide the marketing plan by tomorrow?” 273 Staff came close to telling Richard Sackler no.
Instead, they negotiated an extension and promised to provide full details about sales and
marketing at the July Board meeting in Bermuda. 274 To enforce the deal, Kathe Sackler ordered
staff to circulate materials before the meeting. 275
305. By the Sacklers’ choice, sitting on the Board of Purdue Pharma Inc. was a globe-
trotting endeavor. The Sacklers
. 276
306. In Bermuda, the Sacklers focused on sales tactics again. Staff presented plans for
selling Purdue’s new Butrans opioid. Staff reported that sales reps would try to switch patients
to opioids from NSAIDs like ibuprofen and explained tactics for convincing doctors that patients
needed the new drug. Staff told the Sacklers that they had identified 82,092 prescribers to target
with the Butrans sales campaign. Staff reported that they planned to add 125 sales reps and
increase the number of prescriber visits by 30%. 277
307. Emails between staff and the Sacklers
. The Board asked
. The Board
272
273
274
275
276
#618541.1 ( ); PPLPC012000277864 ( ); #618564.1 (
); PDD1715108129 ( ); #2938358.1 ( ); #618062.1 (
); PKY183307494 ( ).
277
2010-07-22 Butrans Commercial Strategy Plan Board Presentation, slides 17, 66, 81, PPLPC018000404193;
2010-06-01 email from William Mallin, PPLPC012000273600.
102
. 278 The Board
.” 279 In Massachusetts,
Purdue paid to influence opioid prescriptions included Dr. Walter Jacobs, who lost
his medical license for dangerous prescribing.
308. The Board pushed
. Purdue
. 280
309. Purdue
” 281
278
2010-07-22 questions during Board meeting, PPLPC012000283164 (“
”).
279
2010-07-22 questions during Board meeting, PPLPC012000283165.
280
”).
281
103
  
Region Zero
  
310. , the Sacklers and other Board
members asked
. Staff assured the
Board
. 282 Staff
. Staff told
. Staff gave
. 283
311. For example, staff reported
. Staff reported
. 284
312. Staff reported
. Staff reported
. 285
282
2010-07-22 questions during Board meeting, PPLPC012000283169, -170.
283
2010-08-16 email from William Mallin, PPLPC012000283162; 2010-08-11 Region Zero prescribers,
PPLPC012000283175.
284
2010-08-11 Region Zero prescribers, PPLPC012000283175.
285
104
313. The reports of inappropriate prescribing that staff reported to the Board were
accurate. No one knew more about prescribing of Purdue opioids than Purdue. A year after
Purdue staff told the Board about Alvin Chua, the Massachusetts Board of Registration in
Medicine took away his license for improper opioid prescribing. 286 Three years after Purdue told
the Board about Michael Taylor, he lost his license and was convicted in Massachusetts court of
prescribing opioids without a legitimate medical purpose. 287 By then, Purdue and the Sacklers
had collected hundreds of thousands of dollars from their dangerous prescriptions. Far worse —
four Massachusetts patients, who were prescribed Purdue opioids by Taylor and Chua, overdosed
and died.
  
314. , the Sacklers
. 288
286
2011-03-16 Indefinite Suspension, decision by the Massachusetts Board of Registration in Medicine.
287
2013-08-16 “Doctor Pleads Guilty to Illegally Prescribing Oxycodone,” mass.gov.
288
2010-07-22 Board minutes, PKY183212838 (“
).
105
315. The Sacklers knew and intended
. From 2010 to the present, sales reps hired in
the 2010 expansion promoted Purdue opioids to Massachusetts prescribers more than 4,000
times. 289

316. At the same meeting, the Sacklers
. 290
289
In Ayer, Boston, Bourne, Brewster, Cambridge, Canton, Carver, Cataumet, Centerville, Charlestown, Chatham,
Chelsea, Cotuit, Dartmouth, Dedham, Dennis, Dorchester, Everett, Falmouth, Fitchburg, Groton, Harwich, Hyannis,
Hyde Park, Jamaica Plain, Lakeville, Leominster, Lunenburg, Marstons Mills, Mashpee, Middleboro, Milton,
Nantucket, New Bedford, Norwood, Oak Bluffs, Orleans, Osterville, Pepperell, Plymouth, Revere, Roslindale,
Sagamore Beach, Sandwich, Somerville, Vineyard Haven, Wareham, Wellfleet, West Roxbury, West Tisbury,
Westminster, Winthrop, and Yarmouth Port.
290
106
317. Later that month, staff told the Sacklers that Purdue employed 491 sales reps and
that, during Q2 2010, they visited prescribers 135,824 times. 291 More than 2,500 of those visits
were in Massachusetts. 292 Meanwhile, staff
. 293
318. In August, the Sacklers continued to focus on the sales force. That month, they
decided not to acquire a new insomnia drug because of the risk that promoting it could distract
sales reps from selling Purdue’s opioids. Richard Sackler concluded that “loss of focus” in sales
reps’ meetings with prescribers was too great a risk, and the Sacklers decided not to go through
with the deal. 294
319. A few days later, the Sacklers discussed abuse of OxyContin. Staff told them that
the most common way of abusing oxycodone, by far, was swallowing it — which a crush-proof
coating on OxyContin did not affect. Staff also reported to the Sacklers that data from the
Massachusetts prescription monitoring program showed far higher rates of “doctor-shopping” for
OxyContin prescriptions than for any other opioid. 295 The prescription monitoring program
identifies “doctor-shopping” when a patient gets opioids from multiple prescribers — an
indication that the patient is at risk of addiction, overdose, and death.
320. In September, staff reported to the Sacklers about the Board’s July 2010 decision
to hire more sales reps. Staff said they were working to implement the decision, adding 125
291
2010-07-27 Board report, pgs. 5, 27, PWG000422481, -503. Staff told the Sacklers that the target for visits was
142,657; that reps visited 7.0 prescribers per day, on average, compared to the target of 7.5; that the average cost of
a visit was $219; and that they were still working to lower the cost to $201.
292
Exhibit 1.
293
294
295
2010-08-16 email from Stuart Baker, PPLPC012000283342-43; 2010-08-19 presentation by Paul Coplan, slides
7, 31, PPLPC012000283469.
107
sales territories. 296 Staff also told the Sacklers that 82% of prescriptions for OxyContin were to
patients who were already on the drug — a key ingredient in Purdue’s plans to keep patients on
opioids longer. 297 The Sacklers . 298
321. In October, staff told the Sacklers that Purdue employed 506 sales reps and,
during Q3 2010, they visited prescribers 141,116 times. 299 More than 2,600 of those visits were
in Massachusetts. 300
322. Meanwhile, staff told
. 301 The Sacklers
. 302
323. That same month, staff told the Sacklers that Purdue was promoting opioids at
more than a dozen programs in Massachusetts, including:
• an $85,000 program on opioids at Tufts University;
• a $50,000 program on opioid prescribing for chronic pain at Boston University;
• a $50,000 program on customized opioid treatments at the Pri-Med Institute (a

company specializing in continuing medical education) in Massachusetts;
• another $45,000 program on opioids for chronic pain at the Pri-Med Institute in
Massachusetts;
• a $15,000 program on pain management at Northeastern University;
• a $10,000 program at the Massachusetts College of Pharmacy;
296
297
2010-09-15 presentation by Russell Gasdia, slide 10, PPLPC012000290691.
298
299
2010-10-25 Board report, pgs. 3, 26, PWG000421967, -990. Staff told the Sacklers the target was 144,414; reps
visited 6.8 prescribers per day, on average, compared to the target of 7.5; each sales rep visit to a prescriber cost
Purdue $219; and they were working to lower the cost to $201.
300
Exhibit 1.
301
302
2010-04-01 Board minutes, PKY183212854; draft meeting materials, PPLPC012000294206.
108
• a $9,400 program on pharmacological treatment of pain in Brockton,
Massachusetts;
• a $4,400 program on pain treatment by pharmacists in Massachusetts;
• another $4,350 program on pharmacological treatment of pain in Brockton,

Massachusetts;
• a $3,500 program on pain management at the Massachusetts College of

Pharmacy;
• another $2,000 program on pain management at the Massachusetts College of

Pharmacy;
• another $1,675 program on opioid pain therapy at the Massachusetts College of

Pharmacy; and
• another $1560 program on pain management by nurses at the Massachusetts

College of Pharmacy. 303
324. In November, staff warned the Sacklers that doctors were not prescribing
Purdue’s highest dose and most profitable opioids as much as the company had expected, so it
might be necessary to cut the family’s quarter-end payout from
and distribute it in two parts: one in early December and one closer to the end of the month. 304
Mortimer Sackler objected to the decrease and the division into two payments, and he demanded
answers from staff: “Why are you BOTH reducing the amount of the distribution and delaying it
and splitting it in two?” “Just a few weeks ago you agreed to distribute the full
.” 305
303
2010-10-07 report attached to email by William Mallin, pgs. 3, 5, 10, 13, 16, 26, 28, 33, 34,
PPLPC012000292676, -678, -683, -686, -689, -699, -701, -706, -707; 2010-10-07 Report attached to email by
William Mallin, PPLPC012000292759-760.
304
305
2010-11-23 and 2010-11-24 emails from Mortimer Sackler, PPLPC012000299869-870.
109
325. Staff also told
. 306 The Sacklers
. 307
326. Staff also reported
.” 308
327. In December, the Sacklers . 309
   2011   
328. In January 2011, Richard Sackler met with sales reps for several days at the
Butrans Launch Meeting and discussed how they would promote Purdue’s newest opioid. 310
Richard quickly followed up with sales management to demand a briefing on how the sales visits
were going in the field:
“I’d like a briefing on the field experience and intelligence

regarding Butrans. How are we doing, are we encountering the
resistance that we expected and how well are we overcoming it,
and are the responses similar to, better, or worse than when we
marketed OxyContin® tablets?” 311
329. Richard’s interventions into sales tactics made employees nervous. When
Richard followed up to ask for information “tomorrow,” CEO John Stewart tried to slow things
306
307
2010-11-03 Board minutes, 2011 budget, PKY183212865; 2010-11 budget submission, pg. 18,
PDD9273201306.
308
2010-11-10 Executive Committee notes, PPLPC012000299855; 2010-11-10 Slideshow presentation by Bert
Weinstein, slide 7, PPLPC012000299866.
309
310
311
110
down, warning staff that Richard’s requests would be “never-ending.” 312 Stewart was right
about Richard, but wrong to think he could stand in the way.
330. Two hours after sending his request, Richard ordered Sales VP Russell Gasdia to
call him, on a Sunday morning, on his cell phone. 313 Richard wanted to discuss “the resistance”
and how Purdue’s sales reps were “overcoming” it right away.
331. Richard Sackler kept pushing for more sales. After one week of prescriptions
doubled Purdue’s forecast, Richard wrote to the sales staff: “I had hoped for better results.” 314 In
a follow-up message, Richard asked staff to tell him the ratio of prescriptions per sales
representative visit to a prescriber, divided out by the prescribers’ specialties. He asked for a
Board discussion of the barriers that sales reps were encountering during promotion. 315 After
trying to answer Richard’s questions and getting another dissatisfied response, sales staff wrote
to the CEO to ask him to intervene. 316 In a later message, Richard wrote to the staff again:
“What do I have to do to get a weekly report on Butrans sales without having to ask for it?” 317
One exasperated staff member begged another to respond. 318 The CEO announced that, from
then on, staff would send a sales report to the Sacklers every week. 319 When staff sent the first
weekly report, Richard responded immediately: “What else more can we do to energize the sales
and grow at a faster rate?” 320 The next week, Richard wrote to the sales staff to ask about the
performance of a specific sales rep. 321
312
313
314
315
316
317
318
319
2011-03-09 email from John Stewart, PPLPC012000314985; PPLPC022000412102.
320
321
111
332. Mortimer Sackler jumped in, asking staff for more information about sales. When
two days passed without an answer, Mortimer insisted: “Any answer to this yet?” 322 Staff rushed
to prepare answers to share with all the Sacklers. 323
333. The people who worked for the Sacklers knew their appetite for sales was
extreme. When the launch of Purdue’s Butrans opioid was on track to beat every drug in its
class, Richard Sackler asked sales staff: “Do you share my disappointment?” 324 Sales VP
Russell Gasdia replied privately to the CEO: “As far as his disappointment, I do not share
that.” 325
334. Throughout that spring of 2011, the Sacklers
. In January, the Sacklers
326
The Sacklers
In September 2009, a Purdue sales manager
had emailed Crowley that Purdue was promoting opioids to an illegal pill mill: “I feel very
certain this is an organized drug ring,” and “Shouldn’t the DEA be contacted about this?”
Purdue sat on the information and did not report it to the authorities for more than two years,
until after the pill mill doctor had already been arrested and the Sacklers had arranged for
lawyers in case Crowley was questioned. 327
322
2011-04-05 and 2011-04-08 emails from Mortimer Sackler, PPLPC012000320102-103.
323
324
325
326
327
2016-07-10 “More than 1 Million OxyContin Pills Ended up in the Hands of Criminals and Addicts. What the
Drugmaker Knew,” by Harriet Ryan, Lisa Girion, and Scott Glover, Los Angeles Times.
112
335. In January 2011, staff reported to the Sacklers that a key initiative in Q4 2010 had
been the expansion of the sales force. Staff told the Sacklers that Purdue employed 590 sales
reps and, during Q4 2010, they visited prescribers 125,712 times. 328 More than 2,900 of those
visits were in Massachusetts. 329
336. Staff told . But
staff reported that Purdue’s revenue was still hundreds of millions of dollars less than expected
because doctors were prescribing less of Purdue’s highest dose opioids. 330 Staff told the
Sacklers that sales of the highest doses continued to fall below expectations, and the gap had cost
the company $120,000,000 in the month of December 2010 alone. 331 The Sacklers faced the
prospect that, if doctors did not prescribe more of the highest doses, their payouts would shrink.
337. In February, staff reported to the Sacklers that law enforcement was increasingly
concerned about lawbreaking by drug companies and the resulting “danger to public safety.” 332
Staff also told the Sacklers that Purdue was receiving a rising volume of hotline calls and other
compliance matters, reaching an all-time high during Q4 2010. Staff reported to the Sacklers
that sales reps had engaged in improper promotion of Purdue opioids, but the company had
decided not to report the violations to the government. Staff also reported to the Sacklers about
the risks of OxyContin, including that 83% of patients in substance abuse treatment centers
began abusing opioids by swallowing pills, and that it took, on average, 20 months for a patient
to get treatment. Staff reported to the Sacklers that Purdue tracked to individual zip codes the
328
2011-01-24 Board report, pgs. 4, 5, 35, PWG000421551, -552, -582. Staff told the Sacklers that, at the Board’s
direction, Purdue had hired 74 more sales reps and planned to hire 51 more. Staff told the Sacklers that the sales rep
visits compared to a target for the quarter of 125,553 visits; and that reps visited 6.2 prescribers per day, on average,
compared to a target of 7.5; and that each visit cost Purdue $219. They were still working to lower the cost to $201.
329
Exhibit 1.
330
331
2011-01-21 email from Sharon Salwan, PPLPC012000307015.
332
2001-02-03 Board meeting materials, slide 48, PDD8901468062.
113
correlation between poison control calls for OxyContin overdose, pharmacy thefts, and
prescribers Purdue suspected of abuse and diversion in Region Zero. 333
338. Staff even gave the Sacklers a map correlating dangerous prescribers in
Massachusetts with reports of oxycodone poisonings, burglaries, and robberies. 334
Map presented to the Purdue Board in 2011

339. In March, staff reported to the Sacklers on OxyContin sales and again focused on
revenue from doctors in Region Zero — prescribers that Purdue suspected of improper
prescribing but that Purdue had not reported to the authorities. Staff told the Sacklers that if
333
2011-02-03 presentation by Bert Weinstein, slides 22-24, 86, 94-95, PDD8901468036-038, -100, -108-109.
334
2011-02-03 presentation by Bert Weinstein, slide 95, PDD8901468109.
114
Region Zero doctors stopped prescribing opioids, Purdue would lose almost 10% of its sales. 335
340. In April, the Sacklers met with Sales VP Russell Gasdia to talk about sales. He
told them that OxyContin was the best-selling painkiller in America, with more than three billion
dollars in annual sales —almost double the second-place drug. 336 The Sacklers
. 337
341. In May, in response to the Sacklers’ repeated requests, staff sent Richard,
Jonathan, Kathe, Mortimer, and Theresa Sackler a report on the sales tactics reps were using to
push Butrans. The first tactic reported to these Sacklers was focusing on a select “core” of
physicians that Purdue calculated would be most susceptible to sales reps lobbying to prescribe
more opioids. 338 In Massachusetts, the prescribers Purdue identified as “core” include Dr.
Conrad Benoit, Dr. Yoon Choi, Dr. Fernando Jayma, and Dr. Fathalla Mashali. 339 Purdue sales
reps repeatedly reported concerns that these doctors wrote inappropriate prescriptions, but
Purdue ordered the reps to keep promoting opioids to these doctors anyway. Dozens of their
patients overdosed and died.
342. The second tactic staff reported to Richard, Jonathan, Kathe, Mortimer, and
Theresa Sackler in the May 25, 2011 email was “positioning of Butrans for specific patient
types.” 340 In Massachusetts, promotion for “specific patient types” meant pushing opioids for
elderly patients with arthritis. Sales reps recorded in their notes that they urged Massachusetts
doctors to prescribe opioids for elderly patients more than a thousand times in 2011. The reps
335
2011-03-01 2011 OxyContin Tablets Sales Trends and Projections, PPLP004405801, -809.
336
2011-04-14 Board presentation, PPLP004405866, -880.
337
338
339
See, e.g., 2013 Q1 target list, PPLPC015000141319.
340
115
even went to pharmacies to ask Massachusetts pharmacists to encourage doctors to prescribe
opioids for the elderly.
343. A third tactic reported to these five Sacklers was getting prescribers to commit to
put specific patients on opioids. 341 In Massachusetts, sales reps recorded in their notes that they
asked doctors to commit to prescribe opioids more than a thousand times in 2011. Massachusetts
sales reps repeatedly asked prescribers to commit to prescribe opioids without disclosing
significant risks.
344. Jonathan Sackler was not satisfied that these tactics would be enough to boost
sales. He wrote to John Stewart: “this is starting to look ugly. Let’s talk.” 342 Stewart and the
sales team scrambled to put together a response and set up a meeting with Jonathan for the
following week. 343
345. That same month, staff reported to the Sacklers that Purdue had hired 47 more
sales reps . Staff told the Sacklers that Purdue employed 639
sales reps and, during Q1 2011, they visited prescribers 173,647 times. 344 More than 3,800 of
those visits were in Massachusetts. 345
346. Meanwhile, the Sacklers
. 346 The Sacklers
were on notice that Purdue’s unfair and deceptive marketing raised serious concerns. Staff also
341
342
2011-05-25 email from Jonathan Sackler, PPLPC012000326194.
343
344
2011-05-02 Board report, pgs. 5, 6, 36, PPLPC012000322430, -431, -461. Staff told the Sacklers
.
345
Exhibit 1.
346
116
told the Sacklers that they had received another 88 calls to Purdue’s compliance hotline, but not
reported any of them to the authorities. 347
347. In June, staff reported to the Sacklers
. 348 The headline presented at the Board meeting read:
“40 and 80mg tablet prescriptions have decreased significantly. The 10mg and 20mg tablet
prescriptions initially increased, but given their lower value not enough to offset the higher
strength decline.” Staff told the Sacklers: “As a result of the change in prescriptions by strength,
OxyContin brand Kgs dispensed are below mid 2010 levels.” Staff reported to the Sacklers that
Purdue would rely on sales rep visits and paid physician spokespersons to maintain demand. For
a “Super Core” of “Very High Potential” opioid prescribers, Purdue would order its sales reps to
make sales visits every week. 349
348. The Sacklers immediately pushed to find ways to increase sales. Richard Sackler
asked Sales VP Russell Gasdia to include him in a meeting with District Managers who were the
day-to-day supervisors of the sales reps. Then, having missed the meeting, he engaged Gasdia
again by email. Gasdia told Richard that Purdue had hired 147 new sales reps at the Board’s
direction. Gasdia told Richard that Purdue instructed the sales reps to focus on converting
patients who had never been on opioids or patients taking “low dose Vicodin, Percocet, or
tramadol” — all patients for whom Purdue’s opioids posed an increase in risk. 350
349. Sales reps reported to Purdue that they encouraged Massachusetts doctors to
prescribe opioids to opioid-naive patients more than a thousand times in 2011.
347
2011-05-20 compliance report, PPLP004406033.
348
349
2011-06-21 Mid-Year Update, PPLP004406102-123.
350
117
350. Gasdia told Richard Sackler (again) that Purdue instructed sales reps to focus on
the few highest-prescribing doctors in their territory and visit them over and over. Gasdia also
told Richard that staff had initiated performance enhancement plans for sales reps who were not
generating enough opioid prescriptions. 351 In Massachusetts, a sales rep was put on a
performance enhancement plan and ordered to visit 10 specific prescribers twice every week and
increase prescriptions by 43%. 352 Another Massachusetts rep was ordered to increase
prescriptions by 62%. 353 Purdue issued a performance enhancement plan to another
Massachusetts sales rep that said: “Anticipated Challenges: Dr. trying to cut down on opioid
prescribing due to abuse.” “Action Steps: Sell for patients they are willing to Rx opioids
…(elderly).” 354 Purdue also ordered the rep to do a better job using gifts (“coffee, lunch”) to buy
time with Massachusetts prescribers and reminded her that Purdue had a budget for that
purpose. 355
351. Purdue put two other Massachusetts reps on probation and threatened to fire them
because the doctors they visited did not put enough patients on opioids. Purdue told them that
the only way they could keep their jobs was by generating more opioid sales. 356
352. In response to Gasdia’s message about the sales reps, Richard Sackler wrote back
six minutes later and asked to meet with Gasdia without delay. 357 Gasdia scrambled to schedule
351
352
Performance Enhancement Plan, PPLPC014000231426 (“See Top 10 HCPs each Monday. See them again
before end of same week.”).
353
Performance Enhancement Plan, PPLPC014000183394.
354
355
356
2011-11-18 letters from Roland Gustavson, PPLPC029000430006, PPLPC028000391912 (“You are being
placed on probation due to your overall unsatisfactory sales performance … The ultimate measure of your probation
outcome will be your ability to impact sales growth … You must demonstrate continuous and sustained performance
both during and after the probationary period. Failure to do so may lead to additional disciplinary action up to and
including termination of employment.”).
357
118
a meeting about sales tactics with Richard for first thing the next morning. 358 Richard would not
wait until the morning and instructed Gasdia to call him that same day. 359
353. Richard Sackler continued the correspondence that day, criticizing Purdue’s
managers for allowing sales reps to target “non-high potential prescribers.” “How can our
managers have allowed this to happen?” 360 Richard insisted that sales reps push the doctors who
prescribed the most drugs.
354. To make sure his orders were followed, Richard Sackler demanded to be sent into
the field with the sales reps. 361 Richard wanted a week shadowing Purdue sales reps, two reps
per day. In horror, Gasdia appealed to Purdue’s Chief Compliance Officer, warning that Richard
Sackler promoting opioids was “a potential compliance risk.” 362 Compliance replied: “LOL.” 363
To make sure the Sacklers’ involvement in marketing stayed secret, staff instructed: “Richard
needs to be mum and be anonymous.”
358
359
360
361
362
2011-06-16 email from Russell Gasdia, PPLPC012000329494 (“Based on our discussions, perhaps you could sit
down with JS on your thoughts. Also, I haven’t spoken to him about RS going to field with reps. Perhaps you could
also say something to JS and indicate I came to you for counsel as I saw this as a potential compliance risk?”).
363
2011-06-16 email from Bert Weinstein, PPLPC012000329722.
119
Purdue internal emails
355. A slew of executives, including the CEO, got involved in planning Richard
Sackler’s sales visits. All of them were worried. One wrote:
“About 5 last night, John [Stewart, the CEO] was walking by my

office – I yelled out to stop him – and said that you had mentioned
to me that Richard wanted to go into the field, and that you had
raised concerns with me. John seemed angry, and asked if I had
concerns. I told him could be issues and Richard could be out on a
limb if he spoke about product at all or got into conversations with
HCPs, or identified himself, especially with FDA Bad Ad
possibilities. John agreed Richard would have to be mum
throughout, and not identify himself other than as a home office
person.” 364
364
120
356. Richard Sackler indeed went into the field to promote opioids to doctors alongside
a sales rep. When he returned, Richard argued to the Vice President of Sales that a legally-
required warning about Purdue’s opioids wasn’t needed. He asserted that the warning “implies a
danger of untoward reactions and hazards that simply aren’t there.” Richard insisted there
should be “less threatening” ways to describe Purdue opioids. 365
357. Meanwhile, the Sacklers . 366
358. A few days later, sales and marketing staff scrambled to prepare responses to
questions from the Sacklers. Mortimer Sackler asked about launching a generic version of
OxyContin to “capture more cost sensitive patients.” Kathe Sackler recommended looking at the
characteristics of patients who had switched to OxyContin to see if Purdue could identify more
patients to convert. Jonathan Sackler wanted to study changes in market share for opioids,
focusing on dose strength. 367
359. At the same time, sales staff were organizing more ways for Richard Sackler to
oversee their work in the field. Gasdia proposed to Richard:
“In addition to field contacts with representatives, you may want to

consider attending one of the upcoming conventions where we will
be attending. At each of the ones listed below, we will have a
promotional booth for OxyContin & Butrans. In addition, we are
sponsoring educational programs for Butrans and OxyContin in the
form of a ‘Product Theater.’
This would provide you the opportunity to be on the convention

floor, observing numerous presentations being provided by our
representatives and see a wide range of interactions over the course
of a day. In addition, we can arrange for one-on-one meetings with
key opinion leaders who are attending, many of them are approved
consultants/advisors for us and you can have some open
conversations regarding the market, perceptions around Butrans
365
366
367
2011-06-28 email from Edward Mahony, PPLPC012000331343; attachment PPLPC012000331345.
121
and OxyContin. Finally, you could observe the Product Theaters
we are implementing.” 368
360. In July, staff assured the Sacklers that Purdue prohibited sales reps from writing
their sales pitches to prescribers in email. 369 The Sacklers believed that promoting opioids in
oral conversations with doctors, and banning employee email, would protect them from
investigations of their misconduct.
361. In August, staff told the Sacklers that Purdue employed 640 sales reps and,
362. Meanwhile, staff reported to the Sacklers
. 372
363. In September, Richard Sackler directed staff to study a savings card program for
a widely-used cholesterol medication (not an addictive narcotic) to learn how Purdue could use it
for opioids. 373 That same month, the Sacklers . 374
364. In November, staff told the Sacklers that Purdue still employed 640 sales reps
and, during Q3 2011, they visited prescribers 189,698 times. 375 More than 4,100 of those visits
were in Massachusetts. 376 Looking ahead, the Sacklers
368
369
2011-07-21 Board meeting presentation, PPLP004406488-490.
370
2011-08-03 Board report, pgs. 6, 42, PWG000420318, -354. Staff told the Sacklers that the sales rep visits
compared to a target for the quarter of 187,950 visits; and that reps visited 7.2 prescribers per day, on average,
compared to a target of 7.0.
371
Exhibit 1.
372
373
374
375
376
Exhibit 1.
122
. 377
365. , staff told the Sacklers
. 378
   2012   
366. In January 2012, Jonathan Sackler started the year pressing Sales VP Russell
Gasdia for weekly updates on sales. 379 A few days later, Richard Sackler jumped into the weeds
with the sales staff, this time about advertising. Richard noticed that online ads appeared
indiscriminately on webpages with content associated with the ad — regardless of whether the
association was positive or negative. 380 Staff assured Richard that, when Purdue bought online
advertising for opioids, it specified that the ads appear only on pages expressing positive views
toward opioids, and would not appear with articles “about how useless or damaging or dangerous
is our product that we are trying to promote.” 381
367. That same month, staff told the Sacklers that Purdue employed 632 sales reps and,
368. The Sacklers were not satisfied with the sales effort. In February, staff reported
to the Sacklers that prescriptions had dropped, and that a decrease in sales rep visits to
377
2011-11-18 Board minutes, 2012 budget, PKY183212941-942; 2012 budget submission, pg. 22,
PDD9273201436.
378
379
380
381
382
2012-01-25 Board report, pgs. 7, 48, PPLPC012000362250, -291. Staff told the Sacklers that the sales rep visits
achieving the target of 7.0.
383
Exhibit 1.
123
prescribers was a major driver of the decline. Staff asked the Sacklers to be patient, because reps
had missed work for December holidays and the company’s mandatory National Sales Meeting
in January. 384 Mortimer Sackler was not pleased. He suggested that, “in future years we should
not plan the national sales meeting so close following the winter break as it extends the period of
time since the doctor last saw our rep.” Mortimer wrote: “Wouldn’t it be better to have the reps
get back to work for January and back in front of doctors.” 385 Mortimer was agitated by the
thought of doctors going too many days without a sales rep visiting to promote Purdue opioids.
If Purdue rescheduled its meeting, “At least then the doctors will have gotten at least one
reminder visit from our reps in the last month whereas now they might go two months without
seeing one of our reps??” Staff replied to Mortimer, arguing for “balance.” 386 Richard Sackler
replied within minutes that, since the National Sales Meeting prevented sales reps from visiting
doctors, “Maybe the thing to have done was not have the meeting at all.” 387 Purdue’s
compliance officer forwarded the exchange to his staff, commenting: “Oh dear.” 388
369. Meanwhile, Richard Sackler
.” 389 Staff .” 390 Sales VP
Gasdia wrote .” 391
384
385
386
387
388
389
2012-02-02 and 2012-02-03 emails from Richard Sackler, PPLPC021000439058, PPLPC021000439090; see
also 2012-02-22 emails from Richard Sackler, PPLPC021000443801.
390
391
124
370. Richard Sackler
. 392 Employees
. 393 , Purdue’s Chief Medical Officer Craig Landau
. Landau’s assistant wrote:
.” 394
Purdue staff knew that people would bend the rules when Richard Sackler wanted something.
371. Throughout the spring, the Sacklers pressed staff to promote Purdue’s opioids
more aggressively. In February, Gasdia wrote to sales staff that the Board of Directors (“BOD”)
was not satisfied with the money coming in: “Things are not good at the BOD level.” 395 When
sales dropped for one week on account of the Presidents’ Day holiday, Richard Sackler wrote to
sales management: “This is bad.” 396 Gasdia forwarded Richard’s message to his colleagues,
asking how they could “create a greater sense of urgency at the regional management and district
management level.” 397
372. The sales manager who reported to Gasdia had an immediate answer — aimed
straight at Massachusetts. That same night, he drafted a message to the leader of Purdue’s
392
2012-02-14 email from Richard Sackler, PPLPC021000441423 (
”); 2012-02-15 email from Donna Condon, PPLPC012000365558.

393
2012-02-15 email from Donna Condon, PPLPC012000365558. One employee wrote:
.” Russell Gasdia Richard

CEO; Purdue’s lawyer. PPLPC012000365390;
PLPC012000365559.
394
2012-02-23 email from Nancy Camp-Font, PPLPC018000644983.
. PPLPC005000241221.
395
396
397
125
Boston district. He wrote: “the Boston District is failing.” Then the sales manager went person
by person through a list of Massachusetts sales reps and criticized them for not increasing opioid
prescriptions enough. He emphasized that the pressure was coming from Richard Sackler
himself:
“Russ, as well as Mike and myself are constantly defending the

launch of Butrans to BOD members. Just today, Dr. Richard sent
another email ‘This is bad,’ referring to current Butrans trends. I
am quite sure that Dr. Richard would not be sympathetic to the
plight of the Boston District.”
The manager ended his email by threatening to fire every sales rep in Boston:
“I must tell you that I am much closer to dismissing the entire

district than agreeing that they deserve a pass for poor market
conditions.” 398
The manager sent his draft to Gasdia, who asked him to run it by someone in marketing. Gasdia
agreed that they should consider firing the sales reps, because “that will send a message.” 399
373. Meanwhile, Gasdia pleaded with the CEO to defend him against Richard
Sackler’s micromanagement of sales: “Anything you can do to reduce the direct contact of
Richard into the organization is appreciated.” 400 A week later, Richard wrote to sales
management again to criticize them for U.S. sales being “among the worst” in the world. 401
374. In March, staff
. 402
375. On one Saturday morning, Richard Sackler wrote to marketing staff, demanding
monthly data for all extended release pain medications for the past twelve years and an
398
399
400
401
402
2012-03-05 email from Edward Mahony, PPLPC012000368627.
126
immediate meeting that Monday night. 403 Gasdia and Stewart stood by helpless, writing: “Do let
us know how this goes.” 404 Later that month, staff created for Richard a historical summary of
key events determining OxyContin sales. Eleven of the key events in sales history were changes
in the size of the Purdue sales force — all known to Richard because the Sacklers had ordered
them. 405
376. A few days later, staff sent Richard Sackler an assessment of recently-improved
opioid sales. Staff told Richard that the increase in prescriptions was caused by tactics that
Purdue taught sales reps: pushing opioids for elderly patients with arthritis (“proper patient
selection”) and encouraging doctors to use higher doses of opioids (“quick titration”). 406 In the
coming months, Purdue would study, document, and expand the use of higher doses to increase
sales — a tactic that helped to kill people in Massachusetts.
377. Richard Sackler wrote that he was not satisfied with a report on sales and
instructed Gasdia to discuss it with him within a day. 407 Gasdia scrambled to schedule the
meeting. 408 Then Richard raised the stakes and asked Gasdia to address both Butrans sales
tactics and a decline in OxyContin sales and propose corrective actions. 409 John Stewart
suggested that Richard’s frustrations could be linked to dosing: he encouraged Gasdia to tell
Richard that patients on lower doses seemed to stop taking opioids sooner, and that much of the
profit that Purdue had lost had been from doctors backing off the highest dose of OxyContin
(80mg). 410
403
404
405
2012-03-28 presentation, PPLPC012000371063.
406
407
408
409
410
127
378. Richard Sackler was not satisfied. Days later, after sales did not increase, staff
told him that they were starting quantitative research to determine why patients stay on opioids,
so they could find ways to sell more opioids at higher doses for longer. 411
379. In April, staff told the Sacklers that Purdue employed 630 sales reps and, during
Q1 2012, they visited prescribers 179,554 times. 412 More than 3,800 of those visits were in
Massachusetts. 413
380. Meanwhile, Richard Sackler kept pushing the staff to increase sales. When the
mandatory weekly report to the Sacklers showed that sales reps achieved 9,021 prescriptions in a
week, Richard asked Sales VP Russell Gasdia for a commitment that the reps would get weekly
prescriptions to 10,000: “Are you committed to breaking 10K/wk Rx’s this month?” 414 A
colleague replied incredulously to Gasdia: “Is there any question of your commitment?” 415 Even
for people who worked in sales, Richard’s conviction that sales reps should just make doctors
prescribe opioids seemed crazy.
381. Gasdia tried to assure Richard Sackler that they were selling opioids aggressively:
“Windell and the sales force, as well as Mike and the marketing team (initiatives being
implemented) are focused and committed to accelerating the growth trend … everyone in the
commercial organization is focused on exceeding the annual forecast.” 416 Richard wanted more.
Richard wanted to know what tactics sales staff would use to get more prescriptions, and he
wanted to talk about it right away. First he wrote: “give me the table of weekly Rx plan and the
411
412
413
Exhibit 1.
414
415
416
128
actual. Then show how you plan to make up the current shortfall.” 417 Then he asked for a
meeting within 24 hours. 418 Then Richard didn’t want to wait that long: “Can we meet in person
today?” 419 On Friday the 13th, sales and marketing staff met with Richard to review how they
would sell more opioids. 420
382. In May, executives emphasized to the managers overseeing Massachusetts sales
reps that the Sacklers were tracking their efforts, and that Richard Sackler required weekly
reports. 421 Staff gave the only reply that was acceptable at Purdue: “All our efforts are focused
on attaining the objective” of increased opioid prescriptions that the Sacklers set. 422
383. In June, the Sacklers discussed sales and marketing again. 423 Staff reported to
the Sacklers that they had added 120,000 sales visits to drive sales of OxyContin. 424
417
418
419
420
2012-04-12 email from Russell Gasdia, PPLPC012000372335; 2012-04-13 invitation from Donna Condon,
PPLPC012000372332.
421
422
2012-05-15 email from Gary Lewandowski, PPLPC023000468016.
423
2012-05-29 email from John Stewart, PPLPC012000377890; attachment PPLPC012000377892.
424
2012-06-18 Mid Year Sales and Marketing Board Update, slide 10, PPLPC012000382119.
129
. The Sacklers
. 425
Purdue internal presentation showing effect of savings cards

Keeping patients on opioids for these lengths of time was especially dangerous for the patients
and especially profitable for Purdue.
385. Staff also told the Sacklers that (as they had in 2009) they were again targeting
prescribers for OxyContin promotion through a special television network. 426 Purdue selected
physician targets to see the television program in Brockton, Chestnut Hill, Fitchburg, Holyoke,
425
2012-06-18 Mid Year Sales and Marketing Board Update, slides 11-12, PPLPC012000382119.
426
130
Newburyport, North Dartmouth, Springfield, Webster, and Worcester. 427 The video featured a
doctor paid by Purdue to promote opioids, and encouraged prescribers to use opioid savings
cards. 428
386. In July, David Sackler (Richard Sackler’s son) took a seat on the Board. For
events after July 2012, this Complaint includes David in “the Sacklers.”
387. Staff told the Sacklers that Massachusetts now allowed drug companies to host
dinners for doctors to promote their drugs. 429 Purdue hosted meals to promote opioids to doctors
throughout Massachusetts — including in Barnstable, Boston, Brockton, Chelmsford,
Dartmouth, Hingham, Kingston, Lawrence, Newton, Pittsfield, Swansea, Westport, and
Worcester. 430 At one point, staff calculated that Purdue was spending more than $9,000,000 per
year to buy food for doctors who prescribe opioids. 431
388. Staff also told the Sacklers that Purdue employed 633 sales reps and, during Q2
2012, they visited prescribers 183,636 times. 432 More than 3,700 of those visits were in
Massachusetts. 433
389. In August, the Sacklers
. 434
390. In November, staff told the Sacklers the confidential results of a study of 57,000
patients that Purdue performed explicitly to determine how opioid dose “influences patient
427
2012-02-27 OxyContin Broadcast Summary Report, PPLPC023000526992.
428
Video: “A Treatment Plan for Moderate to Severe Low Back Pain That Includes Converting to an Extended-
Release Opioid Analgesic,” PPLP003276093.
429
430
Mass. HCP Payments, PMA000281466.
431
2014-06-16 budget information, PPLPC031001202294 ($9,119,250; food budget for each sales rep: $18,000).
432
2012-07-23 Board report, pgs. 6, 44, PPLPC012000387074, -112; 2012-07 Marketing and Sales report,
PPLP004149354. Staff told the Sacklers that the sales rep visits compared to a target for the quarter of 190,662
visits; and that reps visited 7.0 prescribers per day, on average, compared to a target of 7.1.
433
Exhibit 1.
434
131
length of therapy.” The results showed that patients on the highest doses “are the most
persistent.” The “Recommended Actions” presented to the Sacklers included “additional
workshops for the sales force” and “specific direction” to the sales representatives about using
higher doses to keep patients on drugs longer. Staff told the Sacklers that encouraging higher
doses “is a focal point of our promotion,” and that sales reps would “emphasize the importance”
of increasing patients’ opioid doses, as soon as 3 days after starting treatment. 435
391. That same month, the Sacklers voted to set Purdue’s budget for Sales and
Promotion for 2013 at $312,563,000. 436 Staff told the Sacklers that Purdue employed 622 sales
reps and, during Q3 2012, they visited prescribers 180,723 times. 437 More than 3,600 of those
visits were in Massachusetts. 438
   2013   
392. In January 2013, in what was becoming a yearly ritual, Richard Sackler
questioned staff about the drop in opioid prescriptions caused by Purdue sales reps taking time
off for the holidays. Richard wasn’t satisfied: “Really don’t understand why this happens. What
about refills last week? Was our share up or down?” 439 Staff assured Richard that doctors were
“sensitive” to sales rep visits and, as soon as the reps got back into action, they would “boost”
opioid prescriptions again. 440
393. Staff told the Sacklers that they continued to reinforce the Individualize The Dose
435
436
2012-11-16 Board minutes, 2013 budget, PKY183212995-998.
437
438
Exhibit 1.
439
440
132
campaign, which the Sacklers knew and intended would promote higher doses. Staff also told
the Sacklers that sales reps would place greater emphasis on the opioid savings cards, which the
Sacklers knew and intended would keep patients on opioids longer. Staff reported to the
Sacklers that Purdue had conducted a sensitivity analysis on the opioid savings cards to
maximize their impact and, as a result, had increased the dollar value and set the program period
to be 15 months long. Staff also reported to the Sacklers that Purdue had created promotional
materials to support these tactics and had distributed them to the sales force. Staff also told the
Sacklers that Purdue showed an opioid promotional video to 5,250 physicians on the Physician’s
Television Network. 441 The video urged doctors to give patients Purdue’s opioid savings
cards. 442
395. In February, the Sacklers met with staff about tactics for promoting Purdue’s
opioids. They discussed research on what influences prescriptions, how doctors had responded
to Purdue’s increased promotion, and sales force promotion themes. 445 On the same day, the
Sacklers
. 446
441
2013-01-28 Board report, pgs. 12-14, PPLPC012000407138-140.
442
Butrans promotional video, PPLP003297185.
443
2013-01-28 Board report, pgs. 10, 56, PPLPC012000407136, -182. Staff told the Sacklers that the sales rep
visits compared to a target for the quarter of 191,264 visits; and that reps visited 7.0 prescribers per day, on average,
444
Exhibit 1.
445
446
133
396. In March, staff reported to the Sacklers on the devastation caused by prescription
opioids. Staff told the Sacklers that drug overdose deaths had more than tripled since 1990 —
the period during which Purdue had made OxyContin the best-selling painkiller. Staff told the
Sacklers that tens of thousands of deaths were only the “tip of the iceberg.” Staff reported that,
for every death, there were more than a hundred people suffering from prescription opioid
dependence or abuse. 447
397. In May, staff reported to the Sacklers again that they were successfully using
opioid savings cards to get patients to “remain on therapy longer.” Staff told the Sacklers that
they were using direct mail and email, as well as sales visits, to push the opioid savings cards. 448
398. Staff reported to the Sacklers that, despite these sales efforts, they were not
achieving the goals of getting enough patients on higher doses of opioids and getting doctors to
prescribe more pills in each prescription. Staff told them that “there is an ‘unfavorable’ mix of
prescriptions across strengths,” and Purdue was losing tens of millions of dollars in revenue
because sales of the highest doses (60mg and 80mg) were too low. Staff told the Sacklers that
there was also a second problem: “lower average tablet counts per prescription.” Because
doctors were not prescribing enough pills during each patient visit, Purdue was losing tens of
millions of dollars in revenue. Staff promised the Sacklers: “A deeper analysis is underway to
determine the cause of the decline in the 30mg, 60mg, and 80mg tablet strengths, as well as the
lower than budgeted average tablets per prescription. Once the analysis is complete, we will
have a better sense of what tactics to implement to address both issues.” 449
447
2013-03-21 Board presentation, PPLP004409513-514.
448
449
134
399. The Sacklers met with Sales VP Russell Gasdia about the strategy for selling high
doses. Gasdia told the Sacklers that “Titration up to higher strengths, especially the 40mg and
80mg strengths is declining.” He analyzed the “Causes of OxyContin’s Decline in Higher
Strengths,” and how Purdue would reverse that decline. He told the Sacklers that Purdue’s #1
tactic to sell higher doses was sending sales reps to visit prescribers. The #2 tactic was a
marketing campaign designed to promote high doses — Purdue’s Individualize The Dose
campaign. After that, Gasdia told the Sacklers, came opioid savings cards. After that, special
focus on the most prolific opioid prescribers. 450
400. Gasdia told the Sacklers that the staff would develop even more tactics to sell
higher doses. They were using Purdue’s data on thousands of doctors and patients to learn what
made people willing to use high doses of opioids. They had started a study of physician
characteristics and a “patient level analysis to determine what patient characteristics” were
associated with “higher dose volume.” 451
402. In July, the Sacklers discussed “threats” to their business from data on long-term
opioid use, as public health authorities reacted to the danger of keeping patients on opioids for
longer periods of time. 454 Meanwhile, staff sent the Sacklers a “Flash Report” that OxyContin
450
2013-05 Board presentation by Russell Gasdia, PPLP004409727-728.
451
2013-05 Board presentation by Russell Gasdia, PPLP004409729.
452
2013-05-13 Board report, pgs. 12, 62, PPLP004367551, -601. Staff told the Sacklers that the sales rep visits
compared to a target of 7.1. Staff assured the Sacklers that “call productivity is expected to increase towards the
targeted goal throughout 2013.”
453
Exhibit 1.
454
2013-07-24 Communications and External Affairs Committee minutes, PPLPC012000433553.
135
sales had dropped $96,400,000 from the year before. Staff explained to the Sacklers that
insufficient volume of sales rep visits to promote OxyContin to prescribers was an important
reason for the dropping sales. Staff told the Sacklers that they would increase the number of
sales visits and had hired McKinsey to study how to get doctors to prescribe more OxyContin. 455
403. Staff also reported to the Sacklers that key priorities were to reverse “the decline
in higher strengths” of Purdue opioids, and the decline in “tablets per Rx,” which were reducing
Purdue’s profit. They told the Sacklers that Purdue staff were studying ways to fight these
trends, and McKinsey would analyze the data down to the level of individual physicians. 456
404. Mortimer Sackler asked for more detail on what was being done to increase
sales. 457 Staff told the Sacklers
. Staff told the Sacklers
.” 458
405. That same month, staff told the Sacklers that Purdue defeated legislation to
restrict OxyContin in Massachusetts. Staff also told the Sacklers that Purdue was targeting
Massachusetts prescribers with opioid savings cards: “Emails targeted towards HCPs practicing
455
456
457
458
2013-07-07 email from John Stewart, PPLPC012000431262; attachment PPLPC012000431266-278.
136
in Massachusetts were also developed to remind them that the use of patient savings cards are
now permissible in Massachusetts and that they can download OxyContin Savings Cards at
PurdueHCP.com.” 459
406. Staff also reported to the Sacklers that they had trained Purdue’s sales reps to use
new sales materials designed to get patients on higher doses of opioids for longer periods. Staff
told the Sacklers that Purdue employed 634 sales reps and, during Q2 2013, they visited
prescribers 177,773 times. 460 More than 2,400 of those visits were in Massachusetts. 461 Staff
assured the Sacklers that they were trying to achieve even more sales visits by monitoring the
reps. 462
407. Before the month ended, the Sacklers met
. They urged the Sacklers
459
2013-07-23 Board report, pgs. 17, 52, PPLPC012000433404, -439 (“Two specific concerns were Massachusetts
HB 1786 which rescheduled OxyContin to a CI controlled substance and Mississippi HB 599 which set a 75 unit
limit per RX on OxyContin. Both bills were defeated.”).
460
2013-07-23 Board report, pgs. 11, 12, 59, PPLPC012000433398, -399, -446. Staff told the Sacklers that the sales
rep visits compared to a target for the quarter of 191,184 visits; and that reps visited 6.9 prescribers per day, on
average, compared to a target of 7.1.
461
Exhibit 1.
462
137
. 463
408. Days later, staff told the Sacklers that . 464
409. In August, the Sacklers met
. They also reported to the
Sacklers that
. 465
410.
. Two
months earlier, the Walgreens pharmacy company admitted that it broke the law by filling
illegitimate prescriptions, and it agreed to new safeguards to stop illegal prescribing. 466
told the Sacklers that “
.” Even worse for the Sacklers, the
463
2013-07-18 Identifying Granular Growth Opportunities for OxyContin: First Board Update, PPLP004409871.
464
465
2013-08-08 Identifying Granular Growth Opportunities for OxyContin: Addendum to July 18th and August 5th
Updates, PPLP004409892.
466
2013 Walgreens agreement, https://www.justice.gov/sites/default/files/usao-sdfl/legacy/2013/06/19/130611-
01.WalgreensMOA%26Addendum.pdf.
138
. the
Sacklers
. 467
411. advised the Sacklers
.”
.”
the Sacklers .’” 468
412. In September and October, the Sacklers met
. The Sacklers discussed
. 469
467
Updates, PPLP004409896-897.
468
Updates, PPLP004409897-898.
469
2013-09-12 Board agenda, PPLP004409919; 2013-10-03 Board agenda, PPLP004409965-972.
139
413.
. 470
. 471
Graphic from
414. In October, Mortimer Sackler pressed for more information on dosing and “the
breakdown of OxyContin market share by strength.” 472 Staff told the Sacklers that “the high
dose prescriptions are declining,” and “there are fewer patients titrating to the higher strengths
from the lower ones.” 473 In response to the Sacklers’ insistent questions, staff explained that
470
2013-08-22 email from Russell Gasdia, PPLPC012000437344 ( interim report).
471
2013-08-22 presentation, slide 10, PPLPC012000437356.
472
473
2013-10-28 email from David Rosen, PPLPC012000448832-833.
140
sales of the highest doses were not keeping up with the Sacklers’ expectations because some
pharmacies had implemented “good faith dispensing” policies to double-check prescriptions that
looked illegal and some prescribers were under pressure from the DEA. 474 Staff promised to
increase the budget for promoting OxyContin by $50,000,000, and get sales reps to generate
more prescriptions with a new initiative to be presented to the Sacklers the following week. 475
415. At the end of the month, the Sacklers met to discuss Purdue’s budget for sales and
marketing for 2014. 476 Looking back at sales tactics used in 2013, staff told the Sacklers that a
relationship marketing program targeting Boston had increased opioid prescriptions by 959%. 477
Staff told the Sacklers (again) that Purdue’s opioid savings cards kept patients on opioids
longer. 478 Looking ahead at 2014, staff reported to the Sacklers that doctors shifting away from
high doses and towards fewer pills per prescription could cost Purdue hundreds of millions of
dollars in lost sales. 479 To fight against that threat, staff told the Sacklers the that they would
increase the sales visits by each rep to 7.3 visits per day and visit prescribers 758,164 times in the
year. 480
416. In November, Richard Sackler complained
. Richard
?” 481 Staff
474
475
476
2013-10-28 email from Russell Gasdia, PPLPC012000448832; Sales & Marketing Board presentation,
PPLP004409987.
477
2013-10-29 Analgesic Market Update presentation to the Board, PPLP004410015.
478
2013-10-29 OxyContin 2014 Budget Proposal to the Board, PPLP004410062.
479
2013-10-29 Sales & Marketing presentation to the Board, PPLP004409989.
480
2013-10-29 Sales Force 2014 Objectives presented to the Board, PPLP004409999.
481
141
. 482
417. That same month, Richard Sackler alerted staff that the Massachusetts legislature
was considering a bill to limit the length of prescriptions for the most addictive controlled
substances. 483 The safeguard could help doctors prevent and treat addiction by requiring more
frequent visits for patients on the most dangerous drugs. Staff promised Richard that they would
review the legislation and get back to him to discuss a strategy for opposing it. 484
418. Staff reported to the Sacklers that a key initiative during Q3 2013 was for sales
reps to encourage doctors to prescribe OxyContin to elderly patients on Medicare. 485 In
Massachusetts during 2013, sales reps reported to Purdue that they pushed opioids for elderly
patients more than a thousand times. The sales reps did not disclose to doctors in Massachusetts
that elderly patients faced greater risks of drug interactions, injuries, falls, and suffocating to
death.
419. Staff also reported to the Sacklers that another key initiative during Q3 2013 was
for sales reps to promote OxyContin for patients who had never taken opioids before. 486 In
Massachusetts during 2013, Purdue sales reps did not disclose to doctors that opioid naive
patients faced greater risks of overdose and death.
420. Staff also told the Sacklers that analysis conducted in July 2013 showed that
opioid savings cards earned the Sacklers more money by keeping patients on opioids longer;
specifically, more patients stayed on OxyContin longer than 60 days. Staff reported to the
Sacklers that Purdue was pushing opioid savings cards in sales rep visits, through email to tens
482
2013-11-18 email from Raul Damas, PPLPC023000633066.
483
2013-11-11 email from Richard Sackler, PPLPC020000733992 (legislation would limit schedule II prescriptions
to 15 days).
484
485
486
142
of thousands of health care providers, and online. 487 In Massachusetts during 2013, sales reps
reported to Purdue that they promoted opioid savings cards to prescribers more than a thousand
times. The sales reps did not tell doctors in Massachusetts that savings cards led patients to stay
on opioids longer than 60 days, or that staying on opioids longer increased the risk of addiction
and death.
421. Staff reported to the Sacklers
. But staff told the Sacklers
. 488
422. Staff told the Sacklers that, in Q4 2013, sales reps would increase the number of
visits to prescribers. 489 In Massachusetts, during those three months, sales visits increased by
30%. 490
423. Staff also reported to the Sacklers that a key initiative in 2013 was to train sales
reps to keep patients on Butrans opioids longer. They told the Sacklers that, at the same time as
the initiative to keep patients on opioids longer, Purdue launched a new high dose of its Butrans
opioid; sales reps began promoting the new high dose to physicians using new sales materials;
and initial orders were double the company’s forecasts. Staff reported to the Sacklers that
marketing and sales activities generated 266,842 additional prescriptions and highlighted that
opioid savings cards generate especially “high returns” by keeping patients on opioids longer. 491
424. Staff reported to the Sacklers that Purdue had sent more than 880,000 emails to
487
2013-11-01 Board report, pgs. 15-16, 24-25, PPLPC002000186925-926, -933-934.
488
489
490
Exhibit 1.
491
2013-11-01 Board report, pgs. 11-13, 27, PPLPC002000186921-923, -937.
143
health care professionals to promote its Butrans opioid, and posted online advertising seen more
than 5 million times for Butrans and nearly 4 million times for OxyContin. They told the
Sacklers that hundreds of thousands of communications to prescribers nationwide presented the
same “key selling messages” designed to get more patients on OxyContin at higher doses for
longer periods of time, and specifically promoted Purdue’s opioid savings cards. 492
425. Staff reported to the Sacklers
. Staff also reported that they had direct access to physician level
data to analyze prescriptions by individual doctors. Staff gave the Sacklers the latest results
regarding how opioid savings cards led to patients staying on OxyContin longer. 493
426. Staff also reported results from Purdue’s marketing through the “OxyContin
Physicians Television Network.” 494 Purdue had selected doctors in nine Massachusetts
communities as targets for that scheme. 495 Staff told the Sacklers that it increased opioid
prescriptions. 496
427. Staff also told the Sacklers that they would begin reviews of sales reps according
to their sales ranking, with a focus on the bottom ten percent. Staff reported to the Sacklers that
Purdue employed 637 sales reps and, during Q3 2013, they visited prescribers 179,640 times. 497
More than 2,200 of those visits were in Massachusetts. 498
492
493
494
495
Target list, PPLPC023000526992; video, PPLP003297185.
496
497
2013-11-01 Board report, pgs. 11, 52, 55, PPLPC002000186921, -962, -965. Staff told the Sacklers that the sales
rep visits compared to a target for the quarter of 196,845 visits; and that reps visited 6.9 prescribers per day, on
average, compared to a target of 7.1.
498
Exhibit 1
144
428. In December, staff told Richard Sackler that Butrans sales were increasing, and
they suspected the increase was caused by Purdue’s improved targeting, in which sales reps
visited the most susceptible prolific prescribers. 499
429. Meanwhile, staff contacted Richard Sackler because they were concerned that the
company’s “internal documents” could cause problems if investigations of the opioid crisis
expanded. 500 Early the next year, staff told Jonathan Sackler about the same concern. Jonathan
studied collections of news reports and asked staff to assure him that journalists covering the
opioid epidemic were not focused on the Sacklers. 501
   2014   
430. In January 2014, staff reported to the Sacklers on how Purdue’s program for
complying with state and federal law compared to recent agreements between other drug
companies and the government. Other companies had agreed that sales reps should not be paid
bonuses based on increasing doctors’ prescriptions, but Purdue still paid reps for generating
sales. Other companies disclosed to the public the money they spent to influence continuing
medical education, but Purdue did not. Other companies had adopted “claw-back” policies so
that executives would forfeit bonuses they earned from misconduct; but Purdue had not. The
Boards of other companies passed resolutions each quarter certifying their oversight of the
companies’ compliance with the law; but the Sacklers did not. 502
499
500
2014-01-03 email from Burt Rosen, PPLPC020000748356 (“I spoke to Richard just before the year end and
raised concerns over our internal documents.”).
501
502
2014-01-16 quarterly compliance report to the Board, PPLP004410797.
145
431. In February, staff sent the Sacklers the final results from 2013. 503 Staff told the
Sacklers that net sales were hundreds of millions of dollars below budget because doctors were
not prescribing enough of the highest doses of opioids and were including too few pills with each
prescription, and sales reps were not visiting doctors enough. 504 Sales VP Russell Gasdia wrote
privately to a friend: “Our myopic focus on extended release opioids with abuse deterrent
properties has not yielded the results people thought it would in the market. It’s been hard to
convince colleagues and the board that our success in this market is over.” 505
432. To get higher sales, staff told the Sacklers that they had tightened the
requirements for sales reps’ pay: from now on, sales reps would lose bonus pay if they did not
visit “high value” prescribers often enough. 506 In Massachusetts, Purdue identified as “high
value” doctors like Conrad Benoit, Yoon Choi, Fernando Jayma, and Fathalla Mashali — and
managers ordered reps to keep promoting drugs to them even after reps warned Purdue that the
doctors were involved in diversion and abuse. 507
433. A few days later, staff told the Sacklers that Purdue’s marketing had an immense
effect in driving opioid prescriptions: according to Purdue’s analysis, its sales and marketing
tactics generated an additional 560,036 prescriptions of OxyContin in 2012 and 2013.
Nevertheless, staff reported to the Sacklers that net sales for 2013 had been $377,000,000 less
than budgeted. Staff again reported that Purdue was losing hundreds of millions of dollars in
expected profits because prescribers were shifting away from higher doses of Purdue opioids and
503
504
2014-01-30 memo from Edward Mahony, PPLPC020000756512.
505
506
2014-01-30 memo from Edward Mahony, PPLPC020000756513.
507
2013 Q1 target list, PPLPC015000141319; 2013-12-23 email from Garry Hughes, PPLP004367907 (with ZS
target list).
146
including fewer pills per prescription. Staff told the Sacklers that a “Key Initiative” was to get
patients to “stay on therapy longer.” 508
434. Staff also told the Sacklers that key sales priorities were again to encourage
doctors to prescribe Purdue opioids for elderly patients and patients who had not taken opioids
before. Staff reported to Sacklers again that sales reps were continuing the Individualize The
Dose campaign. 509 As the Sacklers knew, Purdue designed that campaign to encourage higher
doses. 510 Staff also told the Sacklers that Purdue’s eMarketing campaign for OxyContin reached
84,250 health care providers during Q4 2013. Staff told the Sacklers that they found increasing
compliance concerns with Purdue’s speaker programs, in which the company paid doctors to
promote Purdue opioids to other doctors. 511
435. As in the past, staff reported to the Sacklers again about developments in
Massachusetts. Staff told them that Massachusetts had introduced legislation concerning opioid
prescriptions and Purdue staff were developing language to propose modifying the
Massachusetts bill. 512
436. Staff told the Sacklers that Purdue employed 632 sales reps and, during Q4 2013,
they visited prescribers 176,227 times. 513 More than 2,900 of those visits were in
Massachusetts. 514
508
2014-02-04 Board report, pgs. 3, 5, 9, 22, PPLPC002000181037, -039, -043, 056.
509
2014-02-04 Board report pgs. 13-14, PPLPC002000181047-048.
510
2013-05-22 mid-year sales update, slides 4, 14, PPLPC012000424611, 21. See paragraph 670 below.
511
2014-02-04 Board report pgs. 15, 39-40, PPLPC002000181049, -073-074.
512
2014-02-04 Board report pg. 43, PPLPC002000181077. The report refers to legislation on “interchangeable”
drugs that pharmacists dispense in some circumstances instead of the drug listed on a prescription.
513
compared to a target for the quarter of 183,960 visits; and that reps hit the target of visiting 7.1 prescribers per day,
because managers reduced the target for visiting pharmacies to allow more visits to prescribers.
514
Exhibit 1.
147
437. That February report was the last of its kind. After Q4 2013, Purdue abolished
the detailed Quarterly Reports that had created a paper trail of targets for sales visits and been
emailed among the Board and staff. In 2013, the City of Chicago served Purdue with a subpoena
seeking internal documents about Purdue’s marketing of opioids. 515
. 516 Purdue
. 517 For 2014, Purdue decided to limit many of its official Board reports to numbers
and graphs, and relay other information orally. But the Sacklers continued to demand
information about sales tactics, and their control of Purdue’s deceptive marketing did not change.
438. In March and April, staff told the Sacklers that Purdue was achieving its goals
of selling higher doses of OxyContin and more pills of OxyContin per prescription, but weekly
prescriptions of Purdue’s Butrans opioid were below expectations because of a reduced number
of sales rep visits promoting that opioid. 518 The Sacklers had assumed prescriptions would fall,
but staff were concerned that the effect could be greater than anticipated. 519
439. In May, Purdue’s CEO reported to the Sacklers on Purdue’s work to influence
legislation to maximize Purdue’s sales in Massachusetts. He reported “a positive development in
Massachusetts, a state from which we’ve seen significant anti-opioid activity in recent months.
Yesterday, the Massachusetts Senate passed legislation that included a provision developed by
515
2015-11-20 email from Robert Josephson, PPLP004153099; 2013-04-24 email from Burt Rosen,
PPLPC012000419813.
516
2013-05-07 Executive Committee agenda, PPLPC012000421973; 2013-05-03 Board agenda,
PPLPC016000181375.
517
2015-11-20 email from Robert Josephson, PPLP004153099.
518
2014-03-07 email from Edward Mahony, PPLPC012000467494-495; 2014-04-06 email from Edward Mahony,
PPLPC012000471641.
519
2014-04-14 Q1 summary of results, slide 7, PPLPC012000473131. Staff told the Sacklers that Purdue employed
643 sales reps. 2014-04-14 headcount summary, PPLPC012000473138.
148
Purdue.” 520 Richard Sackler replied immediately to agree that the development in Massachusetts
was good news. 521
440. That same month, Richard and Jonathan’s father, Raymond Sackler, sent David,
Jonathan, and Richard Sackler a confidential memo about Purdue’s strategy, including
specifically putting patients on high doses of opioids for long periods of time. The memo
recounted that some physicians had argued that patients should not be given high doses of
Purdue opioids, or kept on Purdue opioids for long periods of time, but Purdue had defeated
efforts to impose a maximum dose limit or a maximum duration of use. Raymond asked David,
Jonathan, and Richard to talk with him about the report. 522
441. In June, the Sacklers removed Russell Gasdia as Vice President of Sales and
Marketing, and began pushing his replacement to sell more opioids faster. 523 Gasdia warned his
replacement that Richard managed the sales operation intensely — “there are times this becomes
a tennis match with Dr. Richard.” 524 Sure enough, Richard told Gasdia’s replacement that he
would be given little time to show that he could increase opioid sales: “it is very late in the day to
rescue the failed launch” of Butrans, which was not making as much money as Richard
desired. 525 CEO Mark Timney tried to caution Richard that it was “a little early” to be attacking
the new sales leader, since he’d been at Purdue only two weeks. 526
520
2014-05-14 email from Mark Timney, PPLPC019000926225. The bill encouraged use of OxyContin by
prohibiting a non-abuse-deterrent formulation from being dispensed if an abuse-deterrent formulation is available.
521
522
2014-05-05 email from Raymond Sackler, PWG000412141; 2014-05-04 attached memo from Burt Rosen,
PWG000412143.
523
524
525
526
2014-06-10 email from Mark Timney, PPLPC012000483235.
149
442. That same month, staff sent the Sacklers an “Update on L.A. Times mitigation
effort” about tactics to discourage scrutiny of Purdue’s misconduct. 527 Staff wrote to the
Sacklers:
As you may recall, one of our efforts to mitigate the impact of a

potential negative Los Angeles Times (LAT) story involved
assisting a competing outlet in marginalizing the LAT’s
unbalanced coverage by reporting the facts before the LAT story
ran. The following Orange County Register story, developed in
close coordination with Purdue, achieved this goal. This fact-
based narrative robs the LAT account of its newsworthiness and
contradicts many of the claims we expected that paper to make. 528
In 2012, the Los Angeles Times had studied coroner’s records and revealed that overdoses killed
thousands of patients who were taking opioids prescribed by their doctors, refuting the Sacklers’
lie that patients who are prescribed opioids don’t get addicted and die. 529 The next year, the Los
Angeles Times revealed that Purdue tracked illegal sales of OxyContin with a secret list of 1,800
doctors code-named Region Zero, but did not report them to the authorities. 530 The “mitigation
effort” that the Sacklers ordered was not designed to protect patients from overdoses or from
illegal prescribers, but instead to protect the Sacklers from reporters revealing the truth.
443. In July, Richard Sackler called staff to complain about studies that the FDA
required for opioids and how they might undermine Purdue’s sales. He emphasized that Purdue
Board members felt the requirements to conduct studies were unfair. Staff tried to reassure
527
2014-06-30 email from Raul Damas, PPLPC022000741863. A few weeks after receiving the mitigation update,
Richard Sackler demanded that the L.A. Times send him all the paper’s correspondence with Purdue. 2014-08-14
email from Scott Glover, PPLPC024000872837.
528
2014-06-30 email from Raul Damas, PPLPC022000741863. Years earlier, the Sacklers had tried to influence the
New York Times to be “less focused on OxyContin/Purdue.” 2011-04-22 email from John Stewart,
PPLPC019000517894.
529
2012-11-11 “Legal drugs, deadly outcomes,” by Scott Glover and Lisa Girion.
530
2013-08-11 “OxyContin maker closely guards its list of suspect doctors,” by Scott Glover and Lisa Girion.
150
Richard that the studies would take “several years to complete, thereby keeping our critics
somewhat at-bay during this time.” 531
444. In July and again in August, September, and October, staff warned the Sacklers
that two of the greatest risks to Purdue’s business were “Continued pressure against higher doses
of opioids,” and “Continued pressure against long term use of opioids.” 532
Staff report to the Board on risks facing Purdue’s business
Staff told the Sacklers that Purdue’s #1 opportunity to resist that pressure was by sending sales
reps to visit prescribers; and, specifically, by targeting the most susceptible doctors, who could
be convinced to be prolific prescribers, and visiting them many times. 533
531
2014-07-22 email from Todd Baumgartner, PPLPC002000187479-480.
532
2014-07-01 Board Flash Report, slide 5, PPLPC016000244173; 2014-08-05 Board Flash Report, slide 6,
PPLPC016000250753; 2014-09-05 Board Flash Report, slide 6, PPLPC016000254916; 2014-10-15 Board Flash
Report, slide 7, PPLPC016000259607.
533
2014-07-01 Board Flash Report, slide 5, PPLPC016000244173; 2014-08-05 Board Flash Report, slide 6,
PPLPC016000250753; 2014-09-05 Board Flash Report, slide 6, PPLPC016000254916.
151
   Project   
445. In September 2014, Kathe Sackler
. 534 Project
. , Kathe and staff
.”
.”
Purdue’s secret “Project ” plan

534
2014-09-10 email from Brian Meltzer, PPLPC017000564600; 2014-09-12 presentation, PPLPC016000255303.
152
446. Kathe Sackler and the Project team
Purdue’s measure of the opioid addiction “market”

Kathe and the staff
.” 535
535
2014-09-10 presentation, slide 4, PPLPC017000564601. The Board
. 2014-10-01 Board meeting materials, PPLP004411288.
153
447. Kathe Sackler and the staff
, the truth is that opioid
addiction can happen to anyone who is prescribed opioids:
Purdue’s “Project
Kathe and the staff
.” Kathe and the staff
. 536
448. Kathe Sackler
.” She
. 537 Staff
.” 538
449. In February 2015, staff
. 539
536
2014-09-10 presentation, slides 2, 4, PPLPC017000564601.
537
538
2014-09-17 email from Mark Timney, PPLPC020000834185-186.
539
2015-02-20 email from Stuart Baker, PPLPC026000138391.
154
450. The team
. The team
. 540
Purdue presentation explaining “Project

451. The next month, Project . Kathe, David, Jonathan, and
Mortimer Sackler
. 541 .
  
540
2015-02-24 Project presentation, PPLPC002000208957.
541
155
452. In October 2014, staff sent the Sacklers a Proposed Operating Plan and Budget to
be approved by the Board for 2015. 542 Staff told the Sacklers that a key tactic for 2015 would be
to convert patients from short-acting opioids to OxyContin. Staff warned the Sacklers that
prescribers were shifting away from the highest doses of Purdue’s opioids, and toward fewer
pills per prescription, and those shifts would cost Purdue $99,000,000 a year. Staff told the
Sacklers that a key tactic to increase Butrans sales in 2015 would be for Purdue sales reps to
push doctors to “titrate up” to higher doses. Staff likewise told the Sacklers that visits to doctors
by sales reps would be a key tactic to launch Purdue’s new Hysingla opioid: the company would:
“Leverage Purdue’s existing, experienced sales force to drive uptake with target HCPs” and
“Add additional contract sales force capacity at launch to drive uptake.” 543 Staff proposed that
Purdue employ 519 sales reps, paid an average salary of $81,300 plus a bonus of up to an
additional $124,600 based on sales. 544
453. Meanwhile, sales staff exchanged news reports of a lawsuit accusing Purdue of
deceptive marketing in Kentucky. 545 They quoted Purdue’s own attorney and Chief Financial
Officer stating that the company faced claims of more than a billion dollars that “would have a
crippling effect on Purdue’s operations and jeopardize Purdue’s long-term viability.” 546
Purdue’s communications staff were delighted by the article, because it did not reveal the
Sacklers’ role in the misconduct. “I’m quite pleased with where we ended up. There’s almost
nothing on the Sacklers and what is there is minimal and buried in the back.” 547
542
2014-10-24 email from Edward Mahoney, PPLPC016000260660.
543
2015 Commercial Budget Review, slides 31, 38, 51, 67, PPLPC016000260706, -713, -726, -742.
544
2015 Budget Submission, slides 13, 56, PPLPC016000260845, -888.
545
2014-10-20 email from John Axelson, PPLPC014000279784.
546
2014-10-20 Bloomberg Businessweek report, PPLPC014000279786.
547
156
454. In November, staff reported to the Sacklers that their sales tactics were working,
and the shift away from higher doses of OxyContin had slowed. 548 Staff also told the Sacklers
that Purdue had helped to pass a law that would encourage OxyContin sales in Massachusetts. 549
455. In December, staff told the Sacklers
. 550
456. On New Year’s Eve, Richard Sackler told staff that he was starting a confidential
sales and marketing project on opioid prices and instructed them to meet with him about it on
January 2. 551
   2015   
457. Early in the morning of January 2, staff began scrambling to collect sales data
for Richard Sackler. 552 They didn’t move quickly enough. Days later, Richard demanded a
meeting with sales staff to go over plans for selling the highest doses. Richard asked for an
exhaustive examination to be completed within 5 days, including:
“unit projections by strength, mg by strength … pricing

expectations by strength … individual strength’s market totals and
our share going backward to 2011 or 12 and then forward to 2019
or 2020 … the same information for Hysingla … [and] the history
of OxyContin tablets from launch to the present.” 553
548
2014-11 OxyContin Brand Strategy and Forecast for 2015, PPLP004411419 (“Strength mix shifting toward
lower strengths has slowed with 40-80mg share going from 29% in the 10 Year Plan to 33% in the Budget”).
549
2014-11 Executive Summary by Mark Timney, PPLP004411374 (“Helped pass nation’s first pro-ADF law in
Massachusetts,” encouraging abuse-deterrent formulations like OxyContin.).
550
2014-12-03 email from Edward Mahoney, PPLPC016000266402; attached report slide 8, PPLPC016000266403.
551
552
2015-01-02 email from Saeed Motahari, PPLPC021000713328.
553
157
The CEO stepped in to say the work would take 3 weeks. 554 Richard let him know that wasn’t a
great response — “That’s longer than I had hoped for” — and directed marketing staff to start
sending him materials immediately. 555
458. That same month, the Sacklers
. The Sacklers
. 556
459. In April, staff told the Sacklers that sales of Purdue’s highest dose 80mg
OxyContin were down 20% and that the average prescription had declined by eight pills since
2011.
460. The Sacklers . 557 As
with every reference to “the Sacklers” after July 2012, that includes Beverly, David, Ilene,
Jonathan, Kathe, Mortimer, Richard, and Theresa Sackler.
461. Staff told the Sacklers the additional reps would increase net sales of opioids by
$59,000,000. 558
554
555
2015-01-08 email from Richard Sackler, PPLPC022000797067. Mark Timney had started as CEO a year earlier
with the idea that he could “separate Board interaction from the organization” so the Sacklers would stop directing
sales staff. 2014-01-29 email from Mark Timney, PPLPC012000461846. That effort failed.
556
2015-01-16 Board minutes, PPLP004416118-121.
557
2015-04-21 Board materials, PPLPC011000025707 (“
”); 2015-05-04 Strategic Plan Update, slide 5, PPLPC017000623090; 2015-04-21 Board
decision, PPLP004417512.
558
2015-04-21 Board materials, PPLPC011000025703.
158
462. The Sacklers knew and intended that, because of their vote, more sales reps would
promote opioids to prescribers in Massachusetts. From 2015 to the present, reps hired in the
2015 expansion promoted Purdue opioids to Massachusetts prescribers more than 4,000 times. 559

463. In October, Purdue executives identified avoiding investigations of Purdue’s
opioid marketing as a “Key Activity” in the company’s Operational Plan. 560
559
In Athol, Attleboro, Auburn, Boston, Bourne, Braintree, Brewster, Bridgewater, Brockton, Burlington,
Cambridge, Carver, Cataumet, Charlestown, Chatham, Chelmsford, Chestnut Hill, Chicopee, Cotuit, Dartmouth,
Dennis, Dighton, Duxbury, Easton, Edgartown, Fairhaven, Falmouth, Franklin, Gardner, Halifax, Hanover,
Harwich, Holliston, Hyannis, Jamaica Plain, Kingston, Lakeville, Lancaster, Lowell, Ludlow, Lynn, Lynnfield,
Malden, Mansfield, Marshfield, Mashpee, Melrose, Middleborough, Milford, Natick, Needham, New Bedford,
Newton, Norfolk, Norton, Norwell, Norwood, Oak Bluffs, Orleans, Osterville, Peabody, Pembroke, Plainville,
Plymouth, Randolph, Raynham, Salem, Sandwich, Scituate, Southbridge, Springfield, Stoneham, Sturbridge,
Taunton, Tewksbury, Vineyard Haven, Wakefield, Waltham, Wareham, Wellfleet, Whitman, Winchendon, Woburn,
Worcester, and Yarmouth.
560
2015-10-27 Executive Operating Committee presentation, slide 16, PPLPC011000065538.
159
464. In November, the Sacklers voted on the budget for Purdue for 2016. 561 Staff
warned the Sacklers that public concern about opioids could get in the way of Purdue’s plans and
told them that Massachusetts, specifically, was one of two states considering legislation that
worried Purdue. Staff again told the Sacklers that two of the most significant challenges to
Purdue’s plans were doctors not prescribing enough of the highest strength opioids and including
too few pills in each prescription. Staff told the Sacklers that declining prescriptions of the
highest doses and fewer pills per prescription would cost Purdue $77,000,000. 562
465. Staff proposed to the Sacklers that, for 2016, Purdue would plan for prescribers to
average 60 pills of Purdue opioids per prescription. They told the Sacklers that they would aim
to make enough of those pills be high doses to make the average per pill 33 milligrams of
oxycodone. 563 That way, Purdue could hit its target for the total kilograms of oxycodone it
wanted to sell.
466. To make sure Purdue hit the targets, staff told the Sacklers that sales reps were
visiting prescribers 21% more often than before. Staff told the Sacklers that they had
aggressively reviewed and terminated reps who failed to generate prescriptions. Staff reported to
the Sacklers that, in 2015 alone, Purdue replaced 14% of its sales reps and 20% of its District
Managers for failing to create enough opioid sales. 564
467. Looking ahead, staff told the Sacklers that “the 2016 investment strategy focuses
on expanding the Sales Force.” They reported that the proposed budget for sales and promotion
was $11,600,000 higher than 2015, “primarily due to the Sales Force expansion.” The top
priority for the sales reps would be to visit the highest-prescribing doctors again and again. Staff
561
562
2015-11 budget for 2016, slides 16, 28, 44, PPLPC011000069967, -979, -995.
563
2015-11 budget for 2016, slide 41, PPLPC011000069992.
564
2015-11 budget for 2016, slides 7, 39, PPLPC011000069958, -990. Purdue fired 107 sales reps in 2015.
160
proposed to the Sacklers that the #1 overall priority for 2016 would be to sell OxyContin through
“disproportionate focus on key customers.” They told the Sacklers that sales reps would also
target prescribers with the lowest levels of training, physician’s assistants and nurse practitioners,
because they were “the only growing segment” in the opioid market. 565 Purdue executives
expected that, each quarter, the sales reps would visit prescribers more than 200,000 times and
would get 40,000 new patients onto Purdue opioids. 566
468. In December, staff prepared to address wide-ranging concerns raised by the
Sacklers. Kathe and Mortimer Sackler wanted staff to break out productivity data by indication
versus prescriber specialty for each drug. Richard Sackler sought details on how staff was
calculating 2016 mg/tablet trends. Jonathan Sackler sought a follow-up briefing on how public
health efforts to prevent opioid addiction would affect OxyContin sales. 567
469. Before the year ended, the Sacklers were invited to a “Beneficiaries Meeting”
where Purdue staff reported to Sackler family members about the company’s efforts to sell
opioids. 568
565
2015-11 budget for 2016, slides 24, 26, 49, PPLPC011000069975, -69977, -70000.
566
2015-11-03 email from Zach Perlman, Executive Committee materials, slide 36, PPLPC011000065030.
567
2015-12-09 email from Zach Perlman, PPLPC011000073228 attaching Executive Committee presentation, slides
12-13, PPLPC011000073230.
568
2015-10-28 email from Stuart Baker, PPLPC011000063897; see also November 2013 Beneficiaries Meeting,
PPLP004410528.
161
   2016   
470. In 2016, the Sacklers met with the Board in January, March, April, June, August,
October, November, and December. 569
471. In April, the Sacklers considered exactly how much money was riding on their
strategy of pushing higher doses of opioids. The month before, the U.S. Centers for Disease
Control announced guidelines to try to slow the epidemic of opioid overdose and death. The
CDC urged prescribers to avoid doses higher than 30mg of Purdue’s OxyContin twice per day.
The CDC discouraged twice-a-day prescriptions of all three of Purdue’s most profitable strengths
— 40mg, 60mg, and 80mg. Staff studied how much money Purdue was making from its high
dose strategy and told the Sacklers that $23,964,122 was at risk in Massachusetts each year. 570
472. In May, Richard Sackler told staff to circulate a New York Times story reporting
that opioid prescriptions were dropping for the first time since Purdue launched OxyContin
twenty years earlier. The Times wrote: “Experts say the drop is an important early signal that the
long-running prescription opioid epidemic may be peaking, that doctors have begun heeding a
drumbeat of warnings about the highly addictive nature of the drugs.” The only person quoted in
favor of more opioid prescribing was a Massachusetts professor whose program at Tufts
University was funded by the Sacklers. 571
569
2016-05-19 Executive Committee pre-read, PPLPC011000096794 (Board schedule for 2016).
570
2016-04-13 Q1 2016 Commercial Update, slide 74, PPLPC016000286167.
571
2016-05-21 email from Richard Sackler, PPLPC021000841074; 2016-05-20 “Opioid Prescriptions Drop for First
Time in Two Decades,” by Abby Goodnough and Sabrina Tavernise. The opioid advocate was Dr. Daniel B. Carr,
director of Tufts Medical School’s program on pain research education and policy.
162
473. In June, the Sacklers met
Board presentation showing
. The Sacklers
.”
163
. 572
474. That same month, staff presented the 2016 Mid-Year Update. They warned the
Sacklers that shifts in the national discussion of opioids threatened their plans. The deception
that Purdue had used to conceal the risks of opioids was being exposed. Staff summarized the
problems on a slide: 573
2016 Mid-Year Board Update

475. First, to convince doctors to prescribe dangerous opioids, Purdue promoted its
drugs as the solution to “undertreatment of pain.” Richard Sackler made sure that Purdue bought
the internet address 5thvitalsign.com so it could promote pain as the “fifth vital sign” (along with
572
2016-05-27 email from Stuart Baker, PPLPC011000099222; 2016-06 Board Book slides 46-49, 114,
PPLPC011000099280-283, -348.
).”
573
2016-06-08 Mid-Year Update, slide 18, PPLPC011000099783. “ADF” on the slide refers to abuse-deterrent
formulations of opioids, such as Purdue’s crush-resistant OxyContin, which do not prevent addiction.
164
temperature, blood pressure, pulse, and breathing rate) to expand the market for opioids. 574 But
now, staff reported to the Sacklers, doctors and patients were starting to worry more about the
epidemic of opioid addiction and death. 575
476. Second, to conceal the danger of addiction, Purdue falsely blamed the terrible
consequences of opioids on drug abuse. One of Purdue’s key messages argued: “It’s not
addiction, it’s abuse.” 576 But now, staff reported to the Sacklers, doctors and patients were
realizing that addiction was a true danger. 577
477. Third, to avoid responsibility for Purdue’s dangerous drugs, the Sacklers chose to
stigmatize people who were hurt by opioids, calling them “junkies” and “criminals.” Richard
Sackler wrote that Purdue should “hammer” them in every way possible. 578 But now, staff
reported to the Sacklers, Americans were seeing through the stigma and recognizing that millions
of families were victims of addictive drugs. Staff told the Sacklers that nearly half of Americans
reported that they knew someone who had been addicted to prescription opioids. 579
478. Fourth, the Sacklers had long sought to hide behind the approval of Purdue’s
drugs by the FDA. But FDA approval could not protect the Sacklers when their deceptive
marketing led thousands of patients to become addicted and die. The U.S. Centers for Disease
Control (“CDC”) reported that opioids were, indeed, killing people. The CDC Director said:
“We know of no other medication that’s routinely used for a nonfatal condition that kills patients
574
575
2016-06-08 Mid-Year Update, slide 18, PPLPC011000099783.
576
PPLPC012000183256; 2008-04-16 presentation by Luntz, Maslansky Strategic Research, slide 28,
PPLPC012000183259.
577
2016-06-08 Mid-Year Update, slide 18, PPLPC011000099783.
578
2001-02-01 email from Richard Sackler, PDD8801133516 (“we have to hammer on the abusers in every way
possible. They are the culprits and the problem. They are reckless criminals.”).
579
2016-06-08 Mid-Year Update, slides 18, 20, PPLPC011000099783.
165
so frequently.” 580 The 2016 Mid-Year Update warned that the truth was threatening Purdue.
479. Staff also told the Sacklers that Massachusetts was one of four states to pass laws
limiting opioid prescriptions. 581 In the face of this pressure, staff told the Sacklers that the sales
team was focusing on the doctors who prescribe the most opioids. 582
480. In November, staff prepared statements to the press denying the Sacklers’
involvement in Purdue. Their draft claimed: “Sackler family members hold no leadership roles
in the companies owned by the family trust.” 583 That was a lie. Sackler family members held
the controlling majority of seats on the Board and, in fact, controlled the company. A staff
member reviewing the draft knew what was up and commented with apparent sarcasm: “Love
the … statement.” 584 Staff eventually told the press: “Sackler family members hold no
management positions.” 585
481. Some employees worried about the deception. When journalists asked follow-up
questions about the Sacklers, communications staff deliberated about whether to repeat the “no
management positions” claim. They double-checked that Purdue’s top lawyers had ordered the
statement. Then they arranged for one of the Sacklers’ foreign companies to issue it, so U.S.
employees would not be blamed: “The statement will come out of Singapore.” 586
482. In December, Richard, Jonathan and Mortimer Sackler
580
2016-03-15 briefing by CDC Director Tom Frieden.
581
2016-06-08 Mid-Year Update, slide 21, PPLPC011000099783. Massachusetts required prescribers to record a
reason if they included more than 7 days of opioids in a patient’s first opioid prescription.
582
2016-06-08 Mid-Year Update, slide 26, PPLPC011000099783 (“Protect OxyContin share among high decile
HCPs”).
583
2016-11-03 email from Robert Josephson, PPLPC023000914978.
584
2016-11-03 email from Raul Damas, PPLPC023000914978 (“Love the second statement” – it was the second of
two statements in the draft).
585
586
2016-12-01 emails from Robert Josephson and Raul Damas, PPLPC020001075830.
166
. 587
.” 588 The Sacklers
   2017   
483. In 2017, the Sacklers
. 589
484. In May 2017, staff told the Sacklers that an independent nonprofit had concluded
that Purdue’s reformulation of OxyContin was not a cost-effective way to prevent opioid
abuse. 590 Theresa Sackler asked staff what they were doing to fight back to convince doctors
and patients to keep using the drug. 591
485. That same month, the Sacklers . Long-time
employee Craig Landau
.” Landau
.” He proposed
.” 592 The Sacklers .
587
2016-12-22 email from Elliott Ruiz, PPLPC022000980230.
588
2016-12-22 Braeburn Pharmaceuticals: Structuring Analysis, slide 3, PPLPC022000980233.
589
2017 heavily redacted Board minutes, PPLP004416457-502; 2017-01-02 Governance Calendar,
PPLPC011000131500.
590
2017-05-06 email from Gail Cawkwell, PPLPC011000147096.
591
2017-05-06 email from Theresa Sackler, PPLPC011000147096.
592
2017-05-02 Landau presentation, PPLPC020001106306.
167
486. In June, staff told the Sacklers that getting doctors to prescribe high doses of
opioids and many pills per prescription were still key “drivers” of Purdue’s profit. Purdue’s
management was concerned that the CDC’s efforts to save lives by reducing doses and pill
counts would force the company “to adjust down our revenue expectations.” 593
487. Staff told the Sacklers that Purdue’s opioid sales were being hurt by cultural
trends such as the HBO documentary, “Warning: This Drug May Kill You.” 594 HBO’s film was
a problem for Purdue because it showed actual footage from Purdue’s misleading advertisements
next to video of people who overdosed and died. 595
488. Staff felt the pressure of the opioid epidemic, even if the billionaire Sacklers did
not. In one presentation, staff came close to insubordination and told the Sacklers: “Purdue
Needs a New Approach.” Their suggestion for a new direction was: “A New Narrative:
Appropriate Use.”
593
2017-06 Board of Directors: Purdue Mid-Year Pre-Read, slides 2, 152, PPLPC011000151189.
594
2017-06 Board of Directors: Purdue Mid-Year Pre-Read, slide 6, PPLPC011000151189.
595
2017-05-01 “Warning: This Drug May Kill You Offers a Close-Up of the Opioid Epidemic,”
https://www.theatlantic.com/entertainment/archive/2017/05/warning-this-drug-may-kill-you-opioid-epidemic-
hbo/524982/.
168
The Sacklers led Purdue so far into the darkness that employees proposed “appropriate use” of
drugs to reinvent the company. Staff also suggested that the Sacklers create a family foundation
to help solve the opioid crisis. 596
489. The Sacklers did not redirect the company toward appropriate use or create the
suggested family foundation. Instead, they decided to sell harder. For 2018, the Sacklers
approved a target for sales reps to visit prescribers 1,050,000 times — almost double the number
of sales visits they had ordered during the heyday of OxyContin in 2010. 597
490. In October, Richard Sackler
. Richard
. Cigna announced that opioid companies influence
dosing: “While drug companies don’t control prescriptions, they can help influence patient and
doctor conversations by educating people about their medications.” Richard’s
. He
. 598
491. On October 17, Beverly Sackler served her last day on the Board. 599 It was the
beginning of the end for the Sackler family. A week later, the New Yorker published an article
entitled “The Family That Built an Empire of Pain.” 600 The story quoted a former FDA
596
2017-06 Board of Directors: Purdue Mid-Year Pre-Read, slides 36-38, PPLPC011000151189.
597
2017-06 Board of Directors: Purdue Mid-Year Pre-Read, slide 147, PPLPC011000151189.
598
599
Declaration of Beverly Sackler dated September 5, 2018.
600
169
Commissioner: “the goal should have been to sell the least dose of the drug to the smallest
number of patients.” The reporter concluded: “Purdue set out to do exactly the opposite.” 601
492. In November, Jonathan Sackler suggested that Purdue launch yet another
opioid. 602 Staff promised to present a plan for additional opioids at the next meeting of the
Board. 603 At the Board meeting that month, the remaining Sackler Board members (Richard,
David, Ilene, Jonathan, Kathe, Mortimer, and Theresa) voted to cut the sales force from 582 reps
to 302 reps. They knew sales reps would continue to promote opioids in Massachusetts. Staff
even gave Richard, David, Ilene, Jonathan, Kathe, Mortimer, and Theresa Sackler a map of
where the remaining sales reps worked, with Massachusetts shaded to show that Purdue would
keep visiting prescribers here. 604
Purdue internal map of planned sales rep territories for 2018
601
602
603
2017-11-21 email from Craig Landau, PPLPC016000321333.
604
2017-11 Board budget, slides 47, 51, PPLPC016000323215.
170
   2018   
493. In January 2018, Richard Sackler received a patent for a drug to treat opioid
addiction — . Richard had applied for the patent in 2007. He
assigned it to a different company controlled by the Sackler family, instead of Purdue. Richard’s
patent application says opioids are addictive. The application calls the people who become
addicted to opioids “junkies” and asks for a monopoly on a method of treating addiction. 605
494. In January, Richard Sackler also met with Purdue staff about the sales force again.
They discussed plans to cut the force to 275 reps. In February, Richard, David, Ilene, Jonathan,
Kathe, Mortimer, and Theresa Sackler . 606
495. By April, staff were scared. Richard Sackler was again asking questions about
sales. Staff prepared a presentation for the Board of Directors (“BoD”). One employee
suggested that they add more information about the company’s problems. Another cautioned
against that:
“I think we need to find a balance between being clear about what

reality looks like - which I certainly support in [this] situation - and
just giving so much bad news about the future that it just makes
things look hopeless. Let’s not give the BoD a reason to just walk
away.” 607
496.
: Richard, David, Ilene, Jonathan, Kathe, Mortimer, and Theresa. 608
605
2018-01-09, U.S. Patent No. 9,861,628 (“a method of medication-assisted treatment for opioid addiction”); 2007-
08-29, international patent publication no. WO 2008/025791 Al.
606
2018-01-18 email from Jon Lowne, PPLPC016000323973; 2018 budget, PPLPC016000323996; 2018-02-07
email from Craig Landau, PPLPC016000325614; 2018-02-01 entirely redacted Board minutes, PPLP004416509.
607
2018-04-10 email from Paul Medeiros, PPLPC023000979571.
608
2018-05-03 heavily redacted Board minutes, PPLP004416514-520 ( ); 2018-06-06 heavily
redacted Board minutes, PPLP004416521-524; 2018-06-08 heavily redacted Board minutes, PPLP004416525.
171
497. On June 12, 2018, the Massachusetts Attorney General filed this suit to hold the
Sacklers as well as Purdue accountable. Just as their employees predicted, the Sacklers tried to
run. Richard Sackler was the first to go: he resigned from the Board in July. David Sackler quit
in August. Theresa Sackler served her last day in September. As of the date of this filing, Ilene,
Jonathan, Kathe, and Mortimer remain. 609
609
2018-09-05 declaration of David Sackler; 2018-09-07 declaration of Theresa Sackler.
172
B. Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa, and Ralph Snyderman
498. After the 2007 Judgment and criminal convictions, the Sacklers
. Their
.” The Sacklers
. 610
499. Starting in 2008, the Sacklers asked five additional defendants to join them on the
Board:
• Peter Boer was a Director from April 2008 to the present;
• Judith Lewent was a Director from March 2009 to December 2013;
• Cecil Pickett was a Director from January 2010 to the present;
• Paulo Costa was a Director from April 2012 to January 2018; and
• Ralph Snyderman was a Director from August 2012 to October 2017.
500. These defendants did not act independently from the Sacklers. Together with the
Sacklers, they controlled the unfair and deceptive sales and marketing tactics Purdue used to sell
its opioids in Massachusetts.
501. They
610
2008-04-12 memorandum to Richard Sackler from Peter Boer, PDD9316314309.
173
502. They
. 611
503. They
. 612
504. They
. 613
505. They
. 614
506. They
. 615
507. They never
508. Not after
. 616
611
612
2013-01-15 Board minutes, PKY183213441; 2013-02-13 Board minutes, PKY183213449.
613
2008-04-18 Board minutes, PKY183213041; 2008-09-25 Board minutes, PKY183213077; 2008-11-06 Board
minutes, PKY183213086; 2009-03-05 Board minutes, PKY183213139; 2009-06-26 Board minutes,
PKY183213174; 2009-09-23 Board minutes, PKY183213211; 2010-02-04 Board minutes, PKY183213263; 2010-
04-01 Board minutes, PKY183213274; 2011-04-06 Board minutes, PKY183213339; 2011-06-24 Board minutes,
PKY183213363; 2011-09-01 Board minutes, PKY183213366.
614
minutes, PKY183213249; 2010-07-22 Board minutes, PKY183212838; 2010-10-15 Draft Board of Directors
Meeting Agenda, PPLPC012000294197; 2010-10-21 Board minutes, PKY183212854; 2011-05-20 Board minutes,
PKY183212910.
615
minutes, PKY183213103.
616
174
509. Not after seeing reports that Purdue received scores of tips to its compliance
hotline and didn’t refer them to the authorities. 617
510. Not after learning about Purdue’s secret Region Zero — a list of doctors suspected
of improper prescribing, including in Massachusetts, whose sales Purdue tracked but who Purdue
did not report to authorities. 618
511. Not after receiving reports of compliance failures by Purdue sales staff, including
improper use of OxyContin promotional materials and opioid savings cards. 619
512. Not after receiving reports that Purdue sales managers violated Purdue’s
Corporate Integrity Agreement by failing to supervise sales reps during their visits to
prescribers. 620
513. Throughout their Board tenures, Boer, Lewent, Pickett, Costa, and Snyderman
learned all these things and engaged with staff on many of them. They participated in many of
the same meetings as the Sacklers. They provided their votes for many of the same decisions as
the Sacklers, and always voted in lock-step when they did. And they continued to direct sales
and marketing conduct aimed at increasing opioid prescribing and sales, despite knowing that
that conduct was contributing to the epidemic of addiction, overdose and death. In all this
misconduct, these five defendants shared responsibility with the Sacklers, including as detailed
below.
617
618
2010-07-22 Response to Questions from Board Meeting, PPLPC012000283169; 2011-02-03 presentation by Bert
Weinstein, slides 94-95, PDD8901468108-109.
619
620
2009-07-30 Board report, pg. 15, PPLPC012000233246. To avoid being excluded from U.S. healthcare
programs, Purdue agreed that its District Managers would observe and supervise each sales rep for five days each
year. Corporate Integrity Agreement section III.K. In the second year of the agreement, staff reported to the Board
that they failed to provide five days’ of supervision for 23 sales reps.
175
   2007 - 2008   
514. Peter Boer was no stranger to Purdue or the Sacklers when he joined Purdue’s
Board. He had been serving on the board of the Sacklers’ Rhode Island-based opioid
manufacturing company, Rhodes Technologies, directing Purdue’s oxycodone pipeline there for
a decade, and he had been overseeing the supply of drug ingredients to Purdue as a director of
the Sackler’s U.K.-based pharmaceuticals company, Bard Pharmaceuticals, since 2002. 621
515. Boer
. 622 By December 2007, Boer and Richard Sackler
. 623 In April 2008, Boer
. 624
516. On April 18, 2008, Boer became a director, and Richard Sackler circulated the
memo to Kathe, Ilene, David, Jonathan, and Mortimer Sackler. 625
517. In June,
. 626 This was
518. In July, staff told Boer, as well as the Sacklers, that Purdue received 890 Reports
of Concern regarding abuse and diversion of Purdue’s opioids in the second quarter of 2008, and
621
2003-07-18 memorandum by Peter Boer, #153960.1; 2002-05-10 Shareholders Meeting notes, #273916.1.
622
623
2008-04-12 memorandum by Peter Boer to Richard Sackler, PDD9316314309; 2008-03-28 emails from Richard
Sackler and Peter Boer, PDD9316304944.
624
2008-04-12 memorandum to Richard Sackler from Peter Boer, PDD9316314309.
625
626
176
they had conducted only 25 field inquiries in response. This was one of scores of reports that
Boer would receive, along with the Sacklers, over the next decade. Staff reported to Boer that
they received 93 tips to Purdue’s compliance hotline during the quarter, but did not report any of
them to the authorities. 627
519. Staff also told Boer that they promoted Purdue opioids in Massachusetts in two
presentations: an April presentation at Tufts University concerning use of opioids to manage
chronic pain and a June presentation at the Tufts Health Care Institute concerning use of urine
screens in pain management. 628 Convincing Massachusetts doctors that opioids were the best
way to manage chronic pain and that urine tests protected patients from addiction were both part
of Purdue’s unfair and deceptive scheme.
520. In October, staff told Boer that surveillance data monitored by Purdue indicated a
“wide geographic dispersion” of abuse and diversion of OxyContin “throughout the United
States.” Staff told Boer that “availability of the product” and “prescribing practices” were key
factors driving abuse and diversion of OxyContin.” On the same day, staff told Boer that Purdue
had begun a new “Toppers Club sales contest” for sales reps to win bonuses, based on how much
a rep increased OxyContin use in her territory and how much the rep increased the broader
prescribing of opioids — the same “availability of product” and “prescribing practices” factors
that worsen the risk of diversion and abuse. In the same report, staff told Boer that they received
163 tips to Purdue’s compliance hotline during the third quarter of 2008, but did not report any
of them to the authorities. 629
627
2008-07-15 Board report, pgs. 21, 28, PPLP004367317, -324.
628
629
2008-10-15 Board report, pgs. 19, 24, 28, PDD9316101020, -025, -029.
177
521. Staff also told Boer that
Purdue now employed 414 sales reps. The Board’s
. During the third quarter of 2008, the
number of sales visits to Massachusetts prescribers increased by 20% to more than 1,800. 630
   2009   
522. Defendant Judith Lewent joined the Board in March 2009. 631
523. In April, staff told Boer and Lewent that Purdue employed 412 sales reps and had
made dramatic progress toward their goal of promoting higher doses: “for the first time since
January 2008, OxyContin 80mg strength tablets exceeded the 40mg strength tablets during
December 2008.” 632
524. Staff also told Boer and Lewent that they received 122 tips to Purdue’s
compliance hotline during the first quarter of 2009, and revealed one of them to an outside
monitor. Staff told Boer and Lewent that the compliance problems included improper use of
OxyContin promotional materials and opioid savings cards. 633
525. In June, staff reported to Boer and Lewent that Purdue had expanded its opioid
sales force at their direction: “As approved in the 2009 Budget, 50 New Sales Territories have
been created.” Staff told them that the expansion was focused on visiting doctors who prescribe
the most, because “there are a significant number of the top prescribers” that Purdue had not
been able to visit with its smaller force of sales reps.” 634
630
2008-10-15 Board report, pg. 26, PDD9316101027; Exhibit 1 (20% increase from Q3 2007).
631
Judy Lewent declaration.
632
633
634
PPLPC012000226606.
178
526. In September, Boer and Lewent
. 635
   2010   
527. Defendant Cecil Pickett joined the Board in January 2010. 636
528. That month, staff
. Purdue was
. This
. 637
529. In February, Purdue’s Sales and Marketing Department reported to Boer, Lewent,
and Pickett that a key objective for 2010 was meeting a prescriber sales call quota of 545,000.
Sales call quotas remained a priority over the next four years, and the Board tracked the sales
force’s performance on at least a quarterly basis as the quota rose from 545,000 prescriber visits
in 2010, to 712,000 visits in 2011, 752,417 visits in 2012, and 744,777 visits in 2013. 638 Boer,
Lewent, Pickett, Costa, and Snyderman all received regular updates on these quotas throughout
their terms on the Board.
530. Boer, Lewent, and Pickett also received regular updates on Purdue’s efforts to
intensify its OxyContin promotion. In April, staff reported to Boer, Lewent, and Pickett that
635
636
Cecil Pickett declaration.
637
2010-01-20 email from Pamela Taylor, pg. 3, PDD8901041368; 2010-02-09 email from Pamela Taylor,
PPLPC012000257443; 2010-01-20 Executive Committee notes, PPLPC012000257446; 2010-02-01 Board report,
pgs. 4, 19, PPLPC012000252778, -793.
638
2010-02-01 Board report, pg. 23, PPLPC012000252797; 2010-04-21 Board report, pg. 3, PWG000423141; 2011-
05-02 Board report, pg. 3, PPLPC012000322428; 2012-04-30 Board report, pg. 3, PPLPC012000374793; 2013-05-
13 Board report, pg. 7, PPLP004367546.
179
they were working in 2010 to increase the average number of daily prescriber visits from the
previous year’s 6.9 and to decrease the cost-per-visit from $219. 639
531. In July, Boer, Lewent, and Pickett joined the Sacklers and sales and marketing
staff for a Board meeting in Bermuda. Staff presented plans for selling Purdue’s new Butrans
opioid and reported that sales reps would try to switch patients to Purdue opioids from NSAIDs
like ibuprofen. Staff told Boer, Lewent, and Pickett that they had identified 82,092 prescribers to
target with the Butrans sales campaign. Staff reported that they planned to add 125 sales reps
and increase the number of prescriber visits from 574,000 to 750,000 per year. 640
532. The Board
. They
. 641
533. The Board
. Purdue was
. 642
534. Purdue was
639
640
2010-07-22 Butrans Commercial Strategy Plan Board Presentation, slides 17, 66, 81, PPLPC018000404193;
641
2010-07-22 questions during Board meeting, PPLPC012000283164-165.
642
”).
180
” 643
535. The Board
. 644 Staff
. 645
536. For example, staff reported to the Board — including Boer, Lewent, and Pickett
— that Purdue suspected Dr. Michael Taylor, in New Bedford, Massachusetts, was prescribing
opioids inappropriately. In response to the Board’s request, staff reported that, in the past two
years, Taylor had prescribed OxyContin more than five hundred times, and provided Purdue with
$392,505. 646
537. Likewise, in response to the Board’s request, staff reported to Boer, Lewent, and
Pickett and the other directors that Purdue suspected Dr. Alvin Chua, in Brookfield,
Massachusetts, was prescribing opioids inappropriately. Staff told them that, in the past two
years, Chua had prescribed OxyContin more than a thousand times, and provided Purdue with
643
644
2010-07-22 questions during Board meeting, PPLPC012000283169, -170.
645
2010-08-16 email from William Mallin, PPLPC012000283162; 2010-08-11 Region Zero prescribers,
PPLPC012000283175.
646
181
$431,474. 647
538. A year after Purdue staff told the Board about Alvin Chua, the Massachusetts
Board of Registration in Medicine took away his license for improper opioid prescribing. Three
years after Purdue told the Board about Michael Taylor, he lost his license and was convicted in
Massachusetts court of prescribing opioids without a legitimate medical purpose. By then,
Purdue and the Sacklers had collected hundreds of thousands of dollars from their dangerous
prescriptions. Far worse — four Massachusetts patients, who were prescribed Purdue opioids by
Taylor and Chua, overdosed and died.
539. The Board — including Boer, Lewent, and Pickett —
540. At that same Board meeting
. 648 Boer, Lewent, and Pickett knew
and intended that the expanded sales force was promoting opioids in Massachusetts. In fact,
Purdue sales reps visited Massachusetts prescribers more than 2,700 times during the last quarter
of 2009 alone. 649
541. Purdue’s aggressive sales strategy to target high prescribers worked. Purdue’s
top-paid physician consultant in Massachusetts at the time, Walter Jacobs, had a patient on
twenty-four pills of 80mg OxyContin per day. In 2010, 72% of the OxyContin pills that Jacobs
prescribed were the highest-dose 80mg pills.
542. In October, staff reported to Boer, Lewent, and Pickett that Purdue would
647
648
2010-07-27 Board report, pg. 19, PWG000422495; 2010-07-22 Board minutes, PKY183212838.
649
Exhibit 1.
182
promote opioids at more than a dozen speaking events in Massachusetts, including an $85,000
program on opioids at Tufts University and a $50,000 program on opioid prescribing for chronic
pain at Boston University. 650
543. In November, staff cautioned Boer, Lewent, and Pickett that drug company
“owners, officers, and managers will especially face even more serious scrutiny in the future.” 651
   2011   
544. In February 2011, staff informed Boer, Lewent, and Pickett that Purdue was using
individual zip codes to track the correlation between poison control calls for OxyContin
poisoning, pharmacy thefts, and Region Zero prescribers; gave Boer, Lewent, and Pickett a map
of dangerous prescribers in Massachusetts; and briefed Boer, Lewent, and Pickett on a study
showing that the financial penalties imposed on drug companies for illegal marketing were
“relatively small” when “compared to the perpetrating companies’ profits.” 652
545. At the same meeting, staff gave the Board data showing that 83% of patients
admitted to substance abuse treatment centers began abusing opioids by swallowing pills, and
that it commonly takes 20 months for patients to get treatment. 653
546. Later in February, staff told Boer, Lewent, and Pickett that Massachusetts
lawmakers had introduced legislation to ban extended-release oxycodone, including Purdue’s
OxyContin. 654
547. In early 2011, Purdue launched Butrans. Over the next few years, Boer, Lewent,
650
2010-10-07 report attached to email by William Mallin, pgs. 3, 5, 10, 13, 16, 26, 28, 33, 34,
PPLPC012000292676, -678, -683, -686, -689, -699, -701, -706, -707, -759, -760.
651
2010-11-10 Executive Committee notes, PPLPC012000299855; 2010-11-10 presentation by Bert Weinstein,
slide 7, PPLPC012000299866.
652
2011-02-03 Board of Directors Meeting Agenda, pgs. 48, 94, 95, PDD8901468062, -108-109.
653
2011-02-03 Board of Directors Meeting Agenda, pg. 86, PDD8901468100.
654
PPLPC012000312667-668.
183
and Pickett, and later, Costa and Snyderman too, received weekly reports on sales metrics
and tactics for Butrans. As it did to promote OxyContin, Purdue identified and targeted
for more frequent promotion a “super core” of physicians who prescribed the most
opioids. 655
548. Staff went on to detail how, after identifying their “super core” of target
prescribers, sales reps were instructed to “improve specific patient focus and effective
positioning of Butrans for specific patient types.” 656 In Massachusetts, promotion for
“specific patient types” translated in many cases to pushing opioids for elderly patients
with ailments such as arthritis. Purdue sales reps recorded in their notes that they pitched
prescribing opioids to elderly patients to Massachusetts providers more than a thousand
times in 2011. 657
549. Boer, Lewent, and Pickett were also briefed on Purdue’s tactics for
“closing” a sale — getting prescribers to commit to putting specific patients on
opioids. 658 This strategy was common to Purdue’s opioid sales pitches, and
Massachusetts prescribers reported to the Attorney General that Purdue sales reps had
asked them on multiple occasions to commit to prescribing Purdue opioids without
disclosing significant risks.
   2012   
550. Defendant Paulo Costa joined the Board in April 2012. 659
551. Soon after joining the Board, Costa began discussing Purdue’s sales and
655
656
657
Exhibit 1.
658
659
Paulo Costa declaration for September 2018 motion to dismiss.
184
marketing strategy with staff, including Sales VP Russell Gasdia, and questioned whether,
despite its aggressive expansion, Purdue was still underfunding its OxyContin promotion. 660
Staff sent Costa an advance copy of the mid-year sales and marketing report, which included
research showing that higher dosages and savings cards are factors contributing to longer
duration of opioid use. 661
552. For five days in June, Boer, Lewent, Pickett, and Costa attended the mid-year
meeting of the Board. 662 Sales staff told them that Purdue had added 120,000 sales visits
devoted to the promotion of OxyContin. To further drive OxyContin sales, staff reported that
they expanded the opioids savings cards and eMarketing programs and promoted opioids on the
Professional Television Network. 663
553. In August, Defendant Ralph Snyderman joined the Board. 664
554. That month, Boer, Lewent, Pickett, Costa, and Snyderman
. 665
555. By the fall of 2012, Costa proposed a plan to Purdue staff to target patients on
Medicaid as a strategy to revive declining OxyContin sales. Sales staff held a series of meetings
to consider Costa’s idea. Costa met with John Stewart and Russell Gasdia to discuss threats and
opportunities in the opioid market. 666
556. In November, staff provided Boer, Lewent, Pickett, Costa, and Snyderman
660
2012-06-04 email from Paulo Costa, PPLPC012000378550.
661
2012-06-11 email from Mike Innaurato, PPLPC012000382120; 2012-06-11 sales and marketing update, slides
11-12, 15-16, PPLPC012000382121.
662
2012-05-25 email from Stuart Baker, PPLPC012000377890-891.
663
664
Snyderman declaration.
665
666
2012-11-03 email from Paulo Costa, PPLPC012000396834; 2012-10-29 email from Paulo Costa,
PPLPC012000396447; 2012-10-30 email from Russell Gasdia, PPLPC012000396469.
185
.” The
. Staff told Boer,
Lewent, Pickett, Costa, and Snyderman, together with the Sacklers,
. 667
   2013   
557. At the start of 2013, at the request of Boer, Lewent, Pickett, Costa, and
Snyderman, staff provided the Board with examples of political and third-party support
for Purdue’s “abuse deterrent” formulations, including in their report five Massachusetts
legislators who had written favorable letters to the FDA. 668 The Board directed staff to
obtain such letters, despite knowing that there was no actual evidence that Purdue’s
reformulated OxyContin helped prevent opioid abuse and that, to the contrary, it did
nothing to prevent the most common method of opioid abuse, by oral ingestion.
558. In January, the decline in high-dose opioid prescribing remained a
preoccupation for Purdue’s sales and marketing staff. Staff updated Boer, Lewent,
Pickett, Costa, and Snyderman on Purdue’s Individualize The Dose campaign to promote
higher doses. Staff also responded to Costa’s recommendation to target managed care
667
668
2013-01-15 email from Burt Rosen, PPLPC032000255061; 2013-01-15 attachment to email by Burt Rosen,
PPLPC032000255064.
186
organizations, including Medicare Part D. Staff also reported that Purdue had increased the
dollar value of opioid savings cards and set the program period to be 15 months long, in response
to research showing the cards kept patients on opioids longer. Boer, Lewent, Pickett, Costa, and
Snyderman also learned that Purdue was pushing the opioid savings cards through mass-mailings
and emails. 669
559. Sales reps reported to Purdue that, during 2013, they promoted opioid savings
cards to Massachusetts doctors more than a thousand times. The sales reps did not tell doctors
that savings cards led patients to stay on opioids longer, or that staying on opioids longer
increased the risk of addiction and death.
560. In February, staff informed Boer, Lewent, Pickett, Costa, and Snyderman of the
ever-growing public concern about the dangers of opioids. A presentation on the opioid
marketing environment noted an “increase in media reports questioning the use, and safety, of
opioids for non-cancer pain.” Staff told Boer, Lewent, Pickett, Costa, and Snyderman about
“family members of overdose victims featured in these stories” who have “testified in support of
restricting the use of opioids.” Staff also warned the Board members about the rise of state task
forces, pill mill legislation, and state-level initiatives to limit opioid prescribing and increase the
utilization of prescription monitoring programs. The presentation characterized the growing
public concern over opioid safety and the opioid crisis as due to a “lack of interest by reporters to
provide balanced reporting” and promised that Purdue would push back. 670
561. In March, staff reported to Boer, Lewent, Pickett, Costa, and Snyderman on the
devastation caused by prescription opioids. Staff told Boer, Lewent, Pickett, Costa, and
Snyderman that drug overdose deaths had more than tripled since 1990 — the period during
669
670
2013-02-13 business condition report to Board, slides 38-40, PPLPC012000408089-091.
187
which Purdue had made OxyContin the best-selling painkiller—and that tens of thousands of
deaths were only the “tip of the iceberg.” Staff reported that, for every death, there were more
than a hundred people suffering from prescription opioid dependence or abuse. 671
562. Although the Individualize The Dose tactics discussed in January were
proving effective, staff stressed to Boer, Lewent, Pickett, Costa, and Snyderman in May
that Purdue needed to get even more patients on higher doses and larger prescriptions of
opioids to meet its sales goals. Staff told Boer, Lewent, Pickett, Costa, and Snyderman
that Purdue was still $16,800,000 below budget due to insufficient sales of the highest
doses of OxyContin and that prescribers writing “lower average tablet counts per
prescription” was exacerbating this issue. 672
563. Staff told Boer, Lewent, Pickett, Costa, and Snyderman that they were
undertaking “[a] deeper analysis…to determine the cause of the decline in the 30mg,
60mg, and 80mg tablet strengths, as well as the lower than budgeted average tablets per
prescription. Once the analysis is complete, we will have a better sense of that tactics to
implement to address both issues.” 673
564. Both “the decline in higher strengths” of Purdue opioids, and the decline
in “tablets per Rx,” remained topics of Board discussion throughout 2013. 674 To address
it, staff informed Boer, Lewent, Pickett, Costa, and Snyderman that Purdue continued
adding more prescriber visits
671
2013-03-21 Abuse Deterrent Strategy Presentation to the Board, slides 38-39, PPLP004409513-514.
672
673
674
188
. 675
565. Staff updated Boer, Lewent, Pickett, Costa, and Snyderman on Purdue’s
successful lobbying against state legislation to impose safety restrictions on OxyContin,
including a defeated bill in Massachusetts. Boer, Lewent, Pickett, Costa, and Snyderman
also learned that Purdue had begun email promotion of opioid savings cards specifically in
Massachusetts. 676
566. In 2013, Purdue also increased its targeting of managed care organizations and
insurance companies, including Medicaid and Medicare plans. In June and July, Paulo Costa
strategized with Purdue staff, including Sales VP Russell Gasdia, to market Purdue opioids
directly to insurance companies and managed care formularies. Under the plan, Purdue would
try to convince them to cover opioids with data that the FDA had never approved. And Costa
recommended Purdue’s CEO promote opioids directly to the insurance company CEOs. 677 Over
the coming months, acting on Costa’s recommendations, Purdue continued to refine its approach
to marketing to managed care patients. 678
567. In July and August, Boer, Lewent, Pickett, Costa, and Snyderman met, together
with the Sacklers, to
675
2013-07-05 email from Edward Mahony, PPLPC012000431312-313; 2013-11-01 Board report, pg. 20,
PPLPC002000186930; 2013-07-23 Board report, pg. 25, PPLPC012000433412.
676
677
2013-06-25 meeting with Paulo Costa notes, PPLPC0021000577371.
678
2013-07-11 email from Tim Richards, PPLPC012000431842; 2013-07-15 email from Tim Richards,
PPLPC012000432169; 2013-07-31 email from Jon Lowne, PPLPC012000434831.
189
. 679
568. Second,
. In June,
. 680
. 681
569. Third,
.” The
.” 682
570. Later that month,
679
Updates, PPLP004409892.
680
2013 Walgreens agreement, https://www.justice.gov/sites/default/files/usao-sdfl/legacy/2013/06/19/130611-
01.WalgreensMOA%26Addendum.pdf.
681
Updates, pgs. 3-5, PPLP004409894-896.
682
Updates, pgs. 6-7, PPLP004409897-898.
190
. 683
571. Stewart identified Costa to sales staff as “a champion for our moving
forward with a comprehensive ‘turbocharge’ process,” . 684
Purdue continued to follow-up on Costa’s recommendations in the following months, as Purdue
rebranded the Turbocharge campaign internally to Evolve to Excellence (or E2E). 685
572. In September and October, Boer, Lewent, Pickett, Costa, and Snyderman met
with the Sacklers
. They
. 686
573. In October, staff informed Boer, Lewent, Pickett, Costa, Snyderman, and the
Sacklers of a correlation between “DEA pressures” and the “declining trend[s]” in sales of both
extended release opioids and higher dose opioid pills. 687 Staff promised to include DEA
enforcement and “increasingly restrictive opioid prescribing guidelines and regulations” in
shaping their ongoing strategy to increase opioid sales, as well as to more than double the portion
of the sales budget spent on promoting OxyContin through the E2E initiative. 688
574. Staff continued to update Boer, Lewent, Pickett, Costa, and Snyderman on the
new sales force tactics as they ramped up their implementation through the final quarter of 2013,
683
2013-08-22 McKinsey presentation, slide 10, PPLPC012000437356.
684
685
2013-09-19 email from Edward Mahony, PPLPC012000441854; 2013-09-19 email from Edward Mahony,
PPLPC012000441858, 2013-09-23 email from Russell Gasdia, PPLPC012000442736.
686
2013-09-12 Board agenda, PPLP004409919; 2013-10-03 Board agenda, pg. 8, PPLP004409965.
687
688
191
during which period sales visits in Massachusetts increased by 30%. 689
575. In November, staff reported to Boer, Lewent, Pickett, Costa, and Snyderman that
key initiatives during the third quarter of 2013 were getting doctors to prescribe OxyContin to
opioid-naive patients and elderly patients on Medicare. Staff showed Boer, Lewent, Pickett,
Costa, and Snyderman how Purdue’s tactic of using opioid savings cards to keep patients
on OxyContin longer was working, and that Butrans sales had been above Purdue’s
forecasts. Nevertheless, staff told the Board that Purdue’s 2013 profits were still
hundreds of millions of dollars below target, and this shortfall was almost entirely due to
the ongoing decline in high-dose and high-volume OxyContin prescriptions. 690
576. Staff also reported to Boer, Lewent, Pickett, Costa, and Snyderman, that a
key initiative in 2013 was training sales reps to keep patients on Butrans longer. Staff
told them that Purdue’s launch of a new, high dose form of Butrans that, after being
included in the E2E marketing push, had received initial orders double what the company
had forecast. Staff reported that marketing and sales activities generated 266,842
additional Purdue opioid prescriptions and again highlighted opioid savings cards as a
promotional coup. 691
577. Staff reported to Boer, Lewent, Pickett, Costa, and Snyderman that Purdue
had sent more than 880,000 emails to health care professionals to promote its Butrans
opioid, and posted online advertising seen more than 5 million times for Butrans and
nearly 4 million times for OxyContin. Staff told them that this national campaign
presented the same “key selling messages” designed to get more patients on OxyContin
689
2013-11-01 Board report, pg. 11, PPLPC002000186921; Exhibit 1.
690
2013-11-01 Board report, pgs. 6, 11-15, PPLPC002000186916, -921-925.
691
2013-11-01 Board report, pgs.11-13, 27, PPLPC002000186921-923, -937.
192
at higher doses for longer periods of time, and specifically promoted Purdue’s opioid savings
cards. 692 Boer, Lewent, Pickett, Costa, and Snyderman understood and intended that the sales
campaign hit Massachusetts.
   2014   
578. In early 2014, staff told Boer, Lewent, Pickett, Costa, and Snyderman that again,
the company’s promotion of its opioids was working, and had generated an additional 560,036
prescriptions of OxyContin in 2012 and 2013, but this increase was still drastically below the
number of opioids Purdue wanted to sell. 693 Like before, this gap was attributed to “continued
pressure against higher doses [and] long term use of opioids,” as well as new FDA labeling
language instructing prescribers to prescribe OxyContin only to patients for whom alternative
therapies were inadequate. 694
579. At 2014’s first Board meeting in February, staff presented Boer, Lewent, Pickett,
Costa, and Snyderman with samples of new opioid messaging and sales analysis on further
methods to “maximize revenue and profitability for both Butrans and OxyContin.” Staff also
reviewed plans to continue Purdue’s core marketing tactics, including the “Key Initiative” to
cause patients to “stay on therapy longer,” the Individualize The Dose campaign, opioid savings
cards, and the campaigns targeting elderly and opioid naive patients. 695
580. Staff also told the Board that Purdue’s OxyContin eMarketing campaign had
reached 84,250 health care providers during the fourth quarter of 2013. 696
581. As in the past, staff informed Boer, Lewent, Pickett, Costa, and Snyderman, about
692
693
2014-02-04 Board report, pgs. 3, 5, 22, PPLPC002000181037, -039, -056.
694
2014-03-31 Q1 2014 financial results presentation, slide 5, PPLPC012000473131.
695
696
2014-02-04 Board report pg. 15, PPLPC002000181049.
193
specific developments in Massachusetts. Staff reported to them that Purdue was
developing language to modify Massachusetts legislation on opioid prescriptions. 697
582. Staff also noted an unusually high number of compliance concerns with the
content of Purdue’s speaker programs, in which the company paid doctors to promote Purdue
opioids or messaging to other doctors, causing Purdue to mail out corrective letters to
attendees in some cases. 698
583. In April, staff reported to Boer, Lewent, Pickett, Costa, and Snyderman,
together with the Sacklers, that Purdue employed 643 sales reps. 699 Staff told them that
visits by sales reps to doctors were essential to drive prescriptions of Purdue opioids: a
drop in sales visits had reduced Butrans prescriptions, underscoring how crucial
prescriber visits were to Purdue’s profits. 700
584. In July, staff told Boer, Lewent, Pickett, Costa, and Snyderman, yet again,
that Purdue’s OxyContin business was threatened by “[c]ontinued pressure against higher
doses of opioids,” and “[c]ontinued pressure against long term use of opioids.” 701
585. In October, staff sent Boer, Lewent, Pickett, Costa, and Snyderman a
Proposed Operating Plan and Budget for 2015, which cited “key tactics” of inducing
doctors to convert patients from short-acting opioids to OxyContin, and moving patients
taking Butrans to higher doses. 702 The budget predicted that prescribers’ continued shift
away from the highest doses and larger prescriptions of OxyContin would now cost
697
2014-02-04 Board report pg. 43, PPLPC002000181077 (bill concerned interchangeability of prescriptions).
698
2014-02-04 Board report pgs. 39-40, PPLPC002000181073-074.
699
2014-04-14 financial report to Board, pg. 7, PPLPC012000473138.
700
2014-03-31 results of operations report, slide 7, PPLPC012000473131.
701
2014-07-01 Board Flash Report, slide 5, PPLPC016000244173.
702
2014-10-24 email from Edward Mahoney, PPLPC016000260660; 2015 Commercial Budget Review, slides 31,
51, PPLPC016000260706-726.
194
Purdue $99,000,000 that year. 703
586. The budget also explained Purdue’s plans to continue sales force
expansion to promote the launch of its new opioid Hysingla. 704
587. On December 31, Judith Lewent resigned from the Board.
   2015   
588. Purdue’s efforts to overcome the decline in high-dose and high-volume opioid
prescribing through aggressive sales calls continued in 2015. In April, staff told Boer, Costa,
Pickett, and Snyderman that sales of Purdue’s highest dose of OxyContin were down 20% and
that the average number of tablets per prescription had declined by eight tablets since 2011.
Staff reported that Purdue employed 508 sales reps and another 57 as contract workers. Boer,
Costa, Pickett, and Snyderman voted to expand the sales force by adding another 122 reps, based
on a prediction that this would increase net sales of opioids by $59,000,000. 705
589. In December, Boer, Costa, and Snyderman demanded more information on sales
and marketing tactics. Boer asked for an update on the Region Zero prescribers Purdue had
flagged as possible illegal diverters, which included prescribers in Massachusetts. Costa sought
a briefing on adjustments made to the distribution of sales territories throughout the country.
Snyderman directed staff to break out sales data by indication versus prescriber specialty for
each drug. Snyderman also wanted more information about the impact of Purdue’s sales force
on prescriptions. 706
703
2015 Budget Submission, slide 6, PPLPC016000260845.
704
2015 Commercial Budget Review, slide 67, PPLPC016000260742.
705
2015-05-21 Board materials, pgs. 23, 32, 35, 39, PPLPC011000025691, -700, -703, -707.
706
2015-12-09 Executive Committee presentation, slides 12-14, PPLPC011000073230.
195
   2016   
590. In 2016, Boer, Costa, Pickett, and Snyderman participated in Board meetings with
the Sacklers in January, March, April, June, August, October, November, and December. 707 As
of the date of this Amended Complaint, Purdue has not disclosed the records of those meetings,
although it has promised to disclose them in the coming days.
   2017 - 2018   
591. In 2017, Boer, Costa, Pickett, and Snyderman participated in Board meetings with
the Sacklers in January, March, April, June, August, and October. 708
592. In October 2017, Snyderman resigned from the Board. 709
593. In January 2018, Costa resigned from the Board. 710
594. Boer and Pickett remained.
595. Boer, Lewent, Pickett, Costa, and Snyderman each collected
from opioid sales in
Massachusetts. In exchange for the money, Boer, Lewent, Pickett, Costa, and Snyderman
did what the Sacklers wanted every step of the way. They each knowingly, intentionally,
and repeatedly directed Purdue’s unfair and deceptive sales and marketing campaign in
Massachusetts, to the great cost of patients and families.
707
2016-05-19 Executive Committee pre-read, pg. 3, PPLPC011000096794.
708
2017-03-23 Executive Committee presentation, slide 3, PPLPC011000139651.
709
Ralph Snyderman declaration.
710
Paulo Costa declaration.
196
C. John Stewart, Russell Gasdia, Mark Timney, and Craig Landau
596. The Sacklers relied on four key executives to get more patients in Massachusetts
to take more opioids at higher doses for longer periods of time. These executives — John
Stewart, Russell Gasdia, Mark Timney, and Craig Landau — are personally liable for their role
in the unlawful scheme.
JOHN STEWART
597. As CEO from 2007 to 2013, John Stewart headed up Purdue’s unfair and
deceptive campaign to get more Massachusetts residents to take more opioids at higher doses for
longer periods of time. The Sacklers found Stewart, a long-time veteran of Purdue,
. 711
598. Stewart knowingly and intentionally sent sales reps to promote opioids in
Massachusetts. At his direction, Purdue’s sales reps visited Massachusetts prescribers more than
70,000 times. 712 Stewart, in collaboration with sales executives like Russell Gasdia,
recommended that Purdue increase the size of the sales force several times, more than doubling
the number of sales reps during his tenure. After the Sacklers approved each expansion, Stewart
ensured that the additional sales reps were deployed to sell opioids to prescribers in
Massachusetts and beyond.
599. Stewart, a long-time employee of Purdue prior to becoming CEO, sent a memo to
Jonathan and Kathe Sackler in 1997, which showed that he knew then that when people use high
doses of opioids for longer periods, they are more likely to suffer adverse effects. 713 Despite this
711
2008-04-18 memo from Richard Sackler, PDD9316300631.
712
Exhibit 1.
713
1997-04-12 memo from John Stewart, PDD1701785443.
197
knowledge, as CEO, Stewart led Purdue’s strategy to drive patients to take opioids at higher
doses for longer periods of time to meet the Sacklers’ sales goals.
600. Stewart knew and intended that the sales reps in Massachusetts would increase
opioid sales by misleading doctors and concealing the true risks of Purdue’s opioids.
601. Stewart also knew and intended that Purdue staff reporting to him would engage
in thousands of additional deceptive acts in Massachusetts, including sending misleading
publications to Massachusetts doctors and engaging in deceptive promotion of Purdue opioids at
Boston University, Massachusetts General Hospital, and Tufts University.
602. Stewart knowingly and intentionally sought to conceal his misconduct.
   2007   
603. In May 2007 — immediately after the 2007 convictions — Stewart began
planning to expand Purdue’s sales force in Massachusetts and across the country. Even though
Purdue sales reps were already visiting Massachusetts prescribers more than 1,000 times each
month, Stewart and Sales VP Russell Gasdia worked to quantify the “market impact” that adding
sales reps would have. 714
604. In June, Stewart met with Purdue’s sales managers, including the Massachusetts
district and regional managers, to present his vision for selling opioids. 715
605. In July, Stewart received the first of more than twenty reports he would receive
during his tenure as CEO, detailing the number and breadth of Purdue’s sales reps across the
country, including in Massachusetts. Staff also told Stewart that Purdue received 572 Reports of
714
715
198
Concern about abuse and diversion of Purdue opioids during Q2 2007 — including several
reports from Massachusetts. 716
606. Staff told Stewart that Purdue had mailed 12,528 marketing pieces to prescribers
and others in the first half of 2007. The most-distributed item was volume #1 of Purdue’s
“Focused and Customized Education Topic Selections in Pain Management” (FACETS), 717
which falsely instructed doctors and patients that physical dependence on opioids is not
dangerous and instead improves patients’ “quality of life.” FACETS also falsely told doctors
and patients that signs of addiction are actually “pseudoaddiction,” and that doctors should
respond by prescribing more opioids. 718 Staff told Stewart that another of the publications they
had sent most often to doctors was “Complexities in Caring for People in Pain.” 719 In it, Purdue
repeated again its false claim that warning signs of addiction are really “pseudoaddiction” that
should be treated with more opioids. 720
607. Under Stewart’s oversight, Purdue sent both of those misleading materials to
doctors in Massachusetts hundreds of times. 721
608. In September, Stewart approved distributing the deceptive book Responsible
Opioid Prescribing, sponsored by Purdue, which reinforced Purdue’s deceptive message that the
clear majority of patients were “trustworthy,” meaning that they were not vulnerable to
addiction. 722
716
2007-07-15 Board report, pg. 33, 52, PWG000300817-836.
717
718
2007-08-29 “Focused and Customized Education Topic Selections in Pain Management”, Vol. 1, pgs. 51, 53,
PTN000004691, -693.
719
720
200709-03 “Complexities of Caring for People in Pain”, pg. 8, PTN000005318.
721
2010-08-26 Medical Education Materials for HCPs, PWG000247083, -084.
722
2007-09-06 email from John Stewart, PWG000184869.
199
609. As Stewart continued to work to expand the sales force, he knew that the national
Blue Cross/Blue Shield association instructed its members, including Blue Cross/Blue Shield of
Massachusetts, to not partner with Purdue, because the association was “concerned about what
[Purdue’s] sales people were telling doctors.” 723
610. In October, Stewart reported to the Board that Purdue received 284 Reports of
Concern about abuse and diversion of Purdue’s opioids in the most recent quarter and 39 tips to
Purdue’s compliance hotline. 724 Nevertheless, staff told Stewart and the Board that they should
authorize a sales force expansion because the existing force was “unable to cover a large
percentage of high prescribers.” 725
   2008   
611. In January 2008, staff told Stewart that, in 2007, Purdue’s net sales were just over
$1 billion, almost “DOUBLE” what the company had planned with OxyContin making up more
than 90% of those sales. Staff also told Stewart that they represented Purdue at the
Massachusetts General Hospital Purdue Pharma Pain Center in Boston on November 1 and at a
Tufts University course on “Pain Policy: Opioid Laws and Policies” in Boston on October 31. 726
612. In February, the Board
. 727 As a result, Stewart knew and intended that more sales reps would promote
opioids to prescribers in Massachusetts by misleading doctors and concealing the true risks of
Purdue’s opioids. In fact, sales reps newly hired in the 2008 expansion promoted Purdue opioids
723
724
725
2007-10-26 email from Russell Gasdia, PPLPC012000159020; 2007-10-25 Sales & Marketing presentation, slide
4, PPLPC012000159022.
726
727
200
to Massachusetts prescribers more than 13,000 times. 728
613. Stewart wrote to Richard Sackler that Purdue’s reformulated OxyContin with so-
called abuse-deterrent properties “will not stop patients from the simple act of taking too many
pills.” 729 Still, Stewart worked to include abuse-deterrent claims in the label of reformulated
OxyContin and heralded the reformulation of OxyContin as a solution to the problems caused by
opioid abuse, misleadingly focusing on crushing and injecting even though he knew that
swallowing intact pills is the most common form of abuse. 730
614. In March, Stewart presented the details of the OxyContin savings card program to
the Board. He explained that offering savings cards increased the share of patients who use
branded OxyContin by fifteen percent. 731
615. In April, staff told Stewart they promoted Purdue’s opioids in Massachusetts at
Tufts Health Care Institute’s program on Opioid Risk Management in Boston on March 27. 732
616. In July, staff told Stewart that Purdue had bought one hundred new Pontiac Vibes
to shuttle around the expanded Sales Force he had proposed. Staff also told Stewart that they
promoted Purdue’s opioids to clinicians, fellows, and medical residents in Massachusetts in a
presentation titled “The Assessment and Management of Chronic Pain with an Emphasis on the
Appropriate Use of Opioid Analgesics” at the Tufts University MSPREP Program in Boston on
April 25; and in a presentation titled “The Role of Urine Drug and other Biofluid Assays in Pain
Management,” at the Tufts Health Care Institute’s program on Opioid Risk Management in
728
Exhibit 1.
729
730
2010-10-27 email from John Stewart, PDD8901374440; 2010-04-28 email from John Stewart, PDD8901562111;
2011-09-28 presentation by John Stewart, slides 9-11, PWG000245725-727; 2011-09-28 presentation by John
Stewart, slides 23-30, PWG000245754-761; 2012-03-06 speech by John Stewart, PWG000245479.
731
2008-03-07 email from John Stewart, PPLPC012000173909; 2008-03-07 board agenda, PPLPC012000173911, -
950-970.
732
201
Boston on June 26 and 27. 733 Convincing Massachusetts doctors that Purdue opioids were the
best way to manage chronic pain and that urine tests protected patients from addiction were both
part of Purdue’s deceptive scheme.
617. In October, staff told Stewart that the sales force expansion had been
implemented and Purdue now employed 414 sales reps — an increase of more than 100 reps. 734
The expansion of the sales force that Stewart had recommended had its intended effect in
Massachusetts: during the third quarter of 2008, Purdue sales reps visited Massachusetts
prescribers more than 1,800 times — a 20% increase compared to the same period in 2007. 735
   2009   
618. In March 2009, Stewart and Richard Sackler discussed a decline in OxyContin’s
market share. Both men wanted more. Stewart stressed that it would not be enough merely to
get patients onto Purdue opioids, but that they needed to get patients onto the most profitable
prescriptions: “the key consideration is more likely to be Purdue’s share of the $ market (as
opposed to Rx’s).” 736 Both men knew that the most profitable prescriptions were those for the
highest doses.
619. In April, staff told Stewart that Purdue had increased prescribers’ use of high dose
opioids: “for the first time since January 2008, OxyContin 80mg strength tablets exceeded the
40mg strength tablets during December 2008.” Staff also told Stewart that Purdue received 122
tips to its compliance hotline during first quarter 2009, including tips regarding improper use of
OxyContin marketing materials and opioid savings cards. 737
733
2008-07-15 Board report, pgs. 21, 30, PPLP004367317, -326.
734
735
Exhibit 1.
736
737
2009-04-16 Board report, pgs. 5, 24-25, PDD9316304317, -336-337.
202
620. In June, Stewart
.” 738
621. In October, staff told Stewart and the Board: “The Sales Force expanded by an
additional 50 territories as of July 2009,” and Purdue had hired even more sales reps since, to
total 475 sales reps in all. Staff reinforced earlier reports that a nationwide review of District
Managers in the sales force had required extensive corrective action, but Stewart did not follow
up that report with any discipline for executives. 739
622. In November, following a question from Richard Sackler, staff told Stewart and
the Board that Purdue promoted OxyContin as reducing pain faster, having less variability in
blood levels, and working for more pain conditions than competitor products. 740 Stewart knew
that there was no support for these claims in OxyContin’s FDA-approved labeling.
623. That same month, Stewart sought Board approval to resume funding the
Massachusetts General Hospital Purdue Pharma Pain Program to promote Purdue’s opioids in
Massachusetts. 741
624. In December, Stewart prepared 2010 objectives for the sales and marketing team,
including how many times sales reps should visit prescribers to promote opioids and how
managers should supervise the reps. Stewart wrote that the target for face-to-face promotion to
738
739
2009-10-20 email from John Stewart, PPLPC012000242813; 2009-10-22 Board report, pgs. 4, 16, 21,
PPLPC016000007322, -334, -339.
740
741
203
prescribers would be 540,000 sales visits, and staff would have to report the number of sales
visits, compared to the target and compared to the prior year, at the end of every quarter. 742
   2010   
625. In January 2010, Stewart informed staff about the Board’s decision to increase the
sales target to $3.1 billion in sales, more than $100 million more than in 2009. 743
626. In February, staff reported to the Board Stewart’s sales objective of at least
545,000 visits to prescribers to promote Purdue opioids in year 2010. 744 That target rose to
712,000 visits in 2011, 752,417 in 2012, and 744,777 in 2013. 745
627. At Stewart’s urging, ,
so that Purdue employed 490 sales reps nationwide, including 14 in Massachusetts. 746
628. Staff regularly told Stewart exactly how many times Purdue sales reps visited
prescribers to promote opioids in the most recent three months, how that total compared to the
budget, how many prescribers an average rep visited on an average day, and what Purdue staff
were doing to increase the number of opioid sales visits.
629. Stewart
. 747 Stewart
. He
742
2009-12-22 email from John Stewart, PPLPC012000249344; 2009-12-22, 2010 Objectives,
PPLPC012000249345.
743
2010-01-27 email from John Stewart, PPLPC012000252171; 2010-01-26 Executive Committee notes,
PPLPC012000252176.
744
745
2011-05-02 Board report, pg. 3, PPLPC012000322428; 2012-04-30 Board report, pg. 3, PPLPC012000374793;
746
2010-02-01 Board report, pgs. 4, 19, PPLPC012000252778, -793; Exhibit 1.
747
204
. 748
630. In March, Stewart requested a report about the Massachusetts OxyContin and
Heroin commission, which the legislature had formed in 2008 to understand the thousands of
opioid-related deaths. The commission reported, among other things: “Addiction to the powerful
painkiller, OxyContin, became evident almost immediately following FDA approval of the drug
in 1995.” 749
631. That same month, Stewart
. 750 Stewart
632. In April, Stewart formally approved the sales target of 545,000 OxyContin calls
on prescribers for the year 2010. 751
633. That same month, staff reported to Stewart and the Board that OxyContin was so
risky Purdue could not get product liability insurance for it. Staff told Stewart that they were
pushing back against the “threat” of public health rules that would limit high doses of opioids.
They told Stewart that Purdue would oppose measures that asked doctors to consult with pain
specialists before putting patients on high doses of opioids. 752
748
2010-02-16 Executive Committee notes, PPLPC012000258759; 2014-07-07 email from John Stewart,
PPLPC012000431279.
749
https://archives.lib.state.ma.us/bitstream/handle/2452/46748/ocn466141823.pdf?sequence=1&isAllowed=y
750
751
2010-04-06 email from John Stewart, PPLPC012000266606; 2010-04-06 Marketing & Sales draft for Board
report, PPLPC012000266607.
752
2010-04-21 Board report, pgs. 15-16, PWG000423154-155. 2010-10 budget submission, pg. 29,
PDD9273201317. In November 2010, staff reported to the Board that Purdue had collected $343,800,000 in
liability insurance payments, including $151,700,000 for settlements and $192,100,000 for legal fees.
205
634. In June, Stewart presented the Board with the projected number of sales reps to
promote each Purdue product over the next 10 years. 753 Stewart approved the mix of products
the sales force was already promoting and applauded their progress on meeting targets. 754
635. In July, Stewart invited sales and marketing managers to attend the board meeting
and strategize even more sales force expansion. 755 Stewart knew and intended that, because of
this undertaking, more sales reps would promote opioids to prescribers in Massachusetts. In fact,
new sales reps hired in the 2010 expansion promoted Purdue opioids to Massachusetts
prescribers more than 4,000 times. 756
636. In September, Stewart and Gasdia discussed how sales reps should talk to doctors
about reformulated OxyContin. In the wake of 770 calls in one week from patients, caretakers,
and prescribers to Purdue for concerns like adverse events, Stewart told Gasdia to have sales reps
stay on message. He told Gasdia that there was no need to have sales reps say more on these
issues with prescribers. 757 Stewart frequently made decisions about what sales reps should say
to doctors, and sales reps in Massachusetts used the words and phrases that Stewart chose.
637. In October, staff told Stewart that Purdue employed 506 sales reps and that,
during the third quarter 2010, they visited prescribers 141,116 times. 758 More than 2,600 of
those visits were in Massachusetts. 759
638. Staff reported to Stewart and the Board that Purdue would promote opioids at
more than a dozen programs in Massachusetts. 760
753
754
755
2010-07-22 Board minutes, PKY183212838; 2010-07-20 email from John Stewart, PPLPC012000279588.
756
Exhibit 1.
757
758
2010-10-25 Board report, pgs. 3, 26, PWG000421967, -990.
759
Exhibit 1.
206
639. That same month, Stewart
. 761
640. Stewart
.” 762
641. In November, Stewart traveled to Massachusetts to promote Purdue’s opioids. He
met with Massachusetts General Hospital to discuss Purdue’s grant. 763 Ultimately, Stewart
would obtain for MGH an additional $500,000 per year for three years from the Board, with the
goal of increasing prescriptions of opioids, including OxyContin. 764 MGH produced a Purdue-
funded program called “Advances in Managing Chronic Pain.” 765
642. In December, Stewart informed the Board that “region 0 accounts for much of the
[prescription] decline at the regional level” after the reformulation of OxyContin. 766 Region
Zero was Purdue’s list of suspicious prescribers, which it stopped promoting to, but continued to
profit from, by failing to report them to authorities.
643. On Christmas Eve, Stewart reviewed printed marketing materials and sales rep
training for Butrans, including the titration guide which Purdue trained its sales reps to use to
push doctors to prescribe higher and more profitable doses. 767
760
The programs were at Massachusetts institutions Tufts University, Boston University, Pri-Med Institute,
Northeastern University, Massachusetts College of Pharmacy, and American Health Resources. 2010-10-07 report
attached to email by William Mallin, pgs. 3, 5, 10, 13, 16, 26, 28, 33, 34, PPLPC012000292676, -678, -683, -686, -
689, -699, -701, -706-707; 2010-10-07 Report attached to email by William Mallin, PPLPC012000292759-60.
761
762
2010-11-10 Executive Committee notes, PPLPC012000299855; 2010-11-10 Slideshow presentation by Bert
Weinstein, slide 7, PPLPC012000299866.
763
2010-11-19 email from David Haddox, PTN000018983.
764
2011-06-13 Budget spreadsheet, PPLPC012000329085
765
2011-07-11 email from Teri Toth PPLPC017000311119–120.
766
2010-12-01 presentation by John Stewart, slide 4, PPLPC012000300458.
767
2010-12-24 email from John Stewart, PPLPC012000304469; 2010-12-23 proposed Butrans titration guide,
PPLPC002000086956.
207
   2011   
644. In January 2011, staff told Stewart and the Board that Purdue employed 590 sales
reps and that, during the most recent quarter, they visited prescribers 125,712 times. 768 More
than 2,900 of those visits were in Massachusetts. 769
645. Staff also reported to Stewart that Purdue had completed one of its key initiatives
that Stewart had proposed; it hired 74 more sales reps during Q4 2010 and planned to hire 51
more reps during Q1 2011. 770
646. In February, staff gave Stewart and the Board a map correlating dangerous
prescribers in Massachusetts with reports of oxycodone poisoning, burglaries, and robberies.
Staff told Stewart and the Board that the company was receiving a steadily rising volume of
hotline calls and other compliance matters, reaching an all-time high during October, November,
and December 2010. 771 Staff also presented an analysis of penalties imposed on pharmaceutical
companies for illegal marketing. That analysis concluded that penalties for breaking the law are
“relatively small . . . compared to the perpetrating companies’ profits.” 772
647. Later that month, Stewart
. 773
648. In March, Richard Sackler asked Stewart and others to explain to the Board the
barriers that sales reps were encountering in their promotion and “what [was] being done to
768
2011-01-24 Board report, pgs. 4, 35, PWG000421551, -582.
769
Exhibit 1.
770
771
2011-02-03 presentation by Bert Weinstein, slides 23, 95, PDD8901468038, -109.
772
2010-12-16 study by Public Citizen’s Health Research Group, pg. 2, PDD8901468062.
773
2011-01-26 Executive Committee notes, PPLPC012000312667-668.
208
overcome them. 774 In April, Stewart met with Gasdia to form a plan to reverse declining Butrans
sales. 775 Stewart tracked sales numbers and sought to head off problems by aggressive
marketing. In May, Stewart co-authored Purdue’s plans to increase targeting of high prescribers,
which included further expanding the sales force. 776
649. When Jonathan Sackler complained to Stewart about sales (“This is starting to
look ugly”), Stewart turned around and ordered Sales VP Russell Gasdia to increase
prescriptions. 777 Stewart gave Gasdia 48 hours to deliver a comprehensive plan:
“the action plan should have elements specifically directed at: sales
force call targeting; sales force prescriptions by representative
(range from high to low, and what ‘performance improvement
plans’ are being put in place for those in the lowest deciles; key
questions/obstacles being identified from the field and medical
services, and how they are being addressed; what other information
the sales force feels will help boost sales; the current situation with
each of the major MCOs [managed care organizations], and the
plan and targets going forward (with specific dates); and key
marketing activities and their start date that by themselves may
help boost sales.” 778
650. That same month, staff told Stewart and the Board that Purdue had hired 47 more
sales reps in the most recent expansion and now employed 639. Staff told Stewart and the Board
that, during the first quarter of 2011, the sales reps visited prescribers 173,647 times during. 779
More than 3,800 of those visits were in Massachusetts. 780
651. In June, Stewart, in discussion with Landau and others, recognized that Purdue’s
opioid sales were hundreds of millions of dollars less than expected, in part, because doctors
774
775
776
2011-05-01 email from John Stewart, PPLPC012000322363; 2011-05-01 Purdue business strategy draft,
PPLPC012000322364.
777
778
779
780
Exhibit 1.
209
were prescribing the highest doses less often. 781 Those decreases in prescribing included
reductions of $300 million by prescribers who had been placed in Region Zero. 782
652. Continuing in June, Gasdia told Stewart that early Butrans sales were trending up,
and that the next strategy to sell even more Butrans was “increasing call frequency to the highest
prescribers.” 783
653. In August, Stewart informed Gasdia that lower-than-expected OxyContin sales
were due to decreased demand for the highest strengths — setting the stage for another push to
get doctors to prescribe higher doses. 784
654. In September, Stewart gave a speech titled Providing Relief, Preventing Abuse in
Connecticut, which deceptively blamed the addiction, overdose, and death on “abuse”—
deploying Richard Sackler’s time-worn strategy to “hammer on the abusers in every way
possible” — to draw attention away from how dangerous Purdue opioids were for everyone. 785
655. In October, Stewart pushed Gasdia for information on the Butrans sales
projections and threatened to cut Purdue’s marketing and sales investment if Gasdia couldn’t
turn Butrans sales around. 786
781
782
2011-06-15 memo from Kim Gadski, PPLPC012000329460.
783
784
785
2011-09-28 presentation by John Stewart, PWG000245717; 2001-02-01 email from Richard Sackler,
PDD8801133516.
786
210
   2012   
656. In January 2012, Stewart had his staff report to the Board that Purdue employed
632 sales reps. 787 In the fourth quarter of 2011, they visited Massachusetts prescribers more than
3,600 times. 788
657. In February, staff told Stewart that patients on higher doses of Butrans stayed on
that opioid longer, and that sales reps would press doctors to move patients to higher doses
rapidly to keep them on Butrans longer. This reinforced Stewart’s strategy to promote higher
doses. 789
658. In March, Gasdia pleaded with Stewart to try to trim back Richard Sackler’s
micromanagement of sales. Stewart replied that “I work on this virtually every day,” and asked
Gasdia to continue to “spur me to get involved directly.” 790
659. That same week, Stewart gave another Providing Relief, Preventing Abuse speech
making the same misleading statements as before: that pain is undertreated and that patients are
to blame for addiction, overdose, and death because of “abuse.” Stewart used these tactics to
draw attention away from how dangerously addictive Purdue’s opioids were for everyone. 791
660. In March, Stewart also created another 10-year projection, emphasizing that “one-
on-one interactions between healthcare professionals and the company’s Sales and Marketing
staff will be the primary driver” of prescriptions. Stewart also planned for Purdue to continue to
push under-treatment of pain as a major message. Finally, the plan highlighted that sales could
be increased by falsely convincing doctors that they could and should prescribe more to patients
787
788
Exhibit 1.
789
2012-02-12 email from David Rosen, PPLPC012000364028-029.
790
791
2012-04-09 email from Joseph Pisani, PWG000217342.
211
deemed to have low risk of addiction and that patients who were at risk of addiction were really
just illegal drug users. 792
661. In April, Stewart continued his focus on higher doses. He wrote to Gasdia that
Richard Sackler’s frustrations about both Butrans and OxyContin could be linked to dosing. He
encouraged Gasdia to tell Sackler that patients on lower doses seemed to stop taking opioids
sooner, and that much of the profit that Purdue had lost had been from doctors backing off the
highest dose of OxyContin (80mg). 793
662. In May, Stewart reiterated to Gasdia the importance of getting prescribers to use
higher doses and doing so “faster than the projections indicate.” He told Gasdia that the lowest
dose of Butrans should be “considered more of a starter dose” from which Purdue would
encourage almost everyone to move up. This would enable Purdue to collect “more $ value per
script.” Stewart told Gasdia that he would join Gasdia’s team in their detailed Butrans
performance review to get their sales strategy straight for the mid-year meeting with the
Board. 794
663. In June, Stewart directed one of his staff to attend the International Conference on
Opioids, which was held at Harvard Medical School in Boston that month. Staff reported that
people at the conference compared Purdue to the tobacco companies. 795
664. In July, Stewart
.”
792
2012-03-27 business strategy plan, pgs. 8, 10, 30, PWG000164127, -129, -149.
793
794
795
212
. 796 The following year, Purdue’s sales reps called on one of the
highest-prescribing Massachusetts doctors more than a hundred times. 797
665. That month, Stewart reported to the Board that Massachusetts now allowed drug
companies to use copay savings cards and to host dinners for doctors to promote their drugs. 798
666. In August, Stewart
.” Stewart also
.” 799 One
of those “high ROI targets” in Massachusetts, Walter Jacobs, lost his license due to unlawful
overprescribing in 2012, after years of being Purdue’s paid spokesman and top prescriber in the
Commonwealth.
667. Stewart knew how sales visits influenced prescribing. In October, Stewart and
Gasdia discussed directing the sales force to focus more on OxyContin and less on Butrans
because the increase in OxyContin sales would be greater than the reduction in Butrans sales. 800
668. That same month, Stewart directed his staff to draft an email, that he then
reviewed and edited, briefing the Board on Purdue’s objections to proposals by Physicians for
Responsible Opioid Prescribing which sought to limit the number of patients on opioids, their
796
2012-06-15 email from John Stewart, PPLPC012000383032; 2012-06-14 memo on project,
PPLPC012000382450; 2012-07-12 email from John Stewart, PPLPC012000383138; 2013-09-05 report,
pg. 41, PPLPC002000156120.
797
Exhibit 1.
798
2012-07-23 Board Report, pg. 39, PPLPC012000387107.
799
2012-08-05 email from John Stewart, PPLPC012000388080; 2012-07-11 overview of studies for Board report,
PPLPC012000388087-088.
800
213
doses, and the duration of use. 801
   2013   
669. In early 2013, Stewart and his staff continued to reinforce the Individualize The
Dose campaign, which Stewart knew and intended would promote higher doses. Stewart and his
sales staff also focused on promoting use of the opioid savings cards, including giving cash
bonuses to sales reps for driving their use, which Stewart knew and intended would keep patients
on opioids longer. 802
670. In February, Stewart drafted proposed sales scripts around the abuse-deterrent
formulation of OxyContin, such as:
“Reflecting the depth of its commitment to drug safety and patient

health, Purdue Pharma has introduced an abuse-deterrent
formulation of OxyContin tablets - that is difficult to manipulate
for the purpose of intentional abuse, misuse, and diversion.” 803
Although Stewart knew the reformulation would not deter abuse by swallowing pills — the most
common route of abuse — the sales scripts did not disclose that. Rather, they focused on
crushing and dissolving to deceive doctors into believing that the reformulation was safe. 804
Stewart and the team débuted these messages to the sales force in May, and sales reps began
using them thereafter.
671. In May, Stewart continued writing sales pitches for the abuse-deterrent
formulation of OxyContin. 805 Again, none of those statements disclosed that swallowing pills is
most common form of abuse. 806 Stewart discussed his sales pitches with top executives, and the
801
2012-10-03 email from John Stewart, PWG000415151.
802
803
2013-02-19 email from John Stewart, PPLPC012000409154; 2013-02-19 draft of proposed communicates,
PPLPC012000409160.
804
2013-02-19 draft of proposed communicates, PPLPC012000409156.
805
806
2013-05-03 guidance for sales reps, PPLPC012000421798.
214
team planned to roll them out to the sales force later that month. 807 In the second half of 2013,
Purdue’s sales reps used Stewart’s misleading sales messages at least 100 times in
Massachusetts.
672. Stewart hand-edited a presentation explaining that the decrease in high dose
prescriptions was causing declining revenue, and that Purdue would respond by: making more
OxyContin sales calls, pressing forward with the Individualize The Dose campaign, and
promoting opioid savings cards. Stewart intended that these initiatives would get patients on
higher doses for longer periods. 808
Stewart’s notes on a slide identifying the problem of lower sales in higher doses
Stewart’s notes on a slide with Purdue’s plan to address the problem
807
2013-05-03 email from Ronald Cadet, PPLPC012000421795.
808
2013-05-22 mid-year sales update, slides 4, 14, PPLPC012000424611, -621.
215
673. Meanwhile, staff reported to Stewart and the Board that they were continuing to
use opioid savings cards to get patients to “remain on therapy longer.” Staff told Stewart that
they were now using direct mail and email, as well as in person sales visits, to push the opioid
savings cards. 809
674. Despite these sales efforts, Stewart knew that Purdue was losing tens of millions
of dollars in revenue because fewer patients were being prescribed higher doses of opioids and
patients were being prescribed fewer pills in each prescription. Staff told Stewart: “there is an
‘unfavorable’ mix of prescriptions across strengths,” and sales of the highest doses were too low.
Staff reminded Stewart of the second problem: “lower average tablet counts per prescription.” 810
675. In July, Stewart directed Gasdia to develop a way to “identify consistently low
performers” in the sales force. He also instructed Gasdia to tell the sales force that they should
be doing half of their calls on OxyContin, half on Butrans. 811
676. That same month, staff told Stewart and the Board that OxyContin sales had
dropped $96,400,000 from the year before because Purdue had fewer sales reps selling
OxyContin to doctors. 812 Stewart
. 813
677. Meeting with his External Affairs Committee, Stewart discussed concerns about
“threats” from “data on long term use of opioids.” 814 Stewart knew in 1997 that long term use
leads to more adverse events and he was worried that the public was figuring it out. 815
809
810
811
812
2013-07-05 email from Edward Mahony, PPLPC012000431149; 2013-07-05 email from Edward Mahony,
PPLPC012000431312.
813
814
2013-07-24 Communications and External Affairs Committee minutes, PPLPC012000433553.
815
1997-03-12, memo from John Stewart, PDD1701785443.
216
678. Stewart and his staff continued to focus on “the decline in higher strengths” of
Purdue opioids, and the decline in “tablets per Rx,” which were reducing Purdue’s profit. One
“specific concern” for Purdue had been Massachusetts legislation to essentially ban OxyContin
in Massachusetts, which Purdue had advocated against and defeated. 816 Stewart knew and
intended that Purdue was promoting and selling OxyContin in the Commonwealth.
679. Staff also reported to Stewart that they had trained Purdue’s sales reps to use new
sales materials designed to get patients on higher doses of opioids for longer periods. Purdue
employed 634 sales reps and, during the second quarter of 2013, they visited prescribers 177,773
times. Staff assured Stewart that they were trying to increase sales visits by increasing
communication to sales representatives and monitoring sales reps more closely. 817 During that
quarter, Purdue sales reps visited Massachusetts prescribers more than 2,400 times. 818
680. In August, Stewart presented to the Board about OxyContin growth opportunities.
He identified diminished use of the highest doses as a major factor in declining sales and
explained that OxyContin prescriptions would increase with more sales calls. 819
681. That same month,
. 820
816
817
818
Exhibit 1.
819
2013-08-14 presentation by John Stewart and Russell Gasdia, slides 2, 4, PPLPC012000436355.
820
2013-08-22 email from Russell Gasdia, PPLPC012000437344 ( interim report).
217
. 821
682. In September, Stewart initiated Project Turbocharge,
to drastically increase OxyContin sales calls and change the way Purdue targets
prescribers. 822 This initiative was renamed E2E: Evolve to Excellence and would be the theme
of the 2014 National Sales Meeting. 823
683. Also in September, Stewart told the Board he was working to oppose the
incorporation of 90-day limits into the FDA’s pain management guidelines or regulations. 824
Stewart knew that patients who stay on opioids longer have more adverse events, but that they
were also more profitable for Purdue. 825 In fact, in Massachusetts, patients who use opioids for
longer than 90 days are thirty times more likely to die of opioid-related overdoses than the
general population.
684. Later that month, Stewart criticized Gasdia and other staff for being “overly
conservative” in their communications with doctors. Stewart directed that sales reps should
promote Purdue’s opioids for “moderate persistent pain” even though the FDA had removed the
word “moderate” from the drugs’ indications. 826
685. In October, Stewart and Gasdia addressed concerns in the budget relating to the
slowing growth in Butrans sales. Their new scheme to boost Butrans sales was to target
821
2013-08-22 presentation, slide 10, PPLPC012000437356.
822
2013-09-16 email from John Stewart, PPLPC012000441611; 2013-09-11 memo from ,
PPLPC012000441614.
823
2013-09-23 email from Russell Gasdia, PPLPC012000442736; 2013-09-18 near term implementation plant, slide
5, PPLPC012000441799.
824
825
1997-03-12, memo from John Stewart, PDD1701785443.
826
2013-09-30 email from John Stewart, PPLPC012000444465-466.
218
“specific populations (e.g. the elderly).” 827 Stewart was instrumental in Purdue’s strategy to
target especially vulnerable patients.
686. In November, staff reported to Stewart that a key initiative during the third quarter
of 2013 was for sales reps to promote OxyContin for patients who had never taken opioids
before. 828 In Massachusetts during 2013, Purdue sales reps reported to Purdue that they pushed
opioids for opioid-naive patients dozens of times. The sales reps did not disclose to doctors that
opioid naive patients faced greater risks of overdose and death.
687. Staff reported to Stewart and the Board that another key initiative was for sales
reps to encourage doctors to prescribe OxyContin to elderly patients on Medicare. 829 In
Massachusetts during those three months, sales reps reported to Purdue that they pushed opioids
for “elderly” or “Medicare” patients more than 300 times. The sales reps did not consistently
disclose to doctors that elderly patients faced greater risk of drug interactions, injuries, falls, and
suffocating to death by taking OxyContin. Some sales reps even made claims that OxyContin
did the opposite, for example, that it reduced the risk of falls. At least 23 Massachusetts patients
aged 65 and older who were prescribed Purdue opioids later died of opioid-related overdoses.
688. Staff also told Stewart and the Board that analysis conducted in July showed that
opioid savings cards earned the company more money by keeping patients on opioids longer;
specifically, more patients stayed on OxyContin longer than 60 days. Staff reported that Purdue
was pushing opioid savings cards through Purdue sales reps, through email to tens of thousands
of health care providers, and online. 830
827
2013-11-12 email from John Stewart, PPLPC012000451664; 2013-10-29 budget presentation,
PPLPC012000451665.
828
829
830
219
689. During 2013, Purdue sales reps promoted opioid savings cards to Massachusetts
doctors thousands of times. The sales reps did not tell doctors that savings cards led patients to
stay on opioids longer than 60 days, or that staying on opioids longer increased the risk of
addiction and death.
690. Staff explained to Stewart and the Board that in the fourth quarter of 2013, sales
reps would increase the number of visits to prescribers. 831 In Massachusetts, during those three
months, sales visits increased by 30%. 832
691. Staff also reported to Stewart that a key initiative in 2013 was to train sales reps to
keep patients on Butrans longer. They told Stewart that, at exactly the same time as the initiative
to keep patients on opioids longer, Purdue launched a new high dose of its Butrans opioid. Sales
reps began promoting the new high dose to physicians and initial orders were double the
company’s forecasts. Staff also reported to Stewart that marketing and sales activities generated
266,842 additional prescriptions and opioid savings cards generated especially “high returns” by
keeping patients on opioids longer. 833
692. Staff reported to Stewart and the Board that Purdue had sent more than 880,000
emails to health care professionals to promote its Butrans opioid, and posted online advertising
garnering more than 5 million views for Butrans and nearly 4 million views for OxyContin.
Staff told Stewart that these hundreds of thousands of communications pitched doctors with
messages designed to get more patients on OxyContin at higher doses for longer periods of
time. 834
831
832
Exhibit 1.
833
834
220
693. Staff also told Stewart and the Board that they would begin reviews of sales reps
according to their sales ranking, with a focus on the bottom ten percent. They reported to
Stewart that Purdue employed 637 sales reps and, during third quarter of 2013, they visited
prescribers 179,640 times. 835 More than 2,200 of those visits were in Massachusetts. 836
694. In December, Stewart informed Kathe Sackler and Gasdia that Evolve 2
Excellence — the aggressive sales strategy — was already increasing prescriptions and revenue.
Stewart knew and intended that these changes in sales practices would drive increased
prescriptions, including in Massachusetts. 837
695. Stewart resigned from Purdue at the end of 2013. 838
696. Stewart has collected substantial revenue from the sale of Purdue opioids in
Massachusetts, as detailed in Exhibit 2.
697. While Stewart was Purdue’s chief executive, at least 247 Massachusetts patients
died of opioid-related overdoses after taking the drugs he sold.
835
2013-11-01 Board report, pgs. 11, 52, 55, PPLPC002000186921, -962, -965.
836
Exhibit 1.
837
838
John Stewart declaration.
221
RUSSELL GASDIA
698. Russell Gasdia worked at the heart of Purdue’s deceptive sales campaign. From
2007 until 2014, Gasdia was Purdue’s Vice President of Sales and Marketing. He was
responsible for getting more patients on opioids, at higher doses, for longer periods of time. By
breaking the law, he enjoyed the privileges of life as a top Purdue executive, and he exposed
families across Massachusetts to addiction, overdose, and death.
  
699. Gasdia
. 839 He
. 840
700. Gasdia had
. Gasdia was
. And he
701. Because
. Those allegations are hereby realleged together with the allegations that follow.
839
840
2008-06-01 deposition of Russell Gasdia, page 6:16-7:5, PWG003803377.
222
More Patients
702. Gasdia
. From 2007 to 2014, Gasdia
. He
. 841
703. , Gasdia
. 842 , Gasdia
. 843
704. Gasdia
. 844
. 845
705. Accordingly, Gasdia
. In a 2008 presentation to the
Board, Gasdia
. 846
706. Then, he . Gasdia
841
842
2012-01-17 Sales and Marketing Board report, PPLPC012000359667.
843
2012-01-22 email from Russell Gasdia, PPLPC012000360275; 2013-03-10 email from Russell Gasdia,
PPLPC012000412627.
844
845
2008-10-05 email from Russell Gasdia, PPLPC021000200047; 2008-10-04 presentation attached to email from
Russell Gasdia, PPLPC021000200048.
846
2008-01-17 email from Russell Gasdia, PPLPC012000166723; 2008-07-17 presentation to the Board, slide 2,
PPLPC012000190563.
223
.” 847
707. Gasdia . He
. 848 Gasdia
. When staff
. He
. 849
708. Gasdia
. 850
Higher Doses
709. Gasdia .
. But
. 851 From that point on, Gasdia
847
848
2010-07-05 email from Russell Gasdia, PPLPC012000277833-834; 2011-02-16 email from Russell Gasdia,
PPLPC012000311888-889.
See paragraphs 63–66, above.
849
850
2011-02-07 email from Russell Gasdia, PPLPC012000309664; 2011-02-07 Butrans launch update, slide 7,
PPLPC012000309665.
851
224
710. In 2013, Gasdia
.” He
. Gasdia
.” 852
711. Gasdia
. First, Gasdia . Purdue
.”
. In
.” 853 In a
” 854 In a
. 855
712. Gasdia .
852
2013-05-24 Sales & Marketing presentation, slides 4, 8, 11, 15, 16, PPLPC004000358097.
853
2013-05-24 Sales & Marketing presentation, slides 4, 8, 11, 15, PPLPC004000358097.
854
855
225
. 856 Indeed,
. Purdue
.” 857 By
713. Gasdia
. Gasdia
. 858
. 859
. Gasdia
But
.” Gasdia
.”
856
2013-05-24 Sales & Marketing presentation, slides 11, 15, PPLPC004000358097.
857
2012-07-27 OxyContin presentation, slide 22, PPLPC018000702766.
858
2013-08-06 email from Russell Gasdia, PPLPC012000435415; 2013-08-06 visual aid, PPLPC028000497109.
859
Paragraph 73 above.
226
. 860
715. That same year, Gasdia
. The
. 861
716. , Gasdia
. In 2010,
. Gasdia
. Days later, Gasdia
. 862 Staff
. 863
Longer Time
717. Gasdia
. In 2012, Gasdia
860
.
861
862
863
227
. 864 He
.” Gasdia
. 865 That
718. Gasdia
. In 2012,
.” He
. 866
719. Gasdia
. Gasdia
. 867 As Gasdia
Targeting Prolific Prescribers
720. In 2002, staff sent Gasdia
864
865
2012-10-24 email from Russell Gasdia, PPLPC012000396054; slide 19, PPLPC012000396055.
866
2012-08-16 emails from Russell Gasdia and Robert Barmore, PPLPC012000389032.
867
2013-08-06 email from Russell Gasdia, PPLPC012000435415; 2013-08-06 visual aid, PPLPC028000497109.
228
. The
.” 868 Gasdia .
Instead, he
. . 869
721. For .
Sales staff
. 870 Gasdia
. Gasdia
. 871
722. In October 2010, Gasdia
: 872
723. Three weeks earlier,
868
869
Exhibit 1; 2013-04-03 list of targeted prescribers, PPLP004367823.
870
2001-06-25 spreadsheet attached to email from Kathy Doran (re Thought Leaders), PPLPC012000038726; 2010-
10-06 Consultant Services Agreement signed by Russell Gasdia and Walter Jacobs, PPLP003479945.
871
2002-10-01 email from Russell Gasdia, #319184.1.
872
2010-10-06 contract, PPLP003479951.
229
. 873 But
724. Gasdia
. Gasdia
. 875 From 2008
725. The
. But . Since 2009,
726. The
.”
Gasdia
. 876
727. Gasdia
. In 2011, Gasdia
.” 877
873
2010-09-17 stipulation.
874
Monthly prescription data by prescriber, PWG003984534.
875
2010-10-06 Consultant Services Agreement signed by Russell Gasdia and Walter Jacobs, PPLP003479945;
2011-04-19 Amendment to 2010 Consultant Services Agreement, PPLP003481935; 2012-04-02 Statement of Work
signed by Russell Gasdia and Walter Jacobs, PPLP003485089.
876
877
230
. He
.” 878 Gasdia
.” 879
729. To
. 880
.” The
.” 881
730.
. Staff told Gasdia
.” 882
731. Their patients were the losers. Across the nation,
878
2013-02-07 email from Russell Gasdia, PPLPC012000407757; 2013-02-07 Q1 Butrans Core/Super Core
Assignment Profile, PPLPC012000407759.
879
880
2013-09-26 Fourth Quarter 2013 Incentive Program, PPLP003579152.
881
2013-12-23 First Quarter 2014 Incentive Program, PPLP003579166.
882
231
. 883 In Massachusetts, for example, Gasdia
.”
. Purdue’s
. 884
732. Compared to Massachusetts
. Under Gasdia’s
Compared to Massachusetts
Region Zero
733. Gasdia
. Purdue
. But Purdue
883
2012-12-22 ASF Q1 2013Aligned TL.xlsx, PPLP004367823.
884
Exhibit 1.
232
734. For years, Gasdia . For
example, in 2003, Gasdia
. Gasdia
. Gasdia
.” 885
735. In 2010, the Board
. Together with three other executives, Gasdia
. 886 That
. 887
736. In 2012,
.” :
885
886
2010-07-22 Purdue Pharma Shareholders and Board Meeting Actions and Notes, PPLPC012000282808-809.
887
2010-08-11 Prescriber List, PPLPC012000282813.
233
“
.” 888
Gasdia . 889
737. The
. Gasdia . But Gasdia
” Gasdia told
. 890
739. In March 2012, Gasdia
.” He
. Gasdia
.” 891
888
2012-10-02 email from Yoni Falkson, PPLPC012000392932.
889
890
891
234
740. Two days later, Gasdia . Because Richard Sackler
.” 892
. 893 As explained in paragraph 350 above, one
Massachusetts sales rep
. 894 Another
Massachusetts rep . 895 Purdue
.” “
.” Purdue also
. 896
741. Gasdia emailed
.” Gasdia stated: “
.” “
.” 897
742. Because Gasdia
892
893
2012-06-12 June PEP Status Report, PPLPC012000382165.
894
2013-12-06 Performance Enhancement Plan, PPLPC014000231426 (“See Top 10 HCPs each Monday. See them
again before end of same week.”).
895
2012-08-28 Performance Enhancement Plan, PPLPC014000183394.
896
2014-07-18 Performance Enhancement Plan, PPLPC014000263371-373.
897
235
.” 898
743. To limit the evidence of its misconduct, Purdue tried to discourage email. No one
was more concerned about avoiding a paper trail than Gasdia.
744. When staff emailed Gasdia a
.” 899
When
.” 900
When sales staff emailed
.” 901
745. Purdue’s
. By
, Gasdia
. When Gasdia
.” 902
746. Gasdia
898
2012-03-06 email from Russell Gasdia, PPLPC012000368278 (criticizing regional sales manager Douglas
Wheeler).
899
900
2001-06-19 email from Russell Gasdia, PPLPC012000034110 (staff noted
”).
901
902
236
Accomplishing the Sacklers’ Scheme
747. As much as anyone outside the Sackler family, Gasdia helped the Sacklers
accomplish their dangerous scheme. Gasdia was
. Gasdia
. When
. When they
. When Richard Sackler
748. Gasdia reported . 903 He
749. Gasdia . Many
times, he
. 904
in 2011, Gasdia
. 905 The next month,
903
PPLPC012000174202; 2011-05-10 email from Russell Gasdia, PPLPC012000323493; 2012-01-09 email from
Jonathan Sackler, PPLPC012000358983; 2012-02-01 email from Russell Gasdia, PPLPC012000361862; 2011-04-
28 email from Russell Gasdia, PPLPC012000322051.
904
PPLPC012000234801; 2011-08-29 email from Russell Gasdia, PPLPC012000340744.
905
237
.” 906
750. Gasdia
. He
. 907
.” 908
  
751. In July 2014,
. 909 For the rest of 2014, he
. 910 On December 31, 2014, Gasdia . 911
752. Selling Purdue opioids was a winning move for Gasdia if he measured it in
money. From 2007 to 2014, Purdue .
753. In the seven years Gasdia oversaw
906
907
PPLPC012000179563; 2014-06-06 presentation by Russell Gasdia, PVT0028342; 2008-05-22 email from Russell
Gasdia; PPLPC012000184138.
908
909
2014-12-05 email from Russell Gasdia, PLPPC012000508248; 2014-06-10 email from Richard Sackler,
PPLPC012000483201.
910
2014-09-15 Commercial Strategic Initiatives by Russell Gasdia, slides 10-19, PPLPC012000494427.
911
2014-12-05 email from Russell Gasdia, PLPPC012000508248.
238
MARK TIMNEY
754. In January 2014, just a few months before Massachusetts declared the opioid
epidemic a public health emergency, Timney picked up as CEO where John Stewart left off,
directing and overseeing the sale and marketing of Purdue’s opioids and the expansion of the
sales force, including in Massachusetts. Timney directed Purdue sales reps to target
Massachusetts doctors to prescribe opioids to more patients, at higher doses, for longer periods
of time.
755. When some health care systems stopped allowing sales reps to visit doctor’s
offices, Timney developed a work-around. Under his direction, Purdue created a call center
where sales reps telephoned doctors and hospitals, including facilities with “no-see” policies, to
encourage them to prescribe more opioids.
756. Timney received near-daily reports of opioid-related abuse, diversion, and
overdoses, including in Massachusetts.
757. Rather than work to address the opioid epidemic, Timney devoted his tenure to
preserving the Sacklers’ narrative that addiction was the fault of abusers: promoting OxyContin
as abuse-deterrent, without disclosing that the reformulation had no effect on the most common
form of abuse — swallowing pills.
758. Starting in January and continuing for his entire time at Purdue, Timney regularly
received internal reports — sometimes multiple times a day — that summarized media coverage
of opioid-related issues. The reports included articles about doctors over-prescribing opioids,
stories of people overdosing, drug abuse chatroom chatter, and more. After receiving these
reports, Timney often followed up with requests to his staff to dig deeper on an item in that day’s
239
summary. 912
759. As CEO, Timney continued John Stewart’s aggressive sales strategy known as
Evolve 2 Excellence or E2E. In an updated presentation to Timney,
. 913 Timney knew and intended that Purdue sales reps aggressively
target prolific prescribers.
760. Timney’s Evolve 2 Excellence sales strategy also brought an increased focus on
OxyContin, requiring sale reps to allocate two thirds of sales efforts to OxyContin and one third
to Butrans, instead of the previous 50/50 split. 914
761. In February, as a competitor prepared to launch another opioid, Timney directed
that Purdue “target KOLs who would respond” with data showing why Purdue’s opioids “should
be used in certain patients first.” 915
762. In March¸ Timney received updates from sales staff about the Evolve 2 Excellence
sales strategy. 916 Sales staff wrote among themselves that Timney had “requested regular
updates” on the E2E project and that “[t]here will continue to be a great deal of focus on the
activity of the Sales Force as a measurement of whether we are making the necessary progress
during 2014.” 917
763. At the same time, Timney created a new way to reach physicians who did not
allow sales reps in their clinics (no- and limited-access prescribers). Timney directed staff to set
up a call center, where sales reps would call restricted-access prescribers and promote Purdue’s
912
2016-11-23 email from Mark Timney, PPLPC023000922832-836.
913
2014-01-17 Evolve to Excellence Presentation by Mark Timney, slide 7, PPLPC012000459931.
914
2014-01-17 Evolve to Excellence Presentation by Mark Timney, slide 13, PPLPC012000459931.
915
916
2014-03-11 Presentation meeting with Mark Timney, PPLPC014000242643.
917
240
opioids over the phone. Timney oversaw this and other initiatives to reach those prescribers,
including email and digital marketing. 918
764. In April, Timney worked with
. 919
765. In May, Timney reported to the Board about how, under his direction, Purdue had
successfully lobbied for legislation in Massachusetts that prohibited a non-abuse deterrent
formulation from being dispensed if an abuse deterrent formulation of that drug was available.
Timney touted this as a “positive development” “in a state from which we've seen significant
anti-opioid activity in recent months” and “closely aligned with our commercial strategy.” 920
766. When Richard Sackler expressed displeasure at the poor commercial performance
of Butrans, Timney assured him “We are turning over every opportunity with every product we
have.” 921
767. Later that month, Timney told the Board about the new sales initiative to target
no- and limited-access prescribers through the call center and to target hospital networks, which
had policies restricting sales rep visits. 922 The initiative called for Purdue to focus on four “high
value geographies” one of which was Massachusetts, including the Partners and Steward hospital
systems. 923 Timney assured the Board that through these efforts, the sales force continued to
target the highest volume prescribers and increase sales of Purdue’s opioids.
768. In August, Timney sent the entire company a 100-days strategy update that keyed
into his vision for how Purdue would sustain profitable growth for the Sacklers, by “Competing,
918
2014-03-11 Presentation for meeting with Mark Timney, slides 2, 23, 50, PPLPC014000242643.
919
2014-04-17 email from , PPLPC012000473723.
920
921
922
2014-05-23 Board Update Memo from Mark Timney, PPLPC021000656750.
923
2014-06-06 Sales and Marketing Update Presentation, slide 16, PVT0028327.
241
Winning, and Growing.” The memo included an update specific to Massachusetts, noting the
passage of legislation that reflected “public policies championed by Purdue.” 924 Timney touted
the Massachusetts legislation in a memo to the Board that month as well, while noting that staff
from Corporate Affairs were coordinating the response to a developing Bloomberg /
BusinessWeek story on the Sackler family. 925
769. In September, as the launch date for Purdue’s new opioid Hysingla approached,
Timney directed staff to prepare a “detailed, full blown, launch plan” that he could review in
detail. 926
770. In October, at the direction of Timney, staff sent the Board advance copies of the
2015 proposed operating budget. 927 The materials included Timney’s strategic plan of
“Compete, Win, Grow.” Timney presented to the Board on “Optimizing the Pain Portfolio,”
again highlighting how Purdue had “[h]elped pass [the] nation’s first pro-ADF law in
Massachusetts.” 928 Timney repeatedly trumpeted this legislative change (as he did in May and
August) because it encouraged the sale of Purdue’s opioids in Massachusetts.
771. After receipt of the proposed budget, Mortimer Sackler wrote to Timney saying
“Not a pretty picture. Is that really the best we can do next year?” Timney tried to temper
Mortimer’s fears by assuring him “everything within control of the team is improving.” 929
924
925
2014-08-01 memo from Mark Timney, PPLPC018001080173.
926
2014-09-22 email from Mark Timney, PPLP004141433.
927
2014-10-24 email from Ed Mahony, PPLPC016000260660.
928
2014-10-24 Mark Timney’s 2015 Budget Summary, slide 6, PPLPC016000260672.
929
2014-10-25 email from Mortimer Sackler, PPLPC021000696384, -385.
242
772. In November, Timney sent his congratulations to the regulatory team upon FDA
approval of Hysingla ER, Purdue’s newest opioid which came in strengths of up to 120
milligrams. 930
773. In February 2015, Timney gave an internal presentation about Purdue’s strategy
for continuing to profit from the sale of opioids. 931 Timney acknowledged that the abuse
deterrent properties of OxyContin do “not address overconsumption” orally —i.e., the most
common mode of abuse—and that “abusers are likely to find a way around the ADP
technology.” 932 At the same time, Timney directed Purdue’s sales reps to promote OxyContin’s
abuse deterrent properties—without disclosing these critical facts.
774. In late November, Timney reported to the Board that authorities were increasing
efforts to restrict access to opioids and noted concern over potential legislation in Massachusetts.
Still, Timney told the Board that Purdue’s sales visits and market share were increasing, and the
2016 strategy sought to “expand[] the Sales Force,” “protect OxyContin against competition and
grow Butrans & Hysingla ER.” 933
775. In January 2016, Timney attended the national sales meeting with hundreds of
Purdue sales reps, including those from Massachusetts. 934
776. In March, Timney received an email from a mother whose daughter was in
treatment for opioid addiction. The mother asked Purdue to fund a recovery treatment center.
Timney forwarded the email to his colleagues and the mother received a form letter in response,
930
931
2015-02-24 emails from Mark Timney and Gail Cawkwell, PPLPC011000015125.
932
2015-03-10 Oxycodone and Buprenorphine Combination Product Presentation, slide 3, PPLPC011000014785.
933
2015-11-30 2016 Budget Presentation, slide 24, PPLPC011000069975.
934
2016-01-08 email from Eric Kizior, PPLP003569274.
243
listing various things Purdue had done to “help solve” the opioid crisis. 935
777. In April, as public pressure against opioids grew, Timney sent an email to staff
titled, “Urgency and Intensity.” Expressing serious concern about the future of the business,
Timney demanded staff calculate Purdue’s potential losses, develop strategies to mitigate them,
and focus on improving the effectiveness of the sales force. 936
778. In September, Purdue received
.” Rather than
Purdue
.” Timney be
.” 937 Timney’s focus continued to be
779. By November, Timney was executing this strategy of humanizing Purdue. He
wrote a letter to the editor of the Boston Globe commenting on an article written about Purdue.
Rather than taking responsibility for Purdue’s role in fueling the opioid crisis, Timney asserted
that, “the Globe should recognize the impactful efforts companies like Purdue have taken to
address the opioid epidemic.” 938
780. Later that month, Timney gave an internal presentation demonstrating the
inadequacies of Purdue’s “system” for tracking prescribers that were prescribing opioids
inappropriately. The presentation made clear that as late as 2016, Purdue’s Abuse and Diversion
935
2016-03-22 email from a mother to Mark Timney, PPLPC017000696223.
936
2016-04-15 email from Timney to Executive Committee, PPLPC011000092068.
937
2016-09-16 Presentations, slides 2, 11, PPLPC021000863236.
938
2016-11-01 letter from Mark Timney, PPLPC011000126443.
244
Detection system consisted of ad hoc, manual reviews of sales reps’ call notes, media reports,
internet searches, and prescribing records to identify opioid abuse and adverse events. Purdue
had no system capable of providing meaningful deterrence, a full nine years after the 2007
convictions and settlement required one. 939
781. In January 2017, Timney sent staff member David Haddox to Massachusetts to
attend a closed-door meeting on the opioid crisis at Tufts. 940
782. In advance of a meeting with Jonathan Sackler and a United States Senator,
Timney suggested, “this is a good time to tell the story about setting the new standard, and the
future of Purdue.” 941 Timney and Jonathan were eager to deflect from their role in the creation
of the opioid crisis and build alliances with powerful people who could protect them.
783. Timney monitored opioid-related developments in Massachusetts and around the
country. In February, staff alerted Timney that Massachusetts Governor Charlie Baker had
attended a White House event about the opioid epidemic. 942
784. Timney continued his public relations campaign to make the public believe
Purdue was trying to fight the crisis. In April, staff reported to Timney that Purdue had
contacted the CDC, following the issuance of the new CDC guidelines, listing Purdue’s efforts to
educate prescribers. 943 Purdue did not tell the CDC that Purdue’s sales reps were continuing to
target prescribers and push them to prescribe Purdue’s opioids.
785. In April, the executive in charge of sales and marketing (who had replaced
Russell Gasdia) resigned. Timney notified every employee at Purdue that he would eliminate the
939
2016-11-09 Executive Committee pre-read, slide 34, PPLPC011000127202.
940
2017-01-19 email from David Haddox, PPLPC011000133242.
941
2017-01-24 email from Mark Timney, PPLPC011000133807, -808.
942
943
245
middleman and communicate directives to the Sales and Marketing teams himself: “I will
assume responsibility for our Sales, Marketing, New Product Planning and OTC [over-the-
counter] functions.” 944
786. In May, Timney reviewed a report from an independent non-profit organization
on the effectiveness of abuse deterrent opioids that concluded the benefit of abuse deterrent
formulations was “inconclusive.” He directed staff to react, and staff scrambled to institute a
“robust action plan” to deal with the fallout. 945
787. In June, Timney resigned from Purdue. 946
788. Timney has collected substantial revenue from the sale of Purdue opioids in
789. Timney’s personal wealth came at immense cost to others. While Timney was
Purdue’s chief executive, more than 350 Massachusetts patients died of opioid-related overdoses
after being prescribed Purdue opioids.
944
945
946
2017-06-22 Internal Press Release, PPLPC024001006343.
246
CRAIG LANDAU
790. Craig Landau has been selling Purdue opioids for nearly twenty years. He joined
Purdue in 1999, was Chief Medical Officer from 2007 to 2013, and has been CEO since 2017.
Landau participated in and directed a significant part of Purdue’s misconduct from the 2007
convictions until today.
791. In each of his positions, Landau worked to get more Massachusetts patients on
opioids at higher doses for longer periods of time. As Chief Medical Officer, he helped to
develop the sales strategy and materials and instruct reps in how to sell Purdue’s drugs. As
CEO, he oversaw the whole sales scheme.
792. As Chief Medical Officer, Landau received each Board report regarding Purdue’s
misconduct in 2007 through 2011, and the reports sent in April and November 2012. 947 As
CEO, Landau himself reported directly to the Board.
793. Landau repeatedly targeted Massachusetts. As detailed below, he analyzed and
reported on a study of doctor-shopping in Massachusetts. He promoted opioids at public and
private meetings in Massachusetts. He promoted opioids through a grant to a Massachusetts
hospital and in correspondence to a Massachusetts university. He tracked Massachusetts opioid
legislation to protect Purdue’s sales.
  
947
2007-07-15 Board report, PWG000300817; 2007-10-15 Board report, PPLPC012000157437; 2008-01-15 Board
report, PDD8901733995; 2008-04-15 Board report, PDD8901724456; 2008-07-15 Board report, PPLP004367297;
2008-10-15 Board report, PDD9316101020; 2009-04-16 Board report, PDD9316100624; 2009-07-30 Board report
PPLPC012000233246; 2009-10-22 Board report, PPLPC016000007322; 2010-02-1 Board report,
PPLPC012000252797; 2010-04-21 Board report, PWG000423141; 2010-07-27 Board report, PWG000422495;
2010-10-25 Board report, PWG000421990; 2011-01-24 email from David Long, PWG000421546; 2011-05-02
Board report, PPLPC012000322461; 2011-08-03 Board report, PWG000420354; 2011-11-09 Board report,
PWG000419343; 2012-04-30 Board report, PPLPC012000374793; 2012-11-01 Board report, PWG000414933.
247
794. In September 2007, Landau directed a staff member to visit Boston for a
conference on opioid risk management. 948
795. He also worked with Sales VP Russell Gasdia on training for new hires about how
to sell OxyContin. 949
796. In January 2008, Landau addressed the entire sales force at the National Sales
Meeting. He explained that he put a commercial representative on every research team, to orient
research in ways that will sell more opioids. 950 He was a guest at a table full of sales reps, and
expressed that he was “pumped” for the meeting. 951
797. In January 2009, Landau attended the National Sales Meeting again, and once
again sat with a table full of sales reps. 952 He addressed the entire national team and emphasized
that R&D depended on the sales force to sell its products to physicians. 953
798. In March, Landau inked a deal with Massachusetts-based Analgesic Research for
the company and its principal—a Massachusetts doctor—to analyze documents, draft and edit
submissions, and engage in related meetings and teleconferences for Purdue’s New Drug
Application for Butrans to the FDA. 954
799. Later that month, Landau informed a staff member that he was working with
Massachusetts opioid maker Collegium Pharmaceuticals on a strategy to position extended-
release and long-acting opioids as safer than immediate release opioids. 955
948
949
950
2007-12-29 script for speech by Craig Landau, National Sales Meeting, PPLPC012000164977.
951
952
953
2009-01-09 email from Russell Gasdia, PPLPC012000208460; 2009-01-09 speech by Craig Landau, National
Sales Meeting, PPLPC012000208461.
954
2009-03-03 Statement of Work #2 signed by Craig Landau and Nathaniel Katz, PPLPC002000042402-403.
955
248
800. In June, Landau
. 956 As Landau knew at all relevant times, controlled or extended
release opioids do not substantially control pain better than lower-dose, immediate release
opioids. Rather, steering patients to high-dose OxyContin was a key part of Purdue's deceptive
marketing strategy.
801. Landau knew there was a high rate of oxycodone misuse in Massachusetts.
Indeed, in April 2010, Landau edited and approved a presentation to the Board showing that the
rate of “doctor shopping” in Massachusetts was far higher for oxycodone products than for other
opioids. He reiterated this information in August. 957
802. In October, Landau received reports from internet chat rooms where abusers
shared how to defeat OxyContin’s new formulation. Landau passed this information on to John
Stewart and Russell Gasdia. 958
803. In January 2011, Landau drafted goals and objectives for the new year that
included supporting approval of OxyContin for children. 959 In Massachusetts, one Purdue
patient was given OxyContin for months starting at age 14, and died at age 21. 960
956
2009-06 emails from Pasha Sarrai, Craig Landau, and Laura Nelson Carney, PDD8901645846.
957
2010-04-29 email from Craig Landau, PDD8901035911; 2010-04-09 presentation by Paul Coplan,
PDD8901035916; 2010-08-18 email from Stuart Baker, PPLPC012000283467; 2010-08-09 presentation by Paul
Coplan, slide 31, PPLPC012000283469.
958
2010-10-05 email from Craig Landau, PDD8901437962; 2010-09-30 Inflexxion Report, PDD8901437965.
959
2011-01-05 email from Craig Landau, PPLPC013000286366; 2011-01-05 Draft Objectives by Craig Landau,
PPLPC013000286367.
960
Another child in Massachusetts was prescribed OxyContin at 16 and died when he was 18 years old.
249
804. Landau worked as part of the team that created In the Face of Pain, a marketing
campaign which deceived doctors and patients by presenting misleading prescriber testimonials
about the use of opioids to treat pain. 961
805. Later that month, Landau
. 962
806. In February, Landau sent his recommendations for the 10-year plan to John
Stewart. 963 Landau suggested Stewart include action items focused on convincing more
prescribers to treat pain in their practices. In his recommendation, Landau noted that the new
formulation had no benefit to patients, but still told Stewart that Purdue would profit from a
“balloon effect” where prescribers would switch patients away from non-abuse-deterrent
formulations. 964 Landau knew and intended that Purdue would trick doctors and patients into
believing the new formulation was less addictive.
807. In March, Landau approved a plan to send sales reps to the Military Healthcare
Convention & Conference to promote Purdue's opioids as part of Purdue's strategy to target
vulnerable patient population such as veterans. 965
808. In June, Landau
. 966
809. In July, Landau emailed a staff member, flagging “publications calling into
961
2011-01-21 Corporate Reputation & Visibility strategic plan, pgs. 1, 4, 26, PWG000387272, -275, -297.
962
2011-01-26 Executive Committee notes, PPLPC012000312667-668.
963
2011-02-22 email from Craig Landau, PDD8901221579.
964
2011-02-07 draft Purdue business strategy with notes by Craig Landau, PDD8901221586-590.
965
966
250
question the benefit of opioid therapy for chronic non/malignant pain,” including a publication
from Massachusetts General Hospital. These publications were funded, in part, by Purdue, and
Landau wanted to make sure they in turn were supporting Purdue’s opioids. 967
810. Landau knew by 2011 that many experts considered opioids unsafe for long
durations of use, and discussed the fact that one of Purdue’s paid Key Opinion Leaders, Russell
Portenoy, had recently admitted it. 968
811. In June 2012, Landau traveled to Massachusetts to attend the International
Conference on Opioids. 969
812. In February 2013, Landau signed another contract with Massachusetts-based
Analgesic Research to work on Purdue’s Hysingla opioid. 970
813. In March, Landau compiled a meta-analysis of studies of chronic opioid use,
writing that most studies showed only “mild to moderate improvement” in function, that some
studies suggested that “long-term opioid therapy is associated with negative outcomes,” and
noting that there is a “critical need for additional studies to determine the long-term safety and
efficacy of chronic opioid therapy for durations longer than 1 year.” 971
814. In June, Landau was a co-presenter at the International Conference on Opioids in
Boston, Massachusetts. 972 He presented on long-term use of opioids for chronic non-cancer pain
— exactly what led so many Massachusetts patients to addiction, overdose, and death.
815. From 2013 to 2017, Landau was the CEO of Purdue Pharma Canada.
967
968
2011-07-12 email from Craig Landau, PTN000022181.
969
970
2009-03-03 Nathaniel Katz Consultant Services Agreement, PPLPC002000042402.
971
2013-03-18 Systematic Review of the Efficacy and Safety of Long-Term Opioid Therapy in the Management of
Chronic Noncancer Pain, PDD8013708195.
972
2013-03-18 Scientific Communications Document Review Form, PPLP003878021.
251
816. In the summer of 2017, Landau returned to the United States as CEO of Purdue
Pharma L.P. and Purdue Pharma Inc.
817. , Landau wrote
.” He started
. The family
.” 973
818. Landau
. “
.” He admitted that Purdue
Landau wrote:
the Sacklers. 974
819. Landau proposed
.”
Purdue would . 975
820. With Landau as CEO, Purdue’s misconduct in Massachusetts continued. While
Landau was the chief executive, Purdue sales reps visited Massachusetts prescribers more than
5,000 times. Now it was Landau who ensured that the sales staff met their targets for prescriber
visits and opioid sales. Now it was Landau who made misleading statements to defend Purdue
973
2017-05-02 email from Craig Landau, PPLPC020001106305; 2017-05-01 Presentation by Craig Landau,
PPLPC020001106306.
974
2017-05-02 Presentation by Craig Landau, PPLPC020001106307-308.
975
2017-05-02 Presentation by Craig Landau, PPLPC020001106313.
252
against its critics. Now it was Landau who tried to please the Sacklers with plans to expand their
opioid business even more.
821. In August, Landau edited Purdue’s contribution to the Biotechnology Innovation
Organization’s Opioid Working Group. In it, Landau continued to push the deceptive idea that
so-called “abuse deterrent” opioids are safe. 976 In fact, abuse deterrent opioids have no effect on
the most common form of abuse: swallowing pills.
822. In September, Landau held a series of meetings with staff about opioid promotion
by Purdue’s sales reps. 977
823. In October, Landau instructed staff to investigate deceptive promotion of opioids
by Purdue’s Massachusetts-based competitor, Collegium. 978 He asked about Collegium sales
reps doing what Purdue had done for decades: visiting doctors to make false claims that their
product was safer than other opioids. Then Landau directed staff to draft a letter for him to send
to insurers accusing other opioid companies of misconduct to distract from Purdue’s. 979
824. In November, Landau wrote to the President of Tufts University, long-time
recipient of the Sacklers’ payments, to rebut “recent news coverage of the Sackler family and
Purdue Pharma.” In his letter, Landau falsely claimed that Purdue’s misconduct ended “sixteen
years ago,” and Purdue had “worked tirelessly” since then to disclose the risks of its drugs. In
fact, Landau and others at Purdue worked to conceal the risks — getting more patients on higher
doses for longer periods, without disclosing that patients on high doses are likely to stay on
opioids longer and overdose and die. Landau wrote to Tufts that Purdue “encourage[d]
976
2017-08-31 email from Craig Landau, PPLPC001000259772; 2017-08-22 Questionnaire - Purdue Response,
PPLPC020001132365; 2017-08-30 BIO Opioid Mission, PPLPC001000259761.
977
978
979
253
physicians to prescribe fewer opioids.” 980 That same month, in the privacy of face-to-face sales
visits, Purdue sales reps kept pushing Massachusetts doctors to prescribe more opioids, just as
they had all along. And Purdue, under Landau as CEO, continued to evaluate sales reps based on
how much they increased opioid sales. 981
825. A week after Landau wrote to Tufts that Purdue wanted fewer people on opioids,
Jonathan Sackler suggested to Landau that Purdue launch yet another opioid to expand the
market. Landau replied that he was already working on it and promised to present a proposal to
the Sacklers within two weeks. 982
826. In December, Landau took out an ad in major newspapers, including USA Today,
The Wall Street Journal, and The New York Times. Landau knew and intended that the ad would
reach tens of thousands of Massachusetts subscribers. In the ad, Landau emphasized the so-
called abuse deterrent properties of Purdue’s drugs, without disclosing that they provide no
protection against the most common form of abuse — simply swallowing the pills. 983
827. In January 2018, staff alerted Landau to a recent publication by the FDA showing
that “multiple studies clearly indicate an increasing risk of serious adverse health outcomes
associated with increasing opioid analgesic dose.” Landau was not surprised, because his own
analysis five years earlier — in 2013 — showed the same thing. 984 Nonetheless, for years after
Landau wrote that analysis, he pushed higher doses to make more money.
980
2017-11-13 letter from Craig Landau, PPLPC021000912689.
981
Exhibit 1.
982
2017-11-21 emails from Jonathan Sackler and Craig Landau, PPLPC016000321333, -334.
983
2017-12-14 email from Craig Landau, PPLPC001000264824, -826-827.
2018-01-25 email from Craig Landau, PPLPC002000292391; 2013-03-18 Systematic Review of the Efficacy and
Safety of Long-Term Opioid Therapy in the Management of Chronic Noncancer Pain, PDD8013708195.
254
828. In February, , Landau laid off 300 sales reps. The
next month he laid off another 125 Purdue employees. 985 He kept his job and his salary.
829. Since the 2007 Judgment, Landau has collected substantial revenue from the sale
of Purdue opioids in Massachusetts, as detailed in Exhibit 2.
830. While Landau was CEO, at least 51 Massachusetts patients who had been
prescribed Purdue opioids overdosed and died.
985
2018-02-07 email from Craig Landau, PPLPC016000325614; 2018-03-14 email from Craig Landau,
PPLPC020001163155.
255
Conclusion
831. Holding the defendants accountable is important because of the people they hurt
in Massachusetts and because of the defendants’ selfish, deliberate choice to break the law.
Purdue’s leaders knew more than anyone about their addictive drugs. They knew how to get
people addicted, how to keep people addicted, and how to collect the most money from the
patients who were trapped on their opioids. They used the powers of a billion-dollar corporation
to engineer an opioid epidemic.
832. As Purdue’s scheme unraveled, in the fall of 2017, Purdue CEO Landau wrote
down notes about the opioid crisis. He wrote:
“There are:
Too many Rxs 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.”986
833. Craig Landau knew he was building an epidemic the whole time. He joined
Purdue in 1999. He helped make OxyContin a billion-dollar drug. His life’s work is getting too
many people on opioids, at doses that are too high, for far too long.
834. The opioid epidemic is not a mystery to the people who started it. The defendants
knew what they were doing.
986
256
XI. DISCOVERY RULE AND TOLLING
835. The defendants’ unfair and deceptive conduct continued from this Court’s 2007
Judgment through 2018.
836. The defendants’ unfair and deceptive conduct was well concealed. The
defendants deliberately conducted much of their deception through in-person sales visits, in
order to avoid a potentially discoverable paper trail. Purdue prohibited its sales reps from
emailing doctors. After this Office notified Purdue of our investigation, Purdue changed its
decade-old procedure so that sales reps would not write down descriptions of their conversations
with doctors for every sales visit, even in Purdue’s internal records. The defendants concealed
from the public and from the Commonwealth their internal documents about their deceptive
scheme, including their plans to hook more patients on higher doses for longer periods; their
findings that higher doses were a way to hook patients onto treatment for longer periods; and
their knowledge of inappropriate prescribing by high-prescribing doctors that they targeted to
prescribe their drugs. The individual defendants further concealed their participation in the
deception and did not reveal to the Commonwealth the fact that they were directing and profiting
from the deceptive scheme.
837. Discovering the nature and extent of the defendants’ unfair and deceptive conduct
required a costly and complex investigation. As part of the investigation, the Attorney General’s
Office has collected more than a million pages of evidence regarding the defendants’ deception.
838. Because of the defendants’ deception, any statutes of limitation otherwise
applicable to any claims asserted herein against all defendants have been tolled by the discovery
rule and rules regarding fraudulent concealment.
839. In addition to the tolling provided by common law, Purdue Pharma Inc., Purdue
Pharma L.P., and the Commonwealth entered into a written agreement tolling any applicable
257
statutes of limitation during the period from August 3, 2016 through May 18, 2018.
XII. JURISDICTION AND VENUE
840. This Court has jurisdiction over the subject matter of this suit pursuant to General
Laws chapter 93A section 4 and chapter 214 section 1.
General Jurisdiction Under M.G.L. Chapter 223A § 2
841. The Court has general jurisdiction over Russell Gasdia pursuant to General Laws
chapter 223A section 2.
Specific Jurisdiction Under M.G.L. Chapter 223A § 3(a)
842. The Court has specific jurisdiction over all defendants pursuant to General Laws
chapter 223A section 3(a), because this action arises from each defendant acting directly and
through agents to transact business in Massachusetts.
843. In the 2007 Judgment entered in civil action no. 07-1967, Purdue Pharma Inc. and
Purdue Pharma L.P. admitted the jurisdiction of this Court.
844. Purdue Pharma Inc. is incorporated with its official purpose as manufacture, sales,
distribution, and research and development with respect to pharmaceutical, toiletry, chemical and
cosmetic products, directly or as the general partner of a partnership engaged in those activities.
It controls Purdue Pharma L.P. and transacts business in Massachusetts, under section 3(a) of the
Massachusetts Long-Arm Statute, M.G.L. c. 223A, §3, both on its own and through Purdue
Pharma L.P.
845. Purdue Pharma L.P. employed scores of sales reps in Massachusetts to promote
Purdue’s opioids in Massachusetts and sold more than $500,000,000 of opioids in
Massachusetts.
846. Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt,
Jonathan Sackler, Kathe Sackler, Mortimer Sackler, Theresa Sackler, Peter Boer, Judith Lewent,
258
Cecil Pickett, Paulo Costa, Ralph Snyderman, John Stewart, Russell Gasdia, Mark Timney, and
Craig Landau voted for and/or ordered sales reps to go door-to-door, making thousands of visits
to doctors in Massachusetts to implement the deceptive scheme described in this Complaint.
847. Despite being warned in writing that it was a high-risk activity, Richard Sackler,
Beverly Sackler, David Sackler, Ilene Sackler Lefcourt, Jonathan Sackler, Kathe Sackler,
Mortimer Sackler, Theresa Sackler, Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa, Ralph
Snyderman, John Stewart, Russell Gasdia, Mark Timney, and Craig Landau directed payments to
Massachusetts doctors such as Walter Jacobs in exchange for the doctors’ promotion of Purdue
drugs.
Craig Landau directed and/or managed efforts to advance favorable legislation and block
unfavorable lawmaking in Massachusetts that would impact Purdue’s sales in the
Commonwealth. These individuals knew and intended that Massachusetts was an important
market for Purdue’s dangerous drugs.
Craig Landau directed the dissemination of tens of thousands of copies of unfair or deceptive
marketing materials to health care providers throughout the Commonwealth to get more and
more patients on Purdue’s drugs for longer and longer periods of time at high and higher doses.
Although they did not lick the stamps themselves, these individuals directed and/or managed a
259
chain-of-command causing these mailings in Massachusetts because they meant increased sales
and profits for the Sacklers and their executives.
850. Through targeted funding and programming, Richard Sackler, Beverly Sackler,
David Sackler, Ilene Sackler Lefcourt, Jonathan Sackler, Kathe Sackler, Mortimer Sackler,
Theresa Sackler, Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa, Ralph Snyderman, John
Stewart, Russell Gasdia, Mark Timney, and Craig Landau unfairly and deceptively promoted
opioids at Massachusetts medical institutions including Tufts University and Massachusetts
General Hospital. Their votes for and/or management of funding and programming at these
institutions encouraged more no- or limited-access doctors to prescribe Purdue’s dangerous
drugs at higher doses for longer periods and made the Sacklers and their executives more money.
851. John Stewart traveled to Boston to network with and influence MGH doctors who
could prescribe opioids in Massachusetts. Craig Landau signed multiple work orders with a
Massachusetts-based consultant for work related to the approval for sale of Purdue’s dangerous
drugs, presented on opioids for chronic pain at the International Conference on Opioids in
Boston, and offered to meet with Tufts’ President in person to maintain the business advantages
that relationship provided. Russell Gasdia traveled throughout Massachusetts to promote
Purdue’s opioids, including at conferences, trade shows, and district sales meetings. Richard
Sackler had a Tufts professor meet with Purdue staff.
Specific Jurisdiction Under M.G.L. Chapter 223A § 3(c)
852. The Court also has specific jurisdiction over all defendants pursuant to General
Laws chapter 223A section 3(c), because this action arises from each defendant acting directly
and through agents to cause tortious injury by acts and omissions in Massachusetts.
260
Craig Landau directed sales reps to go door-to-door, making thousands of visits to doctors in
Massachusetts. Although they did not knock on the doors to clinics and family practices
themselves, these individuals voted for and/or ordered sales reps to deceptively promote
Purdue’s dangerous drugs in person, as a central facet of their deceptive marketing scheme that
killed hundreds of people in Massachusetts.
Craig Landau voted for and/or directed payments to Massachusetts doctors to promote Purdue’s
drugs.
Craig Landau voted for, directed, and/or managed unfair and deceptive efforts to advance
favorable legislation and block unfavorable lawmaking in Massachusetts that would impact
Purdue’s sales in the Commonwealth. These individuals knew and intended that Massachusetts
was an important market for Purdue’s dangerous drugs.
Craig Landau all directed the dissemination of tens of thousands of copies of unfair or deceptive
261
marketing materials to doctors and other health care providers throughout the Commonwealth for
the purpose of getting more and more prescribers to put their patients on Purdue’s drugs for
longer and longer periods of time at high and higher doses. These individuals voted for and/or
managed a chain-of-command causing these mailings in Massachusetts because they meant
increased sales and profits for the Sacklers and their executives.
857. By ordering and/or managing targeted funding and programming, Richard
Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt, Jonathan Sackler, Kathe
Sackler, Mortimer Sackler, Theresa Sackler, Peter Boer, Judith Lewent, Cecil Pickett, Paulo
Costa, Ralph Snyderman, John Stewart, Russell Gasdia, Mark Timney, and Craig Landau
unfairly and deceptively promoted opioids at Massachusetts medical institutions including Tufts
University and Massachusetts General Hospital. These individuals got more and more no- or
limited-access doctors to prescribe Purdue’s dangerous drugs at higher and higher doses for
longer and longer periods of time and made the Sacklers and their executives more and more
money.
858. In addition, Richard Sackler, Beverly Sackler, Ilene Sackler Lefcourt, Jonathan
Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler (directors in 2007) voted for and
caused Purdue Pharma L.P. to enter into a Settlement Agreement with the Commonwealth of
Massachusetts to address Purdue’s liability from the last time it deceived doctors and patients
about its opioids.
859. In addition, Richard Sackler, Beverly Sackler, Ilene Sackler Lefcourt, Jonathan
Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler (directors in 2007) voted for and
caused Purdue Pharma Inc. and Purdue Pharma L.P. to enter into the 2007 Judgment issued by
this Court, which required that: (a) Purdue not deceive doctors and patients about its opioids; and
262
(b) when Purdue found evidence of improper prescribing by its target doctors, Purdue stop
promoting opioids and contact the authorities.
860. Subsequently, as described in this Complaint, Richard Sackler, Beverly Sackler,
Stewart, Russell Gasdia, Mark Timney, and Craig Landau directed or caused Purdue to violate
the 2007 Judgment of this Court.
861. This misconduct caused tortious injury in Massachusetts by killing hundreds of
people and injuring many more.
Specific Jurisdiction Under M.G.L. Chapter 223A § 3(d)
862. The Court also has specific jurisdiction over all defendants pursuant to General
Laws chapter 223A section 3(d), because:
• This action arises from each defendant acting directly and through agents
to cause tortious injury in Massachusetts by acts and omission outside
Massachusetts; and
• Each defendant also regularly does or solicits business in Massachusetts,

or engages in other persistent courses of conduct in Massachusetts, or derives
substantial revenue from goods used or consumed or services rendered in
Massachusetts.
This action arises from each defendant causing tortious injury in Massachusetts
863. The first element of the section 3(d) jurisdictional test is satisfied for every
individual defendant because this action arises from Richard Sackler, Beverly Sackler, David
Sackler, Ilene Sackler Lefcourt, Jonathan Sackler, Kathe Sackler, Mortimer Sackler, Theresa
Sackler, Peter Boer, Judith Lewent, Cecil Pickett, Paulo Costa, Ralph Snyderman, John Stewart,
Russell Gasdia, Mark Timney, and Craig Landau causing tortious injury in Massachusetts. As
described in this Complaint, each individual defendant voted for, directed, and/or managed
263
Purdue’s misconduct, which killed hundreds of people in Massachusetts.
Each defendant derives substantial revenue from goods used in Massachusetts
864. The second element of the section 3(d) jurisdictional test is also satisfied for every
individual defendant because each defendant derived substantial revenue from goods used or
consumed in Massachusetts. Indeed, the defendants acquired the revenue through their tortious
misconduct.
865. Purdue Pharma L.P. and Purdue Pharma Inc. collected approximately 2.8% of
their revenue from Massachusetts. The Sacklers, as well as Peter Boer, Judith Lewent, Cecil
Pickett, Paulo Costa, Ralph Snyderman, John Stewart, Russell Gasdia, Mark Timney, and Craig
Landau, tracked this revenue as it came in to Purdue from the Commonwealth. The defendants
made no effort to segregate Massachusetts revenue, or withhold it from money they directed
Purdue to pay them. Instead, the defendants included Massachusetts revenue in payments to all
of Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler Lefcourt, Jonathan Sackler,
Kathe Sackler, Mortimer Sackler, Theresa Sackler, Peter Boer, Judith Lewent, Cecil Pickett,
Paulo Costa, Ralph Snyderman, John Stewart, Russell Gasdia, Mark Timney, and Craig Landau.
264
Jonathan Sackler, Kathe Sackler, Mortimer Sackler, and Theresa Sackler paid their families
billions of dollars from opioid sales, including approximately $ from Massachusetts
from 2007 to the present. This list of payments is likely incomplete and not exhaustive.
Sackler Defendants Revenue From Massachusetts

Date Payments MA Share
Total
867. The directors paid themselves handsomely for their positions on the Board. Mr.
Snyderman reported to the government some of what Purdue paid him. Purdue paid him at least
$32,972 for a few months of 2013; $166,119 in 2014; $168,887 in 2015; and $124,360 in 2016.
868. Each director defendant was on the board for at least five years (and in many
cases for twenty years). In exchange for sitting on the board, Purdue paid each director
defendant more than $ , including approximately $ from
265
Massachusetts.
869. John Stewart has collected substantial revenue from the sale of Purdue opioids in
870. Russell Gasdia has collected of dollars from Purdue since the 2007
Judgment, including dollars from the sale of Purdue
opioids in Massachusetts.
871. Mark Timney has collected substantial revenue from the sale of Purdue opioids in
872. Craig Landau has collected substantial revenue from the sale of Purdue opioids in
Many defendants also do regular business and engage in a persistent course of conduct in
Massachusetts
873. In addition, the disjunctive second element of the section 3(d) jurisdictional test is
independently satisfied for many defendants because they regularly do business or engage in a
persistent course of conduct in Massachusetts, through agents and instrumentalities as described
above, and in person as described below.
Due Process
874. Jurisdiction over all defendants is also proper under the Due Process Clause.
Constitutional due process requires that: 1) the defendants purposefully availed themselves of the
privilege of conducting activities in Massachusetts or purposefully directed their conduct into
Massachusetts; 2) the Plaintiff’s claim relates to or arises out of the defendants’ contact with
Massachusetts; and 3) the exercise of jurisdiction is reasonable. Each of those requirements is
satisfied.
875. The exercise of jurisdiction over each of the individual defendants is reasonable
266
because the burden on each defendant to defend suit in Massachusetts is minimal while the
interests of the Commonwealth in adjudicating the dispute in this forum are significant.
876. The Commonwealth has a compelling interest in adjudicating this dispute and
obtaining relief for its citizens. The Commonwealth has, since declared by then Governor Deval
Patrick in 2014, been operating under a state of a public health emergency due to an epidemic of
opioid addiction and death. As the Commonwealth’s lawyer and chief law enforcement officer,
the Attorney General has an interest in protecting the people of Massachusetts.
877. All the individual defendants are at least millionaires and, in some cases,
billionaires, and they can afford to travel to the Commonwealth to defend this lawsuit.
878. All the individual defendants are represented by sophisticated counsel in a state
abutting Massachusetts. Their counsel routinely litigate throughout the United States.
Jonathan Sackler, Kathe Sackler, Mortimer Sackler, Theresa Sackler, Paulo Costa, Russell
Gasdia, Mark Timney, and Craig Landau all live in or retain a primary or secondary residence in
states abutting Massachusetts.
880. Richard Sackler has served on the Board of Advisors of a major medical school
and a school of graduate biomedical sciences in Massachusetts during every year from 2011 to
the present. He regularly visited Massachusetts to transact business and make decisions for
schools with thousands of Massachusetts employees. Richard was also an advisor to a research
institute at another major university in Massachusetts, at least from 2012 to 2015, and visited
Massachusetts to advise work there. Richard is also a major investor in a privately-held biotech
company in Boston. From 1998 until at least 2014, Richard served as a director of the Raymond
and Beverly Sackler Foundation, Inc., which registered to do business in Massachusetts.
267
881. Beverly Sackler served, from 1998 until at least 2014, as a director and both
Treasurer and Secretary of the Raymond and Beverly Sackler Foundation, Inc., which registered
to do business in Massachusetts. She signed the certificate submitted to the Commonwealth of
Massachusetts stating that the corporation conducts medical research in Massachusetts.
882. David Sackler invested $100 million in a hedge fund based in Boston in 2014.
The investment is to last until at least 2021. On information and belief, David Sackler regularly
transacts business in Massachusetts in connection with the fund, and visits Massachusetts for
meetings related to the fund.
883. Jonathan Sackler served, from 2004 until at least 2014, as a director and
President of the Raymond and Beverly Sackler Foundation, Inc., which registered to do business
in Massachusetts. Each year, he signed the annual reports of the corporation, submitted to the
Commonwealth of Massachusetts, describing the corporation’s business in Massachusetts.
884. Mortimer Sackler lived in Massachusetts at least during the period from 1991
through 1999. He owned a condominium at 950 Massachusetts Ave., Unit PH2, Cambridge,
Massachusetts, 02139.
885. Judith Lewent is as a lifetime member of the governing board of a major
university in Massachusetts; attends meetings in Massachusetts at least 4 times each year; and
makes decisions for one of the most significant employers in our state. She became a member of
that governing board in 1994; she has served on its Executive Committee and chaired the
Visiting Committee of the university’s School of Management. She is also currently a director
of a significant company, which has been registered with the Massachusetts Secretary of State
since 1960. Ms. Lewent’s address on the company’s 2017 annual report is 168 Third Ave.,
Waltham, Massachusetts 02451. She is also a member of an academy headquartered in
268
Massachusetts, and, on information and belief, she visits Massachusetts to attend meetings there.
886. Cecil Pickett rented a residence at 75 Cambridge Pkwy, Unit 307, Cambridge,
Massachusetts 02142, at least for the period from 2007 to 2009. He was the President and a
director from 2006 to 2008 for a company located at 14 Cambridge Center, Cambridge, MA
02142. He was also the President of an institute located in Boston, MA. The institute was
registered in Massachusetts from 2005 to 2007. He is a director of another company in
Massachusetts. He attends meetings in Massachusetts and makes decisions for a team of
Massachusetts scientists with more than $45 million in funding.
887. Ralph Snyderman co-founded a healthcare technology company in Newton,
Massachusetts, in 2004. For more than a decade, he has served as a director of the company and
chairman of the board. The company registered with the Commonwealth of Massachusetts from
at least 2010 to 2012. On information and belief, Snyderman attends meetings in Massachusetts,
sends and receives hundreds of business communications to and from Massachusetts, and makes
decisions for the company, which is “a leading developer of personalized decision support
technologies for oncology and cardiology” in Massachusetts.
888. [intentionally blank].
889. Venue in the Suffolk County Superior Court is proper under G.L. c. 93A § 4 and
G.L. c. 214 § 5.
269
XIII. CAUSES OF ACTION
COUNT ONE
UNFAIR AND DECEPTIVE ACTS AND PRACTICES
IN VIOLATION OF G.L. c. 93A § 2
890. The Commonwealth realleges each allegation above.
891. G.L. c. 93A, § 4 authorizes the Attorney General to bring an action to enjoin a
defendant from engaging in a method, act, or practice that violates G.L. c. 93A, § 2.
892. On May 8, 2018, the Attorney General notified Purdue Pharma Inc. and Purdue
Pharma L.P. of her intention to file this suit and offered them an opportunity to confer, in
conformance with G.L. c. 93A.
893. On June 1, 2018, the Attorney General notified Richard Sackler, Beverly Sackler,
Stewart, Mark Timney, and Craig Landau of her intention to file this suit and offered them an
opportunity to confer, in conformance with G.L. c. 93A.
894. On November 28, 2018, the Attorney General notified Russell Gasdia of her
intention to name him as a defendant in this Amended Complaint and offered an opportunity to
confer, in conformance with G.L. c. 93A.
895. Through their conduct, including as described in this Complaint, in the course of
marketing and promoting its opioids in Massachusetts, both directly and through third parties
whom the defendants knew were acting in Massachusetts, each defendant engaged in unfair and
deceptive acts and practices in Massachusetts in the conduct of trade or commerce in violation of
G.L. c. 93A, including by making false and misleading claims and failing to disclose material
risks to get more patients on its opioids at higher doses for longer time, and to steer patients
away from safer alternatives. Through their unfair and deceptive conduct, the defendants
270
succeeded in getting many Massachusetts doctors to prescribe and Massachusetts patients to take
and remain on Purdue opioids.
896. Each defendant also violated G.L. c. 93A by targeting medical practices where
they knew or should have known that Purdue’s opioids were prescribed dangerously and patients
were harmed.
897. By means of their unfair and deceptive acts, the defendants collected hundreds of
millions of dollars.
898. Because of the defendants’ unfair and deceptive acts, the Commonwealth and its
residents suffered ascertainable injuries and losses of billions of dollars.
899. Each defendant knew or should have known they were committing unfair and
deceptive acts in violation of G.L. c. 93A, § 2.
900. Each unfair or deceptive act was a distinct violation of G.L. c. 93A.
COUNT TWO
PUBLIC NUISANCE
901. The Commonwealth realleges each allegation above.
902. Under Massachusetts common law, a defendant is liable for the tort of public
nuisance when their conduct causes an unreasonable interference with a right common to the
general public, such as interference with the public health, public safety, public peace, and public
comfort and convenience.
903. The Massachusetts Attorney General is empowered to bring a parens patriae
action on behalf of the Commonwealth for abatement of a public nuisance.
904. Through their conduct, including as described in this Complaint, each defendant
was a substantial participant in creating and maintaining a public nuisance of addiction, illness,
and death that significantly interferes with the public health, safety, peace, comfort, and
271
convenience.
905. Specifically, each defendant engaged in a campaign of deceptive marketing
leading directly to an epidemic of opioid addiction, which resulted in substantial public injuries.
906. The injuries that the defendants caused in Massachusetts have been significant
and long-lasting, for both the Commonwealth and the public, including: (a) opioid addiction,
overdose, and death; (b) health care costs for individuals, children, families, employers, the
Commonwealth, and its subdivisions; (c) loss of productivity and harm to the economy of the
Commonwealth; and (d) special public costs borne solely by the Commonwealth in its efforts to
abate the nuisance and to support the public health, safety, and welfare.
907. The Commonwealth has spent at least hundreds of millions of dollars on special
treatment, prevention, intervention, and recovery initiatives to abate the harms of the opioid
epidemic, including appropriating $134 million in FY 2016, $173 million in FY 2017, $185.3
million in FY 2018, and more than $200 million in FY 2019. The Commonwealth intends to
seek reimbursement from the defendants for its expenses abating the harms they caused.
908. The Commonwealth has a special relationship with, and responsibility to its
residents, including its responsibility to uphold the public health, safety, and welfare. Each
defendant had reason to know of this relationship at all times.
909. Each defendant, at all times, had reason to know of the public nuisance created by
their ongoing conduct.
910. The defendants’ deceptive conduct was unreasonable in light of the lack of
scientific support for their claims and was negligent and reckless with regard to the known risks
of Purdue’s drugs.
272
XIV. PRAYER FOR RELIEF
WHEREFORE, the Commonwealth respectfully requests that this Court grant the
following relief after a trial on the merits:
a. Determine that all defendants engaged in unfair and deceptive acts and practices in
violation of G.L. c. 93A, §2, and the regulations promulgated thereunder;
b. Permanently enjoin all defendants from engaging in unfair and deceptive acts and
practices;
c. Order all defendants to disgorge all payments received as a result of their unlawful
conduct;
d. Order all defendants to pay full and complete restitution to every person who has
suffered any ascertainable loss by reason of their unlawful conduct;
e. Order all defendants to pay civil penalties of up to $5,000 for each and every
violation of G.L. c. 93A, § 2;
f. Award the Commonwealth costs and attorney’s fees, pursuant to G.L. c. 93A, § 4;
g. Determine that all defendants created a public nuisance;
h. Order all defendants to abate the nuisance, to reimburse the cost of the
Commonwealth’s abatement efforts, and to pay compensatory damages for harms
caused by the nuisance; and
i. Grant all other relief as the Court may deem just and proper.
273
XV. JURY DEMAND
The Commonwealth demands a trial by jury on all issues properly so tried.
Dated: December 21, 2018 Respectfully submitted,

By its Attorney,
MAURA HEALEY
ATTORNEY GENERAL
Sydenham B. Alexander III, BBO #

Gillian Feiner, BBO # 664152
Eric M. Gold, BBO # 660393
Jeffrey Walker, BBO # 673328
Jenny Wojewoda, BBO # 674722
Assistant Attorneys General

Health Care & Fair Competition Bureau
One Ashburton Place
617 727 2200
sandy.alexander@state.ma.us
274
Commonwealth v. Purdue Pharma et al.,
Civil Action No. 1884-cv-01808 (BLS2)
Exhibit 2
Compensation of Defendants John Stewart, Mark Timney, and Craig Landau
911. Since 2007, Defendant John Stewart has collected more than from
Purdue.986 The portion of his payout from Massachusetts opioid sales (more than ) is
more than .987
912. Since 2007, Defendant Mark Timney has collected more than from
Purdue.988 More than of that was derived from opioid sales in Massachusetts.
913. Since 2007, Defendant Craig Landau has collected more than from
Purdue in the U.S., not including what he received from Purdue Canada.989 At least of
that money was derived from sales of Purdue opioids in Massachusetts. Landau’s personal
payouts from Massachusetts continue. Landau’s salary is approximately per year, of
which over is derived from Massachusetts.990
986
2008-06-27 John Stewart Employment Agreement, 2013 Total Compensation Program, tax forms and statements
SAG00000023-00002233.
987
Purdue tracked revenue from Massachusetts, and Purdue’s data show that Massachusetts provided approximately
2.8% of Purdue’s overall sales. See 2016-04-13 Q1 2016 Commercial Update, slide 74, PPLPC016000286167;
Purdue Drug Units Dispensed by HCP, Product, and Strength, PWG003984518–45. The U.S. Census Bureau
reports that median household income in Massachusetts was approximately $70,954 per year from 2012 to 2016.
See QuickFacts: Massachusetts, https://www.census.gov/quickfacts/fact/table/ma/INC110216.
988
2013-11-22 Mark Timney Employment Agreement, TIMNEY-00000011; 2016 Executive Long-Term Incentive
Compensation Statement for Mark Timney, TIMNEY-00000026; 2017 Executive Compensation Statement for
Mark Timney, TIMNEY-00000039.
989
2007 W-2 Wage and Tax Statement for Craig Landau, LANDAU-00000011; 2008 Annual Bonus Summary,
LANDAU-00000001.
990
In half of 2017, Landau collected
Exhibit 4
List Of Purdue Documents Cited In Amended Complaint

Commonwealth v. Purdue Pharma, et al., C.A. No. 1884-cv-01808 (BLS2)
Purdue Documents Cited In First Amended Complaint Filed 12/21/2018
Description Start Bates End Bates

1994-04-28 memo from Jonathan Sackler PDD1701827936 PDD1701827936
1995-06-24 Board minutes PDD1715108129 PDD1715108130
1995-10 Overall Conclusion to 1995 FDA review, Curtis
Wright #785793.1 #785793.1
1996 speech by Richard Sackler PKY180280951 PKY180280962
1996-06-28 Board minutes #618062.1 #618062.1
1997-02-27 email from Robert Kaiko; 1997-03-02 email
from Richard Sackler; 1997-02-27 email from Walter
Wimmer PDD1701345999 PDD1701346000
1997-03-12 memo from John Stewart PDD1701785443 PDD1701785444
1997-04-23 email from Richard Sackler PDD1701801141 PDD1701801145
1998-11-20 Board minutes #618564.1 #618564.1
1999-03-11 Board decision PDD1706191713 PDD1706191749
1999-06-17 email from Michael Friedman #228728.1 #228728.2
1999-07-07 attendance list for the meeting to discuss
funding PPLPC013000029936 PPLPC013000029936
2000 Budget Submission PDD1701809193 PDD1701809985
2000-03-26, Peter Healy, Opening the Medicine Chest:
Purdue Pharma prepares to raise its profile #24865.1 #24865.4
2000-05-07 memorandum PPLPC013000048630 PPLPC013000048634
2000-05-28 email from Russell Gasdia PPLPC012000014212 PPLPC012000014213
2000-10-04 Board report PPLPC018000010645 PPLPC018000010649
2000-11-30 email from Michael Friedman; 2000-12-01
email from Mortimer D. Sackler PDD1706196246 PDD1706196248
2001-01-08 letter from Richard Sackler PDD1501720041 PDD1501720041
2001-01-26 email from Joseph Coggins #171855.1 #171855.4
2001-02-08 email from Mortimer Sacker; 2001-02-08
email from Richard Sackler PDD8801151727 PDD8801151729
2001-02-14 email from James Heins; 2001-02-14 email to
Robin Hogen #3072810.1 #3072810.1
2001-03-05 article in New York Times PDD9316101737 PDD9316101742
2001-03-10 email from Russell Gasdia; 2011-03-09 email
from Richard Sackler PPLPC012000315176 PPLPC012000315186
2001-09-28 email from Richard Sackler PPLPC012000345892 PPLPC012000345895
2001-11-16 email from Phil Cramer PPLPC014000021900 PPLPC014000021901
2001-11-19 email from Dan Doucette PPLPC012000041222 PPLPC012000041224
2001-11-19 email from James Lang PPLPC012000041198 PPLPC012000041200
1

2002-02-06 email from Robert Reder PPLPC026000007351 PPLPC026000007351
2002-03-21 email from Merle Spiegel PPLPC023000014497 PPLPC023000014497
2002-05-10 Shareholders Meeting notes #273916.1 #273916.3
2002-07-31 email from David Haddox #3065539.1 #3065539.1
2002-10-01 email from Russell Gasdia #319184.1 #319184.1
2003-03-04 Board minutes #2938358.1 #2938358.1
2003-03-05 The Massachusetts General Hospital and
Harvard Medical School Fund Agreement with Purdue
Pharma L.P. Dated as of March 5, 2003 PPLPC021000425373 PPLPC021000425378
2003-12-23 GAO Report PKY183266820 PKY183266882
2004-08-18 email from David Haddox #381773.1 #381773.1
2006-10-25 agreement PPLP004031281 PPLP004031284
2007 Complexities of Caring for People in Pain PTN000016805 PTN000016811
2007 Responsible Opioid Prescribing (2007) #448.1 #448.1
2007-03-29 email from David Haddox PPLPC012000137085 PPLPC012000137086
2007-03-30 emails from Russell Gasdia and Windell Fisher PPLPC012000137178 PPLPC012000137180
2007-05-03 Board minutes PKY183307494 PKY183307496
2007-05-04 Associate General Counsel’s Certificate PDD1712900054 PDD1712900070
2007-05-29 email from John Stewart PPLPC012000143430 PPLPC012000143432
2007-07-15 Board report PWG000300785 PWG000300838
2007-08 FACETS Vol. 1 PTN000004636 PTN000004701
2007-08-30 email from Howard Udell PPLPC012000153272 PPLPC012000153273
2007-09-03 “Complexities of Caring for People in Pain” PTN000005311 PTN000005350
2007-09-06 email from John Stewart PWG000184869 PWG000184870
2007-09-10 email from Craig Landau PPLPC012000154114 PPLPC012000154116
2007-10-25 Sales & Marketing presentation PPLPC012000159022 PPLPC012000159022
2007-10-28 attachment to email from Edward Mahony PPLPC012000159170 PPLPC012000159170
2007-11 Medication Therapy Management: Opportunities
For Improving Pain Care PTN000006070 PTN000006114
2007-12-29 script for speech by Craig Landau, National
Sales Meeting PPLPC012000164972 PPLPC012000164981
2008 budget submission PDD9273201014 PDD9273201082
2

2008 Clinical Issues in Opioid Prescribing (2008) PWG000058053 PWG000058066
2008 Providing Relief, Preventing Abuse (2008) PTN000003564 PTN000003595
2008-01-15 Board report PDD8901733974 PDD8901734003
2008-01-30 emails from Richard Sackler PPLPC012000168321 PPLPC012000168326
2008-02-07 email from Robert Kaiko; 2008-02-12 email
from Mortimer Sackler; 2008-02-13 email from John
Stewart PPLPC013000244843 PPLPC013000244844
2008-02-17 email from Mike Innaurato PPLPC012000171496 PPLPC012000171499
2008-02-26 email from Mortimer Sackler; 2008-02-26
email from Richard Sackler PPLPC012000172673 PPLPC012000172676
2008-03-07 Board agenda PPLPC012000173911 PPLPC012000173983
2008-03-08 email from Richard Sackler; 2008-03-09 email
from Edward Mahony; 2008-03-11 email from Kathe
Sackler PPLPC012000175155 PPLPC012000175157
2008-03-09 email from David Rosen PPLPC012000174476 PPLPC012000174478
2008-03-09 email from David Rosen; 2008-03-09 email
from Russell Gasdia PPLPC012000174202 PPLPC012000174206
2008-03-09 email from Richard Sackler; 2008-03-10
emails from David Rosen and John Stewart PPLPC012000174476 PPLPC012000174478
2008-03-28 emails from Richard Sackler and Peter Boer PDD9316304944 PDD9316304947
2008-04-12 memorandum to Richard Sackler from Peter
Boer PDD9316314309 PDD9316314313
2008-04-16 Executive Committee notes PPLPC012000183256 PPLPC012000183258
2008-04-16 presentation by Luntz, Maslansky Strategic
Research PPLPC012000183259 PPLPC012000183259
2008-04-18 email and attached memo from Richard
Sackler PDD9316300629 PDD9316300629
2008-04-18 memo from Richard Sackler PDD9316300630 PDD9316300635
3

2008-06-01 deposition of Russell Gasdia PWG003803371 PWG003804046
2008-07-15 Board report PPLP004367297 PPLP004367329
2008-07-17 presentation to the Board PPLPC012000190563 PPLPC012000190563
2008-10-04 presentation attached to email from Russell
Gasdia PPLPC021000200048 PPLPC021000200048
2008-11 budget submission PPLP004401579 PPLP004402031
2008-11 budget submission PDD9273201083 PDD9273201210
2009 Exit Wounds PTN000023058 PTN000023162
2009 Opioid Prescribing: Clinical Tools and Risk
Management Strategies (2009) PWG000242087 PWG000242114
2009 Resource Guide for People with Pain (2009) PVT0037308 PVT0037377
2009-01-09 speech by Craig Landau, National Sales
Meeting PPLPC012000208461 PPLPC012000208471
2009-02-17 attachment to email from Brad Griffin PPLPC012000213088 PPLPC012000213088
2009-02-17 email from Brad Griffin PPLPC012000213086 PPLPC012000213087
2009-03-03 Statement of Work #2 signed by Craig Landau
and Nathaniel Katz PPLPC002000042402 PPLPC002000042403
2009-04-16 Board report (partially redacted) PDD9316100597 PDD9316100624
2009-04-16 Board report (partially redacted, with
different redactions) PDD9316304313 PDD9316304340
2009-04-27 email from Lindsay Wolf PPLPC012000221091 PPLPC012000221095
2009-05-08 corporate compliance quarterly report to the
Board 1Q09 PPLPC019000275103 PPLPC019000275103
2009-05-08 corporate compliance quarterly report to the
Board 1Q09 PPLPC029000274906 PPLPC029000274906
2009-06 emails from Pasha Sarrai, Craig Landau, and
Laura Nelson Carney PDD8901645845 PDD8901645847
4

2009-07-09 memorandum from David Haddox PPLPC023000228147 PPLPC023000228153
2009-08-10 email from John Stewart; 2009-07-31 email
2009-08-19 Board slides PPLPC012000235543 PPLPC012000235543
2009-09-11 presentation PPLPC023000239858 PPLPC023000239858
2009-09-28 email from Mortimer Sackler PPLPC012000240032 PPLPC012000240037
from Richard Sackler; 2009-10-08 email from Russell
2009-10-08 email from Dipti Jinwala PPLPC012000241526 PPLPC012000241527
2009-10-08 email from Robert Barmore PPLPC022000283453 PPLPC022000283455
2009-10-09 email from Kristi Dover PPLPC017000177863 PPLPC017000177865
2009-10-09 email from Rob Barmore PPLPC022000283690 PPLPC022000283692
2009-10-26 Steering Committee meeting presentation PPLPC018000346294 PPLPC018000346294
2009-11 FACETS PTN000006420 PTN000006598
2009-11-02 budget presentation PPLPC012000249328 PPLPC012000249337
2009-12-03 attachment to email from Mike Innaurato PPLPC012000247642 PPLPC012000247642
2009-12-22 2010 Objectives PPLPC012000249345 PPLPC012000249346
2009-12-22 email from Edward Mahony PPLPC012000249327 PPLPC012000249327
2010-01-05 email from Richard Sacklerl; 2010-01-05 email
from Russell Gasdia; 2010-01-08 email from John Stewart PPLPC023000259669 PPLPC023000259674
2010-02-09 email from Pamela Taylor PPLPC012000257443 PPLPC012000257443
2010-03-11 January 2010 OxyContin monthly report PPLPC012000262892 PPLPC012000262892
5

2010-03-15 emails from Richard Sackler and Mike
Innaurato PPLPC012000262889 PPLPC012000262891
2010-04-06 Marketing & Sales draft for Board report PPLPC012000266607 PPLPC012000266610
2010-04-09 presentation by Paul Coplan PDD8901035912 PDD8901035965
2010-04-28 email from John Stewart PDD8901562111 PDD8901562115
2010-06-01 email from William Mallin PPLPC012000273600 PPLPC012000273601
2010-06-24 Purdue Pharma 2010 10-Year Plan PPLPC012000277153 PPLPC012000277276
2010-07-09 email from Kathe Sackler PPLPC012000278272 PPLPC012000278274
2010-07-22 Purdue Pharma Shareholders and Board
Meeting Actions and Notes PPLPC012000282802 PPLPC012000282812
2010-07-22 questions during Board meeting PPLPC012000283163 PPLPC012000283173
2010-08-11 Prescriber List PPLPC012000282813 PPLPC012000282813
2010-08-11 Region Zero prescribers PPLPC012000283175 PPLPC012000283175
2010-08-18 email from Stuart Baker PPLPC012000283467 PPLPC012000283468
2010-08-19 presentation by Paul Coplan PPLPC012000283469 PPLPC012000283469
2010-08-26 Medical Education Materials for HCPs PWG000247083 PWG000247089
2010-09-15 presentation by Russell Gasdia PPLPC012000290691 PPLPC012000290691
2010-09-30 Inflexxion Report PDD8901437965 PDD8901437985
2010-10-06 Consultant Services Agreement signed by
Russell Gasdia and Walter Jacobs PPLP003479945 PPLP003479954
2010-10-07 report attached to email by William Mallin PPLPC012000292674 PPLPC012000292755
2010-10-15 Draft Board of Directors Meeting Agenda PPLPC012000294197 PPLPC012000294278
2010-11-10 presentation by Bert Weinstein PPLPC012000299866 PPLPC012000299866
6

2010-11-19 email from David Haddox PTN000018983 PTN000018983
2010-11-23 and 2010-11-24 emails from Mortimer
2010-12-01 presentation by John Stewart PPLPC012000300458 PPLPC012000300458
2010-12-03 email from Paul Coplan PPLPC017000258652 PPLPC017000258654
2010-12-23 proposed Butrans titration guide PPLPC002000086956 PPLPC002000086965
2011 flyer PTN000003864 PTN000003864
2011 Is It Pain (2011) PTN000007188 PTN000007210
2011 Providing Relief, Preventing Abuse (2nd ed. 2011) PTN000003535 PTN000003563
2011 Responsible Opioid Prescribing (2011) #729.1 #729.1
2011-01-05 Draft Objectives by Craig Landau PPLPC013000286367 PPLPC013000286369
2011-01-21 Corporate Reputation & Visibility strategic
plan PWG000387272 PWG000387299
2011-01-21 email from Sharon Salwan PPLPC012000307015 PPLPC012000307016
2011-01-24 email from David Long PWG000421546 PWG000421546
from John Stewart PPLPC021000352205 PPLPC021000352206
2011-02-03 Board of Directors Meeting Agenda PDD8901468015 PDD8901468109
2011-02-07 Butrans launch update PPLPC012000309665 PPLPC012000309665
2011-02-07 draft Purdue business strategy with notes by
Craig Landau PDD8901221582 PDD8901221597
2011-02-11 Options marketing materials PKY183136248 PKY183136263
2011-02-22 email from Craig Landau PDD8901221579 PDD8901221581
2011-03-01 2011 OxyContin Tablets Sales Trends and
Projections PPLP004405789 PPLP004405857
from Mike Innaurato PPLPC012000314972 PPLPC012000314984
7

2011-04-05 and 2011-04-08 emails from Mortimer
Sackler; 2011-04-08 email from Russell Gasdia PPLPC012000320101 PPLPC012000320113
2011-04-14 Board presentation PPLP004405858 PPLP004405989
2011-04-19 Amendment to 2010 Consultant Services
Agreement PPLP003481935 PPLP003481935
2011-05-01 Purdue business strategy draft PPLPC012000322364 PPLPC012000322370
2011-05-20 compliance report PPLP004405990 PPLP004406094
from Jonathan Sackler PPLPC012000326096 PPLPC012000326109
from Jonathan Sackler PPLPC012000326192 PPLPC012000326206
2011-06-13 Budget spreadsheet PPLPC012000329075 PPLPC012000329092
2011-06-15 memo from Kim Gadski PPLPC012000329460 PPLPC012000329462
2011-06-16 email from Bert Weinstein PPLPC012000329722 PPLPC012000329725
2011-06-21 Mid-Year Update PPLP004406095 PPLP004406192
2011-07-11 email from Craig Landau; 2011-07-11 email
from Teri Toth PPLPC017000311115 PPLPC017000311121
2011-07-12 email from Craig Landau PTN000022181 PTN000022182
2011-07-21 Board meeting presentation PPLP004406347 PPLP004406508
8

2011-09-28 presentation by John Stewart PWG000245732 PWG000245764
2011-10 Guidelines on Product Promotion: Comparative
Claims Workshop PWG000190149 PWG000190177
2011-10-18 OxyContin Level 300 Training PVT0050135 PVT0050209
2011-10-24 website capture, In the Face of Pain PVT0033884 PVT0034056
2011-11-14 memorandum to the Oversight Board PPLPC021000425379 PPLPC021000425380
2011-11-18 letter from Roland Gustavson PPLPC028000391912 PPLPC028000391914
2011-11-18 letter from Roland Gustavson PPLPC029000430006 PPLPC029000430008
2011-12-06 Manager’s Meeting Presentation PWG003840367 PWG003840399
2012 budget submission PDD9273201415 PDD9273201528
2012-01-09 email from Jonathan Sackler PPLPC012000358983 PPLPC012000358983
2012-01-17 Sales and Marketing Board report PPLPC012000359667 PPLPC012000359667
2012-02-07 email from Mortimer Sackler; 2012-02-07
email from Russell Gasdia; 2012-02-08 email from Bert
Weinstein; 2012-02-08 email from Richard Sackler; 2012-
02-08 email from Russell Gasdia PPLPC026000095655 PPLPC026000095662
2012-02-07 email from Windell Fisher PPLPC012000368500 PPLPC012000368502
2012-02-15 10-Year Plan PWG000164204 PWG000164403
2012-02-15 email from Donna Condon PPLPC012000365555 PPLPC012000365558
9

2012-02-23 email from Nancy Camp-Font PPLPC018000644983 PPLPC018000644987
2012-02-27 OxyContin Broadcast Summary Report PPLPC023000526992 PPLPC023000526992
2012-03-06 speech by John Stewart PWG000245479 PWG000245483
2012-03-07 email from Windell Fisher; 2012-03-08 email
2012-03-27 business strategy plan PWG000164118 PWG000164203
2012-04-02 Statement of Work signed by Russell Gasdia
and Walter Jacobs PPLP003485088 PPLP003485089
2012-04-09 email from Joseph Pisani PWG000217342 PWG000217342
from Richard Sackler; 2012-04-12 email from Russell
2012-04-13 invitation from Donna Condon PPLPC012000372332 PPLPC012000372332
2012-04-27 Marketing Welcome PVT0007695 PVT0007751
2012-05-15 email from Gary Lewandowski PPLPC023000468016 PPLPC023000468016
2012-05-29 attachment to email from John Stewart PPLPC012000377892 PPLPC012000377896
2012-06-04 email from Paulo Costa PPLPC012000378550 PPLPC012000378551
10

2012-06-11 sales and marketing update PPLPC012000382121 PPLPC012000382121
2012-06-12 June PEP Status Report PPLPC012000382165 PPLPC012000382165
2012-06-14 memo PPLPC012000382450 PPLPC012000382451
2012-06-18 Mid Year Sales and Marketing Board Update PPLPC012000382119 PPLPC012000382119
2012-07 Marketing and Sales report PPLP004149350 PPLP004149367
2012-07-11 overview of studies for Board report PPLPC012000388082 PPLPC012000388088
2012-07-27 OxyContin presentation PPLPC018000702766 PPLPC018000702766
2012-08-14 OxyContin marketing plan PWG000062583 PWG000062653
2012-08-16 emails from Russell Gasdia and Robert
Barmore PPLPC012000389032 PPLPC012000389035
2012-08-28 Performance Enhancement Plan PPLPC014000183394 PPLPC014000183398
2012-10-01 internal Purdue analysis PWG000226020 PWG000226074
from Yoni Falkson PPLPC012000392932 PPLPC012000392933
2012-10-03 email from John Stewart PWG000415151 PWG000415154
2012-10-24 presentation by Russell Gasdia PPLPC012000396055 PPLPC012000396055
2012-10-29 email from Paulo Costa PPLPC012000396446 PPLPC012000396449
2013 Purdue paper, "Attractiveness of reformulated
OxyContin tablets" PTN000002031 PTN000002073
2013 Q1 target list PPLPC015000141319 PPLPC015000141319
2013-01-15 attachment to email by Burt Rosen PPLPC032000255064 PPLPC032000255067
2013-01-16 email from Pamela Bennett PPLPC017000434836 PPLPC017000434837
2013-02-07 Q1 Butrans Core/Super Core Assignment
Profile PPLPC012000407759 PPLPC012000407759
2013-02-13 business condition report to Board PPLPC012000408052 PPLPC012000408150
2013-02-19 draft of proposed communicates PPLPC012000409156 PPLPC012000409161
11

2013-03-18 Scientific Communications Document Review
Form PPLP003878021 PPLP003878025
2013-03-18 Systematic Review of the Efficacy and Safety
of Long-Term Opioid Therapy in the Management of
Chronic Noncancer Pain PDD8013708195 PDD8013708340
2013-03-21 Abuse Deterrent Strategy Presentation to the
Board PPLP004409476 PPLP004409600
2013-04-03 list of targeted prescribers PPLP004367823 PPLP004367823
2013-04-24 email from Burt Rosen PPLPC012000419811 PPLPC012000419815
2013-05 Board presentation by Russell Gasdia PPLP004409708 PPLP004409773
2013-05-03 Board agenda PPLPC016000181374 PPLPC016000181375
2013-05-03 email from Ronald Cadet PPLPC012000421795 PPLPC012000421796
2013-05-03 guidance for sales reps PPLPC012000421798 PPLPC012000421804
2013-05-13 Board report PPLP004367540 PPLP004367603
2013-05-22 mid-year sales update PPLPC012000424609 PPLPC012000424635
2013-05-24 Sales & Marketing presentation PPLPC004000358097 PPLPC004000358097
2013-06-25 meeting with Paulo Costa notes PPLPC021000577371 PPLPC021000577372
2013-07 Publication Plan for Long-Term Opioid Therapy
for Chronic Non-Cancer Pain PWG000323548 PWG000323562
2013-07 Sales & Marketing Opioid Market Overview PWG000163682 PWG000163769
2013-07-05 email from Edward Mahony; 2013-07-06
email from Mortimer Sackler PPLPC012000431309 PPLPC012000431314
2013-07-07 attachment to email from John Stewart PPLPC012000431266 PPLPC012000431278
2013-07-15 email from Tim Richards PPLPC012000432169 PPLPC012000432169
2013-07-18 Identifying Granular Growth Opportunities
for OxyContin: First Board Update PPLP004409781 PPLP004409889
2013-07-24 Communications and External Affairs
Committee minutes PPLPC012000433550 PPLPC012000433554
2013-07-31 email from Jon Lowne PPLPC012000434831 PPLPC012000434831
2013-08-06 visual aid PPLPC028000497109 PPLPC028000497117
2013-08-08 Identifying Granular Growth Opportunities
for OxyContin: Addendum to July 18th and August 5th
Updates PPLP004409890 PPLP004409918
2013-08-14 presentation by John Stewart and Russell
12

2013-08-19 OxyContin “Initiation, Conversion, and
Titration” workshop PWG000197618 PWG000197657
2013-09-05 report PPLPC002000156079 PPLPC002000156195
2013-09-11 memo PPLPC012000441614 PPLPC012000441619
2013-09-18 near term implementation plan PPLPC012000441799 PPLPC012000441799
2013-09-23 OxyContin marketing plan PWG000062654 PWG000062740
2013-09-26 Fourth Quarter 2013 Incentive Program PPLP003579148 PPLP003579152
2013-10-03 Board agenda PPLP004409965 PPLP004409972
2013-10-23 email from Edward Mahony; 2013-10-28
email from David Rosen; 2013-10-28 email from Russell
Gasdia; 2013-10-28 email from Mortimer Sackler PPLPC012000448832 PPLPC012000448843
2013-10-29 Board presentations PPLP004409973 PPLP004410503
2013-10-29 budget presentation PPLPC012000451665 PPLPC012000451669
2013-11-11 email from Raul Damas; 2013-11-11 email
2013-11-16 November 2013 Beneficiaries Meeting PPLP004410528 PPLP004410678
2013-12 Butrans core visual aid PWG000076569 PWG000076583
2013-12-23 email from Garry Hughes PPLP004367907 PPLP004367907
2013-12-23 First Quarter 2014 Incentive Program PPLP003579166 PPLP003579169
2014-01-02 email from Jonathan Sackler; 2014-01-03
email from Burt Rosen PPLPC020000748356 PPLPC020000748357
2014-01-16 quarterly compliance report to the Board PPLP004410692 PPLP004410815
2014-01-17 Evolve to Excellence Presentation by Mark
Timney PPLPC012000459931 PPLPC012000459931
2014-01-29 email from Mark Timney PPLPC012000461846 PPLPC012000461847
2014-01-30 memo from Edward Mahony PPLPC020000756512 PPLPC020000756518
13

2014-03-11 Presentation for meeting with Mark Timney PPLPC014000242643 PPLPC014000242643
2014-03-31 Q1 2014 financial results presentation PPLPC012000473131 PPLPC012000473131
2014-04-09 email from Thomas Currier PPLPC022000712807 PPLPC022000712808
2014-04-14 financial report to Board PPLPC012000473132 PPLPC012000473138
2014-04-17 email PPLPC012000473723 PPLPC012000473724
2014-05-04 attached memo from Burt Rosen PWG000412143 PWG000412145
2014-05-14 email from Mark Timney; 2014-05-14 email
2014-05-23 Board Update Memo from Mark Timney PPLPC021000656750 PPLPC021000656750
2014-06-06 Sales and Marketing Update Presentation by
Russell Gasdia PVT0028327 PVT0028344
2014-06-10 email from Mark Timney; 2014-06-10 email
2014-06-30 email from Raul Damas PPLPC022000741863 PPLPC022000741865
2014-07-01 Board Flash Report PPLPC016000244173 PPLPC016000244173
2014-07-22 email from Todd Baumgartner PPLPC002000187479 PPLPC002000187480
2014-08-01 memo from Mark Timney PPLPC018001080173 PPLPC018001080173
2014-08-14 email from Scott Glover PPLPC024000872837 PPLPC024000872838
2014-09-15 Commercial Strategic Initiatives by Russell
2014-09-16 email from Kathe Sackler; 2014-09-17 email
from Mark Timney PPLPC020000834184 PPLPC020000834187
2014-09-22 email from Mark Timney PPLP004141431 PPLP004141433
2014-10-01 Board meeting materials PPLP004411288 PPLP004411367
14

2014-10-20 email from John Axelson; 2014-10-20
Bloomberg Businessweek report PPLPC014000279783 PPLPC014000279795
2014-10-24 email from Edward Mahoney PPLPC016000260660 PPLPC016000260660
2014-10-24 Mark Timney’s 2015 Budget Summary PPLPC016000260662 PPLPC016000260675
2014-10-25 email from Mortimer Sackler PPLPC021000696383 PPLPC021000696386
2014-11 OxyContin Brand Strategy and Forecast for 2015 PPLP004411368 PPLP004411616
2014-11-14 Take my Pain Away … A Physician’s
Perspective of Prescription Opioids and Pain
Management PWG000214676 PWG000214682
2014-12-03 November flash report PPLPC016000266403 PPLPC016000266403
from Saeed Motahari PPLPC021000713326 PPLPC021000713330
2015 Budget Submission PPLPC016000260833 PPLPC016000260897
2015 Butrans Patient Identification and Initiation Guide PWG000080068 PWG000080082
2015 Commercial Budget Review PPLPC016000260676 PPLPC016000260769
from Mark Timney; 2015-01-08 email from Richard
2015-01-12 Price Increase Notification PWG000045843 PWG000045890
2015-01-28 Pain Products Presentation PVT0029484 PVT0029528
2015-02-24 emails from Mark Timney and Gail Cawkwell PPLPC011000015125 PPLPC011000015129
2015-03-10 Oxycodone and Buprenorphine Combination
Product Presentation PPLPC011000014785 PPLPC011000014785
2015-04-21 Board decision PPLP004417483 PPLP004417585
2015-04-21 Board materials PPLPC011000025669 PPLPC011000025715
2015-04-30 Sales & Promotion strategic plan PPLPC031001334002 PPLPC031001334002
2015-05-04 Strategic Plan Update PPLPC017000623090 PPLPC017000623090
2015-06-05 mid-year strategic review PPLPC011000036000 PPLPC011000036000
2015-10-15 commercial budget review PPLPC031001379856 PPLPC031001379856
2015-10-27 email to David Haddox PPLPC022000894451 PPLPC022000894452
2015-10-27 Executive Operating Committee presentation PPLPC011000065522 PPLPC011000065569
2015-11-03 email from Zach Perlman, Executive
Committee materials PPLPC011000065030 PPLPC011000065030
2015-11-20 email from Robert Josephson PPLP004153098 PPLP004153102
15

2015-11-30 2016 Budget Presentation PPLPC011000069952 PPLPC011000070126
2015-12-09 email from Zach Perlman PPLPC011000073228 PPLPC011000073229
2015-12-09 Executive Committee presentation PPLPC011000073230 PPLPC011000073230
2016-01-08 email from Eric Kizior PPLP003569272 PPLP003569275
2016-02 NSAID to ERO Switch Research Final Report PWG000072026 PWG000072075
2016-03-22 email from a mother to Mark Timney PPLPC017000696219 PPLPC017000696224
2016-04-13 April Board meeting Commercial Update PPLPC016000286167 PPLPC016000286167
2016-04-15 email from Timney to Executive Committee PPLPC011000092068 PPLPC011000092069
2016-05-11 10 year plan Sales and Promotions expenses PPLPC031001437901 PPLPC031001437901
2016-05-19 Executive Committee pre-read PPLPC011000096792 PPLPC011000096990
2016-06 Board Book PPLPC011000099226 PPLPC011000099348
2016-06-08 Mid-Year Update PPLPC011000099783 PPLPC011000099783
2016-08-12 Purdue news summary PPLPC005000241221 PPLPC005000241223
2016-09-16 Communications Strategy Recommendations
Presentations PPLPC021000863236 PPLPC021000863251
2016-10-04 email to David Haddox; 2016-10-04 email
from Srdjan Nedeljkovic PPLPC022000968264 PPLPC022000968268
2016-10-11 commercial budget proposal PPLPC011000123439 PPLPC011000123682
2016-11-01 letter from Mark Timney PPLPC011000126443 PPLPC011000126444
from Robert Josephson PPLPC023000914978 PPLPC023000914978
2016-11-28 email from Robert Josephson PPLPC019001332704 PPLPC019001332707
2016-12-01 emails from Robert Josephson and Raul
Damas PPLPC020001075830 PPLPC020001075832
2016-12-22 Braeburn Pharmaceuticals: Structuring
Analysis PPLPC022000980231 PPLPC022000980246
2016-12-22 email from Elliott Ruiz PPLPC022000980230 PPLPC022000980230
2017-01-02 Governance Calendar PPLPC011000131500 PPLPC011000131506
2017-03-23 Executive Committee presentation PPLPC011000139651 PPLPC011000139826
2017-04-06 email from Gail Cawkwell PPLPC011000141097 PPLPC011000141100
2017-05-02 Presentation by Craig Landau PPLPC020001106306 PPLPC020001106315
2017-05-05 email from Gail Cawkwell PPLPC001000254479 PPLPC001000254481
2017-05-06 email from Gail Cawkwell; 2017-05-06 email
from Theresa Sackler PPLPC011000147096 PPLPC011000147098
16

2017-06 Board of Directors: Purdue Mid-Year Pre-Read PPLPC011000151189 PPLPC011000151357
2017-06-22 Internal Press Release PPLPC024001006343 PPLPC024001006344
2017-08-22 Questionnaire - Purdue Response PPLPC020001132365 PPLPC020001132367
2017-08-30 BIO Opioid Mission PPLPC001000259761 PPLPC001000259762
2017-09-14 10 year plan spreadsheet PPLPC021000904588 PPLPC021000904588
2017-11 Board budget PPLPC016000323215 PPLPC016000323215
2017-11-13 letter from Craig Landau PPLPC021000912689 PPLPC021000912691
2017-11-17 spreadsheet of MA OxyContin Savings Cards PWG004285076 PWG004285076
2017-11-21 emails from Jonathan Sackler and Craig
Landau PPLPC016000321333 PPLPC016000321335
2018 budget PPLPC016000323974 PPLPC016000324015
2018-04-10 email from Paul Medeiros PPLPC023000979571 PPLPC023000979572
Butrans promotional video PPLP003297185 PPLP003297185
Compiled Board minutes PKY183212603 PKY183213010
Compiled Board minutes PKY183213011 PKY183213458
Compiled Board minutes PPLP004415256 PPLP004416559
Introducing Opioids with Abuse-Deterrent Properties
(OADP) PVT0024614 PVT0024621
Mass. HCP Payments PMA000281466 PMA000281466
Monthly prescription data by prescriber PWG003984534 PWG003984534
Options marketing materials PMA000189013 PMA000189028
OxyContin sales script PWG000334229 PWG000334240
Purdue Drug Units Dispensed by HCP, Product, and
Strength PWG003984518 PWG003984518
Treatment Options: A Guide for People Living with Pain PWG000243973 PWG000244056
Video, transcript “I Got My Life Back” PDD9521403001 PDD9521403625
Video: “A Treatment Plan for Moderate to Severe Low
Back Pain That Includes Converting to an Extended-
Release Opioid Analgesic,” PPLP003276093 PPLP003276093
17

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COMMONWEALTH OF MASSACHUSETTS

SUFFOLK, ss. SUPERIOR COURT

THE COMMONWEALTH’S PRE-HEARING MEMORANDUM

At the conclusion of that hearing, the Court:

1) ordered the Commonwealth to file an impounded, unredacted version of its Amended

Complaint as well as a redacted version for the public file;

2) provisionally granted the CEO defendants’ motion to impound information relating to

remaining disputes within this proceeding.

I. Status of the Redaction Dispute

process that followed, Purdue agreed to lift hundreds of redactions.

Special Master with a copy of this Pre-hearing Memorandum today.

showing the remaining redactions are attached as Exhibit 2 and Exhibit 3.

II. Proposed Next Steps

A. Order Purdue to Produce the Documents Cited in the Amended Complaint in

Commonwealth’s Amended Complaint.

confidentiality designations made to facilitate discovery. Instead, as the Protective Order

564, 571 (1949), cert. denied, 339 U.S. 984 (1950).

In light of Purdue’s contention that documents the Commonwealth obtained pursuant to

allegations that Purdue seeks to withhold from the public.

information to be impounded as the Uniform Rules of Impoundment require. The

Purdue’s final Motion to Impound should be due March 15.

B. The CEOs’ Motion To Impound

At the last hearing, the Court granted a provisional impoundment of information

Executive Officer. The Commonwealth opposes the long-term impoundment of that

merely that they were highly compensated.

confidentiality designations regarding all those allegations in the MDL.

specific motion to impound.

Dated: January 15, 2019 Respectfully submitted,

Sydenham B. Alexander III, BBO #671182

Assistant Attorneys General

Timothy C. Blank, BBO # 548670

Joan A. Lukey, BBO # 307340

James R. Carroll, BBO # 554426

Juliet A. Davison, BBO # 562289

Assistant Attorney General

Massachusetts Attorney General Office’s Letter Brief

January 14, 2019

Via Electronic Mail

Re: In re National Prescription Opiate Litigation, MDL No. 2804

Dear Special Master Yanni:

I write on behalf of the Massachusetts Attorney General’s Office (the “Massachusetts

Purdue designated as Confidential and Highly Confidential millions of pages of

Thank you for your attention in this matter.

List Of Remaining Redactions As Of January 15, 2019

Amended Complaint Showing Remaining Redactions As Of January 15, 2019

SUFFOLK, ss. SUPERIOR COURT

Annotated To Show Redactions Remaining As Of January 15, 2019

1. Dangerous opioid drugs are killing people across Massachusetts. Prescription

the deception and pocketed millions of dollars.

inflicted in our state.

public interest in the name of the Commonwealth of Massachusetts.

decade-long course of misconduct in Massachusetts that involved hundreds of deaths, hundreds

of thousands of unlawful acts, and hundreds of millions of dollars.

accountable for his or her actions. 1

8. Defendants Richard Sackler, Beverly Sackler, David Sackler, Ilene Sackler

their family billions of dollars.

pages 51-269 below.

III. OUTLINE OF THE COMPLAINT

that 2007 Judgment.

then follow, as outlined in the following Table of Contents.

II. PARTIES ...............................................................................................................................2

III. OUTLINE OF THE COMPLAINT ...........................................................................................4

IV. PURDUE’S DRUGS KILL HUNDREDS OF PEOPLE IN MASSACHUSETTS ..............................7

V. PURDUE TARGETED MASSACHUSETTS WITH ITS UNFAIR AND DECEPTIVE SALES

VI. PURDUE DECEIVED DOCTORS AND PATIENTS TO GET MORE PEOPLE ON

A. More People ........................................................................................................... 14

B. Higher Doses .......................................................................................................... 22