Deposition

Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 1 COMMONWEALTH OF KENTUCKY PIKE CIRCUIT COURT - DIV. II CIVIL ACTION NO, 07- CI-01303 1 2 4 1 EXHIBITS CONTINUED: 2 Ex hibit No. 9 .. .... ... . .. ... ............... ... 73 (Memo dated 12-14-93 from James Komorowski to OxyContin Project Team re Project Team Meeting Minutes of 11-30-93) 3 3 COMMONWEALTH OF KENTUCKY, ex rel. JACK CONWAY, ATTORNEY GENERAL 4 PLAINTIFF 5 5 6 6 7 7 vs. VIDEO DEPOSillON FOR THE PLAINTIFF 8 8 9 9 10 10 PURDUE PHARMA L.P., et al. DEFENDANTS 11 11 12 12 13 13 * * * 14 15 16 14 15 DEPONENT: RICHARD SACKLER, M.D. DATE: 16 AUGUST 28, 2015 17 17 18 19 18 * * * 19 2o 20 21 22 23 24 LAUREN I. GOOTEE, R.P.R. Coulter Reporting, LLC 101 East Kentucky Street Suite 200 Louisville, Kentucky 40203 (502) 582-1627 FAX: (502) 587-6299 . E-MAIL: lgootee@coulterreporting.com 21 22 23 24 25 Page: 1 Richard Sackler, M.D. Exhibit No. 10 ... . ... .... ... ..... . ... ... ... ... 74 (Memo dated 8-10-92 to Distribution from R. Reder re Oxycodone Project Team Meeting Minutes of 8-4-92) Exhibit No. 11.. ............ .. .. ..... ......... 77 (E-mail dated 5-28-97 from Richard Sackler to Michael Friedman) Exhibit No. 12 .... .... ................ ........ 86 (Memo dated 6-12- 97 from Richard Sackler to Michael Friedman re OxyContin Team Meeting Minutes) Exhibit No . 13 .. ... .. ..... .......... .... .. .... 103 (Interoffice Memorandum dated 12-29-94 to Mortimer Sackler, Raymond Sackler and Richard Sackler from Michael Friedman re Product Pipeline and Strategy) Ex hibit No. 14 ..... .......... .. ..... ...... .... 109 (Memo dated 4-23-97 from Richard Sackler to Michael Friedman re San Antonio) Exhibit No. 15 ... .... ........... ... .. ... ... ... 110 (Memo dated 4-2-93 from E. Natz to Distribution re PFRC R&D Meeting of 3-22-93) Exhibit No. 16 ................. .. ... .......... 117 (Memo dated 8-30-93 from James Komorowski to OxyContin Project Team re Project Team Meeting Minutes of 8-17-93) Exhibit No. 17 ....................... .. ....... 122 (Article in Teamlink, Winter 1996, titled "OxyContin: The Most Significant Launch in Purdue History) Exhibit No. 18 ....... ... ... ........ ........... 127 (Medical Officer Review, Integrated Summary of Efficacy Oxycodone Controlled-Release) 25 Page 2 1 2 3 Page. 4 INDEX 1 EXHIBITS CONTINUED: 2 Exhibit No. 19 ...... ... ... .. . .. .. .. . .. ..... .. . 134 (Memo dated 4-13-94 from James .Komorowski to OxyContin Project Team re Project Team Meeting Minutes of 3-22- 94) Examination by Mr. Thompson . ... ........... .. .. 10 3 Reporter's Certificate ... ........... ...... .. .. 337 4 4 5 5 6 EXHIBITS 7 8 9 10 11 12 13 14 15 16 17 18 19 2o 6 7 Exhibit No. 1.. .. .. ... . .. .. .. ... . ... .. ....... . 29 (Memo dated 7-16-90 from Robert Kaiko to Richard Sackler and Michael Friedman re Controlled-Release Oxycodone) Exhibit No. 2 .. ..... ..... .... ....... .......... 29 (E-mail dated 5-31-99 from Richard Sackler to EdM at PurdueUS re New Office) Exhibit No. 3 ....... ....... . ... . .. ............ 32 (Memo dated 5-31-99 from Richard Sackler to EdM at PurdueUS re New Office) Exhibit No. 4 .............. ...... .. .. .. ....... 38 (Memorandum dated 7- 15-92 from Dr. JW Watkins re Minutes of Analgesics Compendium Meeting with Shionogi 6-24-92) Exhibit No. 5 ... .. ... .... .... .... ..... ... ..... 39 (Untitled document re "Our meeting ended with a question and comment period ... ") Ex hibit No. 6 ... ..... ......................... 43 (Letter dated 7-5-07 to Randy Ramseyer from Brent Gurney re Profit Calculations) 8 9 1o 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Page 3 Exhibit No. 7 ..... .. ...... ......... .. ... . ..... 48 (Memo dated 3-15-97 from Paul Goldenheim to Richard Sackler re Is this an opening to descheduling the agent?) Exhibit No. 8 .......... ............ .......... . 54 (E-mail chain dated 4-4-97 from Robert Kaiko to Michael Friedman, Howard Udell, Richard Sackler, Paul Goldenheim and Robert Reder re Oxycodone) Coulter Reporting, LLC 21 22 23 24 25 Exhibit No. 20 ................................ 135 (Memo dated 6-22-94 from James Komorowski to OxyContin Tablets Project Team re Project Team Meeting Minutes of 6-8-94) Exhibit No. 21.. ... ..... .................... .. 141 (Confidential Minutes of International R & D Meeting Held at 86 Park Lane, London 11-2-94) Exhibit No. 22 ................................ 154 (Memo dated 9-25-95 from Alfonso at Norwalk re Rescue use in OxyContin PI) Exhibit No. 23 .......... ... ... .......... ...... 164 (Memo dated 4-20-2000 from Richard Sackler to Mark Alfonso re Recommendations of 4-7) Exhibit No. 24 .... . ..... .. ...... .. ... ....... .. 173 . (Memo dated 4-4-95 from Lydia Johnson to OxyContin Launch Team re Launch Team Meeting 3-31-95 minutes) Exhibit No. 25 ... .. .. ... .. ....... ... ....... ... 177 (Memo dated 3-7-96 from Ellen Ingber and Linda Harrison to OxyContin Product Team re Minutes of the OxyContin Product Team Meeting of 2-22-96) Exhibit No. 26 ...... .... ...... ................ 200 (OxyContin Launch Plan) Exhibit No. 27 .. .. ............ .......... .. .... 200 (Memo dated 10-23-96 from Friedman to Alfonso re Phase IV OxyContin Team Minutes) Exhibit No. 28 ... ..... ......... ............. .. 204 (Memo dated 6-9-99 from Richard Sackler to Stuart Baker, Edward Albright, Michael Friedman, James Dolan, Mark Alfonso and Edward Mahoney re Promotion of OxyContin byAbbott) www.cou lterreporti ng .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 5 1 EXHIBITS CONTINUED : 2 Exhibit No. 29 ................... ...... ...... . 205 (Memo dated 6-16-97 from E. Chickering and L. Harrison to Distribution re Phase IV Oxycontin Tablets Team Meeting of 6-13-97) 3 4 5 6 7 8 9 2 3 4 Exhibit No. 30 ......... . ............ . ......... 218 (GAO Report to Congressional Requesters December 2003 titled Prescription Drugs OxyContin Abuse and Diversion and Efforts to Address the Problem) 5 6 7 Exhibit No. 31.. .. ............. .. .......... ... 220 (E-mail chain dated 9-4-96 from Richard Sackler to Friedman and Alfonso re Press Release or similar promotion) 8 9 10 12 12 14 15 16 17 18 19 2o 21 22 23 Page 7 1 10 Exhibit No. 32 ....... .... . .. ... ........ .. ..... 226 (5-17-05 letter to Gregory Stumbo from 11 Howard Udell) 13 Page:2 Richard Sackler, M.D. APPEARANCES FOR THE PLAINTIFF: TYLER S. THOMPSON, ESQ. ANTHONY P. ELLIS, ESQ. Dolt, Thompson, Shepherd & Kinney 13800 Lake Point Circle Louisville, Kentucky 40202 tthompson@kytrial.com aellis@kytrial.com MITCHELL T . DENHAM, ESQ. Assistant Deputy Attorney General Office of the Attorney General The Capital Bu ilding 700 Capitol Avenue, Suite 118 Frankfort, Kentucky 40601 mitchell .denham@ag .ky.gov 11 Exhibit No. 33 ................. ............... 226 (Agreed Statement of Facts re United States of America v. The Purdue Frederick Company) 13 Exhibit No. 34 ....... ....... .. ........ .. ... ... 247 (Memo dated 1-25-01 from Mark Alfonso to Michael Friedman re Hydrocodone) 14 15 Exhibit No. 35 ........................ . ....... 278 (Memo dated 12-8-99 from Michael Friedman to Paul Goldenheim, David Haddox, Paul Goldenheim, Robert Kaiko, Robert Reder re Oxycontin abuse-Jacksonville, FL) 16 17 18 Exhibit No. 36 ................................ 286 (Memo dated 8-29-97 from Joann Coletta to Richard Sackler re Send some Betadine to) 19 2O Exhibit No. 37 ................................ 287 (Memo dated 5-15-96 from Claudia Bobillier To Claydon, Goldenheim, Fleischer, Howell, Kaiko, Kuster, Manners, A.J. Miller, R.B. Miller, Sackler and Wimmer re Minutes of Meeting with Prof. Dayer in Geneva 5-6-96) 21 22 23 24 24 25 25 FOR THE DEFENDANTS, PURDUE PHARMA, LP., PURDUE PHARMA, INC., THE PURDUE FREDERICK COMPANY, INC. d/b/a THE PURDUE FREDERICK COMP.ANY, PURDUE PHARMACEUTICALS, L.P. and P.F. LABORATORIES, Ii'~ C.: DONALD STRAUBER, ESQ. Chadbourne & Parke, LLP 1301 Avenue of the Americas New York, New York 10019 dstrau ber@chad bou rne. com DANIELE. DANFORD, ESQ. Stites & Harbison, PLLC 250 West Main Street Suite 2300 Lexington, Kentucky 40507-17 58 ddanford@stites.com JAY R. HENNEBERRY, ESQ . Chadbourne & Parks, LLP 350 South Grand Avenue, 32nd Floor Los Angeles, CA 90071 Louisville, Kentucky 40202 jhenneberry@chadbourne.com Page 6 Page 8 1 EXHIBITS CONTINUED: 1 2 Exhibit No. 38 ...... .. ........ .... . ........... 324 (Memo dated 1-14-97 from Richard Sackler to Michael Friedman, James Lang, Paul Goldenheim, Robert Kaiko and Robert Reder re Merck-Medco) 3 3 4 5 6 7 8 9 Exhibit No. 39 ...... .. ....................... . 327 (Memo dated 9-30-96 from Alfonso to John Stewart, Friedman, Lang, Sackler, Darke, Jeffery, Stables and Franco re Analgesic Plans) Exhibit No. 40 ......................... . ...... 331 (Sales Bulletin to Prescription Sales Force From Russ Gasdia of 1-25-99, First Quarter Bonus Payouts Oxycontin and MS Contin) 10 13 4 5 6 7 8 9 11 CERTIFIED QUESTION Page 298, Line 11 12 FOR THE DEFENDANTS, ABBOTT LABORATORIES AND ABBOTT LABORATORIES, INC.: JASON SAYERS, ESQ. Venable, LLP 750 E. Pratt Street, Suite 900 Baltimore, MD 21202 jsayers@Venable.com 14 15 15 * * * 17 GEORGE PARKER * * * 16 17 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 Coulter Reporting, LLC VIDEOGRAPHER: 13 14 16 RICHARD W. SILBERT, ESQ. Purdue Associate General Counsel One Stamford Forum Stamford, CT 06901 - 3431 rich a rd .silbert@pha rma . com 10 11 12 2 APPEARANCES CONTINUED: www.coulterreporting.com 502-582-1627 Page: 3 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 11 Page 9 The video deposition of RICHARD SACKLER, 1 And you are here today to give Q. 1 2 M.D., taken in the offices of Dolt, Thompson, Shepherd 2 testimony in a case pending against Purdue, various 3 & Kinney, 13800 Lake Point Circle, Louisville, 3 entities by the State of Kentucky. 4 Kentucky, on Friday, the 28th day of August, 2015, at 4 5 approximately 9 : 11 a.m.; said deposition being taken Are you aware of that? 5 A. Q. 6 pursuant to Notice for use in accordance with the 6 7 Kentucky Rules of Civil Procedure. 7 That's my understanding. And you've given -- MR. STRAUBER: Mr. Thompson, before 8 you get started, I'd just like to note that I expect 8 * * * 9 9 we will be designating portions of this transcript as 1 o confidential pursuant to the order. 10 VIDEOGRAPHER: We are on the record at 11 MR. THOMPSON: Is that correct, 11 12 9 :12 a.m., August 28th, 2015 in the matter of 12 13 Commonwealth of Kentucky, Pike _ C ircuit Court, Division 13 Mitchell? MR. DENHAM: Yeah, they can designate 14 2, Civil Action No. 07-CI-01303, Tfi e Commonwealth of 14 15 Kentucky versus Purdue Pharma. This is the deposition 15 about challenging them. 16 of Dr. Richard S. Sackler. 17 their name into the record . 19 2 o ahead and read the list of the names? 21 VIDEOGRAPHER: Just read the list? 22 MR. THOMPSON: I'll tell you what, 23 25 MR. DANFORD: There's a 30-day period in the rule. We'll get you a copy of the agreed 2 O protective order. MR. THOMPSON: And just so you know - - 21 22 I know you're not from Kentucky; is that correct? let's just go ahead, let's just say our names. MR. SAYERS: Jason Sayers on behalf of 24 until you-all designate and we respond. 18 MR. THOMPSON: Do you want to just go 19 MR. THOMPSON: We won't disseminate 16 If I could have the attorneys state 17 18 portions confidential, and then there's provisions Abbott. 23 MR. STRAUBER: That's correct. 24 MR. THOMPSON: All objections, other 25 than to the form of the question, are preserved in Page 10 2 MR. STRAUBER: Donald Strauber on behalf of the various Purdue defendants. MR. SILBERT: Oh, sorry. Richard 5 6 Silbert in-house at Purdue. MR. HENNEBERRY: Jay Henneberry on 7 8 behalf of the Purdue defendants. MR. THOMPSON: Tyler Thompson on 9 1 o behalf of the State of Kentucky. MR. ELLIS: Anthony Ellis on behalf of 11 12 the State of Kentucky. MR. DENHAM: And Mitchell Denham from 13 14 the Attorney General's Office on behalf of 15 Kentucky. Kentucky on video. MR. STRAUBER: Thank you . 2 3 4 BY MR. THOMPSON : 6 What is your current role at Purdue? Q. MR. STRAUBER: Excuse me. I -- there 5 are a number of defendants that bear some portion of 7 the Purdue name, and the distinction can be 8 sign ificant. So I'd ask when you phrase your 9 questions, specify which Purdue entity you are talking 10 about. 11 12 Well, let's -- let's talk about the Q. number of Purdue entities there are. How many Purdue entities are there? 13 14 A. I don't know. 15 Q. I've seen upwards of 69 different 16 corporations, perhaps, that the Sackler family owns. 16 RICHARD SACKLER, M.D., after first 17 18 1 the Purdue defendants. 3 4 Page 12 MR. DANFORD : Dan Danford on behalf of 1 being duly sworn, was examined and testified as 1 7 Is that correct? 18 A. If you've counted them. I can't 19 follows : 19 differ with you. I don't know the answer. 20 20 EXAMINATION 21 22 22 23 BY MR. THOMPSON: Q. There are a number of Purdue entities. 21 The Purdue Frederick Company, Inc., does it still exist? 23 A. I don 't know. 24 Q. Would you state your name, please. 24 Q. Tell me what companies that you 25 A. Richard Sackler. 2 5 currently have a role with that involve Purdue. Coulter Reporting, LLC www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. Page:4 Richard Sackler, M.D. 8/28/2015 Page 13 Page 15 1 A. Purdue Pharma. 1 2 Q. Do you sit on the board of any other 2 3 Purdue companies? 4 A. 5 6 7 9 Southern District of West Virginia. And does that appear to be your name 3 Not to my knowledge. 4 Q. What about Mundipharma? 5 A. That does. A. I sit on the board of a consulting 6 Q. And it's dated July 30th, 2014. It firm which consults to Mundipharma. Q. 8 This is an affidavit filed in the Q. 7 Does the Sackler family own 10 11 Q. 12 A. says "Declaration of Dr. Richard S. Sackler. I am a 8 director of Purdue Pharma, Inc., the general partner Mundipharma? A. (indicating)? 9 Yes. of Purdue Pharma, LP. I've held this position since 10 1990." What about -- what is Mundipharma? 11 A. Mundipharma is -- is a name that is 12 what it says. 13 attached to many different companies, such as -- just 14 similar to Purdue. 13 14 If that's what it says, then that's How involved are you in the production Q. and marketing and promotion and the training and 15 Q. Is that company over in Germany? 15 management of Purdue sales representatives for 16 A. There is a Mundipharma company in 16 OxyContin? 17 Germany. 18 Q. MR. STRAUSER: I object to the form of 17 What about Roxane? Does Purdue own 18 the question. Roxane? 19 A. 20 A. No. 20 Q. 21 Q. Did they own Roxane in the past? 21 19 Should I answer? Go ahead. MR. STRAUSER: You can answer. 22 A. Never. 22 A. It depends on the time. 23 Q. All right. Do you know how many 23 Q. Okay. And when you say "it depends on 24 current companies are owned by the Sackler family? 25 A. No. 1 Q. All right. In discussing OxyContin, 24 25 the time," why do you say that? A. Because I was involved in the areas at Page 16 Page 14 1 2 how many companies were involved in the production, 3 manufacturing or distribution of OxyContin? a supervisory level, not as an active level, for a 2 period of time that began with the launching of 3 OxyContin and ended in early 2003. 4 A. Could you specify the geography? 4 5 Q. In the world. 5 supervisory level but not the active level, how much 6 A. Many. I've never counted them. 6 7 Q. Does Purdue do licensing agreements 7 8 with other companies to sell OxyContin? 8 When you were involved on the Q. of your day-to-day activity was devoted to OxyContin? A. It varied enormously. Q. In this declaration it says, "During 9 A. 10 Q. Do they own parts of those companies? 10 1996 to 2009, I was not directly involved with the 11 A. No. 11 day-to-day marketing or promoting of OxyContin, the 12 Q. How many companies does Purdue own 12 training or management of Purdue sales 13 representatives, or the scientific research into the It does. 13 that distributes or dispenses OxyContin? 9 the time period set forth in the amended complaint, 14 A. Many. 14 conversion ratio from MS Contin to OxyContin. Those 15 Q. Can you tell me the names of them? 15 responsibilities principally fell to Purdue senior 16 A. A few of them, but not all of them. 16 management in research and development, regulatory 17 Q. Are you still the director of Purdue 17 affairs, sales training and marketing, among others." 18 19 20 21 Pharma, Inc.? I'm not sure. 19 Q. Are you still a general partner of 20 Purdue Pharma, LP.? 22 A. I am not. It is owned by two trusts. 23 Q. On July 30th of 2014, were you a 24 25 director of Purdue Pharma, Inc.? A. Not that I'm aware. Coulter Reporting, LLC Is that accurate? 18 A. 21 A. Yes. Q. I want to show you an e-mail, Dr. Sackler, dated Monday, May 31st, 1999. Do you know who Cornelia -- 22 23 Dr. Cornelia Hentzsch is? 24 A. I do. 25 Q. And who is that? www. cou lterreporting. com 502-582-1627 Page:5 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 17 1 2 3 A. She was general manager of Mundipharma 1 And to give this a little bit of 3 Australia . Q. context, you-all had a drug called MS Cantin, morphine 4 5 sulfate, that was an immediate-release narcotic 5 6 opioid -- or narcotic; is that correct? 7 8 Q. It was controlled release. 11 12 13 Do you recall that one of the concerns Q. that Purdue's senior management had -- and I'm using 6 "Purdue" in relation to Purdue companies that are 7 involved with OxyContin. And rather than just sit 9 say "Purdue," I'm referring to Purdue companies of all 1 o patients or malignant pain patients; is that correct? A. date, no. 8 here and name them all out, can we agree that when I Controlled release. I'm sorry. And that was used primarily for cancer 9 I'm -- I'm not certain that I know the A. 2 4 A. Page 19 set to expire? 1 o the OxyContin? The majority of use, yes; but not -- I MR. STRAUSER: Mr. Thompson, I have to 11 don't think "primarily" conveys an accurate picture. 12 object to that because I said at the outset there are Majority of use was for? 13 different Purdue entities that are defendants in the Q. 14 A. Over 50 percent. 14 case, and the distinction between them may at times be 15 Q. And it was sort of felt by Purdue 15 significant. And so if you lump them all together 16 Pharma that morphine had a stigma attached to it that 16 under "Purdue," we're going to get a record that will 17 kept doctors from prescribing it across the board; is 17 18 that accurate? not be easily decipherable at the end. Q. 18 Well, let's -- let's talk about it 19 A. Yes. 19 then. 20 Q. And you-all had a -- 20 21 A. May I amend that? 21 22 Q. Yes. 22 23 A. It didn't prevent doctors from 23 Pharma were involved in the early years of selling the Which Purdue companies were involved in the sale and distribution of OxyContin? Both Purdue Frederick and Purdue A. 24 prescribing it across the board. It was an inhibition 24 product. 25 to the use of a product in every application . 25 Q. Okay. Were there any other Purdue Page 20 Page 18 1 Q. 1 Have you ever gone back and studied 2 the history of addiction and how it has played out in 3 4 5 2 A. Not in the U.S. Who had the exclusive right to sell 3 Q. A. I'm not a student of that literature. 4 MS Cantin? Q. All right. What was your 5 A. 6 Q. And -- A. I don't know at what point Purdue the 19th and 20th centuries? 6 understanding of why doctors did not want to prescribe 7 morphine for anything or had a stigma about 7 8 prescribing it for anything other than cancer and 8 9 malignant pain? 10 A. As I said before, the stigma prevented 11 many physicians from prescribing it for any pain. 12 13 14 At first it was Purdue Frederick. Pharma acquired rights to sell it or if it did at all. What is the distinction between Purdue Q. 9 10 Frederick and Purdue Pharma? Purdue Frederick was the original A. 11 12 company that my father and uncle acquired in 1952. It I'm not a student of the issue, but I 13 was a shell company and it was the first believe the stigma existed because of a popular 14 pharmaceutical company that they owned. Q. Why do you think that stigma existed? A. 15 understanding shared by both professionals and by 15 16 laymen that morphine was an end-of-life drug, if it 16 17 was to be used at all. 18 companies involved in the selling of the product? Q. Were there concerns about addiction 19 and dependence with respect to morphine? 20 A. Some people had those concerns. 21 Q. So going back to bu_ilding our context Purdue Pharma was established in the early 1990s to take on new products and to also take 17 on the risk of -- well, take on the risk of new 18 products and also a few established products, but not 19 all. 20 Q. Were there any actions taken with 21 respect to Purdue -- or with respect to OxyContin that 22 here. You-all had a drug called MS Cantin that you 22 would not fall under the Purdue Pharma umbrella? 23 23 had the exclusive right to sell; is that correct? 24 A. That's correct. 24 25 Q. Do you know when that exclusivity was 25 Coulter Reporting, LLC A. I'm sorry, could you repeat the question? Q. Yeah. Are you -- are you maintaining www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:6 Richard Sackler, M.D. Page 21 1 Page 23 that there are any actions done with respect to 2 OxyContin, its -- its creation, production, marketing, 1 Dr. Sackler has explained briefly, they were two 2 entities that did different things at different times, 3 sales, that do not fall under the Purdue Pharma 3 and if you lump the two together, inevitably there's 4 4 going to be confusion in terms of the witness's 5 answer. 6 Q. umbrella? Its creation was done in Purdue A. 5 6 Frederick -- Okay. Let's do this. I'm going to 7 Q. Okay. 7 refer to Purdue as Purdue Pharma, L.P. and also Purdue 8 A. -- until the early '90s when that 8 Frederick, L.P. If at some point you feel like it's 9 only Purdue Frederick or only Purdue Pharma, you let 9 responsibility was transferred to Purdue Pharma. And then Purdue Frederick continued to Q. 10 10 me know. Okay? 11 exist, though, correct? A. It did. 12 13 Q. Okay. And was Purdue Frederick also a It's kind of a burden, but with the A. 11 12 help of my attorney ... 13 Q. Sure. 14 company involved with marketing, promoting, sales and 14 A. Because there may be issues. It's 15 production of OxyContin? 15 going to be -- it tests my memory to separate the two. 16 So I'm sorry for the confusion, but it is important. I'm trying to give you an accurate A. 16 17 answer because this is confusing and complex. 18 There was a period of time in which For instance -- let me ask you this. Q. 17 18 Sales reps. Were sales reps employed by Purdue 19 once Purdue Pharma became involved that Purdue 19 20 Frederick was involved, but Purdue Frederick was never 20 21 involved nor Purdue Pharma in manufacturing the drug, 21 sales rep was employed by one, but not necessarily the 22 which was when it was developed, was manufactured by a 22 other. 23 company named P.F. Laboratories. 25 23 Okay. Other than the manufacture, did Q. 24 24 Purdue Frederick and Purdue Pharma both play a role in Frederick or Purdue Pharma? For a period of time they were -- each A. Do you know which sales reps were Q. employed by Purdue Frederick versus Purdue Pharma? 25 A. I don't know. 1 Q. Do you know if they received different Page 24 Page 22 1 the production of it? 2 training? I can't recall in detail whether they A. 2 3 both played a role or whether when Purdue Pharma took 3 4 on the project it carried most of the weight or all of 4 5 5 it. I believe the training was the same. Q. Well, I'll tell you what, I'm going to refer to when I say "Purdue" as Purdue Frederick. If 6 you feel like it's Purdue Pharma, you let me know. Is there any difference between the Q. 6 7 A. employees of Purdue Frederick and Purdue Pharma? 7 Okay? 8 A. There were differences. 8 A. Okay. 9 Q. Okay. Any difference in the board of 9 Q. All right. So back in 19 -- early 1 o '90s when you were developing MS Cantin, this 1 o directors? 11 12 13 14 A. That would test my memory, and I'm not 11 12 going to expire and there was going to be competition Q. All right. Well, let me go back to -- 13 from generic companies, correct? sure. let's talk about OxyContin. And I'm going to use the 15 term "Purdue" for both Purdue Frederick and Purdue 14 exclusive license that you had to sell MS Cantin was Well, the product MS Contin was A. 15 developed in the late '70s and early '80s. And -- so 16 Pharma. If at some point you feel like there's a 16 are you discussing development or are you discussing a 1 7 distinction to be made, you let me know. Okay? But 17 18 at a time when -- 18 19 MR. STRAUBER: Mr. Thompson, I object 19 2 o to your combining the two under the name "Purdue." If 20 21 you're going to do it, then I'd like to have a 21 22 standing objection to that combination. 23 24 25 MR. THOMPSON: What is your reason for the objection? MR. STRAUBER: My reason is, as Coulter Reporting, LLC 22 23 later time? Q. The later time when its license is about to expire. A. Eventually we knew that there would be competition for MS Cantin. Q. And one of the things in developing Oxycodone Controlled-Release, one of the -- one of the 24 concerns was how to position it in the market and 25 whether you were going to position it an obsolete www.coulterreporting .com 502-582-1627 Page:7 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 27 Page 25 1 MS Contin or try to position it alongside MS Contin. 2 Do you recall that issue? 2 MR. STRAUBER: I object to the form of 3 MR. THOMPSON: Sure. That's why I was 1 holding it over here. MR. STRAUBER: It's hard to read from 3 4 the question. Could you repeat it? I'm not sure I 4 5 understood the question. 5 MR. ELLIS: Here's an extra copy. 6 MR. THOMPSON: Great. MR. THOMPSON: Yes. 6 7 Q. One of the concerns when you were that distance. MR. STRAUBER: Do you have a copy for 7 8 developing Oxycodone -- I'm sorry -- OxyContin 8 9 Controlled-Release was how you were going to position 9 me, also? MR. ELLIS: (Passing document.) 1 o it for market share and whether you were going to 10 11 position it and make MS Contin obsolete and take that 11 12 market share that MS Contin had, or whether you were 12 13 going to position it alongside MS Cantin and sell them 13 A. 14 Q. Yeah. I'll tell you where to go. 15 A. Okay. Q. So the second highlighted portion, 14 both together. Do you recall that concern? 15 16 17 I recall discussions, but that wasn't A. 16 the principal driver. The principal -- the principal 17 MR. STRAUBER: Thank you . So do you see down there the second Q. highlighted portion that says "Rationale." Mine is not highlighted. "Rationale for another controlled-release opioid 18 goal was to produce the best product we could, and we 18 analgesic." And do you see the first sentence below 19 19 that? believed when we started it and subsequently ... 20 A. Oh, I see. That's a cross-title. 21 Q. No, no. 21 Q. Yes. 22 A. We believed it was and is a better 22 A. I was looking at the text. 23 Q. And the text below that says, Should I stop? 20 23 24 25 product than MS Cantin. Q. Here's a memo dated -- to Richard S. Sackler from Robert Kaiko. 24 "MS Cantin may eventually face such serious generic 25 competition that other controlled-release opioids must Page 26 Page 28 1 Do you know Dr. Kaiko? 1 2 A. be considered. Other pharmaceutical firms are thought 2 to be -- to also be developing other I do . 3 Q. He's a Ph.D.? 3 4 A. He is. 4 5 Q. What was his role? 6 A. He was the person who undertook or ran controlled-release opioid analgesics." Did I read that correctly? 5 A. You did. 6 Q. And was that a concern at that time? 7 the project and was involved -- the project of 7 A. It was a secondary or tertiary driver. 8 developing OxyContin -- and was -- as a clinical 8 Q. And then if you'll turn to the next 9 pharmacologist was deeply involved in selecting 9 1 o formulations that would be most likely to achieve the 11 desired effect. 12 Q. 13 1 o that. It says, "While we have reason to believe that 11 other pharmaceutical firms are formulating 12 controlled-release morphine and controlled-release And under here it says, "Rationale for 13 Another Controlled-Release Opioid Analgesic." hydromorphone, there is no evidence to date that this 14 is being done with Oxycodone. A controlled-release This is Bates number -- it's actually 14 15 page and look at the second paragraph. And I'll read 15 Oxycodone is, thus, less likely to initially have got two Bates stamps. So it's PDD9520805292. 16 generic competition." 16 But it says, "Rationale for Another 17 Controlled-Release Opioid Analgesic: MS Cantin may Was that a consideration when deciding 17 18 eventually face such serious generic competition that 18 to come out with Oxycodone -- or OxyContin? 19 19 A. Not for me. 2 o Other pharmaceutical firms are thought to also be 20 Q. All right. Now, we read your 21 developing other controlled-released opioid 21 paragraph 11 where you discuss that you had limited 22 analgesics." 22 role in the -- other controlled-release opioids must be considered. MR. STRAUBER: Mr. Thompson, if you're 23 23 24 reading from a document, could you show it to the 24 25 witness? 25 Coulter Reporting, LLC MR. DANFORD: Do you have a copy of that so he can take a look at that? MR. THOMPSON: Yes. Paragraph 11. www. cou lterreporti ng. com 502-582-1627 Page: 8 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 31 Page 29 deposition. (DEPOSITION EXHIBIT NO. 1 MARKED) 4 And this declaration said that you Q. 5 6 MS Contin, to pay perhaps more attention than I 2 thought she was paying to the prospects of potential Let's make this Exhibit 1 to the 2 3 1 (Passing document.) 1 3 for OxyContin. So this was in the spirit of 4 motivating her. It was true that I was very gladdened 5 6 were not directly involved with the day-to-day to see that OxyContin was meeting with so -- with such 7 marketing or promotion of OxyContin, the training or 7 a strong positive reception by both physicians and 8 management of Purdue sales representatives, or the 8 patients, and I was working hard at the business. But 9 it -- if you -- you would misinterpret this if you 9 scientific research into the conversion ratio of 1 o thought that I was working only on OxyContin. That 1 o MS Contin to OxyContin. Is that correct? 11 A. That is correct. 11 was not the case. 12 Q. I want to show you an e-mail. Let's 12 13 encouraged by the number of physicians that were 13 mark this Exhibit 2 to the deposition. (DEPOSITION EXHIBIT NO. 2 MARKED) 14 Okay. When you say you were Q. 14 selling it -15 A. Prescribing it. 16 emphasizing "directly involved." I didn't do any of 16 Q. -- prescribing it, you were not aware 1 7 the work. I didn't do any of the training. I was not 1 7 at this time, were you -- or were you aware -- that 18 a salesperson. 18 your company was committing a felony in how they were 15 I need to just clarify. I'm A. 19 Q. Okay. 19 marketing and branding the drug? 20 A. But as a senior executive, I certainly 20 MR. STRAUBER: I object to the form of 21 was aware of what was going on and I consulted with 21 the question. 22 other senior executives about what was going on and 22 23 what should be going on and so on. 23 saying. And when I say I was heartened by physicians' 24 reception, when I did speak to physicians at 25 meetings -- I didn't go on sales calls -- but at some 24 25 Okay. And then this e-mail that was Q. just handed to you a few moments ago says -- again, I was not aware at all of what you're A. Page 30 1 Page 32 1 meetings and conferences, they were extremely it's Cornelia Hentzsch. It's dated May 29th, 1999. 2 It says -- if you'll read the highlighted portion. It 2 enthusiastic about the effectiveness and the safety 3 3 and the reception their patients had, the response says -- this is an e-mail from you to her, correct? 4 A. Yes. 4 they had to the product. That was what I was 5 Q. It says, "You won't believe how 5 referring to. Because, as I had told you before, our 6 committed I am to make OxyContin a huge success. It 6 goal was to make a better product than MS Contin, and 7 is almost that I dedicated my life to it. After the 7 I believe we -- this was one of the ratifications of 8 initial launch phase, I will have to catch up with my 9 8 private life again." MR. THOMPSON: Let's mark this Exhibit 9 Did I read that correctly? 10 that. 10 3. 11 A. You did. 11 (DEPOSITION EXHIBIT NO. 3 MARKED) 12 Q. When you say you dedicated your life 12 MR. STRAUBER : May I have a copy? 13 MR. ELLIS: You already have it. 14 what were your day-to-day activities with respect to 14 MR. STRAUBER: The witness has it. 15 OxyContin? 15 I'd like to have a copy . 13 to it and that you have no time for your private life, 16 A. May I read the -- the whole document? 1 7 I haven't seen this for 16 years. 18 Q. Have you read your deposition in the 19 Endo litigation? MR. ELLIS: I think you have it in 16 1 7 front of you and your hand is physically on it. MR. STRAUBER: You tell me. I don't 18 19 see it. 20 A. No . In preparation for this? 20 MR. ELLIS: You're holding it. 21 Q. Yes. 21 MR. STRAUBER: I'm holding 1 and 2 . 22 A. No. 22 23 The context of this was to encourage your hand on. We may have just marked it twice. That may be the problem. 24 Dr. Hentzsch, who was the head of the Australian 24 25 business and was meeting with great success with 25 Coulter Reporting, LLC MR. ELLIS: That e-mail that you have 23 MR. STRAUBER: You've marked it twice. www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page: 9 Richard Sackler, M.D. Page 33 1 2 MR. ELLIS : Yeah. 3 MR. STRAUBER: Okay. Then I have it 4 5 Page 35 3 and 2 are the same? because I have 2. 2 investigation as soon as you learned there was a 3 problem? 5 weeks. I can't recall. It was 16 -- 15, 16 years ago. 6 later on, but you're aware that Purdue pied guilty to 6 7 a felony charge of misbranding a drug, which was 7 8 OxyContin, with the intent to defraud or mislead? You 8 9 are aware of that, correct? 9 MR. STRAUBER: That is Purdue -- that 10 11 is -- pursuant to your earlier statement, that is 12 Purdue Frederick; is that right? 13 14 15 16 A. Yes. With in -- within months or A. 4 And we'll get into this a little more Q. And did you-all launch this Q. 1 Q. Do you -- who is Michael Friedman? A. Michael Friedman is the -- was at that time the head of sales and marketing. Have you seen his presentation Q. 10 11 At Purdue that he - - do you know what At Purdue is, 12 your-all's internal newsletter that goes out to all MR. THOMPSON : Yes. 13 the employees? MR. STRAUBER: Okay. 14 Okay. So when you said "Purdue," you 15 At Purdue from him . meant Purdue Frederick? 16 I don't believe I saw a presentation A. All right. We'll get to that later. Q. Q. Purdue Frederick Company, Inc. 18 A. Yes, I am aware. 18 1992, "Meeting with Shionogi held Wednesday July 24th, 19 Q. Did you -- is it your understanding 19 1992" from Dr. J.W. Watkins, and there's a 17 This is a memorandum dated July 15th, 17 2 o that the fraud only occurred with respect to the 2 O distribution list. 21 Purdue Frederick Company and not with respect to 21 22 Purdue Pharma, L.L.P.? 22 23 24 25 That's my understanding. But I'm not A. 23 an attorney and that's a very deep legal question. 24 Did you do any investigation to find Q. 25 I'll assume you are Dr. R.S. Sackler; is that correct? A. That would be me. Q. And if you would turn to page 6 of this document that is PDD1701546226. And to give it a Page 34 Page 36 1 out whether sales reps employed by Purdue Pharma were 1 little context, Shionogi, is that a Japanese company? 2 exceeding what they were allowed to do when they were 2 A. It is. 3 marketing, that they were making claims that were 3 Q. And at one time were you-all talking 4 untrue? 4 about doing some sort of business with them involving 5 potentially OxyContin Controlled-Release? MR. STRAUBER: Objection to form. He 5 6 can answer. 7 A. 8 When you say "you," are you referring to me personally or are you referring to the company? 9 Q. I'm referring to you personally. 10 A. I did not conduct or manage any 6 A. Yes. 7 Q. And did you do business with them 8 involving OxyContin Controlled-Release? 9 A. Yes. 10 Q. Let's look at page 6, if you would, 11 investigation. But from the time we learned at top 11 the -- it looks like maybe the third paragraph down 12 management levels that there was an abuse and 12 that begins with "Dr. Kaiko .. . " Do you see that? 13 diversion program, which was years before the 13 A. Yes. 14 settlement with the government, we launched multiple 14 Q. "Dr. Kaiko presented two options 15 investigations both with inside resources and people 15 16 and with external attorneys and others to identify -- 16 17 and this was before any charges were made -- to 17 18 identify if we had in any sense mislead or caused this 18 19 to happen. 19 20 More important, we spent enormous 20 identified for positioning OxyContin AcroContin ... " Now, is that the controlled-release? A. That was our working title of the controlled-release system. Q. " ... versus MST Contin Tablets in the U.S. The first was relevant if PF" -- who is PF? 21 resources to try to mitigate the problem whatever the 21 A. Purdue Frederick. 22 cost was, and that effort, which was launched sometime 22 Q. -- "did not suffer substantial erosion 23 in 2000 or 2001, continued right through the period 23 of its MS Contin market by generic competition. This 24 that you're referring to of the plea with the U.S. 24 envisioned using Oxycodone AcroContin Tablets over the 25 government. 25 entire spectrum of pain in patients whose treatment Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 10 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 39 Page 37 1 1 had been initiated with this product, whilst MS Contin 2 Tablets would be used as therapy for chronic severe 3 pain in patients who were changed from other 4 medication including Oxycodone AcroContin Tablets. 5 "An alternative scenario would apply 6 if MS Cantin Tablets were subject to erosion by Did I read that correctly? 2 7 generic competitors. In this case Oxycodone 3 A. You did . 4 Q. And who is Lydia Johnson? 5 A. I don't know. 6 Q. This department, it looks like it's 7 the marketing department; is that right? 8 AcroContin Tablets would be promoted for use across 8 9 the entire pain spectrum, including those patients who 9 I just see a distribution list. I A. don't see a source. I don't know -- it says that the 1 o department is marketing, but I don't know Lydia 10 might otherwise receive controlled-release morphine." Did I read that correctly? 11 efforts now to a successful launch of OxyContin." 11 Johnson. Was it your belief that it was of 12 A. You did . 12 13 Q. Okay. And was it your intent to 13 extreme timely importance that OxyContin be Q. 14 promote OxyContin Controlled-Release across the entire 14 established because AB generics were going to arrive 15 pain spectrum? 15 and compete with MS Cantin? 16 A. No. 1 7 which is where Shionogi either had or was negotiating 17 Q. All right. Let's mark this as 18 a license for OxyContin. 18 Exhibit 4. A. 16 Q. 19 Where? You're referring to Japan, Was it also your intent in the U.S. to 2 o promote it across the entire pain spectrum? A. 21 It was our hope that it would be 19 MR. STRAUBER: We already have a 4. 20 MR. THOMPSON: Then this would be 5. (DEPOSITION EXHIBIT NO. 5 MARKED) 21 Dr. Sackler, do you know how much 22 well-received for pain -- moderate to severe pain 22 23 23 money to date has been generated by the sale of 24 OxyContin? requiring opioids. 24 25 MR. THOMPSON: Let's mark this as Exhibit 4. 25 Q. I don't understand the question, money A. Page 40 Page 38 Q. 2 3 1 (DEPOSITION EXHIBIT NO. 4 MARKED) 1 And here is PDD9524706426, OxyContin 2 3 launch team memo dated 3-31-95. And OxyContin was actually launched in 4 5 January of '96; is that correct? generated. How much money has Purdue Frederick or Q. Purdue Pharma made off the sale of OxyContin? 4 A. I don't know. 5 Q. There was an article last month in 6 A. That sounds correct. 6 7 Q. And what this says -- if you will turn 7 to Forbes 2015 List of the Richest U.S. Families." 8 to page -- first of all, let me ask you this. Have you seen that? 8 Do you recall having any significant 9 Forbes. "The OxyContin Clan. The 14 Billion Newcomer 9 A. I have seen it once. Q. Do you know what percentage of Purdue 1 o problem with MS Cantin with respect to addiction, 10 11 abuse, diversion or any of the problems that you 11 Pharma sales is made up of OxyContin? 12 12 A. Presently? 13 Q. Yes. 14 A. Approximately two-thirds. 15 Q. I've looked at the -- 16 the last paragraph. It says, "Our meeting ended with 16 A. That's Purdue Pharma's sales. 1 7 a question and comment period. Michael Friedman 17 Q. Sales. Purdue Frederick does not sell 18 emphasized the threat that AB-rated generics posed to 18 anymore, correct? 19 experienced with OxyContin CR? A. 13 I -- I recall never hearing about 14 that. 15 Q. All right. So let's look at page 2, 19 A. No. 2 o be launched, but we don't think it will be until 1996. MS Cantin. We're not sure when AB-rated generics will 20 Q. You've got another -- a number of 21 Inevitably, AB-rated generics will arrive, and this is 21 22 why it is of extreme timely importance that we must 2 2 OxyContin, correct? other entities that generate income from the sale of 23 establish OxyContin. qxyContin can cure the 23 A. Overseas . 24 vulnerability of the AB-rated generic threat, and that 24 Q. Yes. And do approximately 90 percent 25 is why it is so crucial that we devote our fullest 25 Coulter Reporting, LLC of the profits of the company come from OxyContin? www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 11 Richard Sackler, M.D. Page 41 2 A. 4 Q. 7 9 3 I don't believe it would be 90 4 5 Do you currently make over a billion 9 MR. THOMPSON: Yes. 10 11 A. No, I don't. 11 12 Q. All right. Does Purdue Pharma make 12 13 over a billion dollars a year? 14 be that much. 16 Q. 17 6, I'm sorry. Exhibit 6, PKY1738172006, appears to be a profit calculation for a Purdue entity. Can you tell me which entity that is? If it's not on the document, I A. couldn't possibly tell you. Did Purdue Frederick still exist in Q. 13 I'm not sure. I don't think it would 15 MR. ELLIS: 6 . Q. 8 By "you," now you're talking about Dr. Sackler? A. This appears to me - - what's been marked as Exhibit 5, it's PKY -- 7 MR. STRAUSER: Objection to the form. 10 (Passing document.) Q. 6 dollars a year selling OxyContin? 8 (DEPOSITION EXHIBIT NO. 6 MARKED) 2 MR. THOMPSON: Purdue Pharma. percent, but it is certainly a majority. 6 I don't know. A. 1 company"? You're referring to now Purdue Pharma? 3 5 Page 43 MR. STRAUSER: Question. "The 1 14 2006? Let's talk about gross sales. Are gross sales over 3 billion dollars 15 A. I'm not clear. I think it did. 16 Q. This appears to be a profit 17 18 a year? calculation for OxyContin Tablets only. Do you see 18 that? 19 A. No, they're not. 19 A. I do. 20 Q. What are the gross sales? 20 Q. And it appears that at least by 2006 21 A. Well, I think what you're looking for 21 profit contribution was 4 million -- 4,718,767,000. Is that correct? 22 is net sales. Because in the industry a lot of money 22 23 is inherently rebated back to purchasers, insurance 23 24 companies, hospitals, et cetera, through wholesalers 24 25 in rebate agreements, which are negotiated . So I 25 Q. And what would you subtract from that? A. All of the money that was invested in You've read the number correctly, but A. profit contribution is not profit. Page 42 Page 44 1 believe the net sales are in the range of, this year, 1 2 a billion dollars. 2 the business to develop new products. That would be a 3 major deduction from that. MR. STRAUSER: Your question was 3 4 directed to Purdue Pharma? 5 4 MR. THOMPSON: Purdue Pharma. 5 6 A. Right. 6 7 Q. Are there any other Purdue entities 7 8 that make money that would not be included in that one 8 9 9 10 billion dollar sales? A. Not -MR. STRAUSER: Objection to the form 11 12 of the question. You can answer. 13 14 A. Not in the United States. 15 Q. Do you know how much the Sackler 16 family has made off the sale of OxyContin? Let's mark this -- well, let's -- Q. you're right, I think it is. Look up at the top where it says, "Gross profit 7,502,367,000." Just a second. Small type. Just a A. second. "Gross Profit." I see "Gross Sales." I see 10 "Rebates," and then "Net Sales." Okay, I'm with you 11 on "Gross Profit." 12 Okay. So deducted from that is Q. 13 shipping, warehousing. You have 536 million paid to 14 Abbott for co-promotion commission? That's correct. 15 A. 16 Q. You have an S&P expense. What's that? 17 A. I don't know. 17 A. Sales and promotion. 18 Q. But fair to say it's over a billion 18 Q. All right. That was 141 million on 19 dollars? 19 sales and promotion; is that correct? 20 A. It would be fair to say that, yes. 20 A. 21 Q. Do you know if it's over 10 billion 21 Q. R&D expense, 308 million? 22 A. Right. And I'm looking for the 22 dollars? That's correct. 23 A. I don't think so. 23 24 Q. Do you know if it's over 5 billion 24 Q. Sales force. 25 A. Yes, I see that. But can I explain? 25 dollars? Coulter Reporting, LLC number. I'm sorry. www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 12 Richard Sackler, M.D. Page 45 Page 47 1 That's the R&D associated with the product. Right. Q. 2 1 approximately 95 percent of the patients out there 2 could be treated with MS Cantin? 3 A. Not the R&D for other products . 3 A. No. 4 Q. Right. And then sales force is 960 -- 4 Q. Do you disagree with that statement 5 that -- 5 or 87,222,000 that they've been paid? A. That's what it says. 6 A. I do. I disagree. 7 Q. And then it's got a G&A expense. What 7 Q. What percentage do you think of 8 is that? 6 8 patients could be adequately treated with MS Contin? 9 A. General and administrative. 9 A. Between 50 and 75 percent. 10 Q. All right. 492 million? 10 Q. And what studies are you basing that 11 A. Yes. Over how many years? '96 to 11 on? A. I'm basing it on general experience of 12 2005. So it's nine years. Am I counting correctly? Q. 13 12 You are. Then there is product liability and 14 13 being involved with MS Cantin and OxyContin since 14 1980. 15 patent litigation expense. You had OxyContin 15 16 litigation expenses. Then you have profit after all 16 determine what percentage of patients could be 1 7 those are subtracted on OxyContin of 4,718,000,000. 1 7 adequately treated with MS Cantin? 18 Is that correct? 18 A. I don't remember any. 19 Q. Okay. Did you ever do any studies on A. 19 That's what it says. I can't testify 2 o that that's correct, but that's what it says. Did you ever do any studies to Q. 20 abuse liability for OxyContin before you-all put it on MR. THOMPSON: Let's mark this as 21 the market? 22 Plaintiff's Exhibit 6. I think we've already marked 22 A. I'm not aware of any. 23 it. 23 Q. Let me show you what's been identified 21 24 by Bates stamp PDD8801123847. We'll mark this MR. DANFORD: We've been going about 24 25 Plaintiff's Exhibit 7. 25 an hour. Page 48 Page 46 MR. THOMPSON: I try to go a little 1 2 bit longer. I mean, if you all need a break, we can 3 THE WITNESS: I need to take a break. at 10:06 a.m. 7 (RECESS) 8 VIDEOGRAPHER: We are back on the 9 record at 10:18 a.m. 12 Q. (Passing document.) 5 MR. STRAUBER: May I have a copy? 6 MR. ELLIS: I'm getting one. 7 (Passing document.) 8 MR. STRAUBER: Thank you. And does this appear to be a memo to Q. 9 10 BY MR. THOMPSON: 11 this? 4 VIDEOGRAPHER: We are off the record 5 6 3 And I'll ask you if you can identify Q. 2 take a break, but ... 4 (DEPOSITION EXHIBIT NO. 7 MARKED) 1 10 you from Paul Goldenheim? All right. Dr. Sackler, I want to ask you about one more thing in Exhibit 4. 11 A. It is. 12 Q. And who is Paul Goldenheim? A. At the time he was head of Research 13 (Passing document.) 13 14 And if you look at the second 14 15 paragraph, there's a comment that says, when and Development. Okay. And just to kind of walk Q. 15 16 discussing Oxycodone AcroContin, which is 16 through this memo. From the bottom down there, it 17 1 7 looks like you had sent a memo on March 14th of '97 to controlled-release Oxycodone -- 18 A. I'm sorry. Just -- page what? 18 a number of individuals at -- 19 Q. The first page, second paragraph. 19 A. I'm looking for that. I'm looking for 20 A. Okay. 2 o my -- oh, from me. Okay. I see that. Okay. I'm 21 Q. It says, "The molecule lacks the 21 sorry. I see now. It's two e-mails. Okay. Thank 22 stigma of morphine and may be of particular advantage 22 you. 23 in the five percent, approximately, of patients who 23 24 cannot be adequately treated with morphine." 25 Was it your understanding that Coulter Reporting, LLC Q. And the paragraph at the bottom says, 24 "The BfArM," what is that? 25 A. That was the German regulatory agency www.coulterreporting.com 502-582-1627 Page: 13 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 51 Page 49 1 at that time. It says, "Were asked whether OxyContin Q. 2 3 to be classified as a controlled drug or whether it 2 the subject of "Is this an opening to descheduling the 3 agent?" 4 would be possible to obtain a relaxed status because 4 5 of the difficulty in extracting Oxycodone from the 5 6 matrix and the fact it was less liable to abuse 6 7 because it was unknown." 7 So just dialing down on that first 8 9 1 o be Jess regulated in Germany; is that correct? A. 11 And descheduling means make it less restrictive, correct? 11 That -- that's how I would understand Q. And if it's less restricted, would you think that you could sell it to more people? It would be easier for physicians to A. 10 I believe that I was reporting A. it. 8 9 sentence, you were wondering whether Oxycodone could And then Dr. Goldenheim writes back on Q. 1 prescribe it. 12 something to Paul that I must have heard, but I was 12 Q. It's going to increase sales? 13 not involved in making any discussions or meetings 13 A. That is reasonable because they could 14 with BfArM. 14 15 16 17 Okay. 15 Schedule II, as are some drugs, physicians could A. Can I -- may I just read the rest of 16 it if we're going to continue on this? And his response is, "We do not have Q. 18 any abuse liability studies." 19 it to you. And this is as of 1997, correct? 19 The next sentence says, "The BfArM" -- 20 prescribe by telephone. 17 Sure. I'll tell you what, I'll read Q. 18 prescribe it -- if it were Schedule III instead of Q. 21 B-f-A-r-M -- which I understand is the German 22 regulatory authority? 20 A. That's correct. 21 Q. To date have you done abuse liability 22 studies? 23 A. That's correct. 23 A. 24 Q. -- "answered that unfortunately 24 Q. When were they done? 25 A. I don't know when the first ones were 25 OxyContin would definitely be classified as a Yes; many. Page 52 Page 50 1 controlled drug for all strengths as is morphine. 1 done, but they were done repeatedly for many 2 2 formulations subsequently of both Oxycodone and of There could be no exception because of the 3 controlled-release protection because there had been a 3 other abusable opioids, both in controlled - release 4 few reports of abuse and there were limited data on 4 form and in immediate-release form. 5 long-term use." 6 6 7 A. You did. 7 8 Q. Okay. And then you have here in caps, 8 9 "We have a lot of use data in the U.S. with very, 1 o very, very few ADEs." for OxyContin Controlled-Release? I don't -- yes, the new -- the new A. formulations definitely. 9 Q. And when were those done? 10 A. I don't know exactly. But before the 11 What are ADEs? 11 Have you done abuse liability studies Q. 5 Did I read that correctly? products were submitted to the agency. 12 Q. You're saying the new formulations? 13 A. The new formulation. 14 All adverse drug experiences are reportable to the 14 Q. When were the new formulations 15 submitted? A. 12 13 Those are reports to the agency, to the FDA. And ADE stands for adverse drug experience. 15 agency. Anything we are aware of we must report 16 periodically. Anybody else, however, can also report 16 17 ADEs to the agency. And so the agency maintains a 17 2008 . 18 catalog for every drug of ADEs . 18 Q. Okay. 19 A. But I could be in error by a year or Q. So by 1997, two years after this Q. 19 And then you have in caps, continuing, A. 2 o "We can run another long-term trial to get more data, 20 two . 21 and if the abuse potential is equal or lower than with 21 22 another nonscheduled drugs, would BfArM unschedule 22 23 it?" product was on the market, he says, "We do not have 23 any abuse liability studies. I think this is a dead That's your question, correct? 24 25 I'm doing this from memory now. About A. That was a question. Coulter Reporting, LLC 24 end. Adding naloxone, I think, is the only 25 possibility, but this is a difficult project from the www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 14 Richard Sackler, M.D. 8/28/2015 Page 53 1 Page 55 clinical perspective. We are investigating for 1 2 Oxycodone." Was that his response? 3 2 THE WITNESS: Pardon? 3 MR. ELLIS: I've highlighted your 4 A. That is what he wrote. 4 5 Q. He's basically saying they're not 5 6 going to deschedule this? 6 Unless -- perhaps they might if it A. 7 Q. And naloxone is an additive? 10 A. It is - - it is a reversal agent. It MR. ELLIS: These are the -- this is the way this document was produced to us. The reason 13 two pages is because Purdue produced a totally random 14 document in between it. But if you look at the Bates We subsequently did in some markets. A. MR. STRAUSER: Yeah, I'm not sure that all the pages have been assembled properly. 12 that there's a skip in the Bates range from the last 13 naloxone, correct? 14 MR. DANFORD: Can we organize those? 10 11 And you-all did not incorporate Q. 2-27 . It's not -- oh, it's the middle A. page for me, not the last. Okay. Yep. 8 9 11 blocks the effect of opioids. 12 e-mail. 7 8 incorporated naloxone. 9 you, Dr. Sackler. 15 In Europe in particular and to some extent elsewhere. 15 numbers of the original Bates stamp on this document, 16 Q. Did they require you to do that? 16 they're consecutive among those pages in a consecutive 17 A. No. We did it for another reason. 17 18 Q. What was the reason? 18 19 A. We discovered that it did not block 19 removing the completely erroneous page that has e-mail chain. So I have taken the liberty of 2 o the effect of the opioid apparently at all, but it did 2 o nothing to do with this e-mail chain and produced it 21 reduce the gastrointestinal side effects dramatically, 21 22 including constipation, which is the most common side 22 23 23 that. The question is if he has a different 24 formulation. effect for any opioid. I could add that by the time we had a 24 25 full press to develop an abuse-resistant form of to the witness. MR. DANFORD: My question is not about MR. ELLIS: No. He's got the same 25 Page 54 1 Page 56 OxyContin we did do extensive work with another 1 document. 2 antagonist called naltrexone, and naltrexone did, when 2 3 it got released, block the effect of the opioid. But, 3 trying to make sure that we're all working from the 4 unfortunately, after a huge investment, we could never 4 same document here. 5 be certain that it wouldn't be released when it was 6 7 perfect because the agency said that if it released 7 and blocked the effect of the opioid in patients, they 9 would not approve it and we could not reach 8 11 Q. MR. STRAUSER: That's it (indicating). I had to look for it. I expected it A. at the end, but it wasn't. Okay. Yes. It says -- this is from Walter Wimmer Q. 9 1 o perfection. So if you'll go to the 2-27-97 e-mail. Q. 5 6 taken orally. It was almost perfect, but it had to be 8 MR. STRAUSER: Exactly. We're just 1 o at Mundipharma-Germany. Let me show you an e-mail chain that's And that's a company that's owned by 11 12 been produced. I'll mark this. 12 the Sackler family, correct? (DEPOSITION EXHIBIT NO. 8 MARKED) 13 A. 14 Q. And who is Walter Wimmer? 15 at the back, I believe, this e-mail chain begins at 15 A. He was the general manager at that 16 the back. And this is an e-mail from you dated -- the 16 Q. And he says, "Dear Bob." First 13 14 Q. It's PDD29520806439. And if you start It is. time. 1 7 last e-mail is the first e-mail, and it's dated 17 18 3-2-97. 18 paragraph. "In the course of this conversation he 19 A. Wait_. I'm seeing 3-11-97. It's sort 2 o of a little out of order, isn 't it? 21 Q. I'm sorry, yeah. There is -- mine 22 tore off. 19 explained to you that due to his discussions with 2 o BfArM he does see a 50 percent chance to get OxyContin 21 off the narcotic drug status provided you could give 22 some information on the very low abuse potential of our CR formulation." 23 A. Oh, no, 3-12-97. 23 24 Q. 2-12-97 is the first. 24 25 MR. ELLIS: I've highlighted it for Coulter Reporting, LLC 25 Did I read that correctly? A. You did. www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 15 Richard Sackler, M.D. Page 57 Q, 1 Page 59 And then in response to that, if you Were you aware at that time that 1 2 go up to the top, Dr. Robert Kaiko has an e-mail dated 3 2-27-97. 2 OxyContin -- there was a concern that Oxycodone 3 opioids could be injected or abused? 4 A. He does. 4 5 Q. And he says, "While my thinking is 5 remember whether I had read the whole chain carefully or not or even saw it. I don't remember this memo and I don't A. 6 still developing, frankly, I'm very concerned, and I 6 7 would have to recommend against the uncontrolled but 7 8 monitored proposal at this time. (Perhaps if only to 8 acknowledges" -- by "dossier," I assume he means the 9 make sure the risks are appreciated and accepted 9 documents -- 1 O before we proceed as proposed)." 11 Do you know what risk he was Then he says, "Our dossier Q. 10 A. Yes. 11 Q. -- Purdue has? 12 discussing? 12 A. Yes. 13 A. I have no idea. 13 Q. "Our dossier acknowledges a small 14 Q. Did you ever discuss with him why he 14 15 was recommending against going uncontrolled but 16 handful of patients in our research program" -- and 15 that means studies you-all were doing; is that monitored with respect to OxyContin? 16 17 A. I don't even know what it means. 17 18 Q. All right. 18 19 A. If I read the rest of it, do you think 19 2 o it would give me a clue or -- I infer that because you correct? That's -- that's what I would A. understand it would mean. -- "who were suspect in terms of their Q. 2 o drug accountability." 21 didn't highlight it, you don't think it would shed any 21 22 light on what was meant above? 22 anyone, that your-all's dossier had a handful of 23 patients who were suspect in terms of their drug accountability? 23 Q. Well, let's read the rest of it. It 24 might help. He says under paragraph B, "I don't 24 25 believe we have a sufficiently strong case to argue 25 Do you know if that was reported to I don't know if it was reported, but A. Page 58 1 Page 60 that OxyContin has minimal or no abuse liability." 1 I'm confident it was . If it was an FDA-submitted This is dated 1997, correct? 2 3 A. Yes. 4 Q. He says, "In the U.S. 2 trial, it would have been in either the safety summary ·3 4 or the -- or the efficacy summary, or both. Do you remember the issues with the Q. 5 Oxycodone-containing products were once less 5 Roth reprint where there were patients who they 6 controlled than now. Abuse resulted in greater 6 determined had withdrawal symptoms and that was not 7 controls." 7 reported? Is that accurate? 8 9 A. I believe it is. 10 Q. And what he's saying there is, these MR. STRAUBER: Objection to form. 8 9 A. No. I'm sorry. 10 Q. Are you familiar with the Roth 11 weren't as controlled at one time and they got abused, 11 12 12 and that's why we have controls now, correct? reprint? A. No. Q. Do you know whether that was part of 13 A. I believe that is the case. 13 14 Q. He says, "Oxycodone-containing 14 the plea agreement that Purdue Frederick had when they 15 pied guilty to a felony? 15 products are still among the most abused opioids in 16 the U.S. This information is available to BfArM, the 16 A. I don't -- I don't recall. 17 17 Q, And it says under paragraph C, 18 19 German regulators." A. I -- that's certainly true that the 18 continuing on, "We do not" -- "We do not have a information would be available to them. 19 post-marketing abuse monitoring system and database And he says, "The local tissue 20 from which we could conclude that diversion abuse is 21 necrosis that can result from injection of OxyContin 21 not occurring." 22 'fixed' for such abuse is not likely to be a deterrent 22 23 to abuse. Let us not forget that in New Zealand MST 23 20 Q. Were you aware that you-all put this on the market, OxyContin CR, and did not have a 24 is the most common sources of parenterally abused 24 post-marketing abuse monitoring system or database 25 morphine/heroin." 25 from which you could tell whether abuse or diversion Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 16 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 63 Page 61 1 was occurring? I was not aware of that. I don't A. Q. 1 And this is your response to Robert 2 Kaiko saying this is a bad idea for all these reasons. 3 believe it was a requirement at the time. I'm sure we 3 And you say, "This is the first time I've heard of 4 would have fulfilled all the FDA requirements that 4 this idea. What makes us believe that we can 5 they asked us. 2 7 Do you think it would have been a good Q. 6 5 accomplish it, Walter? How substantially would it 6 improve your sales?" And what you're talking about there is idea before putting OxyContin Controlled-Release on 7 8 the market to have an abuse monitoring system and 8 9 if we can get it uncontrolled in Germany, how 9 substantially will it improve sales, correct? database from which to tell if it was being diverted 10 or abused? Yeah. Yes, that was -- it would A. 10 11 A. Absolutely, yes. 11 appear that that's what my question was. 12 Q. And then under paragraph C it says, 12 "Please give a five-year projection Q. 13 "If OxyContin is uncontrolled in Germany, it is highly 13 with control and without. Does each member of the 14 likely that it will eventually be abused there and 14 EU" -- is that the European Union? 15 then controlled. This may be more damaging to 15 A. Yes. 16 Q. -- "decide this for themselves or 16 OxyContin internationally than any temporarily higher 1 7 sales that could be gleaned from an uncontrolled 1 7 would one lead? If one would lead, then is Denmark or 18 status. Let us not forget the experience with 18 Germany more likely to agree?" 19 buprenorphine, which was initially uncontrolled. 19 2 o Reports of abuse in Germany in part eventually led to 20 writes you back on March 7th and says, "Dear Dr. Richard" -- 21 lots of bad press and controlled status. Worldwide 21 22 sales suffered even where buprenorphine had already 22 23 been controlled. So, given the above, what do others 23 24 have to offer that should prompt us to pursue the 25 proposal for uncontrolled status for OxyContin And then Harry Kletzko of Mundipharma A. Just a second. Now we're on page 1 or 24 Q. That's the same page. The one right 25 above. 1 A. Okay. Q. "Please find stated below our 27 Page 62 Page 64 1 anywhere?" And was that the response of Robert 2 3 Kaiko? 2 3 five-year projection of OxyContin without and with controls as requested." 4 A. It appears to be so. 4 5 Q. And who was Robert Kaiko? 5 A. He was in charge of the development 6 7 program of OxyContin. 6 7 A. Uh-huh. Q. And it was projected that with first year non-narcotic -- narcotic drug with control would 8 Q. Was he the chief medical officer? 8 be 3.000 TDM. Do you know what that is? 9 A. No. But he was -- he was respected. 9 10 His opinions were respected and were heeded. Q. 11 12 from you, is Dr. Richard Sackler at Norwalk. A. 13 14 And then the next e-mail, which comes Give me just a little time to find it since they're not in order. Okay, Norwalk. And could 15 you read the date, please? I assume total or something A. 1 o Deutsch marks. Something Deutsch marks. 11 Q. And that would be 3 million? 12 A. That would be my understanding. 13 Q. And then turnover non-narcotic drug 14 without control is 10 million? 15 A. The first year. Q. The first year. And on the fifth year 16 Q. It looks like it's 3-2-1997. 16 17 A. 3-12. 3-12-97? 17 18 Q. I'm looking at 3-2. It says 02-03-97, it was projected to be 18 million with control but 30 18 million without control, correct? 19 but I think the way it's computed, it's really March 19 A. That's what it says. 20 20 Q. And then you wrote back on 3-8-97, 21 22 3rd. A. Okay. I see something from 3-12. I see something from 11- 3- 97. 23 Q. It's page 5, Maybe that will help. 24 A. Oh, I don't think I have page -- oh, 25 page 5. Okay. Thank you. Coulter Reporting, LLC 21 right above that one, and it says, "BK advised that 22 the regulatory authorities did say" -- 23 A. RK. BK. I'm sorry. I heard DK. 24 Q. -- "advised the regulatory authorities 25 said that Oxy would be scheduled and so it would be "'(WW.coulterreporting.com 502-582-1627 Page: 17 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page 67 Page 65 1 under narcotic control. Does this correspond to your 1 2 info? If so, is this matter now closed or is there 2 back, "Yes, Richard, this does correspond to the Let's go to the next one, which is page 4. He writes 3 some appeal or other procedure you would want to 3 information given by Mr. Goerich, our registration 4 consider?" 4 officer. We also attended the meeting with the BGA. 5 This matter is now closed. There is no way of 6 getting OxyContin CR uncontrolled and were wondering 6 appeal." 7 if there was some way you might appeal the German 7 So you still saw the advantage of 5 8 decision? MR. STRAUBER: Objection to form . 9 1 o That's not what the statement says that you just read. Q. 11 Is that what he told you? 8 A. That seems to be what he told me . 9 Q. And then you wrote back and said, 10 "When we are next together we should talk about how 11 this idea was raised and why it failed to be realized. Well, correct me if I'm wrong there. 12 Why did you say is there some appeal or other 12 I thought that it was a good idea if it could be 13 procedure you want to consider? 13 done." A. 14 Okay. This whole experience is 15 actually like reliving a third of my life, and I had Was that your response to -- 14 15 That's what it said, but I didn't mean A. 16 completely forgotten, until I saw this document, that 16 it. I just wanted to be encouraging. I was very glad 17 Walter had been very hesitant to pursue the 17 it was closed. 18 development or the marketing of OxyContin because he 18 Q. didn't believe it would sell very well. He turned out 19 there's another response from Walter Wimmer who says, 19 Up at the top there's a note -- 2 o to be completely wrong and when it was introduced it 2 Q "To get the product off narcotic drug status, it would 21 21 did extremely well. 22 23 be possible to combine Oxycodone with naloxone 22 provided the development costs weren't too high." We were of the contrary opinion, but he said -- he came back and he did quite a bit of work 23 That was sent on 3-12. 24 without any reference to anybody else on determining 24 A. Okay. Let me -- 25 or trying to get the BfArM to consider not scheduling 25 Q. And then the top one is cut off, but Page 68 Page 66 1 1 it says, "Paul, Michael. Would this be a feasible it. And this whole stream was occasioned by that. 2 We -- many of us in the U.S. were not enthusiastic 2 approach here in the U.S.? I don't know of any C-II 3 about not scheduling it. 3 narcotic that is de-scheduled when naloxone is added, 4 do you?" In Germany there is no equivalent, at 4 Was that a question you were raising? 5 least at that time that I recall, of anything like 5 6 Schedule III. You are either an abusable drug and, 6 7 thus, you had all the abusable drug controls or you 7 matter of information. As I said, they eventually did 8 were not. And we were not in favor of this, but we 8 develop that product and it was extremely successful. 9 were trying to be polite and solicitous rather than 9 At the time they researched it, they quickly It looks like I raised it just as a A. 1 o saying, this is a terrible idea, forget it, don't do 1 o discovered that naloxone didn't achieve the desired 11 11 blocking effect, but they made another discovery that 12 which we thought would be appropriate and were 12 was even more valuable . 13 13 it. Because we still felt that with the controls, appropriate obviously, it would still be very welcome, Would I be correct that Purdue Pharma Q. 14 never conducted or retained anyone to conduct studies 15 regarding addiction and physical dependency rates of 16 trail really was occasioned by that. But I don't 16 Oxycodone products at least as of March 4th, 2002? 17 remember anymore. So if we go on, I'm going to relive 17 A. I don't know the answer. 18 another few days of my life. 18 Q. Are you aware that counsel for Purdue 14 very useful to patients in the German market. So this whole stream -- this whole 15 19 Q. 19 Sure. Let me ask you. If you thought Pharma's answer to interrogatories that requested the 2 o controls were appropriate, why were you asking here or 2 o names of all individuals retained by Purdue Pharma to 21 raising the issue if there was some appeal that could 21 22 be taken with regard to the -- 22 rates of OxyContin products and copies of all studies, 23 24 25 A. Just to be polite, not to just shut 23 and he answered, "We never conducted or retained 24 anyone to conduct studies regarding addiction and Okay. Well, let me ask you this. 25 physical dependency rates of Oxycodone products." him down. Q. do studies regarding addiction and physical dependency Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 18 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 71 Page 69 MR. STRAUSER: Mr. Thompson, if you're 1 Do you have a knowledge of what Q. 1 2 reading from a document, could you show it to the 2 Percocet and Duragesic was used mostly to treat? 3 witness? 3 Percocet and -- Percocet was an A. 4 extremely widely used product used to treat both short 5 he's aware of it because I'm trying to move the 5 and long-term pain conditions, both non-malignant and 6 deposition along. 6 malignant. MR. THOMPSON: No. I'm just asking if 4 7 Q. So are you aware of that? 8 A. No, I'm not aware of his -- his 8 paragraph 2.3. And this says 1993. It says, "Abuse 9 Toxicity Bench-Top Study - The results of a spoon" -- 9 statement. Are you aware of any studies conducted Q. 10 And then, if you'll turn over to Q. 7 11 or retained -- or anyone being retained to conduct 10 A. Okay. I see. 2.3 you said? 11 Q. Yes. 12 studies regarding addiction and physical dependency 12 A. Thank you. 13 13 Q. -- "The results of a 'spoon & shoot' 14 rates of Oxycodone products prior to 2002? I'm not aware of any or don't remember A. 14 study have been sent to the FDA." 15 any. In 2002 I was the president of Purdue Pharma, What was a 'spoon & shoot' study? 15 16 and this would not have necessarily -- this wouldn't 16 17 17 have required my approval or knowledge unless it I don't know. I could guess, but I A. don't know. Was that a study done to determine if 18 was -- it led to something that was surprising or 18 19 important and unexpected . 19 the drug could be abused by extracting Oxycodone from 2 O the tablet? MR. STRAUSER: Mr. Thompson, did you 20 Q. 21 put an -- give an exhibit number to the last document 21 22 that we were discussing, which was a series of 22 23 e-mails? 23 It's a reasonable guess, but I don't A. know the details of what that study was. And then under 3.2, the last sentence Q. 24 MR. THOMPSON: It was 8. 24 25 MR. STRAUSER: 8. Okay. Thank you. 2 5 decide such a study is needed." says, "A crushed tablet study may be conducted if we Page 72 Page 70 (Passing document.) 1 2 All right. I'm going to switch and Q. Do you know if you ever decided such a 1 2 study was needed? 3 ask you a little bit about the OxyContin Project Team. 3 A. 4 And this is a memo dated December 14th, 1993, 4 like to read it. What's the number on that? I'd just 5 PDD9520509356. There's a few paragraphs I want to try 5 Q. 3.2, the last sentence. 6 to cover here. 6 A. I'm sorry. Thank you. 3.27 7 Q. Uh-huh. 8 points on the front page, the second one from the 8 A. Yes. Okay, I've read that. 9 bottom says "Marketing: OxyContin Tablets will be 9 If you will look at the bulletin 7 I don't know if such a study was done. 1 o marketed against Percocet and Duragesic. The 10 11 OxyContin line may replace our MS Cantin line if 11 sentence says, "Mike Innaurato." Was he a guy in 12 12 charge of marketing? ' MSC generics are competing." Is that correct? 13 A. That's correct. 13 14 Q. And that's not the -- is that the 14 And then on 5.4, the very last Q. No. He was -- he worked in the A. marketing department, but he was not -- at this time 15 malignant cancer group of patients, or is that the 15 he was not in charge. He was a middle manager of 16 non-malignant cancer group of patients? 16 marketing. 17 Q. 17 A. I'm sorry? MR. STRAUSER: Objection to the form. 18 19 I don't understand the question. 20 21 Q, Go ahead, you may answer. A. MS Cantin, as I said before, was used 19 ongoing studies. Robert Reder stated that we did not, 2 o but that we could include quality of life questions in 21 future studies." 22 in treating both cancer patients and non-cancer 22 23 patients and there was no focus, I don't believe, or 23 24 consideration in this statement of whether it would be 24 25 both, I think. 25 Coulter Reporting, LLC All right. It says, "Mike Innaurato 18 asked if we had any quality of life questions in our Do you know if quality of life questions were included? A. I believe there were studies later that included quality of life measures, but I am not www.coulterreporting.com 502-582-1627 Page: 19 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 75 Page 73 1 certain of that. I am certain it would have been Correct. And if you'll look at this, Q. 1 2 favorable, but I'm not certain just what studies were 2 it says, "A literature search" -- the second 3 or were not done. 3 paragraph. "A literature search on oxycodone and 4 oxymorphone is being conducted" -- MR. THOMPSON: Let's mark that as -- 4 5 has it been marked yet? I'm sorry. It's just not very clear. A. 5 6 COURT REPORTER: No. 9. 6 Give me a second. "A literature search" -- are we 7 MR. THOMPSON: -- Exhibit 9. 7 looking at the same page? (DEPOSITION EXHIBIT NO. 9 MARKED) 8 9 8 9 With respect to Oxycodone and Q. 1 o morphine, do you know whether OxyContin is more 10 11 powerful or less powerful a drug than morphine? 11 13 It depends what you mean by A. 12 12 "powerful." No, we're not. You're on page 2, I'm Q. on page 1, second paragraph. I'm sorry. I thought you said August A. 10th. This one is August 4th. Okay. I'm sorry. Second paragraph. "A literature Q. 13 search on oxycodone and oxymorphone is being conducted by one of the summer employees." 14 Q. I think Dr. -- is it Goldenheim? 14 15 A. Yes . 15 16 Q. Was he an~employee of -- 16 17 A. Yes. 17 Q. I think he testified that -- that 18 daughter of one of the people who worked for Purdue 19 Frederick or Purdue Pharma. 18 19 Oxycodone was twice as strong as morphine. Is that 2 O your understanding? 21 22 A. 20 21 If the question -- if powerful means Do you know who was doing the literature search initially? No. It would have been a son or A. Fifth paragraph down, second sentence Q. says, "The current consideration is to develop 20, 40, potency, absolutely, it is twice as potent as 22 80 and 160 milligram tablets in addition to the 10 23 morphine. And we were very proud that we discovered 23 24 this, first in animal studies and then in human 24 25 studies, and we made it widely known perhaps even 25 milligram tablets now in the clinic." And whose idea was it to develop 20, 40, 80 and 160 milligram tablets? Page 74 Page 76 1 before the drug was introduced, but certainly in the 1 2 package insert and all the promotional material. 2 3 Q. Do you know how many doctors or what percentage of doctors thought that it was equal to or 4 5 less strong than morphine? 5 6 I would assume very few if they -- if are you reading from, Mr. Thompson? MR. THOMPSON: The first page, just 3 4 A. MR. STRAUBER: I'm sorry. Which page 6 what I called out, fourth paragraph, second sentence. MR. STRAUBER: Okay. Thank you. This was a team decision. It was A. 7 they were promoted to. I can't believe that they 7 8 wouldn't have understood that. That formed the basis 8 discussed extensively. 9 of our recommendations of dosing of the strength of 9 first paragraph, it says, "With regard to the package 10 the tablets that were developed. And, in fact, it was 10 Then if you'll go to the second page, Q. insert and the first year advertising claims, it was consistent with physicians' own experience with 11 discussed that Mr. Segar should meet with others and 12 Percocet where they would administer a 5-milligram 12 rework the 'draft' package insert. The purpose would 13 dose and they -- if they used morphine, they knew that 13 be to idealize the insert and coordinate the contents 14 5 milligrams of morphine would achieve very little 14 with the advertising claims and clinical trials 11 15 pain relief if given orally, perhaps somewhat more if 15 program. The package insert should include 16 given by injection. 16 comparative claims. It must be kept in mind this is a MR. THOMPSON: Let's mark this as 17 18 Plaintiff's Exhibit 10. 1 7 working document." 19 (DEPOSITION EXHIBIT NO. 10 MARKED) 19 20 (Passing document.) 20 21 22 Q. This is the memo dated 1992, August 10th, Oxycodone Project Team Meeting Minutes. Why did you want to coordinate the 18 package insert with your advertising claims? A. The package insert is the Bible for 21 the product. It is the core document from which all 22 promotion or communication with physicians is to be 23 A. I'm sorry, August 10th. 23 based. It is typical in the industry that a lot of 24 Q. And it is PDD9521410329. 24 work is expended to make the package insert as 25 A. 39? I have 30. The first page is 39. 25 comprehensive and complete as possible. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page:20 Richard Sackler, M.D. Page 77 Q, 1 Page 79 Then this is a -- you talked about 1 market." 2 physicians being aware of OxyContin being twice as 2 3 strong as morphine a second ago. Let me hand you -- 3 product was geared toward the non-malignant market. 4 let's mark this as Exhibit 11. 4 We knew if we priced low per milligram for the higher (Passing document.) 6 Q. 7 8 5 dosed cancer patient we would be priced way too low {DEPOSITION EXHIBIT NO. 11 MARKED) 5 This is an e-mail. It says the author is Dr. -MR. STRAUBER: May I have a copy? 9 And it says, "Our pricing of the 6 per milligram for the standard non-malignant pain 7 patient, where we really wanted to make a market. We 8 feared that the 'cancer pain experts' would object to 9 the two-to-one ratio" -- and that two-to-one ratio is 10 MR. THOMPSON: Right in front of you. 1 o the ratio of oxycodone -- OxyContin to morphine; is 11 MR. STRAUBER: I'm sorry. 11 that correct? Q. 12 13 It says the author is Dr. Richard Are you familiar with this e-mail to 14 15 Michael Friedman? understand the ratio, the two-to-one would refer to 14 the ratio of morphine to oxycodone. Okay. 16 A. Not the other way around. 17 Q. All right. He was head of marketing and sales. 18 A. That's what you -- I know that's what Okay. And let's drop down and see 19 you meant to say. 16 Yes. 17 Q. Who is Michael Friedman? 18 A. Q. 20 13 Q. A. 19 Actually, if you want to strictly A. 12 Sackler at Norwalk dated 5-28-97. 15 what Michael Friedman has written. 20 Yes. Yes. Q. 21 The first paragraph he says, "My 21 22 purpose in writing this memorandum is to clarify our 22 23 position on the very complex issues raised by Mike 23 our position for OxyContin. In any case, we're 24 Cullen during the Phase IV team meeting and which were 24 developing hydromorphone codeine" -- 25 the subject of Dr. Richard's inquiry." 25 -- "and resulting cost of therapy for high-dose patients. However, we had no choice given I've lost you here. "In any case" -- A. Page 78 2 1 A. 4 Q. That was me. All right. 2 Q. -- "for the high-dose patient." A. Okay. I'm at the end of paragraph 4. Q. And then it says, "Despite our initial 4 First paragraph. "We are well aware what paragraph are you in now? 3 that? 3 5 Page 80 When they say "Dr. Richards," who's 1 5 uncertainty, we've been successful beyond our expectations in the non-malignant pain market." 6 of the view held by many physicians that oxycodone is 6 7 weaker than morphine. We all know that this is the 7 A. Yes. 8 result of their association of oxycodone with less 8 Q. And non-malignant pain market is sort 9 serious pain syndromes. This association arises from 9 of the chronic arthritis, back pain, those types of 10 their extensive experience with and use of oxycodone 1 o patients? 11 combinations to treat pain arising from a diverse set 11 12 of causes, some serious, but most less serious. This 12 moderate pain patients, some of them may be severe. 13 'personality' of oxycodone is an integral part of the 13 But there are many less common conditions that produce 14 'personality"' -- "this 'personality' of oxycodone is 15 an integral part of the 'personality' of OxyContin. Well, those are most typically A. 14 severe, crippling, life-destroying pain. And we had 15 an indication, and still have, for all pain states 16 "When we launched OxyContin, we 17 intentionally avoided a promotional theme that would 17 18 link OxyContin to cancer pain. We specifically linked 18 16 that are appropriately treatable with opioids for an extended period of time. We wanted -- so non-malignant really 19 OxyContin to the oxycodone combinations with our 19 2 o directly caused by the encroachment and destruction of 20 'old way, new way' campaign. We made sure our initial 21 detail piece provided reps with the opportunity to 21 22 sell the product for a number of different pain 22 23 states. With all of this, we were still concerned 23 is a distinction. All pain other than the pain tumor tissue in the patient. Q. And then he says here, "Doctors use the drug in non-malignant pain because it is effective 24 that the drug would be slotted for cancer pain and we 24 and the personality of OxyContin is less threatening 25 would encounter resistance in the non-malignant pain 25 to them and their patients than that of the morphine Coulter Reporting, LLC www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:21 Richard Sackler, M.D. Page 81 Page 83 1 alternatives. I apologize for this unspecific term, 1 2 but I feel it captures the notion that there are 2 less likely to write prescriptions and sales of less twice as strong as morphine, that they would be 3 image-related attributes that influence drug 3 4 acceptance. While we might wish to see more of this 4 5 product sold for cancer pain, it would be extremely 5 6 dangerous at this early stage in the life of the 6 limit its usefulness. The term "stronger" here meant 7 product to tamper with this 'personality' to make 7 8 physicians think the drug is stronger or equal to 8 that this intended or had the effect of causing 9 morphine. We are better off expanding use of 9 1 o OxyContin in the non-malignant pain states and waiting 11 for hydromorphone, in 1999, to relaunch into cancer 11 12 13 14 No. If its personality was changed, A. if it was stigmatized as an end-of-life drug, it could more threatening, more frightening. There is no way physicians to overlook the fact that it was twice as 10 potent. 12 pain." OxyContin would go down? It was called out in virtually every promotional piece of literature, it was reflected in a 13 conversion chart which we had developed for the few Why was it felt that there would be a danger -- it would be extremely dangerous at the early 14 patients who were being treated with morphine where we 15 stage in the life of this product to tamper with this 15 made it very clear if they're on any dose -- daily 16 16 dose of morphine, you cut that dose in half for "personality" to make physicians think the drug is 1 7 stronger or equal to morphine? 18 1 7 OxyContin. The context of this was, as you know, A. And every action we took before the 18 19 a thread of e-mails that actually, he alludes to, I 19 20 started. 2 o insert and promotion and in all detailing emphasized The whole context and the whole product was launched with the FDA in the package 21 that it was twice as strong. Some physicians had 2 2 discussion of Mr. Friedman here and in other -- I'll 22 formed their own impression that it wasn't twice as 23 23 strong, it was less strong, and we insisted that they 21 pause here. 24 Q. No, go ahead. 24 observe -- we said, "With this drug, Doctor, it is 25 A. Because I think it's really important 25 twice as strong." Even when they said, "No, I think Page 82 Page 84 1 1 for you to understand this. The whole context was not to -- the 2 3 context was not to stigmatize oxycodone in a way that it's one and a half times as strong." And some 2 physicians even said, "I think it's about the same 3 potency as morphine." We would insist, "No. Please use it the way we have researched it and the way the 4 morphine was stigmatized. Morphine was seen as an 4 5 end-of-life extreme duress -- patient in extreme 5 FDA has approved it." 6 Q. Okay. Now -- 7 A. And I think we were effective in 6 duress, often dying of cancer, but not only cancer. 7 It was reserved by most physicians, if it was used at 8 all, even when patients were in serious severe or even 8 getting that message across in time to most and 9 crippling pain, because telling a patient "I'm going 9 eventually almost all physicians. 10 to put you on morphine," "I'm going to prescribe 10 11 morphine for you," "Now we've got to use morphine," 11 the launch of OxyContin Controlled-Release, correct? Okay. This is 1997, two years after Q. 12 A. Yes. 13 associated with a death sentence. Oh, thinks the 13 Q. So it's been on the market now over -- 14 14 well, you launched it January '96. We're now in May 12 however the physician told the patient, it often was patient, he's telling me I'm going to die. Even 15 worse, my doctor's putting me on morphine, he's giving 16 up on me. 17 We didn't want oxycodone to -- to 15 of '97. And it says, "We are well aware of the view 16 held by many physicians that oxycodone is weaker than 17 morphine." 18 change the, as he says, personality of oxycodone, but 18 19 you could say all the associated feelings of 19 And the conclusion of this was, "I do not plan to do anything about that." 2 o oxycodone, which were generally appropriate to a 20 21 narcotic. We didn't want that to be polluted by all 21 22 of the bad associations that patients and healthcare 22 some holdouts?" 23 givers had with morphine. 23 24 Q. Did you think that if physicians 2 5 thought it was stronger or equal to morphine, much Coulter Reporting, LLC And you wrote back and said, "I agree with you. Is there a general agreement, or are there Is that what you wrote at the top of 24 the e-mail? 25 A. I did. And I agreed with him then and www.coulterreporting.com 502-582-1627 Page:22 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 87 Page 85 1 1 being as strong as MS Contin; is that correct? I agree with him now because I knew what he meant, and 2 so did everybody else know -- knew what he meant. 3 And, more important, our actions in promoting the 4 "twice as potent as morphine" never wavered . We never 5 disguised it or hid it; we emphasized it. 2 A. That's what the words say. 3 Q. And he says, "Although this perception 4 has had some effect with physicians switching to 5 MS Contin with more severe cancer pain patients, it 6 has actually had a positive effect with physicians' 7 pain market for non-malignant pain was a much greater 7 use in non-cancer pain." 8 market share; is that your testimony? 8 And there he's saying non-cancer 9 physicians that don't think it's as strong as Q. 6 A. 9 So you weren't doing this because the No. No, that isn't. We wanted to 1 o address both markets. The e-mail -- which perhaps you 1 o MS Contin were having a positive effect from that. 11 want to explore or not. What started this was, as he 11 And I assume it's talking about sales, 12 says in the first paragraph, something that I had 12 wouldn't you? 13 inquired about. And what I had inquired about was an 13 A. Yes. 14 error on my part. 14 Q. He says, "Since oxycodone is perceived 15 as being a weaker opioid than morphine, it has When we -- before we launched 15 16 OxyContin, we thought that our sales would be about 17 16 resulted in OxyContin being used much earlier for 17 non-cancer pain. Physicians are positioning this equally divided between cancer pain and non-malignant 18 pain. We knew that the market for non-malignant pain 18 product where Percocet, hydrocodone and Tylenol with 19 was much larger, of course. Fortunately for all of 19 codeine have been traditionally used." 2 o us, cancer is not -- is much less common than other 20 So he's saying here physicians are using it because they think it's weaker than morphine, 21 pain states. But we had expected it would be about 21 22 50/50. 22 correct? I had seen some report or had attended 23 23 He's using the word "weaker," but not A. 24 a meeting where I learned it was about 20 percent of 24 meaning less potent than morphine. Within this time 25 our sales, and, thus, I wrote to Michael and said, 25 it appears that people had fallen into a habit of Page 86 Page 88 1 why -- what's going on here? Why aren't we getting 2 1 signifying less frightening, less threatening, more more cancer sales? Q. 3 Let's -- let's look at the e-mail you 2 patient acceptable as under the rubric of weaker or 3 more frightening, more -- less acceptable and less 4 wrote to Michael Cullen at Norwalk. Let's mark this 4 desirable under the rubric or word "stronger." But we 5 Plaintiff's Exhibit 12. 5 knew that the word "weaker" did not mean less potent. 6 We knew that the word "stronger" did not mean more (DEPOSITION EXHIBIT NO. 12 MARKED} 6 Q. 7 7 And Michael Cullen writes on June 2nd potent. And we knew that because, by this time 8 of '97 -- that was after the e-mail we were just 8 surely, anybody who was using this product recognized 9 looking at -- and says, "In recent team meetings we've 9 it was more potent, they knew it was more potent. So it's very unfortunate for your 10 discussed the issue that OxyContin is perceived by 10 11 some physicians, particularly oncologists, as not 11 understanding as well as anybody else's understanding 12 being as strong as MS Cantin." 12 that all those issues of the stigma of morphine, of 13 the frightening nature of morphine, of morphine being Now, oncologists are cancer -- 13 14 A. Yes. 14 a cancer drug, end-of-life drug, it's very unfortunate 15 Q. -- doctors, correct? 15 for your understanding and for most people's 16 understanding that the word "weaker" and "stronger" So even the cancer doctors don't think 16 1 7 that OxyContin is as strong as MS Contin according to 18 this, correct? 18 MR. STRAUBER: Objection to the form. 19 20 MR. THOMPSON: Well, let me rephrase 21 22 22 it. 23 24 Q, Coulter Reporting, LLC Q. We're not done reading it yet, but let A. Okay. Q. You were advised by your senior employees that physicians perceived OxyContin 23 Controlled-Release as less strong than morphine? Many You were aware -- or at least Michael Cullen was advising you that OxyContin is perceived by 2 5 some physicians, particularly oncologists, as not was used, but we understood what it meant. 19 me ask you this. 2 o That's not what it says. 21 17 24 25 physicians perceived it that way, correct? A. Words used, but didn't mean that they www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:23 Richard Sackler, M.D. Page 89 1 Page 91 1 smaller cancer pain market but hurt us in the believed it was less potent, because I knew they 2 believed it was more potent. Their own practice 2 larger -- larger potential non-cancer pain market. 3 proved they recognized it was more potent. As I said 3 Some physicians may start positioning this product 4 before, Percocet was 5 milligrams. 4 where morphine is used and wait until the pain is 5 severe before using it. Q, 5 Did you do any studies yourself or 6 conduct any investigation to determine what percentage 6 "Marketing has decided that" -- and by 7 of physicians believed that OxyContin 7 that, they're talking about the marketing group, 8 Controlled-Release was less powerful than morphine and 8 correct? 9 were not aware it was twice as strong as morphine? 9 A. Q, 10 A. You're talking about less potent? 10 11 Q. Yes. 11 12 A. I don't know of such studies. But in The marketing department, yes. Yeah, marketing department. So it says, "Marketing has decided 12 that the effects of the Phase IV team should be 13 common parlance in discussions with physicians, if 13 predominantly focussed on expanding OxyContin use for 14 really a substantial -- if any substantial number of 14 15 them believed -- believed in the -- believed - - had an 15 16 erroneous belief -- excuse me. If any had an 16 non-cancer pain." And then if you look at the last paragraph, it says, "It is important that we be 1 7 erroneous belief and said to a representative, "Oh, 1 7 careful not to change the perception of physicians 18 this is -- this stuff is less potent than morphine," 18 toward oxycodone when developing promotional pieces, 19 the salesman had ample materials to demonstrate to the 19 symposia, review articles, studies, et cetera." 2 o physician that he was in error and was instructed to 20 21 21 use those and did use it. 22 physicians have that OxyContin is not as strong as And I wish we had a survey - - had done 22 And what they're talking about there is, let's not clear up this misconception that 23 a survey to demonstrate it in retrospect, but it was 23 24 so generally accepted that it was at least one and a 24 25 half times more potent by even the skeptics -- most 25 NS Cantin, correct? MR. STRAUBER: I object to the form of the question, Mr. Thompson. You, in reading this, Page 90 Page 92 1 skeptics -- and there weren't many -- but generally 1 skipped over two sentences. I 'd ask that you go back 2 recommended to be twice as potent as morphine, it just 2 and read this with the two sentences that you omitted. 3 never occurred to us. 4 Q, 3 The one beginning with "The sales force can teach the Sure. And it's your belief that your 4 5 sales force was telling these physicians that it's oncologists ... " MR. THOMPSON: Oh, sure. 5 6 actually twice as strong as morphine and correcting 6 7 7 to get physicians to use it earlier instead of 8 that misperception that they had? A. 8 Absolutely. It was in the package 9 insert, the promotion, in the conversion tables, and 11 12 1 o and titrate OxyContin to ensure that they stay with it So promotional pieces, your 11 as the pain increases." symposiums, your review articles, your studies would 13 all point that out? 14 Now, oncologists are the cancer pain 12 13 doctors, correct? I can't say that every one would point A. products such as Percocet, Vicodin or Tylenol 3. The 9 sales force can teach the oncologists the proper dose 10 in the recommended dosing, which -Q. "Our approach to cancer pain will be Q. 14 A. Yes. Q. That doesn't say anything about all 15 it out in every page, but it should have been an 15 16 important part of most promotional materials. 16 the non-malignant doctors -- all the doctors that 17 1 7 treat non-malignant pain, correct? Let's read the rest of Michael Q. 18 Cullen's e-mail dated 6-2-97, well after the launch of 19 20 OxyContin. 18 A. 19 thing, how to titrate. Because that was the -- that 2 o was, in a sense, the fundamental doctrine of treating Paragraph 3 says, "Since the 21 non-cancer pain market is much greater than the cancer 21 22 pain market, it is important that we allow this 22 pain with opioids; start low and titrate. Q. And -- well, the whole -Adjust the dose, in other words, 23 product to be positioned where it currently is in the 23 A. 24 physician's mind. If we stress the 'power of 24 upward. 25 OxyContin' versus morphine, it may help us in the 25 Q. Coulter Reporting, LLC But they would be taught the same Well, the whole purpose of this e-mail www.coulterreporting.com 502-582-1627 Page:24 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 93 Page 95 is that you not teach the non-malignant pain 1 develop. And that was understood and contained within 2 physicians that OxyContin is twice as strong as 2 this dialogue, not all of it documented here. 3 morphine and let them continue with their perception 3 4 that it's not, correct? 4 1 about it a little bit more, then. 5 A. No, not correct. 5 6 Q. Well, let's -- let's continue reading 6 In the first paragraph he says, "We've discussed the issue that OxyContin is perceived by 7 some physicians, particularly oncologists, as not 7 the rest of it, then. 8 The last paragraph. "It is important 8 Yeah. Sure. Let's go back and talk Q. 9 that we be careful not to change the perception of 9 being as strong as MS Contin. Although this perception has had some effect with physicians 10 switching to MS Contin with the more severe cancer 11 promotional pieces, symposia, review articles, 11 pain, it has actually had a positive effect with 12 studies, et cetera." 12 physicians' use in non-cancer pain." 10 physicians toward oxycodone when developing Now, am I correct that what he's 13 So what he's saying there, if I'm 13 14 saying in here is, let's not clear up the 14 reading this correctly, is that because they think it 15 15 is not as strong as MS Contin, when they need a strong misperception in any of our promotional pieces, 16 symposia, review articles or studies? 17 Don't change the personality. Don't A. 16 drug for cancer pain patients, some of the physicians 17 aren't switching to it because they don't think it's 18 change this to an end-of-life cancer drug to a drug 18 as strong, and that may hurt sales a little bit there. 19 that shouldn't be used except at the end of life when 19 But with the non-cancer pain, where you don't want as 20 everything else has been exhausted. That was the 2 o strong a drug as an end-of-life malignant cancer pain 21 thrust. 21 patient might need, it's actually helping our sales 22 that they have this misperception because they are 23 going ahead and prescribing it because they don't think it's as strong as MS Contin. 22 23 I may just add something here. There's a conflation within this which you wouldn't 24 understand, and that was in the first paragraph which 24 25 you read where he said that oncologists think it isn't 25 Is that what that first paragraph is Page 96 Page 94 1 1 as strong as MS Cantin. Here the meaning that we saying? You're -- that's what the words say. 2 understood -- certainly I understood and anybody who 2 3 was involved - - was the cancer doctors who were using 3 But the meaning of "strong" here would be effective. 4 the drug were stopping at -- they had established a 4 It is not as effective. And the reason they thought A. 5 notional idea based on their past habit of using 5 it was not as effective is, they had a mental notion 6 Percocet that they shouldn't go above 40 to 60 6 of a limit and they didn't follow the doctrine of 7 milligrams a day of oxycodone. And the reason they 7 titrating -- increasing the dose when the pain is 8 developed that habit, that practice limit, was not 8 getting worse. 9 because of the oxycodone, it was because of the 10 Tylenol, which was the more toxic agent in that 11 combination. 12 13 You're probably aware that recently the FDA has recommended lowering the maximum daily 14 Tylenol dose from 4 grams a day to 3. But even then And all of this was greatly known. I 9 10 mean, by 1997 most of the people who disagreed and 11 thought that OxyContin was not two-to-one, they 12 thought it was one-and-a-half-to-one, that was by far 13 the most common objection. Still stronger than 14 morphine, but not quite as much stronger as we said it 15 4 grams a day was recognized as being the then 15 was. They had been persuaded if they used the drug, 16 16 oh, yes, particularly those oncologists who switched 17 from MS Cantin to OxyContin. 17 practical limit. So oncologists who were using Q. So then he says, "Since oxycodone is 18 oxycodone as Percocet were just in the habit, well, 18 19 you're getting 40 milligrams a day of Oxycodone, your 19 2 o pain is coming back. Rather than titrate those 2 o has resulted in OxyContin being used much earlier for 21 patients to a higher OxyContin level, they said, Well, 21 22 we've got to switch to something else. 22 23 And that was really what was going on non-cancer pain." Correct? So he's saying more people are using 23 it earlier for non-cancer pain because they think it's weaker? 24 and in part why oncologists' use of a product had not 24 25 developed as well as we had wished that it would 25 Coulter Reporting, LLC perceived as being a weaker opioid than morphine, it A. Not -- not less potent. More www. cou lterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:25 Richard Sackler, M.D. Page 97 Page 99 1 acceptable to the patient, not frightening, not 1 2 stigmatized as morphine unfairly was by history. That 2 'power of OxyContin' versus morphine, it may help us 3 was the meaning. 3 And I've lost my thought here. Could 4 Sure. He says, "If we stress the Q. in the smaller cancer pain market ... " That means let them know that it is 4 5 you just repeat your question so I can finish my 5 more powerful than morphine; that will help in the 6 answer? 6 smaller cancer pain market, correct? 7 Q. Sure. And what he's saying here is, 7 A. That's what he says. 8 the non-cancer pain doctors -- which is the much 8 Q. Yeah. " ... but hurt us in the larger 9 bigger market share when you're trying to sell 9 potential non-cancer pain market. Some physicians -- 1 o physicians may start positioning this product where 10 OxyContin, is the non-malignant pain market -- it's 11 actually helping sales there because they don't think 11 morphine is used and wait until pain is severe before 12 it's as strong as morphine? 12 Again, as I've testified before, the A. 13 13 14 term "stronger" and "weaker" was a very unfortunate 17 18 He's coming back probably to the A. 14 cancer market. I'm not sure. But we always said it 15 term. 16 using it." 15 was a powerful drug. We implied that. We didn't use Q. Do you want to use "effective"? 16 the words. Because words can elicit a whole variety A. In the case of here, "effective," yes, 17 in the case of cancer. Because they were using it. 18 Let me explain one other thing. At 19 19 of responses. And then, "The marketing department Q. has decided that the efforts of the Phase IV team 2 o the time that this product was introduced, the World 2 o should be predominantly focused on expanding OxyContin 21 Health Organization had promulgated a stepladder 21 22 approach to cancer pain. And when OxyContin was 22 23 introduced, we properly, with the agreement of the 23 24 FDA, said that MS -- that OxyContin was appropriate 24 you clear up the misperception may be less likely to 25 for the second step and the third step. That's where 25 prescribe according to what he's written here, use for non-cancer pain." A. Right. Q. That's the -- that's the group that if Page 98 1 1 So I know that this could cause real 2 3 Page 100 the start with and stay with theme came from . 2 confusion reading these documents if you're not 3 correct? If you change the -- if you change the A. character of the drug in their mind. If you tell them 4 involved day to day, but there is no way that any of 4 it's a cancer drug, it's for end-of-life care, yes, 5 the people on these documents understood "stronger" to 5 you might change their perception. We didn't believe 6 mean more potent, "weaker" to mean less potent. We 6 that that was appropriate, nor did the FDA, nor did 7 had never departed from a strong promotional theme, 7 the opinion leaders believe it was appropriate. It 8 that it was twice as strong as morphine. 8 truly was a drug that, in appropriate doses, could 9 manage moderate and severe and extremely severe pain 9 And then down at the bottom he says -- Q. 1 o or let's take the middle paragraph. "Since the 10 where patients needed an opioid to manage their pain. 11 non-cancer pain market is much greater than the cancer 11 It's important, also, that you 12 pain market, it is important we allow this product to 12 understand that for a hundred years, and even today, 13 be positioned where it currently is in the physicians' 13 there is no drug that is more effective or safer than 14 mind." And that means let them believe that 15 14 opioids for treating pain over a long term. And it 15 was a shame that when -- that for decades no opioid 16 OxyContin Controlled-Release is not as effective as 16 was used in many -- most, perhaps overwhelming 1 7 morphine? 17 majority of patients who had severe pain. 18 A. No. I said the effectiveness really 19 applied to the oncologists who were saying, This isn't 18 Q. Do you think it might compromise 19 patient care if Purdue Pharma allowed patients' 2 o as effective, or, you know, I have to -- when the pain 2 o physicians to believe that the drug they are 21 gets really bad, I switch them to something else. And 21 22 that was the one place or the one circumstance in 22 A. Could you just repeat the question? 23 which we understood it as effective. And I've 23 Q. Yes. 24 explained that we believe that that was a consequence 24 A. I just want to get the question 25 of them just having a mental limit. 25 straight. Coulter Reporting, LLC prescribing them is weaker than morphine? www.coulterreporting.com 502-582-1627 Page:26 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 101 Q. 1 Page 103 Do you think it might compromise 1 promotional pieces, symposia, review articles or studies." 2 patient care if Purdue Pharma was aware that many 2 3 physicians felt like OxyContin was weaker than 3 4 morphine and did nothing to clear up that 4 character of the drug, not change -- not change it 5 misconception? 5 into a frightening, scary, end-of-life drug. No. If they believed it was less A. 6 7 7 All right. Let me hand you -- let's Q. 6 potent than morphine, we clearly cleared up that That's correct. Not change the A. mark this as Plaintiff's Exhibit 13. 8 misconception. We told them it was twice as potent. 8 (DEPOSITION EXHIBIT NO. 13 MARKED) 9 We told them to use doses that were considerably lower 9 (Passing document.) 10 than the morphine doses that they might have been 10 11 accustomed to. What we didn 't want to do is to turn 11 12 this into a cancer drug. 12 Q. This is an interoffice memo dated 1994. MR. STRAUBER: You gave me two copies. 13 Q. Right. And this is 1997. 13 14 A. That's correct. 14 15 Q. Well after the launch, well after your 15 A. 16 Q. And it's to? 17 A. To the three people he reported to. Q. And that's Mortimer Sackler, Raymond 16 17 18 19 package insert has been put out and all that, correct? A. Yes. Q. And Michael Cullen says, "It is 18 important that we be careful not to change the 19 And this is from Michael Friedman. Q. What was his role in 1994? He was head of marketing and sales. Sackler, and Dr. Richard Sackler, which would be you? 2 o perception of physicians toward oxycodone when 20 A. That's correct. Yes. 21 developing promotional pieces, symposia, review 21 Q. And under "Discussion," if you go to 22 articles, studies, et cetera," correct? Is that what 22 page 4, it says, "We believe that the FDA will 23 he wrote? 23 restrict our initial launch of OxyContin to the cancer 24 A. It looks like that's what he wrote. 24 pain market." 25 Q. And you replied to him and did not 25 Did you believe that at the time? Page 104 Page 102 1 say, no, we need to clear up this misconception 1 2 immediately. What you said is, "I think that you have 2 3 this issue well in hand." 3 He may have believed it; I didn't A. believe it. Q, Okay. "However, we also believe that 4 A. That's correct. 4 5 Q. "If there are developments, please let 5 That's what I said. But the 7 Q. Next sentence, 1.3. 1.3. Thank you. "However, we also believe that 6 me know." 7 A. 6 physicians will perceive OxyContin" -- Where are you reading from, which A. number? 8 misconception that you're referring to didn't exist. 8 A. 9 The misconception that this was a benign, harmless, 9 Q. 1 o weak drug for treating pain was not the perception 1 o physicians will perceive OxyContin as 11 that existed. So that was not the error that he -- I 11 controlled-release Percocet without acetaminophen and 12 don't know quite what he -- let me just read what he 12 expand its use." 13 said here. 13 14 What are we reading from, please? 14 15 We've gone through this a number of times, so where 15 16 were you reading from here? 17 A. You just read me something from -- 18 19 Q. From your top where you said "I think 19 21 A. But where you said I was responding, where was that? Q. Where he says, " It is important that Without acetaminophen that would be active ingredients, acetaminophen and oxycodone. We were reading from -- 18 22 A. one way of describing it, because there are only two Q, that you have this issue well in hand." Percocet? 16 17 20 Now, is OxyContin Controlled-Release 20 Q. Is -- is OxyContin Controlled-Release more powerful than Percocet? A. It depends on the dose. The initial 21 dose at 10 milligrams twice a day would be equivalent 22 to the standard introductory dose of Percocet four 23 tablets -- one tablet four times a day; in other 24 we be careful not to change the perception of 24 words, four. So it would be the same dose. 25 physicians toward oxycodone when developing 25 23 Coulter Reporting, LLC Q. When you-all did studies, did you find www.cou lterreporting .com 502-582-1627 Page:27 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 107 Page 105 1 1 "There will always be misconceptions about drug out that 10 milligrams of OxyContin had the same 2 effect as a placebo and it was really only the 20 3 I don't recall that, but it's A. 3 these misconceptions are the result of residual attitudes associated with the immediate-release 5 forms." possible. Q. 6 substances. For controlled-release drugs, many of 4 milligram that was effective? 4 5 2 "We do not want to position OxyContin 6 I'll just read the whole thing. "For example, morphine has a 7 in a way that will discourage physicians from using 7 8 OxyContin for the chronic non-malignant pain, 8 'personality' that was shaped when it was an IV drug. 9 especially" -- 9 Oxycodone has a 'personality' that was influenced by Where are you reading from again? 10 many years of Oxycodone use in Percocet. We built a 11 large part of our platform on this personality and it 10 A. 11 Q. Next paragraph. 12 A. Okay. 12 is to differentiate OxyContin from MS Cantin and 13 Q. I mean next sentence. 13 Duragesic. This differentiation has led to much 14 non-malignant business. -- "especially when we have studies 14 15 available that demonstrate efficacy and safety for 15 16 this indication." 16 "Marketing" -- this is the next paragraph. "Marketing is not only about what you 17 A. Okay. 17 18 Q. Do you know what your studies showed 18 are, but it's about what you are not. We have had 19 success beyond our expectations that is in part due to 19 about non-malignant chronic pain patients developing 2 o tolerance or dependency or withdrawal from OxyContin? A. 21 21 to increase the use of the drug in higher doses, we I don't have them immediately in my 22 22 mind. 23 24 MR. THOMPSON: Let's mark -- that's been marked, correct? MR. DANFORD: Just off the record. 25 2 o the unique personality of OxyContin. Even as we seek should be very careful. As you know, the strength of 23 the drug is principally a barrier in malignant pain. 24 If we do not want to change the image in a way" -- I'm 25 sorry. "We do not want to change the image in a way Page 108 Page 106 2 (RECESS) record at 11:57 a.m. 6 BY MR. THOMPSON: Q. And you wrote back, "Excellent points. 4 What about rifle shots?" Is that correct? 5 I'm going to hand you a document that is dated April 23, 1997. (Passing document.) 9 would be ill advised." 3 VIDEOGRAPHER: We are back on the 4 5 8 2 at 11:45 a.m. 3 7 1 that will discourage non-malignant use. A barrage VIDEOGRAPHER: We are off the record 1 6 A. That's correct, that's what I wrote. 7 Q. And over here before that, there's a 8 letter to you from James Lang, and he's pointing out 9 that he sat in some oncology focus groups and -- 10 A. What page is that? 11 e-mail you sent regarding San Antonio, and it says -- 11 Q. It's page 2. 12 it's 4-22-97. This is PDD1701801141. And it's to, it 12 A. The second page of what you handed me? 13 looks like, Michael Friedman. 13 And on the bottom of page 1 is an 10 "Michael, I am somewhat surprised that 14 15 14 15 18 months into marketing significant groups of Oh, Jim. Yes. Okay. It says, "Issues affecting the Q. oncologists' utilization of OxyContin are: M.D.s feel 16 experts, oncologists, for example, believe that 16 the product dosing has a ceiling; don't feel it is as 17 17 OxyContin has a ceiling effect." 19 A. Has a dose above which it would not be 19 2 o effective. That was what I meant, not be effective. 21 Q. strong as MS Contin; like and are very comfortable 18 with MS Contin and don't see a need for another What did you mean by "ceiling effect"? 18 20 Okay. "What materials could we pull 21 product except where MS Cantin fails. "Interestingly, when asked to describe what they like about OxyContin, they for the most part 22 together that would smash this critical misconception? 22 cited all the key points our reps are or should be 23 Can we put together some approaches and test whether 23 stating in their sales presentation. 24 they would be potent weapons in this effort?" 24 "The anesthesiology focus group 25 And he writes back and says to you, 25 Saturday evening was of less value however. Their Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:28 Richard Sackler, M.D. Page 109 Page 111 1 primary concerns were the Medtronic pump being used by 1 A. That's what it says . 2 the orthopods and the need for Purdue to educate 2 Q. And the part I wanted to ask you 3 surgeons on proper post surgery pain management and 3 about, if you go back to page 10 -- and you were in 4 fears with opioid prescribing." 4 Is that the e-mail that prompted you 5 attendance at this meeting, correct? 6 I don't -- let me check that. I A. 5 6 to write the letter? certainly don't recollect by date. 7 A. It might be; I don't recall. 7 Q. R.S. Sackler attended. 8 Q. I'm sorry, prompted you to write your 8 A. Yes, that was me. 9 e-mail. 9 Q. All right. So on page 10, it looks 10 A. 10 like you're discussing an osteoarthritis study that It could be. MR. THOMPSON: Why don't we mark that 11 11 was being done. 12 as Exhibit 14. (DEPOSITION EXHIBIT NO. 14 MARKED) 13 But I'm not sure. It could have been A. Okay. Where on page 10? 12 A. 13 Q, I am on the third paragraph. Okay. I'm sorry. 14 A. 15 there could be another e-mail in which I pointed out 15 Q. Fourth paragraph. 16 the lack of sales development with oncologists as 16 A. It says page 10, but it doesn't look 17 compared to our plan . So I'm not sure that this is -- 17 like what you have here. 18 but it would have been around the same time perhaps. 18 14 Q. That's it. Is it? 19 Maybe I looked at the results with oncologists after I 19 A. 2 o read this. 20 Q. Yeah. 21 A. Okay. Pardon my eyesight. 22 Q, So read along with me the section over MR. ELLIS: That's already in 21 22 evidence. It's either Exhibit 2 or 3. It's the May 23 1993 memorandum. Here we go. 24 25 A. 23 here "RR." Do you know who "RR" is? MR. THOMPSON: All right. 24 A. Robert Reder. Are we finished with this 25 Q. What was his job at that time? 1 A. He was senior medical researcher. Q. And he says here in this paragraph, Page 110 1 (indicating)? 2 Q. 2 3 memorandum. 5 6 7 Yes, sir. I wanted to go back to the May 1993 3 4 A. 4 two dose levels in patients with osteoarthritis was 5 discussed with C. Wright." And this is the -- 6 July '92? Q. Would that be Curtis Wright? 8 understand it to be. And at that time he was the person who Q. 9 1 o was reviewing your-all's OxyContin submission to the Wait a minute. Let me -- can I see 11 what you have here? 11 FDA? 12 (Passing document.) 12 A. 13 Let me just clear this up. It's not 13 correct. 14 Q. 14 in evidence yet. April 2nd, 1993. Let's -- I'm sorry. I misspoke. 15 That's -- that's what I would A. 7 MR. STRAUSER: What exhibit number are 8 "The protocol for the placebo- controlled study versus (Passing document.) 9 we talking about? 10 Page 112 He was the medical reviewer, that's And he's the guy that actually 15 approved it to be sold, you know, allowed you-all to 16 Let's -- let's jump to the April 2nd, 1993 memorandum. 16 sell it from the FDA? 17 Let's mark this as Sackler 15. 17 A. That's my recollection. Q. You-all ultimately hired him a few 18 (DEPOSITION EXHIBIT NO. 15 MARKED) 18 19 (Passing document.) 19 years later, didn't you? 20 Q. What is "PFRC" at the top of this? 20 21 A. Purdue Frederick Research Center. 21 22 Q. And it's the R&D meeting? 22 Purdue when he was planning on leaving the FDA, and 23 A. R&D meeting. 23 Paul and I discussed it and agreed that we should not Q. And it is dated April 2nd, 1993, 24 25 correct? Coulter Reporting, LLC A. We did hire him, but not after his tenure at the FDA. We - - he spoke to somebody at 24 hire somebody who had -- who had reviewed our product 25 and had left. And so he went to another company, www.cou lterreporti ng. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 29 Richard Sackler, M.D. 8/28/2015 Page 113 1 regrettably for us, because he was very, very 2 knowledgeable -- Page 115 And then down below that it says, 1 2 "Dr. Richard Sackler asked if there was consensus 3 within the pain group about the appropriate use of Q. Sure. He went there -- 4 A. -- and very smart. 4 opiates for certain patient groups. B. Kaiko stated 5 Q. He went there for a short period of 5 this is very -- a very controversial area, and most 3 6 time and then came to work for you-all? A. 7 I don't remember. It was certainly -- 6 people in the pain group say that well-controlled 7 studies are necessary to investigate the questions." 8 it was certainly -- my recollection is a couple of 8 9 years, two or three years, but I don't recall exactly. 9 1 o in-house to clarify the politica I issues." 1 o The record, I'm certain, could be produced. Q. 11 "Dr. Sackler" -- next paragraph says, "Dr. Sackler has suggested a smaller group meet All right. Well, let's -- let's take What were the political issues? 11 12 a look at page 10. "The protocol for the 12 13 placebo-control study versus two dose levels in 13 referred to the preferences and the sometimes 14 patients with osteoarthritis was discussed with 14 prejudices of physicians and other experts. 15 C. Wright. He stated there were very strong opinions The political issues would have A. Over whether you should prescribe Q. 15 16 of members at the FDA that opiates should not be used 16 opioids for non-malignant pain at all? 1 7 for non-malignant pain. And this study" -- 17 A. 18 Let me just follow you, if I may. I'm 19 a slow reader, I'm sorry, but I just do want to follow 20 And for what conditions in A. 18 non-malignant pain . I don't think there were very 19 many people, or any people really, of any reputation 2 o who would have proscribed, that is prohibited, the use you. 21 Q. Great. Well, I'll read it again. 21 of opioids for non-malignant pain, but there were a 22 A. Okay . 22 lot of opinions when it came to listing one condition 23 Q. "He stated there were very strong 23 or another or another or another. 24 opinions of members at the FDA that opiates should not 24 Pain is the most common symptom that 25 25 patients have and present to doctors, and so every be used for non-malignant pain and this study would Page 114 1 Page 116 1 not be greatly accepted by the FDA as it is written doctor has his own opin ion as to what is -- what is 2 now for that reason. C. Wright has suggested 2 best and what is appropriate for treating pain, or in 3 rewriting the protocol in order to make it clear 3 some cases what pains are not appropriate to be 4 osteoarthritis is being used as a convenient pain 4 treated at all. And this is a highly -- is a highly 5 model. He would also like the open label extension to 5 personal and contentious issue in the medical world 6 be eliminated from the protocol." 6 and has been so for a hundred years. Now, what do you refer to as the open 7 8 A. 9 And that's the reason that morphine Q. 7 8 was stigmatized and not prescribed generally for label extension? In many trials of chronic-use drugs, 9 non-malignant pain, it was more reserved by physicians 10 after the trial period, which might have been 12 10 for end-of-life Hospice care and cancer pain in the 11 weeks, was completed, the subjects in the trial were 11 medical community? 12 given an option to continue being treated and 12 I don't understand the connection A. 13 monitored by their physician. It's completely at 13 14 their election or choice. They -- they -- some decide 14 is unique and it doesn't relate to what we're talking 15 that they want to, some decide that they don't. And 15 about here. 16 we continue them on medication for an extended period 17 of time . This is extremely common in all kinds of Q. Q. 16 What about heroin, was it prescribed 1 7 for -- 18 trials. 19 you're drawing. I think the situation with morphine "P. Goldenheim stated the open label 2 o extension could be done as a post-marketing study. 18 A. For pain? 19 Q. -- pain? 20 A. It is prescribed for pain in many 21 B. Kaiko and R. Reder will meet with P. Lacouture to 21 countries and is part of the pharmaco -- the 22 communicate what is necessary to revise the protocol. 22 pharmacopeia. For example, it is very popular in the 23 The protocol must be clear that we are not going for a 23 UK. 24 general indication for the treatment of osteoarthritis 24 Q. Is it controlled? 2 5 with osteo -- with oxycodone." 25 A. It is, just like morphine. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 30 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page 117 2 1 I can't tell you that because I don't 3 the principal agents of getting the word out, to use know . But it is -- it's -- I don't believe that it 4 your expression. mostly? to write prescriptions? Not directly. The salespeople were A. 2 A. 3 4 Page 119 Is it used for end-of-life pain Q. 1 5 established itself as an analgesic in the United 5 Q. All right. 6 States at any time even when it was -- was an 6 A. Of putting the materials in the hands 7 analgesic and was available. 7 of doctors, et cetera. I don't recollect that 8 advertising ever played much of a role in the 9 promotion of OxyContin. 8 9 Q. I'm going to hand you a memo -- A. Are we finished with this 10 (indicating)? 11 Q. 11 4.3, "Potential Studies." "Mike" -- I'm going to read Yes, we are. 12 I'm going to hand you a memo dated -- 12 Let's talk about -- if you'll look at Q. 10 that paragraph. "Mike Innaurato said that an 13 Project Team Meeting Minutes of Tuesday, August 17, 13 OxyContin versus Percocet comparative study" -- 14 14 A. 15 Q. From "Potential Studies." 16 A. Okay. I'm sorry, this is so small, 1993. 15 (DEPOSITION EXHIBIT NO. 16 MARKED) 16 (Passing document.) 17 18 1 7 it's not too easy. It says here under "Marketing," Q. Oh, you weren't reading -- I see. "There's some initial interest in having a 5 milligram "Mike Innaurato" -- and, Q. 18 19 and 10 milligram immediate release Oxycodone capsule 19 20 2 O we're stuck with it, too. produced." Do you know why marketing wanted those 21 22 23 24 25 I -- I could -- I could guess, but I don't know specifically why they wanted it. Q. "Potential Studies: Mike Innaurato 21 produced? A. unfortunately, that's the way Purdue gave it to us, so 22 said that an OxyContin versus Percocet comparative 23 study would be useful for marketing purposes." Now, in trying to decide whether the 24 Well, if you don't mind, turn back to 25 drug is safe, is it normal to have the marketing Page 120 Page 118 1 1 page 4. And on page 4 what I really want to ask you 2 about is potential studies. 3 4 5 A. Okay. Q. And Mike Innaurato is the guy we 3 on it or suggesting things, but normally it's the 4 medical department that has the primary responsibility 5 both for the medical research strategy and the -- and certainly the implementation. 6 A. Innaurato, yes. 6 7 Q. -- in the marketing department, 7 8 correct? A. Yes. Yes. 10 Q. And he's the guy in charge of perhaps A. read the next sentence. "Through such a study 9 (OCSB-1105) has previously been conducted and 10 12 No. He would be in charge of the published in abstract form, it was a single-dose study stated that a multiple-dose study would be best to 13 support claims relating to relief of post-surgical 13 marketing execution of the strategy. So he would be 14 "Through such a study" -- I'm going to Q. 8 11 using non-GMP released material. Mike Innaurato 11 the sales force that goes out and tries to sell? 12 They might be involved in commenting A. 2 mentioned earlier who was in -- 9 people decide what studies will be done? 14 intimately involved with the promotional materials, pain, low back pain and herpetic neuralgia pain." 15 secondarily involved with training, and would be the 15 16 person who would set the direction and themes that 16 17 1 7 design studies to support them. would be used. But he wouldn't be a person who would From my review of that, it looks like he's got claims he wants to make and is trying to Is that what that appears to you? 18 be responsible for sales, although he might go out in 18 19 the field, and he should, to determine what is 19 20 happening. 2 o think he is doing here in the general is he is, in a 21 Q. Let me rephrase it then. 21 A. No. He -- half yes, half no. What I group meeting, presenting ideas for consideration by 22 A. Sure. 22 the group. Certainly this was not directed and he was 23 Q. As part of marketing, he's the guy who 23 not in a position to direct any studies be done or not is supposed to get the word out and hopefully increase 24 done. 25 sales by advertising the product and convincing people 25 24 Coulter Reporting, LLC Q. Then the next sentence says, "Mike www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 31 Richard Sackler, M.D. Page 121 Page 123 1 Innaurato stated marketing would like to position 1 -- halfway down it says, "The 2 differently than MS Contin. Robert Reder" -- 2 development and launching of OxyContin Tablets is the first time that we have chosen to obsolete our own Q. 3 A. Just a second. 3 4 Q. Who is Robert Reder? 4 product, and we have done it before the competition 5 A. He was the senior medical officer in 5 has slowed our growth of sales." 6 this -- in this minute of the meeting. Let me just read -- catch up to you. 7 Q. 8 9 And you were referring to MS Cantin 6 7 "Robert Reder stated that the FDA has suggested that we do not issue claims supporting the that you obsoleted; is that correct? 8 A. That's correct. 9 Q. And then at the bottom it says, "We 1 o have the most powerful selling package insert in the 10 general use of a Schedule II opiate in patients with 11 non-malignant pain. Robert Reder indicated that 11 12 decisions to make additional claims could be developed 12 13 after the product is marketed. Jim Conover agreed 13 14 with Robert Reder, but added that any study conducted 14 15 in a patient with non-malignant pain could be included 15 Q. The very last paragraph. 16 in the clinical studies section of a package insert. 16 A. Yes, that is correct. 17 "Robert Reder added that any proposed 17 Q. And if you'll turn to page 8. It says 18 marketing claims and their supported studies should be category and in the industry." And is that accurate? I'm trying to see where it is. "We A. have" -- which paragraph in that column?" 18 "Speech" at the top, "continued from page 2." So I'm 19 first reviewed with our legal and regulatory 19 assuming this is a speech you gave? 2 o departments; perhaps the marketing concepts could be 20 A. Maybe, but I don't know. We'll see. 21 reviewed now. Robert Reder stated that the marketing 21 Q. "OxyContin was brought to NDA" -- 22 could start thinking of a five-year plan on potential 22 What's NDA? 23 marketing studies and strategies." 23 Did I read that correctly? 24 24 " ... to NDA filing." That's the filing A. of the new drug application. 25 A. You did . 1 Q. I'm going hand you -- let's mark 1 2 and in an incredibly compressed period of two years' 3 A. Are we finished with this? 3 time." 4 Q. -- Exhibit 17. 4 25 Right. Q. Page 122 2 Page 124 this -- -- "from early Phase I work on time That's because an NDA usually takes 5 (DEPOSITION EXHIBIT NO. 17 MARKED) 5 6 (Passing document.) 6 A. Well -- 7 MR. THOMPSON: If I haven't done it, 7 Q. And let me just preface it with, the longer, correct? 8 I'm going to move to admit all these into evidence as 8 reason that it takes longer is because there's a 9 Exhibits 1 through 16 and 17. 9 number of studies that have to be done, both animal 10 Q. And this is a -- appears to be a 11 speech you gave, is that what this is, or a 12 13 publication you made? A. This looks like it was a newspaper or 10 and human, to determine if a drug is safe and 11 efficacious, correct? 12 A. Right. In general, that's correct. 13 Q. But in this case you-all got it done 14 magazine-like internal document for the field force 14 in an incredibly compressed period of time of two 15 principally. I think it was basically the field 15 years. 16 force. And -- and in-house marketing and salespeople 16 17 would like to see their picture there or be quoted or 17 18 whatever. 19 20 Q. "Robert Reder set the goal in November of '93 to file by December 31st, '95, and we submitted 18 on December 28th, '95, three days ahead of schedule. And it's the winter of 1996; is that 19 This didn't 'just happen.' It was a deftly 2 o coordinated planned event that took dozens of workers right? 21 A. That's correct. 21 22 Q. And if you'll turn to page 8 for me, 22 A. True. 23 Q. "The most demanding NDA package for 23 please. I'm sorry, I misspoke. Turn to page 2, 24 please. Over on the third column -- 25 A. Yes. Coulter Reporting, LLC years of effort to succeed." 24 any analgesic product ever submitted didn't languish 25 at the agency. Unlike the years that other filings www.coulterreporting.com 502-582-1627 Page: 32 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 125 Page 127 1 linger at FDA, this product was approved in 11 months, 1 2 14 days. Our previous best approval time for other 2 subsequently, correct? 3 products was measured in years, not months. "Much can be attributed to the 4 3 A. He was hired by Purdue Pharma -- 4 Q. In his last -- A. -- maybe three years after this . I 5 unparalleled teamwork of the product team and the 5 6 FDA's approval team which came into being as a result 6 7 of our joint desires to operate within the context of 7 8 a new time frame. Both we and the Pilot Drug Division 8 9 of the FDA were motivated by the same goal to set the 9 10 high standard NDA with the broadest indications about that? Q. 15 No. I just wanted to know if that was A. His overall conclusion on the last 13 A. Yes . 14 Q. -- "appears to be a b.i.d. alternative 15 to conventional q.i.d. Oxycodone. Approval is 16 the statement you got and is it accurate? 17 (DEPOSITION EXHIBIT NO. 18 MARKED) Q. 12 correct? You did. Did you have any questions A. Why don't we go ahead and mark this as Q. Exhibit 18. 11 page is, "CR Oxycodone" -- that's controlled-release, Did I read that correctly? 13 14 don't recall ex actly. 10 11 approved in the shortest possible time frame." 12 He was hired by Purdue Pharma Q. This was a -- I believe it is 18 accurate. I'm certa in that the facts in there were 16 recommended. Care should be taken to limit 17 competitive promotion." What is "competitive promotion"? 18 I'm not sure what he meant. I could 19 accurate . The tone was very upbeat, almost a team 19 2 o enthusiasm building expression. I believe the facts 2 o guess that he means promotion comparing this to other 21 are correct. And I perhaps -- I don 't regret trying 21 agents that are used in various pain conditions, but 22 to energize our sales force, I think that was my 22 that's a guess on my part. A. And, then, I think the next sentence 23 mission. But this isn't what I would have written if 23 24 a board had been -- or said if the board had been 24 explains it. He says, "The product has been shown to 25 there . I wouldn 't have been -- the tone would have 25 be as good as current therapy, but has not been shown Q. Page 126 1 Page 128 1 to have a significant advantage beyond reduction in been more restrained . I'm not embarrassed by the 2 tone. In the context, I think it was very reasonable . 3 4 5 2 frequency of dosing." Do you have any questions about the reason it was so quick or anything else? Q. So other than you don't have to take 3 4 No. We've got a lot of documents to it as much, the FDA has concluded that there's no 5 benefit other than -- "it has not been shown to have a 6 get through, so I'm trying to hit the high points and 6 significant advantage beyond reduction in frequency of 7 ask you about those. 7 dosing "? 8 A. Okay. 8 A. Not been shown in the NDA, yes. 9 Q. One of the things that they wrote 9 Q. All right. Let's -- 10 you -MR. THOMPSON: Do you have the other 11 12 pages of this (indicating)? 10 (Knock at the door.) 11 THE WITNESS: Probably announcing 12 13 MR. ELLIS: Yeah. Here. Right here. 13 14 (Passing document.) 14 15 Q. -- when you got your approval . lunch. MR. THOMPSON: Probably so. Let's go off the record . VIDEOGRAPHER: We are off the record 15 16 (Passing document.) 16 17 If you'll look at the last page on 17 (RECESS) VIDEOGRAPHER: We are back on the 18 overall conclusion. And this is a document from the 18 19 Medical Officer Review, Curtis Wright. 19 20 A. This is part of the approval -- part 21 of the FDA approval process. 22 23 24 25 Q. He's the guy that now works for Purdue Pharma, correct? A. No. No, he hasn't worked for Purdue Pharma for a long time, regrettably. Coulter Reporting, LLC at 12:32 p.m. record at 12:32 p.m. (Passing document.) 20 21 22 Q. This is the OxyContin Project Team Memo. Do you know if you ever reviewed this 23 24 memo? 25 A. I wasn't on the project team. I don't www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 33 Richard Sackler, M.D. Page 129 1 know if I reviewed it. I'm curious. I could read 2 through this. Was it sent to me or not? 3 4 5 Page 131 2 regulatory department, were the principal owners of Q. I don't know if it was or not. 3 the document in the company. And the owner of the A. It looks like I was not on the 4 document for the government was the Food and Drug 5 Administration, and, of course, they had determinative 6 power as to what it -- what it ultimately ended up as. circulation list. Q. 6 But the medical department was, and 1 Well, this list down here is -- yeah, 7 there's a circulation list. It appears that it was 7 8 not. 8 And, if you would, go over to page 4. Sure. If you'll turn to page 5 under Q. 7.0, "Marketing." 9 A. Yes. 1 o The last paragraph down at the bottom, 6.2, "Mike 10 Q. It says, "Post-Marketing Studies (QQL, 11 Innaurato asked if marketing would be able to review 11 12 12 discussed some of the planned post-marketing studies. 9 the package insert." Do you have any idea why marketing 13 14 wanted to review the package insert? Pharmacoeconomic, Percocet, Duragesic) - Robert Reder 13 These included an OxyContin versus MS Cantin 14 comparative study, the Duragesic study, which is 15 A. Surely. They have many reasons. 15 currently on hold, and a relative potency study 16 Q. "Robert Reder stated the package 16 comparing OxyContin to MS Cantin. 17 insert will be circulated to marketing and other 17 18 reviewers at the same time as the protocol review." 18 need additional studies to recruit several hundred A. 19 As I said earlier, the package insert 19 "Robert Reder stated that we would patients in order to get data to support claims for 2 o was becoming -- originally, 20 years prior to this, 2 O non-cancer pain." 21 package inserts were very, very brief and very simple. 21 22 Over time the agency wanted them to be more complete 22 This was in March of 1994. Do you know if those studies were done? 23 documents, and then it had regulatory implications, as 23 24 well. 24 approval, but I don't know whether any were done 25 before approval. So if you look at the history of use 25 I'm sure they were done after A. Page 130 Page 132 1 of package inserts, they, by this time, had become 2 fairly long and extensive documentation for the 2 3 physician. Their notion of being printed in that tiny 3 A. 4 format and stuck with every package in a sense was 4 Q. Okay. Who is Robert Reder? 5 inconsistent, so you ended up sometimes having this 5 A. He was the senior medical officer on 6 package insert that was as big as the bottle adhered 6 7 to every bottle. But it was available to physicians 7 8 in a variety of other forms. The Physician's Desk 8 9 Reference, I think you must be familiar with, which 9 A. Right. Q. -- "stated that a Percocet comparative 1 Do you know if they were done before Q. the drug was put on the market? I don't know. this project at Purdue Frederick. And then it says, "Mike Innaurato" -- Q. again, he's the marketing guy, correct? 1 o was the way most physicians then would read a package 10 11 insert. It was just a compilation of all the approved 11 study would be of benefit to marketing. Mike 12 products package inserts. 13 14 15 Q. 13 First of all, they have to understand 15 claim. Mike Innaurato stated in the future Tramadol answering that equal efficacy of OxyContin to Percocet 14 with better quality of life would be a beneficial that? A. 12 Innaurato replied to Bob Kaiko's question on claims by What is marketing going to add to 16 what the package insert is going to say about the 16 would pose a threat to the OxyContin market." 17 product so that they can think of how they're going to 17 18 present promotional materials. Secondarily, they might, if the 19 18 And then down below that it says, 7.2, "Marketing Claims/Studies Desired - Mike Innaurato 19 gave a presentation on the results from the focus 2 o package insert is in draft form and under discussion 2 o groups. A copy of the market research results would 21 21 with the agency, turn to the responsible medical be issued to the OxyContin team. The results of the 22 officer as an example or the regulatory people and 22 focus groups are attached. The results cover issues 23 say, you know, this could be misunderstood, this could 23 such as benefits, positioning and claims." 24 represent a problem, and so they would contribute to 24 25 the clarity . 25 Coulter Reporting, LLC Do you know whether the studies recommended by Robert Reder were done before it went www.coulterreporting.com 502-582-1627 Page:34 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page 133 1 to market or the studies requested by the marketing 1 2 guy were done before it went to market? 2 Page 135 (DEPOSITION EXHIBIT NO. 20 MARKED) Now it's 20. A. THE WITNESS: Are you keeping these? 3 A. I don't know. 3 4 Q. Then there is a -- if you go to 4 MR. STRAUBER: Yes. 5 page -- the very last page, I guess, it is -- 5 THE WITNESS: Okay. It's No. 20. 6 6 "OxyContin Tablets Project Team." 7 A. Okay. 8 Q. And this is June 22nd, 1994, correct? 9 A. That's what it says. Just a second. "OxyContin A. 7 8 Q. "OxyContin Presentation 3-22-94" up at the top. Presentation." I see it. And it says down at the bottom, it's Q. 9 10 Q. And on page 2, "Marketing" it says -- 11 as the only opioid combining the efficacy and safety 11 A. Wait, wait. 12 of Oxycodone with the convenience of a 12-hour 12 Q. -- 1.0. 13 schedule, which allows for precise and accurate 13 A. I see June 8th, not June 22nd. 14 conversion and titration, while allowing the patient 14 Q. Oh, the date it's sent is June 22nd 15 to lead a more normal quality of life. OxyContin is 15 over on the right. 10 got all the list of -- "OxyContin will be positioned 16 the opiate to start with for patients who may be on 16 A. Woops. Okay. My mistake. Okay. 1 7 Percocet, Lortab or Vicodin and the opiate to stay 17 Q. But it's project team meetings from 18 with as the disease progresses." 18 June 8th, you're correct. Now, that was a marketing campaign, 19 20 On page 2 under 1.0 "Marketing," under 19 20 the "OxyContin Tablets Project Team Meeting Minutes," correct, the "Start With, Stay With"? 21 A. Yes. 21 "Mike Innaurato gave an overview of the Oxycodone 22 Q. And the "Start With, Stay With" 22 market referring to sales and growth charts and 23 campaign, do you know who came up with the "Start 23 prescription data. Mr. Innaurato also presented our 24 With, Stay With" marketing campaign? 24 current strategy for introducing OxyContin Tablets to 25 I wish I could lay claim to it, but, A. 25 the market. OxyContin Tablets will be targeted at the Page 136 Page 134 1 1 no, I don't know who came up with it. cancer pain market." Was a decision subsequently made not 2 Q. And then it says -- 2 3 A. That was not the launch campaign in a 3 to target specifically at the cancer pain market? 4 sense. It may have been a subtext of the launch 4 5 campaign, which was the old way and the new way. 5 6 But ... 6 7 8 abuse than other opioids." 8 9 Do you know where that claim came 9 I don't know. Looking at -- is this A. 12 after the package insert? No. No, it's before the 13 package insert was approved. I don't know. 14 A. I don't know what this refers to. MR. THOMPSON: Let's mark that as 19 17 18 and move to admit it into evidence. (DEPOSITION EXHIBIT NO. 19 MARKED) 19 20 Yes. It doesn't say, however, that A. we -- let me just read this again. "Will be targeted And here is this one. Q. It doesn't say that it will not be 11 12 13 Do you know whether OxyContin had less Q. 15 potential abuse than other opioids? 16 But at least by June 8th of '94 the Q. 10 at the cancer pain market." 10 from? 11 when. 7 plan was still to target the cancer pain market? It says at the bottom, "Less potential Q. I would infer that, but I don't know A. promoted to the non-malignant pain market. It says, "OxyContin Tablets will be Q. 14 targeted at the cancer pain market. Since it is 15 possible that morphine generic products may soon be in 16 competition with MS Cantin Tablets, we will target 17 patients who are currently receiving MS Cantin as well 18 as those patients thought to eventually use MS Cantin 19 Tablets (i.e., on the analgesic ladder late step one, 2 o step two and step three). The bulk of opiate business 21 (Passing document.) 21 comes from 7,500 physicians, 3,000 of whom are 22 This is PDD9520821306. This appears 22 oncologists." 23 to be the -- 23 A. That's correct. Q. So you-all had market share from 24 A. Do you want to mark it? 24 25 Q. Yes, let's do that. 25 Coulter Reporting, LLC MS Cantin, correct? www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 Page: 35 Richard Sackler, M.D. Page 137 1 A. Yes. 2 Q. And in order to keep from losing that Page 139 And then under "Publications," right Q. 1 2 below that, "Manuscripts for studies C90-0708 and 3 market share to generics who are going to be priced 3 OC93-0101 have been sent to Drs. Stanski and Mandema 4 much lower than MS Contin generally, correct? 4 for review as potential authors." 5 A. That was the trend at that time, yes. 5 6 Q. What you did is put out OxyContin and 6 7 obsoleted MS Contin, and if you could keep the Why was Purdue sending out manuscripts to doctors to be potential authors? I can't say for sure, but two A. 7 8 MS Contin market through the use of OxyContin, you 8 9 9 that the manuscript had come to us in draft form and wouldn't lose any market share there; and if you could possibilities arise in my mind. One possibility is 10 expand it to non-malignant pain, you would gain all of 1 o we had helped them fill in details, such as the 11 that market share, correct? 11 MR. STRAUBER: I object to the form of 12 references and so forth. That was one of the ways 12 that companies helped authors lighten the burden, so 13 the question. At the minimum, it's compound. 13 14 MR. THOMPSON: Sure. 14 to speak, of writing a paper. The second possibility is the first 15 Q. Go ahead, you can answer. 15 draft might have been written in-house and sent to 16 A. So could you just break it into two 16 them for their review and their correction and 17 additions. 1 7 questions and I'll answer them both? MR. THOMPSON : Can you read the 18 18 19 question back? 20 THE WITNESS: And stop after one. 21 A. 22 Well, it says "as potential Q. 19 authors" - - 20 A. Yes. (Record read .) 21 Q. -- meaning it would appear that they Okay. And that's what this seems to 22 authored the manuscript even though it really came 23 say, and certainly that was an element of 23 24 consideration and part of the strategy. What I think 24 25 might be m issing here is any discussion of the 25 from Purdue, correct? MR. STRAUBER: Objection. It's a collaborative effort. It's -- A. Page 138 Page 140 1 non-malignant pain market, which you asked me a 1 we can't -- we don't impose on any author what they 2 question. 2 submit. What they submit for publication is submitted 3 from them, by them and totally in their control. THE WITNESS: Could you read question 3 4 two? 4 5 A. 6 7 Do you know if Drs. Stanski and Q. (Record read.) 5 We would not -- we would not gain all 6 A. I don't know. 7 Q, Do you know whether these manuscripts of the non-malignant pain market share, but we could Mandema were paid by Purdue? 8 augment or add to the cancer pain market non-malignant 8 ultimately identified Purdue Pharma as being any part 9 pain. 9 of the author? And I'm quite surprised, actually, 10 11 10 that this didn't discuss non-malignant pain as late as 11 I don't know. But it was not A. infrequent that employees of Purdue Pharma would be 12 June 8th. So for whatever reason, the -- either 12 co -authors on manuscripts. I don't know whether in 13 Mr. Innaurato or the person who was writing the 13 this case they were. 14 minutes didn't seem to include that, because I don't 14 And then if you'll turn over to page 4 Q. 15 think -- not to my recollection was there ever 15 of this document. It says, "Clinical: Status of Core 16 consideration of restricting this product to malignant 16 Clinical Program - Robert Reder" -- now, he's the 17 pain alone. It was widely used. Percodan, Percocet 17 18 were widely used in non-malignant pain . 18 A. 19 this product. 19 Q. Down below that it says, "Marketing 2 o has been interviewing potential advertising groups and 20 21 21 is close to selecting one." Do you know which advertising group 22 23 24 25 was ultimately selected? A. I don't know, but I'm sure we could find out if that were important. Coulter Reporting, LLC medical -- Q. Senior -- senior medical officer on Okay. "Robert Reder stated that the OC92-1102 study (OA Pain) has been completed and 22 preliminary data is currently being reviewed. It 23 appears that the 10 milligram tablet is similar to 24 placebo in efficacy, but the 20 milligram tablet was 25 significantly different compared to placebo." www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page 141 Were you aware that the 10 milligram 1 2 A. 4 Q. 2 morphine and that there is a stigma attached to 3 morphine so far as many patients and physicians are 4 concerned." I don't recall that. That would not be unusual in any analgesic trial, however. 5 6 I'm going to ask you about the 9 MR. THOMPSON : I'm sorry. We can go 7 principally cancer, drug associated with a whole bunch 8 of negative associations. Were one of the negative associations Q. 9 1 o ahead and mark it if you want. It's an end-of-life in many hands, A. 6 7 did we mark that? We did. This is PDD -- And that stigma is what? 5 meetings of the international R&D meeting. This is -- 8 Page 143 1 that not all patients can be successfully treated with tablet was similar to placebo in efficacy? 3 Page: 36 Richard Sackler, M.D. 10 side effects addiction, dependency, tolerance buildup? 11 PDDl 701824723, Exhibit 21. 11 12 (DEPOSITION EXHIBIT NO. 21 MARKED) 12 not differentiate it from any other opioid. It was 13 (Passing document.) Q. 14 Yes . But that -- the dependency did A. 13 not more dependence causing or less. Which appears to -- now we're in Q. 14 And under this, "In summary, the 15 November of '94, and present was Dr. R.S. Sackler, 15 efficacy of the product has been demonstrated" -- I'm 16 correct? 16 sorry, go to page 12. 17 A. If that's what it says, I must have 18 been present for at least part of that. 19 Q. Then on page 13 -- 20 A. Oh, yes, I was probably present for 21 all of it. Q. 22 17 A. Okay. Thank you . Okay . 18 Q. It's therapeutic -- 19 A. Okay. I'm on page -- 20 Q. Third paragraph. 21 A. From the top or bottom? Page 13, third paragraph. 22 Q. Third paragraph from the top. 23 A. Okay . 23 Actually, the fourth. Where it says, "In summary ... " 24 Q. "Dr. Yeang asked if there were any" -- 24 A. Yes. Thank you. 25 A. Just a second. I'm sorry. Page 13. 25 Q. " ... the efficacy of the product has Page 142 1 This one (indicating)? Are you reading from the top 2 here? Q. 3 4 Page 144 1 5 A. Okay. Thank you . 6 Q. About the eighth line down. "Dr. Yeang asked if there were any 7 2 involving 713 patients. Therapeutic conclusions are: 3 The equivalence of 1 milligram of Oxycodone to 2 4 milligrams of morphine sulfate." Yes, I'm reading from the middle of the paragraph. 5 A. That's correct. 6 Q. All right. No. 2 says, "Equivalence 7 8 statistically significant results. It was confirmed 9 that the 20 milligram product was significantly better been demonstrated in six double-blind clinical trials to IR Oxycodone." 8 A. Immediate release. 9 Q. Yeah. So they're saying 10 than the placebo but the 10 milligram product was 1 o controlled-release is equivalent to immediate-release 11 not." 11 Oxycodone? Was that brought up at the meeting? 12 13 A. It must have been. This is minutes of 12 A. The implication here is in terms of 13 potency, I assume. 14 the meeting, so I'm sure this was -- these minutes 14 15 were generally of good quality. 15 titration." 16 17 Q. If you'll turn over to page 11. And this is shortly before the launch of OxyContin, No. 3 was "The need for dose Q. 16 A. Yes. 17 Q. And No. 4 says, "The need for the 18 correct? We're now into November of '90- -- no, it 18 availability of a rescue formulation." And No. 5 19 was not. This is over a year before the launch, 19 said, "The need for aggressive management of side 2 O November of '94. 2 o effects." It says, in the third paragraph, 21 22 halfway down that paragraph -- Why would you need the availability of 21 22 a rescue formulation? 23 A. Yes. Dr. Reder? 23 24 Q. Dr. Reder. 24 doctrine of using opioids is to titrate to effect. 25 It says, "Advantages for OxyContin are Coulter Reporting, LLC 25 A. At this time, and still today, the But in some conditions, cancer and others, the dose www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 37 Richard Sackler, M.D. 8/28/2015 Page 145 Page 147 1 that has, in general, a good effect may suddenly be 1 whether to say it was for three to four hours or for 2 insubstantial due to what's called breakthrough pain, 2 six hours, and there was a real debate at the company 3 and breakthrough pain could be occasioned by movement 3 of how we're going to market this because we're going 4 or trauma or just occasioned by the fluctuation in the 4 to hurt ourselves one way or the other depending on 5 pain state. 5 whether we say our rescue drug is three to four versus 6 six, because it's the same and you're marketing it two Rather than maintaining a patient on 6 7 different ways? 7 the highest number of milligrams of any opioid around 8 the clock just to prevent breakthrough pain, the 8 9 normal practice -- and I think it's the prudent and 9 1 o safest practice -- is to give the patient an MR. STRAUBER: Objection to the form of the question. It consists of multiple questions 1 O and parts. 11 immediate-release form ideally of the same analgesic 11 12 agent that they can take when they have breakthrough 12 13 pain on an as-needed basis. 13 you could show me some documents - - if you wanted to 14 pursue this with other questions, please show me some 14 Q. Were there studies done at Purdue that You can answer it if you can. I have a vague recollection of it. If A. 15 showed that blood plasma levels that the medication, 15 documents. I have -- I do have a very hazy 16 instead of lasting for 12 hours really lasted between 16 recollection of this very minor complication, but 1 7 8 and 12 hours? 18 19 There were -- there were blood level A. studies that showed the profile of blood level, but 17 perhaps it was a big regulatory complication. I don't 18 remember. I couldn't explain it to you. 19 So we'll go back to that in a second. Q. 2 o there is no prediction of what blood level you will 2 o He's going to pull something . Let me continue to read 21 need to control what pain. So when we -- what we 21 22 attended to were the clinical results of treating 22 from this document. It says, "Dr. Kaiko reported that bio 23 patients at a 12-hour basis, and that was what we 23 24 researched. 24 A. Right. 25 Q. -- "undertaken to show that the 10, 20 Now, may I just go on a little bit? 25 studies" -- it's the fourth paragraph. Page 146 1 Q. Page 148 1 Sure. Let me ask you this though. and 40 milligram tablets were bioequivalent and dose 2 What your research actually showed is that OxyContin 2 proportional. In normal subjects it has been 3 Controlled-Release provides pain relief somewhere 3 demonstrated that at the same total daily dose the 4 between 8 and 12 hours, correct? 4 controlled-release product given 12 hourly showed the 5 6 A. appeared that way, but principally most were 12 hours . Allow me to just elaborate just a bit. 7 Normally people take a Tylenol tablet 8 9 I think there were some patients who every -- or two tablets every four hours, but they 5 same twofold fluctuation as the immediate-release 6 product given six hourly and that this held across the 7 four-fold dosage range." Were you-all aware of that in 1994? 8 9 I'm not certain what this means. I'm A. 1 o will get essentially the same effect if they take one 1 o sorry, but I don't know -- I don't know what "two-fold 11 tablet every two hours. What we had found was in most 11 12 patients - - this was found as the drug was marketed -- 12 13 who complained that at eight or nine hours they were 13 14 back in pain, yes, they could be treated every 15 three -- three times a day. But if you took that 14 15 fluctuation" means. I'm sorry. Did you ask anybody when you were at Q. the meeting? A. I'm sure I understood it, but I have a - - my -- my best guess is that whoever was taking 16 dosage, daily dose, and divided it twice a day, q. 12 16 the minutes somehow perhaps even didn't understand the 17 hours, they were just as pleased with the pain relief. 17 discussion or may have understood it but wrote it up 18 It was simply that the physician, perhaps by habit or 18 in a way that doesn't make any sense to me now. 19 for other reasons, rather than increasing the 19 Q. Going down to the fifth paragraph. 2 o twice-a-day dose increased the daily dose by telling 20 "A clinical study has been undertaken comparing 21 the patient, Well, take it every eight hours, and it 21 22 would work fine. 22 q.i.d. in patients previously stabilized to pain 23 Q. Do you recall Purdue Pharma running 23 24 into a real problem with their rescue drug because 24 25 they were trying to decide how to market it and 25 Coulter Reporting, LLC Oxycodone b.d. versus immediate-release Oxycodone relief." And then if you drop down, "the study demonstrated that both products maintained baseline www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:38 Richard Sackler, M.D. 8/28/2015 Page 149 1 pain control and pain intensity was the same Page 151 Do you recall that study being Q. 1 2 throughout the day. The acceptability score was the 2 3 same throughout the study and the same for immediate- 3 4 and controlled-release products." 4 It was studied. But they must have concluded that 5 that finding is not consistent with either their And then if you drop down to the next 5 dismissed as a failed study? I don't know that it was dismissed. A. 6 paragraph. "The conclusion from the study was that 6 expectation or ours, or, more importantly, other 7 the 12-hour product was equivalent in efficacy to 7 studies and experience. And clearly the product's 8 immediate-release Oxycodone." 8 success in treating patients in pain, which is 9 And is that why the FDA said other 9 indisputable, would put a lie to anybody who would 10 than how many times you take the product being the 1 o say, Oh, Oxycodone is no better than placebo. I don't 11 dosing requirements, there's really not any other 11 think any doctor would assert that. For treating 12 12 13 14 benefit? A. The F- -- I can't tell you whether this was the study that convinced the FDA of that, but pain, I should say. 13 Q. Right. 14 A. Maybe they -- maybe they would say in 15 it certainly -- it's not -- the finding is completely 15 terms of urinary incontinence it's not effective, but 16 consistent with that. There may have been other 16 for treating pain. 1 7 studies that led them to that conclusion with this 17 18 18 depends on other factors, such as abuse. I mean, you 19 being just supportive of that conclusion. In pain studies, I might point out But whether it's effective or not also Q. 19 can kill somebody and take away their pain, but that 2 o that the biggest advance in measuring pain -- which, 20 certainly wouldn't be effective, would it? 21 of course, is a personal experience. No doctor can 21 22 look at you and say, Oh, you've got a pain level of 3 22 considered a sign of efficacy. I don't think that death would be A. 23 and you have a pain level of 6. There's no way of 23 Q. Correct. 24 doing it. You have to depend on the patient's report. 24 A. Yes -- I mean, in the extreme, yes, 25 And the huge advance that led to all the research in 25 what you said is correct. 1 analgesia and pain relief was called the McGill Visual 1 Page 150 Page 152 2 Analog Scale that was developed in the 'S0s at McGill 2 3 University in Montreal. Seventy years later we have 3 4 no advance on that. 5 And needless to say -- I suspect 4 5 So just because it takes away pain Q. doesn't mean it's a good drug, does it? A. No. Q. All right. Let's look at Sackler Exhibit 13 again. I did want to c;1sk you one question 6 everybody in this room has gone to a doctor where they 6 about this. 7 say, "Do you have pain," and if you say -- or to a 7 8 nurse when they take your blood pressure -- "Yes, I 8 effectiveness -- I'm sorry. There's always a balance 9 have pain," and they ask you to rate it. That is 9 between effectiveness and safety. 1 o clearly better than just saying, patient has pain 10 11 plus, yes or no. But it's not a lot better. It's not 11 There's always a balance between A. If you go to page 4, 1.4. It says, Q. "If physicians perceive OxyContin as 12 terribly -- it's not reproducible and it is highly 12 controlled-release Percocet, it is likely that they 13 influenced by the environment and other factors that 13 14 affect the report the patient gives. 15 So very often you can compare a highly will start to use it in place of Oxycodone 14 combinations. As physicians become more comfortable 15 with the use of the Oxycodone combination market, it 16 effective pain reliever to a placebo and you get in 16 17 the study no difference, and that is widely 1 7 of Class III hydrocodone or codeine combination 18 recognized, and that probably related to the study 18 drugs." 19 that you talked about earlier. 19 20 The FDA, however, would have required 21 studies that showed a difference, and they did, before 22 is possible they will start to use OxyContin in place And Class III are not as regulated as 2 o Class II, correct? 21 A. That is correct. they would approve the product. In other words, the 22 Q. "Therefore, it is imperative that we 23 negative didn't -- was dismissed as a failed study by 23 24 the FDA. The positive studies control, because 24 25 negative studies -- 2 5 establish a literature to support a Class III use for Coulter Reporting, LLC establish a literature to support such use." Who at Purdue Pharma was trying to www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:39 Richard Sackler, M.D. Page 153 1 Page 155 1 OxyContin? MR. STRAUSER: Object to the form of 2 3 the question. 4 A. R-E-D-E-R. 2 A. Yes. 3 Q. And he says, "Currently our draft Your -- the answer to your question is 4 5 nobody. We had no plan, program or expectation 5 A. Yes. 6 that -- or intention to change OxyContin from a 6 Q. -- "and, therefore, our sales material 7 Class II to Class III. In fact, it is not too long 7 8 ago the FDA has reclassified Oxycodone as a Class II 8 9 drug. Okay. So you think that -- where it Q. 10 have the same dosing of rescue as q. 3-4h p.r.n." And that is -- means what? 9 A. 10 needed . 11 says, "Therefore, it is imperative we establish a 11 12 12 literature to support such use" is referring to PI" -- that's package insert, correct? It means every three to four hours as Okay. And do you know if the people Q. who were involved in the studies of OxyContin were 13 physicians believing where it says "Physicians 13 given OxyContin for rescue pain? 14 perceive OxyContin as controlled-release Percocet, it 14 A. OxyContin? 15 is likely they will start to use it in place of 15 Q. Yes. 16 Oxycodone combinations"? Is that what that 16 A. Or you mean Oxycodone? 1 7 development of literature is referring to in your 17 Q. Oxycodone. I'm sorry. 18 A. I'm sorry. I don't know. 19 A. Probably, yes. 19 Q. It says, "BK brought this issue up 20 Q. Who -- who was -- 20 21 A. I don't know. 21 the review of our sales material. OxyIR" -- and is 22 Q. -- trying to develop that literature? 22 that Oxycodone? A. I don't know. That would have been a 18 opinion? some time ago. It is now surfacing again because of 23 A. Yes. 24 combination. That would have been the medical 24 Q. -- "is being promoted as rescue q. 25 department to do studies and then have them published. 25 23 3-4h." Page 154 1 Page 156 That would have been a research effort. And that's every three to four hours, 1 2 Are we finished with this one? 2 3 MR. STRAUSER: Off the record. In 3 A. That's correct. Q. He said, "While this may be consistent right? 4 between subjects, would now be a good time to break 4 5 for lunch? 5 with the OxyContin package insert if it is approved as stands, it will be inconsistent with the OxyIR 5 6 MR. THOMPSON: Yes. 6 7 VIDEOGRAPHER: We are off the record. 7 milligram package insert which uses q. 6h," meaning 8 you take it every six hours, correct? 8 1:11 p.m. (RECESS) 9 VIDEOGRAPHER: We are back on the 10 13 BY MR. THOMPSON: Q. up after our break. We've taken a number of breaks, but I'll just remind you, any time you need to stop or 16 need a break, just let us know -17 Q. 10 Q. He says, "Moreover, if we use the q. What was the reason that you-all did 13 14 18 That's what it means. 12 their package insert." All right. Dr. Sackler, picking back 15 A. A. 11 3-4 hours, it will help to validate Roxane's change in 11 record at 2:03 p.m. 12 9 14 not want to validate Roxane's change in their package 15 16 Thank you. -- and we'll stop again. We were talking earlier about this insert? A. I -- I would have to read this 17 completely and try to answer your question, but I'm 18 not sure this will prompt me to remember. May I? 19 Q. Sure. 2 o issue with rescue OxyContin. And let me hand you what 20 A. I really don't remember this well 21 21 19 we're going to mark as Exhibit 22. 22 (DEPOSITION EXHIBIT NO. 22 MARKED) 22 23 (Passing document.) 23 24 25 Q. And if you go back to the last page, there is a memo dated 9-21-95 from Robert Reder, Coulter Reporting, LLC enough to answer your question. Q. Well, let me continue reading here. It says, "Finally, it creates a problem for the OxyIR 24 10 milligram and 20 milligram capsules as the package 25 insert would have two different dosing intervals www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 157 1 depending upon the use, i.e., q. 4 for rescue and q. 6 Page 159 1 2 for usual pain use." 2 3 He says, "One suggestion would be to 3 Page:40 Richard Sackler, M.D. A. No, but it looks like I wrote it. Q. Okay. And then Robert Kaiko writes back and says, "Unfortunately soon may be too late. 4 make everything consistent at q. 6 hours. Rescue 4 Robert? As previously" -- so he's saying I brought 5 would then be q. 6 p.r.n." -- as needed -- "as would 5 this up again. 6 some acute pain prescriptions. For ATC use, it would 6 7 be just q. 6 hours. 7 everything to q. 6 hours for immediate-release 8 Oxycodone products." "Although I hate the thought of 8 9 10 recommending a PI change" -- package insert change -"I understand FDA may recommend a change or two such "As previously, I recommend we change 9 10 And he is the head of what, Robert Kaiko? 11 as removing the plasma curve graph. At this point we 11 12 could change the frequency of dosing in the PI. What 12 he was the project -- the research project head for 13 13 the overall OxyContin project. do you guys think?" So what he's saying here is, we've got 14 He was in the medical department and A. Okay. So he's saying, it appears to Q. 14 15 the exact same drug, we've marketed it for two 15 me, maybe perhaps to be a little frustrated and 16 different purposes, and we've got two different dosing 16 saying -- 1 7 regimens for the exact same drug, correct? 17 A. I don't know. 18 Q. -- "Soon may be too late. As A. 18 It seems to suggest that, but I can't 19 confirm it. 19 previously, I recommend we change everything to q. 6 20 hours"? And then Paul Goldenheim -- if you Q. 20 21 turn to the next page and read the next one at the 21 22 bottom -- says -- and who is Paul Goldenheim? A. 23 24 22 He was head of R&D, research and development and medical. He says, "The issue that won't go Q. 25 I can't say why he wrote the first A. sentence, whether he was frustrated or whether he was 23 actually referring to some sort of deadline, maybe in 24 a clinical trial, maybe on submissions to the FDA. I 25 don't know why. Page 158 Page 160 1 away. Robert is right, we need to discuss again. 1 2 Robert, please arrange a meeting. Round up the usual 2 But at least from the appearance of Q. this, you've got Friedman, the head of marketing, 3 suspects. This is too complicated for e-mail." 3 saying why don't we take the same product and just say Then Friedman -- and what was his 4 take it every six hours, and if it's for rescue it's 5 good for three or four hours? 4 5 role? 6 A. He was head of marketing and sales. 6 7 Q. Right. This -- essentially to fill in A. The head of marketing and sales writes 7 8 back and says, "Is it unreasonable to have a q. 6h 8 was, have two indications. For regular use of 9 dose" -- meaning take it every six hours -- "for 9 immediate- release Oxycodone, administer it around the 10 1 o clock every six hours; for rescue use, administer -- normal dosing and a q. 3-4 hour for rescue?" So the marketing guy is saying, Well, 11 the blank here, what his -- what he must have meant 11 you can administer the dose every three to four. But 12 hey, can't we just take the exact same medication and 12 that wouldn't be indefinite, this would be for rescue 13 say if it's for a normal dosing, take it every six 13 for breakthrough -- actually for breakthrough pain . 14 hours, but if it's for rescue, take it every three to 14 15 four hours? 16 A. 15 is not a physician, correct? That's what he says. And what he 16 A. 1 7 meant was for normal around-the-clock dosing rather 1 7 suggestion. 18 than rescue, which is one or two or three doses and 18 19 that's it, as needed. 20 Q. And Friedman, the head of marketing, Q. That's correct. So he's making a Dr. Robert Kaiko, the head of the Q. 19 project for Oxycodone, is a physician, correct? And then up at the top you write back 20 A. He is. Q. And he's saying, don't do what 21 and say, second one down, "I agree, this is too 21 22 complicated to solve through written exchange. Paul, 22 Friedman's saying, we need to make it q. 6 hours for 23 I think that you should get us together soon. Good 23 24 pickup someone." 24 25 Do you recall writing that e-mail? Coulter Reporting, LLC 25 immediate-release Oxycodone products, correct? A. First of all, Friedman asks a question here. He's not asserting a proposition, he's asking, www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:41 Richard Sackler, M.D. Page 161 1 Page 163 1 immediate releases? Is that what that is? explain to me why we can't do this. And I understand 2 why he asks the question. And the only answer could 2 3 be it would -- it might be confusing to a physician, 3 I'm just reading the sentence because I'm not -- I 4 but I think the emphasis should be on "might be 4 didn't follow what it meant. 5 confusing." 5 and say, "I don't know how urgent this is. If it He says -- the next sentence says, "In Q. 6 essence if you can use an IR q. 6 hours at a cheap 7 price, then those doctors that use OxyContin q. 8 And then you write back the next day Q. 6 7 Yes, IR would be immediate releases. A. 8 can't wait until tomorrow, let us know immediately. I 8 hours (there will be some regardless of what we say or 9 don't have a problem with this change at all. Does 9 do) will not see a benefit over the immediate 1 o releases. In addition, our promotional campaign has a 1 o anyone question it?" And who is Mr. Alfonso? 11 12 A. He was head of marketing at the time. 13 Q. Okay. So the head of marketing comes 11 visual, six cups representing q. 4 hours. If we go 12 q. 6 hours, we will -- might have to change the visual 13 to four cups, and this will not have as much impact. 14 back and he says, "The way these drugs are written are 14 We need to go q. 6 hours for maintenance and q. 3-4 15 q. 4-6. The rescue is for q. 3-4 hours." And he 15 hours for rescue so that we can maintain the integrity 16 explains, "The problem might be that if we go the q. 16 of our OxyContin studies." 1 7 3-4 hour route, we will validate the Roxane dosing ... " 17 Again, I'm going to ask you, do you 18 19 know what the problem was what validating the Roxane Did I read that correctly? 18 A. You did. 19 Q. Do you know whether you went q. 3-4 2 o hours for rescue and 6 hours for maintenance? 2 Q dosing and why he thought it was a problem? 21 A. I don't know. 22 think it was a problem. I can't imagine what he was 22 Q. All right. Let's -- let me jump back. 23 23 I'm going to hand you this document. 21 24 I don't remember. I don't really A. thinking of. Q. Okay. So he writes, "The problem 25 might be that if we go the q. 4 -- q. 3-4 hour route, 24 (Passing document.) 25 MR. THOMPSON : Why don't we go ahead Page 164 Page 162 1 we will validate the Roxane dosing and possibly 1 2 present a challenge to the OxyContin studies." 2 3 So if he's validating the Roxane with 3 4 the q. 3-4, would it appear that perhaps the Roxane 4 5 had required -- now, that's an overseas company, 5 6 correct? 7 8 9 6 and mark that as Exhibit 23. (DEPOSITION EXHIBIT NO. 23 MARKED) This is from you dated April 20th, Q. 2000. So OxyContin has been on the market over four years at this point, correct? No. Roxane was an American company, I 7 A. Yes. believe, at that time owned by Boehringer-Ingelheim. 8 Q. And under No. 5 it says, "OxyContin A. Q. Okay. Did they -- did they put a 9 1 o dosing limit on OxyContin to your knowledge? Tablets price increase is the central decision. Every 10 0.1 percent is 1M" -- I'm assuming that's one million? 11 A. Oxycodone you mean? 11 A. That's correct. 12 Q. On Oxycodone. 12 Q. -- "one million to the bottom line. 13 A. No, not to my knowledge. I don't 13 What would the risk of having a 4 percent 14 think it was an issue of limit. 15 Q. 14 increase instead of a" -- "what would the risk be of 15 having a 4 percent increase instead of a 3 percent Do you know what Roxane's dosing was 16 that he's referring to? 17 18 19 A. No. Q. So he says, "The problem might be that 16 increase?" 17 And you're talking about price 18 increase, correct? if we go the q. 3-4h route, we will validate the 19 A. That's correct. 2 o Roxane dosing and possibly present a challenge to the 20 Q. "Our average realized price is 21 21 OxyContin studies. On the other hand, a much more constant, suggesting that rebates and other discounts 22 dangerous scenario can occur if we go the q. 6 hour 22 are taking a larger share of our business. 3 percent 23 for maintenance and rescue. If we go this route and 23 annual notional increases seems to hold our per KG" -- 24 price continues to be a major issue when we narrow the 24 is that kilogram? 2 5 value of OxyContin closer to the IRs" -- and that's 25 Coulter Reporting, LLC A. Kilogram. www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page: 42 Richard Sackler, M.D. Page 167 Page 165 2 2 Was it true that every time you increased the price 0.1 percent you added one million 5 to the bottom line of Purdue Pharma? A. 6 Yes. Q. You-all paid him approximately 50 I don't remember. The answer is no to 3 million dollars to defend you in that case -- or paid 4 his firm approximately 50 million dollars to defend 5 Purdue in that case? 7 8 correct or not when I wrote it, but it certainly 8 9 wouldn't have been correct every time. I'm -- I can't verify. That's the A. 6 7 your question. I don't remember whether this is Q. A. 1 where many prices are going up." 3 4 -- "price constant in an environment Q. 1 first time I've heard a number attached to that. If he testified to that, would you Q. 9 dispute it? We were talking earlier about Purdue 10 A. I would have no basis to dispute it. 11 Frederick versus Purdue Pharma. Did you ever 11 Q. And do you know if anybody at Purdue 12 determine whether the employees -- the sales force 12 10 made an effort to determine whether the submission and 13 that engaged in improper conduct as referenced in the 13 the call notes that were pulled by the lawyer hired to 14 felony plea agreement were employees of Purdue 14 represent you were accurate or not? 15 Frederick or employees of Purdue Pharma? MR. STRAUBER: I object to the form, 15 MR. STRAUBER: I object to the form of 16 because I don't know how anyone knows what it is 1 7 the question. I don't think it accurately reflects 17 you 're referring to . 18 the plea agreement. 18 16 19 A. Could you just restate the question 2 o because I kind of lost the thrust? 21 Q. Are you aware that he made a Q. 19 submission on behalf of Purdue to the U.S. Attorney's 20 Sure. Did you ever make a -- we've Office? talked about Purdue Pharma and Purdue Frederick. Did 23 you ever make a determination whether the employees 22 I am not aware of anything that he A. 21 22 submitted to the U.S. Attorney's Office. You've not reviewed any of the Q. 23 24 who engaged in illegal activity as referenced in the 24 materials he submitted to the U.S. Attorney's Office 25 25 when he was defending Purdue? felony plea agreement -- or improper activity as Page 166 1 Page 168 referenced in the felony plea agreement were employees 1 2 of Purdue Frederick or employees of Purdue Pharma? 3 A. 2 I'm not aware of whether such a study A. I did not. Q. Were you aware of the call notes that 3 he pulled and purported were evidence of improper behavior on behalf of Purdue salespeople? 4 was done or anybody focused on that question that may 4 s have been done. But you should be -- you should think 5 6 of this, that the felony plea agreement came years 6 7 after many remedial actions had been taken to retrain 7 A. No. Q. Did anyone at Purdue, to your knowledge -- Purdue Pharma or Purdue Frederick -- make 8 everybody, to discipline, sanction -- correct, 8 any attempt to ascertain what percentage of reps in 9 discipline, sanction or dismiss employees who had 9 10 behaved improperly, and those processes which started Kentucky were engaging in the type of behavior that 1 o the plea agreement says was improper? 11 late in 2000 or early 2001 continued right up to the 11 A. I'm not aware of that. 12 12 Q. Did you ever instruct anybody to do To do? Could you be more precise, 13 plea agreement and then after the plea agreement. Q. Sure. Have you looked at the call 14 notes of the reps in Kentucky? 13 it? 14 A. 15 please? 16 were showed to me during my preparation. There were 16 Q. 17 1 7 Purdue to undertake an investigation to find out what 15 18 19 A. I have not seen any except those that three or four that I saw. Q. Did you review the documents that Mr. Shapiro, the lawyer that you-all hired, put 2 o together for the U.S. attorney in Virginia? 21 22 23 A. I don't think so. Those don't seem familiar to me. Q. And that was the attorney that you-all 24 hired to defend you in the case brought by the U.S. 25 attorney in Virginia; is that correct? Coulter Reporting, LLC 18 Did you ever instruct anybody at percentage of reps in Kentucky, and which ones, were 19 engaging in conduct that was referenced as improper in 2 o the felony plea agreement? 21 A. No, I did not. 22 Q. Have you reviewed Howard Shapiro's 23 deposition in this case? 24 A. I have never seen it. 25 Q. He was asked -- let me read this www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:43 Richard Sackler, M.D. 8/28/2015 Page 169 1 question and his answer. "Mr. Shapiro, before the break, we 2 Page 171 No. I think he would like to see it. A. 1 MR. STRAUSER: I'd like to see it 2 3 were discussing the agreed statement of facts, and 3 also . Plus, he really can't see that distance 4 specifically paragraph 20. One of the questions that 4 physically. 5 I asked you previously about the conduct described in 5 6 the agreed statement of facts was, did you ever figure 6 7 out who the employees referenced in the agreed 7 8 statement of facts worked for, was it Purdue Frederick 8 9 Company, was it Purdue Pharma, L.L.P., or some other 10 entity? MR. ELLIS: We'll print off some copies . MR. THOMPSON: Why don't we go off the record while we get some copies of this. VIDEOGRAPHER: We are off the record 9 10 at 2: 28 p.m. 11 (RECESS) 12 been discussing -- and those are employees whose 12 VIDEOGRAPHER: We are back on the 13 conduct is described in paragraph 20 and its various 13 "With respect to the employees we've 11 record at 2:29 p.m. Sure. And to save time, I'll let you 14 subparts -- did you ever do a determination to 14 15 determine whether those employees were employees of 15 read it. Can you start with the next question, which 16 16 was "Uh-huh" and read the answer. Purdue Frederick Company who signed the agreed 1 7 statement of facts or some other Purdue entity?" 18 Read the answer. The "Uh-huh" doesn't A. 17 And his answer is, "Without going into 18 Q. really set up the answer for me. 19 too much work product, let me state we did sufficient 19 2 o investigation once -- once it turned this direction to 2 O 27, the "Uh-huh ." 21 satisfy ourselves and our client that there were MR. STRAUSER: That's page 214, line THE WITNESS: 2017? 21 22 Purdue Frederick employees who engaged in the conduct 22 23 that's referenced in here and that forms the basis for 23 24 the guilty plea." 24 THE WITNESS: 214. 25 MR. STRAUSER: -- 14, line 17. "Question: Were there any employees 25 MR. STRAUSER: Yes, I'm sorry. Page 2 -- Page 172 Page 170 1 of Purdue Pharma, LLP that are referenced here or any 2 other Purdue entity?" MR. STRAUSER: Okay. 2 "Answer: Well, again, and I'm -- just 3 THE WITNESS: Right. 1 3 "Uh-huh" is the question. A. "Answer: Of people who are referenced 4 what I said before, the -- I don't know whether at -- 4 5 at which point in time Michael Friedman hired Udell, 5 but not named in some of the paragraphs, I don't 6 Paul Goldenheim, whether they were Purdue Pharma or 6 believe that we made any effort to determine whether 7 Purdue Frederick or some of the -- some of them had 7 at the relevant times they were Purdue Frederick 8 been one and then the other. Beyond them there 8 Company employees or Purdue Pharma employees." 9 were -- when we looked, for instance, at the names 9 Q. Okay. And is that testimony accurate? A. I can't -- I can't vouch that it's 1 o that are associated with the -- in the first 10 11 supplemental responses to whatever that was, 23, I 11 accurate. It's consistent with my knowledge. 12 think." 12 Now, did you understand that answer? 13 MR. STRAUSER: Mr. Thompson, I object 14 13 14 15 to the question. Plus, could you let the witness have 15 16 a copy to read, as it's very hard to follow when 16 17 you're reading such a lengthy - - 17 So the next question says, "So it Q. could have been either or one or both." A. Yes. The question is, "So it could have been one or either or both; you're not sure?" And the answer is, "Correct." Q. Yeah. Now, in 2001, who did Michael 18 MR. THOMPSON: Sure. 18 19 MR. STRAUSER: -- series of questions 19 A. I don't know. 20 Q. You don't know if he worked for Purdue 20 and answers. MR. THOMPSON: Do we have another copy 21 22 of this, Tony? 23 Q. 21 22 Friedman work for? Pharma in 2001? A. My best guess is he worked for Purdue 23 Frederick, but it's a guess, and maybe for Purdue 24 just read along with me, if you want to do that, and 24 Pharma, but I don't really know. 25 25 Here. I'll tell you what, you can I'll hold it over here. Coulter Reporting, LLC Q. How about Howard Udell, do you know www.coulterreporting.com 502-582-1627 Page:44 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 173 1 2 3 4 A. No. Q. What about Paul Goldenheim, do you know who he worked for? 5 A. I don't -- I don't know that. 6 Q. Do you know whether you worked for 7 Purdue Pharma or Purdue Frederick in 2001? Page 175 1 interviews were conducted with more than 500 2 healthcare professionals. In our focus group findings who he worked for? 3 we learned that MS Cantin" -- that's the drug that you 4 already sold, correct? 5 A. I'm sorry, I didn't hear the question. 6 Q. That's morphine sulfate, correct? 7 A. Yes. Q. That's the one that you had not had 8 A. I don't know for sure. 8 9 Q. So going back to our OxyContin launch 9 any reports of abuse or diversion with that you could 1 O recall, correct? 10 team. I'll hand you that. (Passing document.) 11 A. None that I was aware of, yes. Do you want to put a number on this? 12 Q. And it says, "We learned that Q. Yes. Let's mark that as Exhibit -- 13 25? 14 creative concept testing showed the likelihood of 11 12 A. 13 MS Contin is the gold standard for cancer pain. Our 14 A. 15 Q. -- 25. 15 16 A. No. 16 scale of 1 to 5, which is very favorable." OxyContin usage by physicians and nurses were 4.6 on a Were you aware of this creative 17 COURT REPORTER: 24. 17 18 (DEPOSITION EXHIBIT NO. 24 MARKED) 18 concept testing and focus groups that were being Q. 19 And I've just got a couple of 19 conducted? 2 o paragraphs I want to ask you about. 20 A. I don't recall . Q. And then if you go to the next page, 21 A. Sure. 21 22 Q. So on -- this is dated April 4th, 22 page 2, last paragraph. "Our meeting ended with a 23 1995, and it says at the first paragraph, second 23 question and comment period. Michael Friedman 24 sentence, "Mike Innaurato" -- 24 emphasized the threat that AB-rated generics posed to 25 MS Cantin. We're not sure when AB-rated generics will 25 A. Oops. First paragraph on which page? 1 Q. I'm sorry. Page 1, second paragraph. 2 A. 3 Q. Page 176 Page 174 4 be launched, but we don't think it will be until 1996. Oh, second paragraph. Okay. 2 Inevitably the AB-rated generics will arrive and this "Mike Innaurato" -- he's the marketing 3 is why it is extremely timely importance that we must guy again, correct? 4 establish OxyContin. OxyContin can cure the 5 vulnerability of the AB-rated generic threat, and that A. Yes. Q. -- "discussed the marketplace that 6 is why it is so crucial that we devote our fullest OxyContin will enter and how OxyContin will expand out 7 efforts now to a successful launch of OxyContin." 5 6 7 1 8 of the cancer pain market. OxyContin will be launched 8 9 in 10, 20, 40 milligram tablet strength, 80 and 160 9 10 milligram tablet strength to follow." 10 And if you go on down a little bit 11 Were you aware that was part of the strategy? I'm sorry, but what was part of the A. 11 strategy? That the AB-rated generics were going Q. 12 further, he says, "OxyContin will be indicated for the 12 13 relief of pain with the convenience of q. 12 dosing. 13 to arrive and that is why it was extremely timely 14 OxyContin's primary market positioning will be for 14 importance -- that's the way it's written -- that we 15 just establish OxyContin and it was crucial to devote 15 cancer pain and the secondary market will be for 16 non-malignant pain, musculoskeletal injury and trauma. 16 the fullest efforts to a successful launch because of 17 It was reinforced that we do not want to niche 17 18 OxyContin just for cancer pain." And was it part of your-all's 19 AB-rated generics? MR. STRAUBER: Objection to the form. 18 19 The witness can answer. 2 o marketing strategy not to niche OxyContin for cancer 20 21 21 pain? A. Yes, I was aware of that. And the reason is clear. MS Cantin was our most important 22 A. Not to limit it, yes. 22 product at that point, and when the sales were eroded 23 Q. Below that it says, on the last 23 by generics, we would have -- if we had not replaced 24 paragraph, "In our market research efforts, focus 24 those sales with other product sales, we would have a 25 groups, personal one-on-one interviews and telephone 25 much smaller company. That would cost many people Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 45 Richard Sackler, M.D. 8/28/2015 Page 177 1 their jobs. Are you familiar with the OxyContin Q. 2 3 I've become reminded of it, yes. A. long-term safety study devoid of some condition, so the long-term study would be focused on following a 4 condition, that's low back pain or osteoarthritis. 5 And at that time the studies were typically 12 weeks MR. THOMPSON: Let's mark this as 5 6 2 3 Product Team? 4 Page 179 I don't know how you would do a A. 1 Exhibit -- is it 257 6 and with an open extension at the end they could go on 7 COURT REPORTER: 25. 7 for a year. 8 (DEPOSITION EXHIBIT NO. 25 MARKED) 8 (Passing document.) 9 9 And this is minutes of the OxyContin Q. 10 That is a subcategory of non-malignant Q. pain, correct? These two studies, low back pain and A. 10 11 Product Team dated -- the meeting was February 22nd, 11 osteoarthritis. Long-term safety would be a general 12 1996 up at the top. 12 concept that would apply to any kind of study that's 13 A. Washington's birthday. 13 14 Q. It says, first paragraph, "The 14 long enough to accumulate that data. They've included long-term safety data Q. 15 OxyContin Product Team met on Friday, February 22nd, 15 under their marketing wish list under non-malignant 16 1996, and topics of discussion included the 16 pain, correct? 17 following:" Number one is "Marketing's wish list for 17 A. They did. 18 18 Q. So it looks like they're saying we clinical studies," and then it's got a list of 19 studies. Number one is "Postoperative pain to support 19 2 0 the Abbott agreement." 2 0 for non-malignant pain. Why did you need studies on 21 22 need long-term safety data on prescribing OxyContin Do you read that the same way or 21 postoperative pain to support the Abbott agreement? 22 differently? 23 A. I don't recall. 23 24 Q. "Pharmacoeconomic." What was the 24 than you do. Just that it wasn't that we needed it, 25 it was a wish list. But it was inherent in any 25 reason for pharmacoeconomic studies being needed, if I -- I guess I read it differently A. Page 178 Page 180 1 you recall? 1 2 A. I don't recall that circumstance . 2 3 Q. And then it says, "Non-malignant pain 3 long-term study we did of any pain condition. And then we talked about the FDA's Q. statement about comparative studies. Do you remember 4 (example, functional improvement)." And then the 4 that, where they said you should refrain from 5 subcategories are "Low back pain; osteoarthritis, 5 comparative analysis? 6 long-term safety data." 7 8 9 6 I don't remember. So if you could A. A. Right. 7 just go forward with the question, that would be Q. Why did you think that marketing 8 needed -- was needing on March 7th, 1996, after the 9 great. Sure. One of the things that the Q. 1 o product had already been launched, long-term safety 1 o OxyContin marketing team's wish list has under No. 5 11 data? 11 is "Comparative studies, especially versus: 12 13 A. 12 Combination opioids such as hydrocodone combinations, I don't remember precisely. But all 13 studies would include or would enhance the data Duragesic, MS Contin, Kadian and Ultram NSAIDS." 14 available to support long-term safety if the studies 14 15 were long term. And the studies that were referenced 15 antiinflammatory drugs; is that right? 16 here, low back pain and osteoarthritis, would surely 16 1 7 have been long enough to add to that database. 17 Those are nonsteroidal A. Ultram is an opioid drug. NSAIDS are nonsteroidal antiinflammatory drugs. 18 Q. Right, NSAIDS. 19 the OxyContin -- or the OxyContin Product Team on 19 A. So they're not the same. I don't know 20 2 o why they were -- the bullet put them together, but 18 Q. Then can you explain why the head of February 22nd, 1996, after the product launch said we 21 need long-term safety data? 22 A. I don't think there was any question 21 they're different. 22 Q. Right. No, no. I get it. I'm asking 23 about the safety of the drug. It was just an addition 23 you, is that what NSAID stands for, nonsteroidal? 24 that it would enhance the dossier that was available. 24 A. Yes. 25 Q. Has that been marked? 25 Q. Do you -- Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page:46 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 183 Page 181 1 2 A. That's been marked 25. Q. All right. Now, let's go to the 1 other healthcare companies weren't involved? launch plan. And this is dated September 27th, 1995. 4 And if you 'll go to page 42 of the launch plan. I don't know whether other healthcare A. 2 3 3 companies were involved, but the government would not 4 have been involved in setting up this program. 5 (Passing document.) 5 6 Under 5.851 under " Public Relations" 6 reiterate the prevalence and problems uncovered in the 7 consumer survey and explain how Purdue Frederick has 7 at the top it says, "The objective of the public And it says, "This campaign would Q. 8 relations campaign is to create broad awareness of the 8 made a commitment to improving the level of care for 9 launch of OxyContin. This awareness will be directed 9 patients suffering in pain. In addition, the campaign 10 at the consumer and healthcare professionals through 10 would expand the recent launch of Purdue Frederick's 11 various media channels, such as print, TV and radio. 11 newest partner against pain; OxyContin." 12 In an effort to create a 'media hook' that would 12 13 coincide with the launch of OxyContin, a consumer 13 just made an error in reading . "It would explain" not 14 survey conducted by a company such as the Gallop Poll 14 15 is being proposed. This survey would focus on the 15 16 prevalence and problems of chronic pain, both 16 MR. STRAUBER: Excuse me. I think you "would expand." MR. THOMPSON : I thought I said "explain." 1 7 malignant and nonmalignant. The release of the 17 18 18 addition to the above public relations campaigns, we 19 are exploring the possibility of Purdue Frederick results of such a survey would be publicized along 19 with the recent FDA approval of the new And then the next paragraph says, "In Q. 2 o controlled-release Oxycodone preparation OxyContin. 20 sponsoring a pain management foundation in association 21 This is a classic problem/ solution strategy to create 21 with an organization such as Gilda's Club." 22 a need for the launch of a product such as OxyContin." Did I read that correctly? 23 Do you know if you sponsored a pain 22 23 24 A. You did. 24 25 Q. Do you know if a poll was conducted by 25 management foundation? I do not, but I -- no, I don't -- I A. don't know if we did that. I don't think we did, but Page 184 Page 182 1 someone such as the Gallop Poll? 2 3 4 5 A. 1 I don't know what the poll is 2 precisely. Q. Then -- then the next paragraph says -- 5.852. It says, "In an effort to continue the that's a vague recollection. Can we agree that the main way you Q. 3 marketed and promoted OxyContin was with your sales 4 force? 5 A. Yes. Q. And those are the people that actually 6 publicity about the launch of OxyContin, approximately 6 7 two to three months after the initial public relations 7 8 campaign, another campaign would be launched focusing 8 to the communities and sell OxyContin, correct? 9 go out to the physicians' offices and pharmacies and They don't actually sell, but they on the expansion of Purdue Frederick's Partners 9 1 o Against Pain Program developed to improve pain 10 11 management knowledge among healthcare professionals 11 don't actually take orders and arrange deliveries and 12 and patients' caregivers." 12 collect any money. Partners Against Pain was a creation 13 14 13 of Purdue Frederick, correct? most valuable resource that Purdue had to sell OxyContin, correct? A. That's what it says . 15 16 Q. And there were no partners, correct? 16 A. No, I think there were partners, the 17 17 meaning of the campaign. Okay. And you would consider them the Q. 14 15 18 A. promote OxyContin. The distinction being that they A. It was the most valuable resource that we used. We thought it was the most efficient 18 resource and that's why we used them. Whether other 19 Q. Who do you think the partners were? 19 approaches or resources would have been more valuable, 20 A. Physicians, nurses. Other healthcare 20 Ican'tsay. 21 22 23 workers are partners. Q. 21 24 the sales force? government wasn 't involved in Partners Against Pain, Coulter Reporting, LLC At some point did you figure out that 2 3 prescribing OxyContin was through regular visits from it up, there weren't any other partners involved in 24 setting up Partners Against Pain? I mean, the 25 Q. 2 2 the key to getting physicians to prescribe and keep Oh, okay. So -- but as far as setting 25 A. That would be typical of any www. cou lterreporti ng .com 502-582-1627 Page: 47 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 185 1 pharmaceutical sales force, yes. Q. 2 1 And was there a realization that Page 187 And then your top sellers were Q. 2 rewarded with trips to Bermuda or London in what was called the Toppers Program; is that correct? 3 developed that certain physicians, so-called core 3 4 physicians, were more likely to prescribe OxyContin? 4 A. Yes. 5 Q. And during the first five years of A. 5 I'm not sure. It wasn't -- I think it was the other way around. Our most significant 6 7 prescribers were called core, not that we identified a 7 8 core and then they became important prescribers. 8 A. That's correct. 9 Q. And do you know how much of the sales 6 Q. 9 And how many companies were sending 1 o sales representatives to physicians' offices to talk OxyContin's release, Purdue more than doubled the size of its sales force, correct? 10 force during the first five years was Purdue Frederick 11 versus Purdue Pharma employees? 11 to them about opioids during this time? 12 A. I don't know. part. I don't recall any survey that counted that up. 13 Q. At some point were some people 14 But it's a guess based upon my recollection of what 14 designated -- all new hires designated Purdue Pharma 15 was being actively promoted. A. 12 13 16 Q. Three to five. It's a guess on my 15 as opposed to Purdue Frederick? And you compensated your sales force 1 7 very well based predominantly on how much OxyContin 18 they sold; is that correct? 16 A. I believe that that's the case. 17 Q. But you're not sure what date that 18 started? The successful -- the most successful 19 A. No. 2 o salespeople, a majority of their income was bonus . 20 Q. Do you know if it was after the 21 The average salesman, certainly when we launched the 21 creation of Purdue Pharma that that started? 22 22 19 A. product the overwhelming majority of their income was It would had to have been. If Purdue A. 23 their salary and the benefits that they received. And 23 24 for the average sales force -- salesman, I think it 24 Pharma didn't exist, we couldn't have hired somebody. 25 would have been 50 percent of their income or 70 25 immediately after that that all -- once it was created Right. But, I mean, was it Q. Page 186 Page 188 1 percent of their income salary and the balance in 1 all reps were hired by Purdue Pharma as opposed to 2 bonus. 2 Purdue Frederick? 3 Q. Sure. 3 A. 4 A. But I don't -- I don't remember this 4 Q. Who would know that at Purdue? in detail. And, of course, it changed over time. 5 A. I don't know. At Purdue now? 6 Q. Yes. At Purdue Pharma you mean? 5 6 Q. The way the sales scheme was set up, I don't know. 7 if they sold more OxyContin, they made more money, 7 A. 8 basically? 8 Q. Yes. 9 A. Well, the people who were there at 9 A. Yes. Yes. The same as almost every 1 o other company in the industry. 11 Q. 10 that time might recall it, but I don't know who today 11 would know it. And then you-all gave your reps an 12 additional incentive because you decentivized them to 12 13 13 sell MS Cantin but you increased the incentive for 14 targeted wholesalers, correct? 14 selling OxyContin; is that true? 15 16 17 18 19 A. Yes. Q. And then you had one of the highest 15 A. Wholesalers were called upon by the 16 salesmen, yes. paid sales forces in the country; is that accurate? A. And then in addition to targeting or Q. providing initiatives to the sales force, you also 17 Q. And, in fact, I think if you go to 18 page 27 of the initial launch plan -- let's see if I I've heard that said for one or two 19 can find this -- the last paragraph. It says, "All years. It certainly wasn't the case or hasn't been 2 o promotional efforts for the retail distribution of 2 o the case during the history of OxyContin. 21 OxyContin will focus on the incredible success that 22 sold OxyContin sometimes ended up making over $250,000 22 Purdue Frederick has achieved and sustained with the 23 23 MS Cantin product line. Wholesale pharmaceutical 24 buyers and retail pharmacists should be reminded of 25 how MS Cantin created such a large market for the use 21 24 25 Q. Do you know if reps that promoted and a year? A. I've heard that that was the case. I'm sure it was unusual. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page:48 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 191 Page 189 1 of sustained-release opioids for the treatment of It says, "A cooperative direct mail Q. 1 2 pain. This in turn created profits for pharmacists 2 advertising sales sheet offering a rebate on the 3 helping to grow their businesses. Promotional copies 3 initial order of OxyContin to retail pharmacists will 4 should focus on the market potential for OxyContin and 4 be mailed every month during the first three months of 5 patient populations to be targeted, including the 5 launch." What was the rebate you-all were 6 number of prescriptions written for Class II and Class 6 7 III opioids every year. 7 offering to pharmacists? "The executive director of national 8 9 Some discount on their early orders to A. 8 9 accounts should work with drug wholesalers in encourage them to stock the product in advance of 1 o developing programs to utilize the wholesaler sales 1 o seeing any prescriptions or one or two prescriptions. 11 11 And like the rest of -- there was nothing innovative 12 Consideration should be given to advertisements in 12 in this program. This is -- this was standard 13 13 programming in the pharmaceutical industry and in 14 other industries. representatives to ensure adequate distribution. drug wholesaler ad books and computer programs." Were the sales force told to emphasize 14 15 with pharmacists that they could make more money with A. Well, some of your other literature Q. 16 talks about you-all had an unprecedented marketing 16 OxyContin prescriptions? 17 15 I don't think that they would have 1 7 campaign. Have you ever seen another company 18 been encouraged to say that. The objective when any 18 19 product is launched, and certainly any medicine is 19 that instituted a more broad-ranging marketing 20 launched, is to be -- is to minimize the number of 20 21 times a patient -- number of patients who get 21 22 prescriptions from their doctor and go to the pharmacy 22 Unprecedented perhaps for us, but not unprecedented in 23 and the pharmacist says "I don't have that" or, even 23 the industry. This would -- this is conventional 24 worse, "I never heard of that," for obvious reasons. 24 standard textbook. This is how you do it. So in order to reduce that, one tries 25 25 campaign than you-all did for OxyContin? I think this was conventional. A. All right. You-all also were involved Q. Page 192 Page 190 1 1 with third-party orga·nizations, Partners in Pain. to stock all three strengths in as many pharmacies as 2 possible. But to begin with, there's no demand. So 2 3 there's a bit of tension there. In order to supply 3 you use Partners in Pain to drum up demand for 4 the pharmacists, the wholesalers have to have enough 4 OxyContin? 5 stock on hand for the ones who buy it early and a 5 6 sufficient backup stock both to supply the early 6 7 buyers and the later adopters. And that was all that 7 the proper use of our drugs, our medicines, and to 8 we needed to accomplish and there's not much more I 8 encourage patients who may have had pain, sometimes 9 can say about it except that however we did it was 9 for years, inadequately treated or not treated at all 1 o ethical and proper. 11 Q. They were referenced in the launch campaign. And did 1 o to present themselves to their physicians. And let me go back to my question. 11 12 Where it says "Wholesale pharmaceutical buyers and 13 retail pharmacists should be reminded of how MS Cantin There was also -- Purdue funded a Q. 12 variety of so-called pain societies. The American 13 Pain Society, was that funded by Purdue Pharma? 14 created such a large market for the use of 14 15 sustained-release opioids for the treatment of pain. 15 Society. 16 This in turn created profit for pharmacists." 16 A. Q. We donated money to the American Pain Did you also fund the American 1 7 Association for Pain Management? Am I reading that incorrectly somehow 17 No. I -- I think that Partners in A. Pain was principally designed to inform doctors about 18 that -- 18 19 A. You're reading it correctly. 19 20 Q. What you're telling -- what this 20 A. If -- it wouldn't surprise me. I don't remember. Q. Did you also fund the Appalachian Pain 21 launch plan, sales force -- under the title "Sales 21 22 Force Allocation and Representative Delivered 22 23 Promotional Materials" is saying, hey, remind them 23 known it. But if that's what the record shows, it 24 they're making a bunch of money selling our product? 24 wouldn't surprise me. 25 A. As opposed to not selling any product. Coulter Reporting, LLC 25 Society? A. Q. I . don't know that, and I wouldn't have There was a figure we looked at a www.coulterreporting.com 502-582-1627 Page:49 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 193 1 1 while ago that said there was -- basically the target Page 195 attended and spoke were trainers, and some of them 2 market for physicians was about 7,500 physicians, 2 were in-house people and some were outside physicians. 3 including the cancer, malignant pain and the 3 4 non-malignant pain across the U.S. Do you remember 4 5 seeing that? 5 A. Certainly might have. Q. And would these take place at resorts, like in Florida and Arizona, these meetings? 6 A. No. 6 Q. And you also -- 7 Q. Do you think the market was more than 7 A. But - - but -- but to my knowledge, I 8 8 7,500 physicians -- don't think anybody would go more than once, and they 9 were trained in what they could say, what they 9 A. Much larger. 10 Q. -- for pain? 1 o couldn't say, and they were given materials to use in 11 A. Much larger. Pain is the most common 11 the presentations, for a while slides and then I guess 12 12 eventually PowerPoint presentations. So it was to presenting symptom for physicians in total, and very 13 few physicians would have a different experience. 13 create some control to see, hopefully, that they would 14 14 Perhaps ophthalmologists or dermatologists may, but not go off label. And did Purdue pay for that, or did Q. 15 every other physician it would be the most common or 15 16 16 they pay their own way? the second most common presenting complaint. 18 Do you recall whether Purdue Pharma Q. 17 17 set up a speakers bureau in which it allowed 19 physicians who were recommended by salespeople to be 20 put on the so-called, quote, speakers bureau? A. 21 18 paid for it. This was, again, customary in the 19 industry. 20 They -- yes, such a program existed. 21 22 Not everybody who was recommended was put on the 22 23 speakers bureau. They were vetted by internal experts 23 24 to determine their qualifications. Q. 25 Do you recall that there were over At the time it was started, Purdue A. Who told you that was customary in the Q. industry? I don't remember who told me. But I A. can tell you that sometimes I'd go to hotels and I'd 24 see events sponsored by Pfizer or sponsored by J & J, 25 and they were precisely -- either they were speaking Page 196 Page 194 1 3,000 physicians on the speakers bureau? I don't recall it, but it wouldn't 2 A. 3 surprise me. 4 Q. 5 Do you think somebody vetted all 3,000 physicians internally that were on the speakers 6 bureau? 1 engagements in which somebody spoke, and occasionally 2 they were Train the Trainer kind of ideas where the 3 company in question -- other companies in that case -- 4 trained physicians, you can say this and this and 5 this, beware you shouldn't say that and that and that. 6 Do you know whether pharmaceutical Q. 7 companies and medical device companies have come under 8 do that and to manage the speakers bureau. So I think 8 criticism for giving incentives for doctors to write 9 9 prescriptions or use their medical devices? 7 A. We had quite a large organization to everyone was -- should have been vetted. There was -- 1 o there was no excuse for not validating their degrees 10 11 and confirming that they were licensed to practice in 11 12 12 the place that they were practicing and so forth. I 13 don't know precisely how they were vetted, but they 14 definitely should have all been vetted. 15 Q. A. I'm aware of that. Q. And the answer is, they have come under criticism for that? 13 A. Yes. I... 14 Q. Was Russell Portenoy one of the 15 speakers that spoke on behalf of Purdue Pharma at Do you think putting these 3,000 16 doctors on your speakers bureau caused them to write 16 these meetings? 1 7 more prescriptions for OxyContin or less prescriptions 17 A. OxyContin? 18 Q. Yes. 18 for OxyContin? 19 20 21 22 A. I don't think it would have had an effect. Q. And there were also individuals -- you started a program called Train the Trainers where you 19 A. I don't know. 20 Q. In addition to the stuff we've just 21 talked about, you also hired a number of third parties 22 to assist in the marketing of OxyContin, such as marketing firms, correct? 23 would fly physicians around the country to speak on 23 24 behalf of Purdue. Do you recall that? 24 A. I don't know. 25 Q. Do you know if Purdue retained Lyons 25 A. Actually, the -- the physicians who Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 50 Richard Sackler, M.D. Page 197 1 Page 199 Lavey to market OxyContin? I've heard the name, but I don't know A. 2 2 3 that it was OxyContin. were also hired to assist in the marketing and the 6 expansion of the market -7 A. I don't know. 8 Q. You've got to let me finish my in the industry. 4 discussed would be done, these marketing efforts, to 5 sell more OxyContin, correct? had access to OxyContin, yes. Were you aware that there was a direct Q. 8 9 To see to it that appropriate patients A. 6 7 9 question. And all of the things we've just Q. 3 Do you know if public relation firms Q. 4 5 I don't know, but that would be common A. 1 link between the number of sales representatives that 10 A. I'm sorry. Excuse me. 10 were out promoting OxyContin and how much OxyContin 11 Q. That's okay. We've got a video, but 11 would be prescribed? 12 we also have a court reporter/stenographer taking it 12 A. Could you just ask that again? 13 13 Q. Yeah. Was there a link -- a direct down. 14 A. I'm sorry. Apologies. 14 15 Q. She can't get it if we both talk at 15 were out promoting OxyContin and how much OxyContin 16 the same time. 16 would be prescribed? 17 So my question is, do you know -- 17 18 MR. THOMPSON: Can you read my 18 19 question back? I don't think "direct link" would A. capture the concept. So the answer is no. Do you believe that the number of Q. 19 2 o sales representatives that promoted OxyContin would (Record read.) 20 link between the number of sales representatives that 21 Q. -- for OxyContin? 21 22 A. I don't know. 22 OxyContin, the more prescriptions would be written? 23 Q. Have you heard of a company called 23 24 FleishmanHilliard? A. 25 That's a vaguely familiar name, but I increase; the more sales representatives that promoted I don't think anybody thought of it A. 24 that way. We had a product that had tremendous 25 potential and our principal means of getting it used Page 198 Page 200 1 don't know whether they were ever hired by Purdue 2 3 4 1 Frederick or Purdue Pharma . Q. Do you recall at some point being notified of a problem with abuse occurring with was to convince physicians -- convince physicians that 2 he had in his practice appropriate patients to use it, 3 but the linkage there is very loose. Was there also a correlation between Q. 4 5 OxyContin and Purdue Pharma hiring a crisis management 5 the number of times a sales representative called on a 6 physician to how much OxyContin that physician would 7 A. Yes. 7 prescribe? 8 Q. Do you recall when that crisis 8 6 firm? 9 10 11 12 management firm was hired? A. I don't recall precisely, no. Q. Have you ever read the interview 9 Again, that would be a loose A. correlation, and there would be -- clearly if he 1 o called not at all, there would be nothing to 11 correlate. And I am sure there was a practical limit Michael Friedman gave to the crisis management firm? 12 as to how many calls he could make. I don't know whether there was any kind of specific relationship 13 A. No. 13 14 Q. And in addition to all that, you also 14 between calling every quarter or every month or more 15 frequently or less frequently. 15 put out videos. Are you familiar with the "I Got My 16 Life Back" video? 17 A. I've heard the title; I'm not familiar 18 with it. Okay. Why don't we mark the OxyContin Q. 16 1 7 Launch Plan as 27. 18 MR. STRAUSER: It's 26. 19 (DEPOSITION EXHIBIT NO. 26 MARKED) 2 o out whether the participants in the "I Got My Life 20 MR. THOMPSON: And this is going to be 21 21 19 Q. Did you ever do any follow-up to find Back" video actually got their life back or wound up 22 having problems with dependency on OxyContin? 27. 22 (DEPOSITION EXHIBIT NO. 27 MARKED) MR. STRAUSER: Mr. Thompson, I note on 23 A. No, I did not. 23 24 Q. Did Purdue also give away coupons so 24 Exhibit 27 there's some material that's been -- a good 25 deal of material that's been bracketed, and I've seen 25 people could get a week's free supply of OxyContin? Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 51 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 Page 201 1 Page 203 1 that on other documents that you've marked . My meaningless. Was the number of increased 2 assumption throughout is that the brackets were not on 2 prescriptions commercially significant? If so, what 3 the original and this is something that you guys 3 would the cost per increased prescription be assuming 4 added. 4 that the absolute difference persisted? When will a 6 brackets were produced that way. brackets? MR. ELLIS: These documents that have 9 And was that your -- 6 MR. STRAUBER: It came to you with the 7 8 5 more complete report be available?" MR. ELLIS: That is incorrect. The 5 7 A. 8 Q. You read it correctly. -- e-mail? Did you ever get a more complete 9 10 writing on them were produced that way. If the e-mail 10 report? 11 ends and it's only half an e-mail, that's also the way 11 A. I don't remember. 12 12 Q. And then above that it looks like that they were produced to us. 13 Alfonse (sic) writes back to you. And Alfonse was -- MR. STRAUBER: And what if the 13 Alfonso. 14 document was highlighted in yellow, was it produced to 14 A. 15 you -- 15 Q. Alfonso was head of marketing? 16 A. He was head of marketing. 17 Q. And he says, "Interesting comments MR. ELLIS : If it was highlighted in 16 17 the context that I just gave it to him, I would have 18 from Dr. Richard. I also wonder if there was a bias 18 added that highlighting just now; but in terms of 19 attachments that aren't connected to the e-mails, 19 in the form of representatives increasing calls to the 2 o that's because we didn't get them from Purdue. 20 selected physicians. Would we get the same ROI" -- is MR. STRAUBER: I'm asking about the -- 21 MR. ELLIS: I'm trying to explain to 22 23 you -MR. THOMPSON: Tony, it's okay. 24 25 21 Brackets were not added. that return on investment? 22 A. Yes. 23 Q. -- "in prescriptions" -- "Would we get 24 the same return on investment in prescriptions as a 25 result of the representatives increasing the call rate Page 202 2 Page 204 1 to the selected group regardless of dinners? I don 't MR. STRAUBER: Okay. Thank you. 1 2 have the list, therefore, I don't know if there was a BY MR. THOMPSON: 3 selected preference toward this group in the part of 4 e-mail from you, "Phase IV OxyContin Team Minutes" 4 the reps. It's reasonable that these core doctors 5 dated 10-23-96, and you have a copy of it. 5 were already receiving special attention, which would 6 have generated an increase in prescriptions. If this 3 Q. Sackler Exhibit 27. And this is an And -- so this would have been after 6 7 is the case, the cost of the dinners would 8 A. Yes. 8 unnecessarily increase the cost per prescription." 9 Q. Okay. And it says here, "Michael: 9 A. Right. 10 Q. Did you-all ever determine whether the 7 the launch of OxyContin, correct? 10 The oxymin12 said:" 11 dinners that you were taking the doctors on were What was the oxymin12? 11 12 A. I don't know. 12 13 Q. Reading from it, it says, "Results 13 helping to sell OxyContin? A. I don't remember. MR. THOMPSON: Let's mark this 28 . 14 showed the following: Physicians who attended the 14 15 dinner programs or the weekend meetings wrote more 15 (DEPOSITION EXHIBIT NO. 28 MARKED) 16 than double the number of new prescriptions for 16 (Passing document.) 17 OxyContin compared to the control group, and this was 18 sustained over the three-month post-meeting evaluation 17 And this says, "6-9-99, Dr. Richard Q. 18 Sackler. Subject: Promotion of OxyContin by Abbott." And if you would go down to the 19 period. Weekend meetings had the greatest impact, 19 2 o increasing new prescriptions for OxyContin by a factor 2 o bottom, it says, "Enclosed for your information is a 21 between 2.16 and 2.62. These results will be 21 memorandum from Mark Alfonso that describes a 22 presented in more detail at a later date. 22 substantial increase in Abbott's field force allocation toward OxyContin. 120 Abbott reps 23 "This is very encouraging, although I 23 24 must allow that a proportion of the percentage without 24 previously selling urokinase, which has been 25 the associated absolute numbers is inherently 25 temporarily withdrawn from the market, will be Coulter Reporting, LLC www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 52 Richard Sackler, M.D. Page 205 Page 207 1 assigned full time to OxyContin. This will be totally 2 at Abbott's expense and should have a very positive 2 A. You read the words . 3 effect on OxyContin sales." 3 Q. "Words such as powerful may make some That is from Michael Friedman, 4 5 correct? 4 people think the drug is dangerous and should be 5 reserved for the more severe pain." 6 A. Right. 6 7 Q. What was the agreement reached with 7 8 9 10 11 Abbott to sell OxyContin? I don't recall the details of the A. agreement. Q. Now, did I read that correctly? 1 And then up at the top it says, MR. STRAUBER: If I could interject for one second . While you are reading it correctly, 8 what you haven't included is the fact that the word 9 "powerful" is in quotes. 10 MR. THOMPSON: Yes . 11 MR. STRAUBER: Okay. 12 "Sender: Dr. Richard Sackler." So this would be, I 12 13 think, your reply to that. And it says, "This sounds 13 include those. 14 very good for the brand. I just hope that we can 14 Q. 15 supply the surge that may follow this program." 15 show that we are 'effective' as morphine, but do not And were you referring to a surge of 16 MR. THOMPSON: We'll read it again and "We can" -- second paragraph. "We can 16 want to say OxyContin is as 'powerful' as morphine. 17 OxyContin sales? 17 Words such as 'powerful' may make some people think 18 A. Yes. 18 the drug is dangerous and should be reserved for the 19 Q. And was it your expectation that the 19 more severe pain. This could have a negative effect 2 o sales representatives were going to create a surge in 2 o in the much larger non-cancer pain market. Mike 21 21 22 OxyContin sales? A. 23 24 25 Q. reminded the team that we should keep this positioning I didn't know. I said let's hope. 22 in mind as we develop future marketing programs, (DEPOSITION EXHIBIT NO. 29 MARKED) 23 symposia, clinical study manuscripts and any other (Passing document.) 24 items that discuss the use of OxyContin." And then this is a document that I Did I read that correctly? 25 Page 206 Page 208 1 wanted to bring to your attention, because we were 1 A. Are you asking me? 2 talking earlier today where you said -- you know, when 2 Q. Yes. 3 I was pointing out to you the documents from your 3 A. I believe you did. 4 officers that said OxyContin is believed by other 4 Q. All right. Were you aware that your 5 physicians to be not as strong as morphine. 5 marketing and sales team were being careful not to and Remember us having that discussion? 6 did not want to say that OxyContin is as powerful as morphine? 6 7 A. I recall. 7 8 Q. And this is a Phase II OxyContin 8 A. I don't recall if I was aware of this. 9 Q. And, in effect, it's twice as powerful 9 Tablets Team Meeting, June 13th, 1997. 1 o as morphine, correct? So this would be well over a year 10 11 after -- a year and a half after OxyContin has been 11 12 12 13 14 15 launched and in the marketplace, correct? Yes. About a year and a half. Maybe A. a little less. Q. And if you could go to the -- it says No, it's not. We've gone through this A. quite a few times. And here "powerful" is in quotes. 13 Sometimes the words "stronger," "weaker," "powerful" 14 are not in quotes. But here it is very clear that it 15 was specifically the word "powerful" that he did 16 "Marketing and Sales Update." The first paragraph. 16 not -- he was advising people to stay away from. It 17 "Mike Cullen discussed in detail marketing's 17 had nothing to do with potency. 18 positioning of OxyContin. He explained we want to 18 Q. When you go in and see a doctor and 19 expand extensively in the non-cancer market segment 19 you say -- if they say OxyContin is not as powerful as 2 o while promoting OxyContin as the one to start with in 2 o morphine, what do you think the doctor thinks? 21 cancer pain and the one to stay with through proper 21 22 titration." 22 23 And the next paragraph reads, "We can A. He was not supposed to say that, and I don't think he did say that. That would create 23 confusion. He was warning not to use the word 24 show that we are as effective as morphine, but do not 24 "powerful" in any context. But he clearly didn't mean 25 want to say OxyContin is as powerful as morphine." 25 potency, because potency was declared as twice as Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 53 Richard Sackler, M.D. 8/28/2015 Page 209 1 potent as morphine from day one of marketing to 1 2 Page 211 having that conversation? 2 yesterday and today in every piece of material, in all 3 the conversion charts and was recognized and 3 seen a lot of documents. But I do recall having -- 4 understood by physicians. 4 talking about this many times, yes. THE WITNESS: Do you want to take a 5 6 8 MR. STRAUBER: It's almost 3:30. 7 Would this be a time to take a break? MR. STRAUBER: I object to the form of 9 1 O that question. 10 time. VIDEOGRAPHER: We are off the record 11 12 it's not as effective. I'm sorry. Let me rephrase 8 that. MR. THOMPSON: This would be a great 9 Yes. And your comment was, Well, Q. 5 6 we're not saying that it's not as strong, we're saying break now? 7 I'm not sure which documents. I've A. 12 13 (RECESS) 13 14 VIDEOGRAPHER: We are back on the 14 Your comment was, We're not trying to Q. 11 at 3:27 p.m . convey that it's not as powerful; is that correct? No. What I thought I communicated -- A. perhaps I didn't do it well -- was that the meaning of 15 record at 3:42 p.m. 15 that word "strong" was not that it was a weak drug, 16 BY MR. THOMPSON: 16 weaker than morphine. It was not that meaning. The Q. 17 Okay. A while ago when we were 17 18 talking about salespeople making calls, did I meaning related to the stigma of morphine and to the 18 fear of morphine. And precisely in this case I 19 understand you to say that you did not believe the 19 believe that the efficacy of the drug -- and I really 20 number of calls made by a salesperson affected the 20 would like to see the document, if I might, if we're 21 number of prescriptions for OxyContin? 22 A. I didn't mean to communicate that. 23 Q. Thank you. In fact, Purdue had 21 going to talk about it, because I'd like to refresh my 22 memory not only as to the document but as to what I 23 had meant to say if I didn't say it clearly. 24 requirements on their salespeople that they had to 24 25 make a certain number of calls every day to 2 5 when we broke. Here's the one we were talking about Q. Page 210 Page 212 1 physicians, correct? A. 2 3 There was a standard number of calls, 3 Q. MR. STRAUBER: What exhibit is that, 2 yes. 4 (Passing document.) 1 And before we broke, we were sir? Is that 29? THE WITNESS: 29. 4 5 discussing this Phase II OxyContin Tablets team 5 MR. THOMPSON: It's on the bottom. 6 meeting. And to kind of put this in perspective, 6 THE WITNESS: 29. 7 there was this e-mail dated 6-2-97 -- so that's June 7 MR. STRAUBER: 29. Okay. 8 2nd, '97 -- that we were discussing earlier where we 8 9 9 discussed that physicians did not think OxyContin was And they've actually used two words Q. here that are in quotes, correct? One is "effective" 1 o as strong as MS Contin and that perception was out 10 and one is "power." And the sentence reads, "We can 11 there, and it noted that it was important to be 11 show that we are as effective as morphine, but we do 12 careful not to change the perception by physicians 12 13 toward Oxycodone when developing promotional pieces. 13 14 MR. STRAUBER: Mr. Thompson, if you're 14 A. That's correct. 15 Q. Have you reviewed the "OxyContin Abuse 15 referring to another document, could you identify it 16 and give it to the witness? MR. THOMPSON: We've already talked 17 18 about it earlier. I'm just asking a question right 19 now. MR. STRAUBER: Well, but you're asking 20 16 not want to say OxyContin is as powerful as morphine." Did I read that correctly? and Diversion and Efforts to Address the Problem" that 1 7 was put out in December of 2003 by the GAO? 18 A. No, I did not review that. 19 Q. I'll give you a copy of that. 20 (Passing document.) You've never seen that document; is 21 your question based on the earlier document and 21 22 reading from the earlier document. 22 that correct? 23 24 25 MR. THOMPSON: I won't read from it 23 A. Do you want to mark it as an exhibit? 24 Q. I will, yes. But have you ever seen Let me ask you. Do you recall us 2 S that document? then. Q. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 54 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 213 Page 215 I don't recollect seeing that 1 2 in 1997 through 2002. According to IMS Health data, If you would, turn to page 9. And I'm 3 the annual number of OxyContin prescriptions for looking at the second paragraph, last two sentences. 4 non-cancer pain increased nearly tenfold, from about 5 "In both 2001 and 2002, OxyContin's sales exceeded 1 5 670,000 in 1997 to 6.2 million in 2002." 6 billion and prescriptions were over 7 million. The 6 7 drug became Purdue's main product, accounting for 90 7 8 percent of the company's total prescription sales by 8 9 2001." A. 1 2 document. Q. 3 4 A. 11 10 To the best of my recollection, it's 12 correct -- very close to correct. Q. 13 Is that information accurate? And if you'll turn to page 17. Under 14 the heading "Purdue Focused on Promoting OxyContin for I don't know. I just don't have these A. numbers in my mind. Q. 9 Is that information correct? 10 prescriptions for non-cancer pain than for cancer pain If you'd go to page 20, the second paragraph. "By more than doubling its total sales 11 representatives, Purdue significantly increased the 12 number of physicians to whom it was promoting 13 OxyContin. Each Purdue sales representative had 14 specific sales territory and is responsible for 15 Treatment of Non-Cancer Pain," and if you go down to 15 developing a list of about 105 to 140 physicians to 16 the last sentence in the second paragraph, it says, 16 call on who already prescribe opioids or who are candidates for prescribing opioids. 17 "One of Purdue's goals was to identify primary care 17 18 physicians who would expand the company's OxyContin 18 19 prescribing base. Sales representatives were also 19 2 o directed to call on oncology nurses, consultant 21 2 o 33,400 to 44,500, By 2000, the nearly 700 pharmacists, hospices, hospitals and nursing homes." Is that information accurate? 22 "In 1996, the 300-plus Purdue sales representatives had a total physician call list of As a general proposition, yes. It 21 representatives had a total call list of approximately 22 70,500 to 94,000 physicians. Each Purdue sales 23 representative is expected to make 35 physician calls 24 doesn't include oncologists. I don't think -- in the 24 per week and typically calls on each physician every 25 spirit I think it's accurate. 25 three to four weeks. Each hospital sales A. 23 Page 214 Q. 1 Page 216 And then down, the second sentence 1 representative is expected to make about 50 calls per 2 from the bottom, "Purdue has stated that by 2003 2 week and typically calls on each facility every four 3 primary care physicians had grown to constitute nearly 3 weeks," 4 half of all OxyContin prescribers, based on data from 4 5 IMS Health, an information service providing 5 information about how Purdue was marketing OxyContin 6 pharmaceutical market research." 6 through its sales force? Is that information accurate? 7 A. 8 9 10 7 I can't vouch for the accuracy of 8 Was that, to your knowledge, accurate Without quibbling, it isn't really -- A. you're asking me to vouch for the accuracy of this. I 9 just don't carry these numbers in my mind, so I can't this . Q. 1 o agree or dis- -- I just don't know. But this is a The next sentence says, "DEA's count of physicians and a description of the standards analysis of physicians prescribing OxyContin found 11 12 that the scope of medical specialties was wider for 12 of calls, but I don't -- but that's -- that really 13 13 doesn't describe how we were marketing it, to use your 11 OxyContin than five other controlled-release, 14 schedule II narcotic analgesics. DEA" -- and is that 14 question. So I'm not trying to quibble with you, sir, 15 the Drug Enforcement Agency? 15 but I just don't know. 16 A. I believe it would be. 16 17 Q. "DEA expressed concern that this 17 Q, All right. And if you'll go down to the middle of that next paragraph. "The total amount 18 related in OxyContins being promoted to physicians who 18 of -- the amount of total bonuses that Purdue 19 were not adequately trained in pain management." 19 estimated were tied to OxyContin sales increased 2O 21 Do you recall the DEA expressing that concern? 20 significantly from about 1 million in 1996, when 21 OxyContin was first marketed, to about 40 million in 2001." 22 A. No. 22 23 Q. The next two sentences. "Purdue's 23 24 promotion of OxyContin for the treatment of non-cancer 24 reason to disagree with the 40 million number for 25 pain contributed to a greater increase in 25 bonuses paid out to your marketing salesmen in 2001? Coulter Reporting, LLC Do you recall -- do you have any www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:55 Richard Sackler, M.D. 8/28/2015 Page 217 A. 1 2 I don't have -- I don't know the 1 number, so I don't have any reason to disagree. Q. 3 And then if you go to the next page, Page 219 "What Happened to the Poster Children of OxyContin"? 2 A. No, that doesn't sound familiar. 3 Q. Nobody has ever provided that to you 4 the last paragraph, it says, "According to DEA's 4 5 analysis of IMS Health data, Purdue spent 5 A. When was it published? 6 approximately 6 to 12 times more on promotional 6 Q. September 8th, 2012. 7 efforts during OxyContin's first six years on the 7 A. No. That wouldn't necessarily have at Purdue Pharma? 8 market than it had spent for its older product, 8 been provided to the board. But I don't -- I 9 MS Cantin, during its first_six years or than had been 9 really -- I'm not familiar with it. 10 spent by Janssen Pharmaceutical for one of OxyContin's 10 11 11 OxyContin was considered so successful that other 12 companies were thinking about whether they could make drug competitors, Duragesic." Do you see that? 12 A. 13 Do you recall a time when Purdue's Q. 13 their own version of OxyContin? Yes. Yes, I did . 14 Q. Is that accurate? 14 15 A. I don't know. I have no reason to 15 so I can answer it. 16 agree with it or disagree with it at this point. Q. 17 18 overly aggressive? No. 20 Q. Do you believe Purdue's marketing was 21 appropriate? 19 Sure. Do you recall a period of time Q. 16 1 7 where OxyContin was considered so successful that Do you believe Purdue's marketing was A. Just -- just -- ask the question again A. 18 other companies were considering making their own 19 version of OxyContin? I can 't say that they did it because A. 20 21 it was, quote, so successful, but I do recall that I 22 A. I believe so . 22 did hear that other companies were trying to copy 23 Q. It says here under -- on page 30, 23 OxyContin, yes. 24 "OxyContin's Wide Availability May Have Increased 24 25 Opportunities for Illicit Use." 25 (Passing document.) So this is an e-mail chain that was Q. Page 218 A. 1 2 Page 220 I'm sorry. What page are you reading 1 from? provided . Let's go ahead and mark that as 31. (DEPOSmON EXHIBIT NO. 31 MARKED) 2 3 Q. Page 30. 3 4 A. Page 30? 4 "Subject: Press release or similar promotion . Author: Dr. Richard Sackler, 8-23-96 ." And if you go to page 2 it says, Q. 5 Q. Yes. 5 6 A. 3-0. Okay. Where should I look? 6 7 Q. Last paragraph. 7 8-23 -- oh, the bottom of the page. Okay, I'm with 8 A. Okay. Thank you. 8 you . 9 Q. "The large amount of OxyContin 9 1 o available in the marketplace may have increased Just let me catch up with you. A. And it says, "I think it is noteworthy Q. 1 o to release information on OxyContin Tablets, its use 11 opportunities for abuse and diversion. Both DEA and 11 and success in the market and the tremendous reception 12 12 it received in Vancouver." Basically, "The newsworthy Purdue have stated that an increase in a drug's 13 availability in the marketplace may be a factor that 13 occasion is that this product has achieved our first 14 attracts interest by those who abuse and divert 14 year's sales projection four months early and that by 15 15 the end of the year we should have 130,000 to 150,000 drugs." "OxyContin" -- if you go on down. 16 17 18 pain reliever seller in 2001 ... " Is that accurate? 19 20 21 A. MR. THOMPSON: So let's mark that as Exhibit 30. (DEPOSITION EXHIBIT NO. 30 MARKED) 24 25 I don't know, but -- I just don't know. 22 23 16 "OxyContin became the top-telling name-brand narcotic Q. Have you ever seen an article called Coulter Reporting, LLC 17 per salesman of sales. "The objectives of this release would 18 be: Stimulate interest in the U.S. community -- in 19 the medical community of the U.S. to recognize the 20 tremendous success of OxyContin Tablets clinically and 21 the ratification commercially. We want many more 22 physicians than have presently used it to become aware 23 of its availability and importance in their practice. 24 It would be hoped that this would lead to greater use 25 by those currently prescribing and broaden our www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 56 Richard Sackler, M.D. Page 221 1 Page 223 prescribing base in the U.S. and Canada." 1 Do you know whether that press release 2 3 took place? 4 A. I don't know. 5 Q. And then above that it looks like A. Yes. 8 Q. "Given the diverse in both short- and 9 2 Kentucky. And he points out that none of the federal 3 courts in Kentucky has found any misconduct on the 4 part of Purdue. Correct? 6 mid-term goals, I would recommend a full-fledged PR I'm not sure just where you 're reading A. 5 6 there's a response to your e-mail from Robert Reder. 7 17th, 2005 to Greg Stumbo, the Attorney General of from. 7 Q. Oh, I'm sorry. I'm on page 5. 8 A. Oh, page 5. I'm sorry . I was on the 9 wrong page . And where are you reading from? 1 o firm with a one- to three-year contract. That way 10 Q. The third paragraph down. 11 this can be coordinated actively to achieve all goals 11 A. It begins, "I believe that even this 12 rather than a one-shot flash. Is this a departure 12 13 from traditional PF/PPLP?" 14 15 14 Pharma, LP. strategy; is that correct? 16 Correct. 17 Q. And you wrote back and said, "I don't 15 courts has found any misconduct on the part of 16 Purdue." Please bear with me while I try to A. 18 find this. And then it looks like -- and perhaps 19 paragraph. "Significantly, however, not one of these 17 18 see this as a 'departure' from policy." No. I'm reading in the middle of the Q. 13 And that's Purdue Frederick/Purdue A. brief... "? 20 21 you want to use PR to signal our market as to our 21 22 development pipeline, I have no problem. I do not 22 Do you see that? Right above the case Q. 19 2 o this is Friedman who says, "My view is different. If cites. I'm sorry. In the paragraph that has A. a list of cases? 23 want to spend money on PR to increase sales. We do 23 Q. Yes. The paragraph right above it. 24 not need to have an agency in our pockets. I have 24 A. "Significantly, however... " Thank 25 learned my lessons." 25 Q. Yeah. Purdue answered -- filed an you. Page 222 Page 224 And then you write back on page 1 and 1 1 2 say, "I agree about the agency. I want to signal the 2 answer in all of these cases and claimed they had 3 licensing in market for the product around the world, 3 never done anything improper or wrong; isn't that true? 4 get an audience for our patent infringement suits so 4 5 that we are feared as a tiger with claws, teeth and 5 A. 6 balls and build some excitement with prescribers that 6 Q. Are you aware prior to the -- 7 OxyContin Tablets is the way to go." 7 A. That is, I don't know whether we filed And what was your concern there about 8 9 10 licensing and patent infringement? A. Well, licensing in market meant the -- 11 get the attention of companies that had products that 12 might be attractive for us to license. 13 Q. 8 in all these cases or whatever. That's what I mean 9 when I say "I don't know." 10 Do you recall Howard Udell making a 12 where the company pied guilty to a felony of 13 misbranding a drug with the intent to defraud or mislead? trip down to Kentucky to meet with Attorney General 14 15 Greg Stumbo and other members of the -- of his staff? 15 16 A. I don't recall it, no. 16 17 Q. This is a letter dated May 17th, 2005. 17 And that would be prior to the felony plea agreement 19 that Purdue Frederick entered into, correct? 20 A. I'm not -- I think I'm clear on the 21 dates and that that would be correct. Please 22 correct -- somebody here correct me if I'm wrong. (Pass ing document.) 23 24 25 Are you aware of Purdue ever admitting Q. 11 to doing anything improper prior to the plea agreement 14 18 I don't know. Okay. Just ask the question. Before A. the plea am I what? Aware? Q. Are you aware of anyone at Purdue ever 18 admitting they did anything improper prior to entering 19 into the plea agreement where the company pied guilty 2 o to misbranding a drug with the intent to defraud or 21 mislead? 22 A. I am not aware of anybody. 23 Q. And then if you go to page 6, the If you'll turn to page 6. This 24 middle of the second paragraph from the bottom, it appears to be a letter from Howard Udell dated May 25 says, "First, any suit brought under the Act requires Q. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page: 57 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 227 Page 225 1 1 proof that a defendant engaged in a practice of agreement? 2 violation of KRS 367.170, an unsurmountable obstacle 2 A. Yes. 3 since Purdue has committed no unlawful act." 3 Q. Do you recall whether Purdue had Did I read that correctly? 4 4 received warning letters about its marketing of MS Cantin? 5 A. You did . 5 6 Q. And were you aware that Howard Udell 6 A. I don't recall. 7 had communicated with Greg Stumbo that Purdue had 7 Q. You don't recall six warning letters 8 8 coming in from MS Cantin? committed no unlawful act on May 17th, 2005? A. 9 I think he was writing for Purdue 1 o Pharma, just for clarity, but I was not aware of this. Q. 11 12 No, I don't - - I don't recall the A. 9 1 o instances. And May 17th of 2005, did Purdue 12 Frederick exist? Do you recall Purdue getting warning Q. 11 letters with respect to the way it was marketing 13 A. I don't know. 13 MS -- marketing OxyContin? 14 Q. Do you know if the companies were 14 A. I don't recall. 15 Q. Do you know if Purdue consistently 15 merged at some point? 16 A. I don't believe they were. 17 Q. Let's talk about the Agreed Statement 16 denied it was doing anything wrong with respect to 17 18 of Facts. marketing OxyContin? I'm not sure. I would think that we A. 18 19 denied doing anything wrong, but that's a guess on my 2 o the letter and the Agreed Statement of Facts. 20 part. I don't really know. 21 MR. THOMPSON: Yeah, that's a good 21 MR. ELLIS: The letter is going to be MR. ELLIS: Might as well mark both 19 22 idea, T. 23 24 The guilty -- 22 A. I don't recollect. 23 Q. Were you involved in approving the 24 Exhibit -MR. THOMPSON: 32 . 25 Q. 25 Agreed Statement of Facts for the guilty plea? The board voted in favor of A. Page 228 Page 226 2 1 MR. ELLIS: -- 32, and the Agreed 1 2 plead guilty under a plea agreement with the 3 U.S. Attorney. Q. Statement of Facts is going to be Exhibit 33. (DEPOSITION EXHIBIT NOS. 32 AND 33 3 management's recommendation that we have -- that we And just so there's no confusion, the 4 MARKED) 4 5 MR. STRAUBER: By "the letter," you 're 5 board voted to adopt the Agreed Statement of Facts; is 6 8 9 6 that correct? talking about the Udell letter? 7 Q. MR. ELLIS: Yeah, May 2005. 7 A. I don't know. I don't remember. Who was in charge of preparing and 8 Q. Is the Agreed Statement of Facts 9 approving the sales and marketing materials at the 1 o time of OxyContin's release? I'm sorry. At the time of 11 A. 12 OxyContin's -- 13 Q. Release? accurate? 10 A. I believe it is. 11 Q. And in addition to the guilty plea of 12 a felony for misbranding a drug with the intent to 13 defraud or mislead -- and that drug is OxyContin, 14 A. Release, meaning launch? 14 correct? 15 Q. Launch. 15 A. I believe it is. 16 A. Michael Friedman, I believe. 16 Q. -- these three individuals, Howard 17 Q. And at that time -- at the time of the 1 7 Udell, Michael Friedman and Paul Goldenheim, also pied 18 launch, who was in charge of the marketing department? 19 A. 20 Alfonso. 21 Q. To the best of my recollection, Mark 18 guilty to misdemeanors, correct? 19 A. Yes. 20 Q. And Howard Udell was Purdue's 21 And Michael Friedman, was he the 22 person who ultimately was appointed CEO of Purdue? executive vice president and chief legal officer? 22 A. He was. 23 A. He was. Purdue Pharma . 23 Q. Michael Friedman was the president and 24 Q. Is he one of the individuals who pied 24 25 guilty to the misdemeanor at the time of the plea Coulter Reporting, LLC 25 CEO of Purdue at the time of the guilty plea? A. I believe he was. www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:58 Richard Sackler, M.D. Page 229 Page 231 1 And Paul Goldenheim was the former Q. 1 investigating OxyContin abuse and diversion and that 2 executive vice president for worldwide research and 2 the law department in general and Howard Udell in 3 3 particular were providing any documents he wished development and chief scientific officer, correct? 4 A. I believe so . 4 voluntarily to help his investigation. That the 5 Q. By 2006 Dr. Goldenheim had already 5 investigation turned on Purdue was a surprise, but I 6 6 don't remember when that happened. left Purdue, correct? 7 A. Yes. 7 Q. Was it before you left as CEO? 8 Q. Did he leave voluntarily? 8 A. I don't recall. 9 A. He did. 9 Q. Do you recall there being issues about 10 Q. What reason did he provide you 10 addiction, dependency, tolerance buildup, abuse and 11 regarding why he was leaving Purdue? He was leaving Purdue in order to be A. 12 11 diversion prior to your leaving as CEO? 13 diversion, yes. Have you seen this Agreed Statement of Q. 14 14 15 Facts before? 16 A. Before today? Yes. 16 Q. Did you provide comments on this 17 18 document? 19 20 21 Q. Were you surprised by any of the 18 20 21 I don't -- I didn't read the whole A. Yes. Same time as I was informed A. about possible abuse and diversion. Q. And when were you first informed about 19 possible abuse and diversion? allegations in the document? 22 23 No, I did not. Do you recall there being issues with Q. 15 addiction? 17 A. Yes. Not all of those, but abuse and A. 12 13 CEO of another company. document, so I can't say if there are allegations that Sometime in 2000 an article was A. published in a newspaper in Maine that very 22 graphically described the impact of abuse and 23 diversion of individuals who were using OxyContin . 24 would surprise me. I had understood that this was a 24 That was the first -- the first time I became aware of 25 settlement document and that people in the company who 25 that possibility. Page 230 1 investigated thoroughly said to the board that the 2 statements in the document were true. 3 4 And when you say "I didn't read the Q. document," as we sit here today, have you ever read 5 the entire document? 6 Page 232 1 A. No. Q. Do you recall receiving a letter or Q. 2 being notified about a letter from a hospital in 3 Pikeville or Hazard concerning problems with patients 4 who were on OxyContin? 5 I don't recall a letter. Was it A. 6 directed to me? At the time this was signed, May 7th 7 8 and 8th of 2007, what was your position in the 8 to Purdue, and I'm wondering if you saw it. 9 company? 9 All right. Let's go back to the plea 7 10 11 12 13 A. I was a director of the company. Q. Did you have any other role at that A. 1 o agreement and we'll try to get through this. Not to my recollection. For a period Are you aware that we've requested 11 12 time? I don't believe so. I think it came Q. Purdue to identify the names of documents referenced 13 in the Agreed Statement of Facts? 14 of time after I ceased to be CEO in early 2003, I was 14 A. I'm not aware of that. 15 co-nonexecutive chairman of the board . But that came 15 Q. Are you aware we've asked them to 16 to an end more or less around this time, but I don't 16 identify the individuals who are referenced in the 17 Agreed Statement of Facts? 17 18 remember whether it was before the plea or after. Q. You ceased to be CEO in 2003; is that 19 correct? 20 21 A. That's correct. Q. When were you first notified that the 22 U.S. attorneys for the Western District of Virginia 23 were investigating Purdue? 24 25 A. I can't recall precisely. We were, as a board, notified that the U.S. attorney was Coulter Reporting, LLC 18 A. No. 19 Q. Paragraph -- if we can go to paragraph 2 o 13 of the Agreed Statement of Facts. Paragraph 13 21 says that on December 28th, 2004 "Purdue submitted an 22 OxyContin NDA to the FDA. The NDA included clinical 23 trials showing that OxyContin, when dosed every 12 24 hour, was as safe and as effective as 25 Immediate-Release Oxycodone dosed every 12 hours." www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:59 Richard Sackler, M.D. 8/28/2015 Page 233 Page 235 Every six hours. A. They might. Q. Paragraph 16 says, "The Medical 1 A. 2 Q. I'm sorry, every six hours, yes. 2 3 A. Yes, that's what it says. 3 Officer Review of the ISS included these statements: Q. And then paragraph 14 says, "The NDA 1 4 The blood level data in clinical use suggests the 5 did not claim that OxyContin was safer or more 5 opioid effects of OxyContin and Immediate-Release 6 effective than Immediate-Release Oxycodone or other 6 Oxycodone would be similar." 7 pain medications, and Purdue did not have and did not 7 4 8 provide the FDA with any clinical studies 8 9 demonstrating that OxyContin was less addictive, less 9 To your knowledge, is that clinically correct? Well, it's an inference, and I A. 10 subject to abuse and diversion or less likely to cause 1 o certainly can't differ with the inference. But it may 11 tolerance and withdrawal than other pain medications." 11 Is that paragraph correct? 12 A. 13 14 15 And then there are some medical A. 18 Q. possible in patients who have their dosage abruptly 14 reduced or discontinued." 16 Yes. I believe those are within the FDA. 19 13 Is that your understanding of the 15 16 officer reviews, correct? 17 Under "d" it said, "Withdrawal is Q. 12 That's what it says. I don't know if it's correct, but I wouldn't differ with it. Q. not be correct. Right. And those also did not state characteristic of the drug? 17 A. Absolutely. 18 Q. Then it said, "Care should be taken to 19 limit competitive promotion. OxyContin has been shown 20 that OxyContin was more effective than or superior to, 2 o to be as good as current therapy, but has not been 21 21 shown to have a significant advantage beyond reduction 22 in frequency of dosing." safer, had less opioid effects or caused fewer adverse 22 events than any other marketed product, correct? 23 A. 24 Q. I believe that's true. And let me back up a minute. 24 Do you know what-- when salespeople 25 Is that your understanding of the 23 25 characteristic of the drug? No. It is my understanding that that A. Page 234 Page 236 1 go call on physicians what type of information the 2 physician usually asks the salesperson? A. 3 4 5 6 1 I would not be able to comment on that. Q. You don't know whether they want to know if there's any studies, if there's any statement is correct. But the reason I said that that 2 may not be the case was the very surprisingly large 3 number of reports from the field that I heard second 4 and third hand, that early in the life of the product 5 doctors spontaneously volunteered that the drug was 6 better than we said it was. And this was so frequent 7 contraindications to the medicine, any problems 7 and so unusual that it raised in my mind, and 8 8 continues to raise, the question maybe it is actually 9 superior, but we were never able to demonstrate using 9 10 reported? Have you ever heard that sort of thing? A. That makes sense. I thought you meant in more -- that's a very general thing. They want to 1 o the methods that would be generally accepted that this 11 understand what is the medicine for, what kind of 11 was the case. It was an impression that doctors 12 condition, who are the patients, what is the -- what 12 developed on their own. 13 is the effectiveness. They might ask for comparative 13 14 effectiveness if it exists; and if it doesn't exist, 14 anything of that nature that would support that 15 the answer is we can't give you any. They might ask 15 statement? 16 about safety. They might ask about anything related 16 A. No. I said we could never prove it. 17 to what they feel they should know when they -- were 17 Q. So if you go on here under the heading 18 they to use the medicine. 18 19 Q. One of the things they might ask is 20 why is it better than what I'm already using, why 21 should I switch. Is that reasonable? Any studies -- retrospective studies, Q. "Misbranding of OxyContin" and -- and when we talk 19 about misbranding, that's just really making claims 2 o and statements that aren't true about a drug. That's 21 called misbranding the drug. Is that correct? 22 A. Perfectly reasonable. 22 23 Q. One of the things they might ask is, 23 say it's got a different meaning in the regulatory 24 world. It's stating things that are not strictly in 25 the package insert. 24 you know, you got any studies that show it's better. 25 Is that another thing that comes up? Coulter Reporting, LLC A. No, I wouldn't say it's that. I would www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:60 Richard Sackler, M.D. Page 239 Page 237 1 2 3 Q. Okay. A. They may be true, but if they're not 1 representatives they could tell healthcare providers 2 that there was less chance for addiction with in the package insert, they're misbranding. Do you know if Purdue had information Q. 4 3 5 that physicians were concerned about the abuse 6 4 A. No, I was not aware of that. 5 Q. And under "c" it says, "Sponsored potential for OxyContin? I did not have that. It wouldn't A. 7 OxyContin than with immediate-release opioids? 6 training that taught Purdue's sales supervisors that 7 OxyContin had fewer 'peak and trough' blood level 8 surprise me that physicians would be concerned about 8 effects than immediate-release opioids resulting in 9 that as with any other strong opioid or, in fact, any 9 less euphoria and less potential for abuse than 1 O short-acting opioids." 10 other opioid. Let me refer you to paragraph 20. It Q. 11 Were you aware that they were teaching 11 12 says here, "Beginning on or about December 12, 1995 12 13 and continuing on or about June 30th, 2001. .. " 13 A. 14 Q. And that is the time frame that the 14 15 U.S. Attorney's Office looked into the conduct at 16 Purdue, correct? 17 18 19 A. I don't know. Q. " ••. certain Purdue supervisors and sales supervisors to make that misleading -Absolutely not. -- statement? Under "d" it says, "Told healthcare 15 16 providers that patients could stop therapy abruptly 1 7 without experiencing withdrawal symptoms and that 18 employees, with the intent to defraud or mislead, patients who took OxyContin would not develop 19 tolerance to the drug." 2 o marketed and promoted OxyContin as less addictive, 20 MR. STRAUBER: I object to the form of 21 21 the question. In reading "d," you omitted the word 22 to cause tolerance and withdrawal than other pain 22 "certain" which appears before " healthcare providers." 23 23 less subject to abuse and diversion, and less likely medications as follows:" Oh . Well, let me read it again. Q. 24 Under "a" it says that you "Trained 24 Under "d," "Purdue told certain 25 Purdue sales representatives" -- meaning -- when I say 25 healthcare providers that patients could stop therapy Page 238 Page 240 1 "you," I mean Purdue, the company -- "Trained Purdue 1 abruptly without experiencing withdrawal symptoms and 2 sales representatives and told some healthcare 2 that patients who took OxyContin would not develop 3 providers that it was more difficult to extract the 3 tolerance to the drug ." 4 Oxycodone from an OxyContin tablet for the purpose of 4 5 intravenous abuse, although Purdue's own study showed 5 providers were being told that they could stop therapy 6 that a drug abuser could extract approximately 68 6 abruptly without experiencing withdrawal symptoms and Were you aware that certain healthcare 7 percent of the Oxycodone from a single 10 milligram 7 that patients who took OxyContin would not develop 8 OxyContin tablet by crushing the tablet, stirring it 8 9 in water and drawing the solution through cotton into 9 A. No. 10 Q. Okay. And that statement is false, 1 o a syringe." Were you aware that Purdue trained 11 12 tolerance to the drug? 11 correct? sales representatives to make that misrepresentation? 12 It -- no. It's -- it's not clear to A. 13 A. No. 13 me it's false, but I am eager not to contend with it. 14 Q. Is that a misrepresentation that would 14 It says "certain healthcare providers" and it -- the rest of it is conditioned really, in large measure, 15 cause a physician to be more likely to use -- to write 15 16 prescriptions for OxyContin or less likely to write 16 on, in the first case, the dose that the patient is 1 7 prescriptions for OxyContin? 18 19 I would -- I couldn't guess. The A. implication is that it would be more likely, but I 17 on, and the second case in the duration that the 18 patient is on. But reading between the lines, as I 19 suspect those who shaped this did and understood the 2 o government, I can accept it as being a reasonable 2 O don't know. 21 ex pression of improper conduct. That is, certain 22 healthcare providers might have been told regardless providers that OxyContin potentially creates less 23 of dose or regardless of duration. 24 chance for addiction than immediate-release opioids." 24 21 Q. And then number "b" says, "Told Purdue 22 sales representatives they could tell healthcare 23 25 Were you aware that Purdue told sales Coulter Reporting, LLC 25 But had I known about this, I would have alerted our attorneys when negotiating this that www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:61 Richard Sackler, M.D . Page 241 1 Page 243 th is ought to be a little bit more specific because 1 showing Oxycodone plasma concentration provided by 2 it's going to be difficult to agree with it the way 2 OxyContin on a logarithmic scale along with a 3 3 statement that OxyContin's Oxycodone blood plasma it's written . But I'm -- I won't quibble with it. Q. 4 5 A. 6 7 8 9 Well, there was actually a whole lot of back and forth on this document. There may have been, but it wasn't And a lot of the things brought up the U.S. Attorney's Office said, no, we've reviewed the 12 7 8 Q. Oxycodone. Oxycodone. I'm sorry. Paragraph 23 says, On December 20th of 1 o '95, after - - Is that what happened? A. MR. STRAUSER: Oxycodone. A. 9 10 documents and we're not changing this stuff. 11 levels provided fewer 'peaks and valleys' than Immediate-Release OxyContin." 6 with me. Q. 4 5 I don't know. 12 MR. STRAUSER: Just to be clear, in We're going -- I'm sorry. Turn the A. 11 page? Q. Yes. 14 the document we're reading, the Agreed Statement of 14 A. Thank you. 15 Facts, "Purdue" refers to the Purdue Frederick 15 Q. On December 20th, '95, "After 16 Company, which is the practice we've had in this 16 reviewing the proposed OxyContin launch materials, 1 7 deposition from the outset that you've used "Purdue" 17 DDMAC" -- what is DDMAC? 13 18 19 to refer to Purdue Frederick. Q. 13 DDMAC. It's the division of the A. 18 Yes. And because nobody at Purdue is 19 FDA -- I don't know what the letters stand for, but it 2 o able to say which employees were Purdue Frederick and 2 o is the division of the FDA that reviews promotional 21 21 materials and comments on their agreement that they 22 able to ascertain in any of the depositions I've read 22 are reasonably reasonable and accurate and consistent 23 so far, and including ones taken in the past, but 23 with the package insert or they differ with them and 24 we'll cover that later. 24 recommend changes or elimination of things. which employees were Purdue Pharma as far as I've been Under "e" here it says that Purdue -- 25 25 And to sort of cut through it, what Q. Page 242 1 Page 244 1 "Certain Purdue supervisors and employees, with the they did is they said, if you wish to compare blood 2 intent to defraud or mislead, told certain healthcare 2 levels in this text, we suggest that the blood levels 3 providers that OxyContin did not cause a 'buzz' or 3 for both dosage forms be presented in the graphic so 4 euphoria, caused less euphoria, had less addiction 4 that the reader can accurately interpret this claim. 5 potential, had less abuse potential, was less likely 5 6 to be diverted than immediate-release opioids, and 6 7 could not be -- and could be used to 'weed out' 7 8 addicts and drug seekers." 9 1 o were being made to healthcare providers? 11 A. No. 12 Q. And then the next section is No, I don't -- I don't think so. I A. 8 think they had a suggestion that we should add that. Were you aware that those statements 9 They thought it was misleading the way it was, correct? And I don't know why it wasn't there. We certainly 1 o had the data as is shown above. 11 Q. Okay. 12 A. So I assume we added the data. Q. And then it says, paragraph 24, "On or 13 "Misbranding of OxyContin: Use of Graphical 13 14 Depictions by Sales Representatives." And it says, 14 about January 11, 1996, Purdue told DDMAC that it had 15 "Data from Purdue's clinical studies was used to 15 'deleted' the statement 'fewer peaks and valleys than 16 create the following graphical demonstration of the 16 with Immediate-Release Oxycodone."' 17 difference in the plasma levels at steady state 17 18 between patients who took OxyContin every 12 hours and 18 19 patients who took Immediate-Release OxyContin every 6 19 20 hours." 2 o dialogue between them or why they took it out. 21 22 And it says that "On October 12th, 21 They took the statement out, correct? A. That's what it says. I don't know why. It was true. But I have no knowledge of the Q. Did you review any of the studies that 1995, Purdue requested comments from the FDA's 22 were done -- I mean actually get down and look at the 23 Division of Drug Marketing, Advertising and 23 data in the studies that were done prior to the 24 Communication about its proposed launch marketing 24 launch? 25 materials, which included the following graph and text 25 Coulter Reporting, LLC A. I looked at the analysis of studies, www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 Page: 62 Richard Sackler, M.D. Page 247 Page 245 1 but I didn 't look at the data, that is, the individual 2 case report forms. ever seen the data of the studies themselves? No. That would be voluminous, and I A. 5 6 And as we sit here today, have you Q. 3 4 1 4 label when we said it was a Class II narcotic, and every doctor knows that Class II narcotics are among 6 the most abusable products. A Class II narcotic that your own Q. _8 records show there was a belief among physicians that database with the paper record, the paper record that 9 1 o exists with the doctor's own records. it wasn't as strong as morphine, correct? No. That it wasn't stigmatized as A. 10 And so this approach, which has been 11 denied that, in fact, has called it out explicitly in several places, including right in the front of the 7 8 subject to extremely rigorous validation of the 9 2 3 5 don't -- I don't think it would be necessary for a 7 senior executive to do that because every study is package insert then and through many changes has not 11 morphine was . They knew it was -- if you would ask them, Is it more potent than morphine, many physicians 12 standard in the industry and, I believe, part of good 12 13 laboratory practices or one of the other standards 13 knew it was more potent. If they used both drugs, 14 that the FDA has promulgated, is extremely exhaustive, 14 they knew that they would always start with a much 15 lower dose of Oxycodone than they would with morphine. 15 which is one of the reasons the studies take so long, 16 because the validation of the data can take anything 16 17 from a month to a year. 17 18 Are you saying that your studies that Q. 20 21 19 extremely exhaustive? it in. 20 They were certainly appropriate for a A. Yes. They also knew what doses to use A. 18 19 you did before putting Purdue on the market were So you think physicians -- most Q. physicians knew it was more potent than morphine? 21 MR. THOMPSON: Let's mark this as Exhibit -- 22 molecule that had been in use, at that point, 80 years 22 MR. STRAUBER: It's 34. 23 or more, that was believed then to be safe and 23 (DEPOSITION EXHIBIT NO . 34 MARKED) 24 effective as a molecule, and that had no -- at that 24 25 time no long-term toxicities that hadn't been 25 (Passing document.) Let me refer you to the first Q. Page 248 Page 246 1 well-developed, and so a lot of that information was 1 2 brought into the package insert whether we observed 2 3 them in the trials or not. 3 So the standards for this kind of an 4 paragraph of this document dated January 26th, 2001. We're now five years after OxyContin has been on the market, correct? Which part of this should I read from? A. 4 5 approval, which has its own designation, are easier to 5 6 meet. They're called 505(b)(2) NDA, and draw upon, in 6 7 this case, a vast publ ic literature, as I said 7 8 extended back 80-plus years. So for that it was very 8 will. In the mind of the physicians, hydrocodone 9 extensive in those kind of applications. 10 Q. 9 Yes, the date is around five years from marketing. And it says up here -- this is from Q. Mark Alfonso. The first paragraph says, "I think it gives them a great degree of comfort. Physicians rank 1 o the drugs based on the position that they have created But when you took a controversial 11 opioid and expanded it to non-malignant pain at pills 11 in their mind as a result of prescription" -- 12 that contained high dosages of opiate, you didn't do 12 A. 13 any addiction studies before putting it on the market, 13 Q. 14 correct? 14 MR. STRAUBER: I object to the form of 15 16 the question . 17 A. First of all, the compound Oxycodone 18 was mostly used in non-malignant pain before we 15 Prescribing . -- "prescribing habit and promotion." And promotion would be, what, marketing from Purdue Pharma? 16 A. No. 17 Q. What do you think it means when it 18 says -- 19 entered the market. That was where the market -- the 19 2 o great bulk of the market existed. So there was no 2 o everybody in the industry from going back years and 21 innovation or change in our bringing it to the 21 22 non-malignant pain market. 22 23 The second thing was that we didn't - - Promotion is the promotion of years. Q. Okay. It says, "For them morphine and 23 hydromorphone are the most potent, followed by Oxycodone and then hydrocodone." 24 we assumed that it was potentially addictive, that it 24 25 could be subject to abuse and diversion, and the 25 Coulter Reporting, LLC A. A. I see it. www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 63 Richard Sackler, M.D. 8/28/2015 Page 249 Yeah. Were you aware that on January Q. 1 1 Page 251 Oxycodone are close to equal potent. But he didn 't 2 25th of 2001 Mark Alfonso -- and what was his role at 2 say "potent," he said "powerful," and "powerful" in 3 3 this case has to do with the hierarchy that they place Purdue? 4 A. He was head of marketing . 4 drugs. Morphine was the last because it was the most 5 Q. -- the head of marketing, felt like 5 stigmatized. 6 physicians did not feel like Oxycodone was as potent 6 7 as morphine? 7 we tried to reposition OxyContin as powerful as 8 morphine and we could not, finally we decided not to 9 mess with this perception since it was helping us in We've gone through this before . It A. 8 9 was -- that was a term that didn't refer to relative So when he says here, "Remember that Q. 1 o potency, it just didn't. He didn't include Fentanyl 1 O the non-cancer market." 11 in this, which is the most potent, but is often used 11 12 12 A. I see where he wrote it. 13 Q. All right. Let's go back to the plea before hydrocodone or morphine. 13 Q. Well, let me ask you this -- 14 A. So -- well, I'm just saying, it 14 agreement. 15 just -- I realize that you've changed the meaning that 15 16 was intended and understood by the recipients. 16 17 No. That's his word, "potent," not Q. MR. THOMPSON: It's marked. MR. STRAUSER: It's No. 34. 18 No, no, no. You've changed the A. MR. ELLIS: Tyler, we need to mark that document. 17 18 mine, correct? 19 Did you see where he wrote that? Paragraph 25 of the Agreed Statement Q. 19 2 o meaning of the word "potent." Not the word, the 2 o of Facts says, "On or about December 1998, Purdue 21 21 22 meaning of the word. Well, I didn't change it. It's -- Q. 22 managers." 23 it's his word. 24 25 Now, it wasn't some of them, it's all 23 No. You've changed it when you've A. sponsored training for all its district sales 24 tried to use it as though it means relative potency. of them, correct? 25 A. It says "all." 1 Q. "During this meeting, a pharmacist Page 250 1 Q. Page 252 All right. When we first discussed 2 the first group of documents, you said, no, they're 2 retained by Purdue" -- do you know who that pharmacist was? 3 just talking about effectiveness, not strength. The 3 4 second group of documents where they said it's 4 A. No. 5 stronger than morphine, you said, no, they just mean 5 Q. -- a pharmacist retained by Purdue to 6 strong in a general sense, they don't mean potent. 6 7 Here they .use the word "potent." 7 graphical demonstration (instead of the graphical 9 8 demonstration of the actual clinical data described in Do you just not think physicians don't 8 think it's as strong as morphine? Because that's what 10 they keep saying they don't want to clear up in the 11 physicians' mind, that it's as strong as morphine. It -- this is a hierarchy here. conduct a portion of the training used the following 9 paragraph 21 of this Agreed Statement of Facts) and 1 o falsely stated that OxyContin had significantly fewer 11 'peak and trough' blood level effects than 12 immediate-release opioids resulting in less euphoria 12 A. 13 Q. Okay. 13 and less potential for abuse than short-acting 14 A. Okay? 14 opioids." And they've got a graph that was used at 15 Q. Well, we'll just have to disagree 16 about that. 17 A. Here Mark Alfonso said here that -- if 18 following your reasoning, if your reasoning were 19 correct -- the physicians would see morphine as the 15 the training for the Purdue employees. 16 17 18 19 A. I would call that a cartoon, not a graph . Q. And it says on paragraph 26, "Beginning in or around 1999, some of Purdue's new 2 o most potent of all these drugs. It was the for them 2 o sales representatives" -- those would be Purdue Pharma 21 morphine, and then hydrocodone, and in most places 21 22 Oxycodone, and then hydrocodone. 22 23 The facts are that hydromorphone is sales representatives in 1999, correct? A. I can't say. MR. STRAUBER: Object to the question. 23 24 three to eight times more potent than morphine, but 24 Purdue is defined in this document as Purdue 25 that isn't how he listed it. And hydrocodone and 25 Frederick. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Page:64 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 Page 253 2 So are we talking about Purdue Pharma Q. or Purdue Frederick? I just don't know. A. 5 10 12 4 May I read it? If you don't want to 8 helped put the document together, the lawyer, we took read it into the record, can I just read it and then Sure. I'll tell you what, it will Q. save time, I'll read it into the record. A. Okay. Q. "On or about January 16, 1997, certain 9 his deposition. Have you seen his deposition? 10 MR. STRAUBER: I've seen his 11 12 results of a clinical study pertaining to the use of MR. THOMPSON: Yeah. And he says he 13 low doses of OxyContin by osteoarthritis patients." deposition. 13 Yeah. Are you familiar with that? A. 7 MR. THOMPSON: Yeah. The guy that 11 A. Q. 6 respond? face is talking only about Purdue Frederick. 8 9 That's okay, you don't have to rush. 2 3 5 MR. STRAUBER: The document on its 6 7 Purdue had an osteoarthritis study -- 1 sales representatives." 3 4 Page 255 MR. THOMPSON: Yeah, but it says "new 1 Purdue supervisors and employees sent to the FDA the 14 doesn't know if they're Purdue Frederick or Purdue 14 They call it the "Osteoarthritis Study." "And a final 15 when he refers to this. 15 MR. STRAUBER: I'm telling you, I'm 16 1 7 taking this document on its face defines Purdue as 1 7 reported 'withdrawal syndrome' as an adverse 18 Purdue Frederick. I don't care what anyone else said. 18 experience during the respite periods.' MR. THOMPSON: Sure. And I'm asking 19 22 23 24 25 Q. You don't know, correct? A. That's -- go -- I said I don't know 20 Experiences by Body System During Respite Periods,' 21 the report summary of the major results listed the who employed these new representatives. Q. "In a section entitled 'Adverse 19 2 o him if it's correct, and he's saying -21 report that included, in a section pertaining to 16 respite periods, the statement 'No investigator Okay. It says, "Some of Purdue's new sales representatives were permitted, during training 22 most frequently reported adverse experiences in 23 respite periods to be nervousness, insomnia, nausea, 24 pain, anxiety, depression and diarrhea followed by the 25 statement: '28 patients {26 percent) had symptoms Page 254 Page 256 1 at Purdue's training headquarters, to draw their own 1 2 blood level graphs to falsely represent that 2 recorded during one or more respite periods."' Did I read that correctly? 3 OxyContin, unlike immediate-release or short-acting 3 A. 4 opioids, did not swing up and down between euphoria 4 ahead of you. 5 and pain and resulted in less abuse potential. 5 6 Were you aware that the sales reps 6 about May 1997, certain Purdue supervisors and 7 employees stated that while they were well aware of 7 8 9 10 were doing that? A. No. Q. And then it says, "During the period I think so. I was kind of reading And then it says, paragraph 29, "On or Q. 8 the incorrect view held by many physicians that 9 Oxycodone was weaker than morphine, they did not want 1999 through June 30th, 2001 Purdue reps used 10 to do anything 'to make physicians think that 11 graphical depictions similar to the one described in 11 Oxycodone was stronger or equal to morphine' or to 12 paragraph 25 of this Agreed Statement of Facts and 12 'take any steps in the form of promotional material, 13 falsely stated to some healthcare providers that 13 symposia, clinical publications, conventions or 14 OxyContin had less euphoric effect and less abuse 14 communications with the field force that would affect 15 potential than short-acting opioids." 15 the unique position that OxyContin had in many 16 physicians' minds."' Were you aware that they had -- 16 17 A. No. 18 Q. -- engaged in that conduct? And did I read that correctly? 17 18 A. You read the words correctly. Q. And was that part of the Agreed 19 A. No. I'm sorry. 19 20 Q. And then to go on with the conduct, 2 o Statement of Facts? 21 paragraph 28 says, "Misbranding of OxyContin: 22 Misleading Use of Article to Claim No Withdrawal or 21 A. It is. 22 Q. And then it goes on to say, "On or 23 Tolerance," and it proceeds to discuss how Purdue -- 23 about February 12th, 1997, certain supervisors and 24 well, let's go ahead and read it. I'll try to shorten 24 employees of a United Kingdom company affiliated with 25 Purdue provided certain Purdue supervisors and 2 5 this a little bit. Coulter Reporting, LLC www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 Page 257 1 employees with an analysis of the osteoarthritis study 1 2 together with another clinical study. This analysis 2 Page: 65 Richard Sackler, M.D. Page 259 -- "included the following three Q. statements pertaining to the incidence of withdrawal 3 included a list of eight patients in the 3 syndrome and withdrawal symptoms experienced by study 4 osteoarthritis study and eleven patients in the other 4 patients: One patient was hospitalized for withdrawal 5 study who had symptoms recorded that may possibly have 5 symptoms. The patient who was hospitalized with 6 been related to opioid withdrawal, including one 6 withdrawal symptoms had completed the study on the 7 patient in the other study who required treatment for 7 previous day and had been receiving CR Oxycodone, 70 8 withdrawal syndrome." 8 milligrams. Symptoms resolved after three days. 9 "A second patient received 60 Did you ever review that study? 9 10 A. No. 1 o milligrams CR Oxycodone, experienced withdrawal Q. "The 'Discussion' section of this 11 symptoms after running out of study medication. The analysis included the following: 'It's not surprising 12 patient had not reported withdrawal symptoms during 13 that some patients in the clinical trials developed 13 scheduled respites from doses of 30 or 40. 14 some degree of physical dependence and consequently 14 11 12 "Withdrawal symptom was not reported 15 experienced withdrawal symptoms as a result of abrupt 15 as an adverse event for any patient during scheduled 16 discontinuation of OxyContin Tablets. All patients 16 respites. Adverse experiences reported by more than 17 who were suspected to have withdrawal symptoms have 17 10 percent of patients during scheduled respites were 18 been reported, but this may have resulted in a falsely 18 nervousness (nine patients) and insomnia (eight 19 high incidence. 19 patients)." "Of the patients who participated in 20 Paragraph 32 says the article included 20 21 the osteoarthritis study (in which patients entered 21 a "Comment" section, summarized the three statements 22 respite periods without OxyContin Tablets) many 22 and the "Results" and "further suggested that patients 23 symptoms suspected to be due to opioid withdrawal may 23 taking low doses could have their OxyContin treatment 24 simply have resulted from the return of pain. After 24 abruptly discontinued without experiencing withdrawal 25 withdrawal of OxyContin Tablets, patient 6007 25 if their condition so warranted." Page 258 1 Page 260 Were you aware they were making that complained of nervousness, patient 2004 complained of 1 2 insomnia and felt restless, patients 2020 and 2028 2 claim? 3 were restless and anxious. 3 A. No. Q. If you go over to paragraph 34, it "Since these are symptoms which often 4 4 5 says, "On or about June 26, 2000, certain Purdue 5 accompany the return of significant pain, it may be 6 wrong to label these as withdrawal symptoms. 6 supervisors and employees sent the full text of this 7 Nonetheless, the incidence of withdrawal symptoms in 7 osteoarthritis study article ... " Do you know which supervisors and 8 patients treated with OxyContin Tablets is a concern, 8 9 and it is safer to over report than under report this 9 employees sent the full text of this article? 1 o problem.' 10 A. No. Do you know if it was the marketing 11 Q. 12 the statement: 'As expected, some patients did become 12 group? 13 physically dependent on OxyContin Tablets, but this is 13 A. I don't know. 14 not expected to be a clinical problem so long as 14 Q. And it says, " ... together with a 15 abrupt withdrawal of the drug is avoided."' 15 11 "This analysis' conclusions included Were you aware that certain Purdue 16 17 employees participating in the final draft of the 'marketing tip' to Purdue's entire sales force. The 16 marketing tip stated that a reprint of the 17 osteoarthritis study article was available for use in 18 article regarding the osteoarthritis study that was 18 achieving sales success. The marketing tip also 19 published in a medical journal on or about March 27th, 19 included as one of the articles 12 key points: There 20 2000, were you aware they participated in the 2 o were two reports of withdrawal symptoms after patients 21 publishing of that study? 21 22 A. No. 22 70. Withdrawal syndrome was not reported as an 23 Q. "The 'Results' section of the 23 adverse event during scheduled respites, indicating 24 25 article" -- I'm reading from paragraph 31. A. Right. Coulter Reporting, LLC abruptly stopped taking CR Oxycodone at doses of 60 or 24 that CR Oxycodone at doses below 60 milligrams can be 25 discontinued without tapering the dose if the patient www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 66 Richard Sackler, M.D. Page 261 1 Page 263 condition so warrants." 1 It says, "On or about February 13th, it and asked should we write it up or is this going to 2 add to the current negative press and should be 2001, certain Purdue supervisors and employees 3 deferred, the person's supervisor said, "I would not 4 received a review of the accuracy of the withdrawal 4 write it up at this point." Correct? 5 data in the osteoarthritis study and stated" -- 5 A. That's what it says. 6 Q. Do you know if it ever got written up? 2 3 Now, this is Purdue's own people 6 7 reviewing this data, correct? 7 A. I don't know. 8 A. That's how I would read it. 8 Q. Do you know if any of these doctors 9 Q. And it says, "Upon a review of all 9 1 o comments for the enrolled patients, it was noted that 10 that were shown this were ever told that it actually wasn 't correct? 11 multiple had comments which directly stated or implied 11 A. I don't know. 12 that an adverse experience was due to possible 12 Q. Do you know if anybody at Purdue made 13 withdrawal symptoms. This was followed by a list of 13 an effort to go tell these doctors that all of these 14 11 study patients who reported adverse experience due 14 marketing things that have been brought up in the 15 to possible withdrawal symptoms during these periods. 15 Agreed Statement of Facts were not correct? 16 106 patients initially participated in the 16 A. I don't know. 17 osteoarthritis study. 32 of them withdrew because of 17 Q. Did you yourself ever tell anybody to 18 severe" -- I'm sorry - - "because of adverse (not 19 18 go inform doctors that these marketing statements that necessarily related to withdrawal) and 38 patients 19 2 o remained in the study at 12 months." And then the next paragraph reads, "On 21 22 had been used by Purdue's employees that were not 2 o accurate were -- were, in fact, not accurate? 21 or about March 28th, 2001" -- so this was a month and 22 23 a half later -- "a Purdue employee e-mailed a Purdue 23 24 supervisor regarding the review of the withdrawal data 24 25 described in paragraph 35 of the Agreed Statement of 25 1 Facts asking: 'Do you think the withdrawal data from 1 2 the osteoarthritis study is worth writing up (an 2 3 abstract)? Or would this add to the current negative I was not aware of this story or the A. study or the marketing materials or statements. And as the director of Purdue Pharma, Q. you were not made aware of any of this? MR. STRAUBER: I object to the form of Page 264 Page 262 3 the question. You can answer. I do not recall whether we were -- A. 4 press that should be deferred? ' The supervisor 4 you're talking about at the time of this document 5 responded: 'I would not write it up at this point.' 5 being written? 6 And no abstract was prepared." 6 Q. Yes. 7 A. I don't recall. Q. And at the time that this conduct went Do you see that? 7 8 A. I see it. 8 9 Q. So am I correct that Purdue was using 9 on, from '96 to 2001, the time period investigated by 10 the marketing material from this article improperly 1 o at least this U.S. attorney under this Agreed 11 and not reporting the adverse effects and was allowing 11 Statement of Facts, you were, in fact, the CEO of 12 their sales force to use it? 12 Purdue Pharma, correct? MR. STRAUBER: I object to the form of 13 14 the question. 15 A. 16 17 18 19 20 21 13 14 Let's break that into one question at 15 a time, please. Q. Sure. Was Purdue's marketing department using this article? A. That's what it says here. Q. And were they using it 22 That's what it says here. 23 Q. And when somebody pointed out that the 16 18th, 2000, June 22nd, 2000, February 13th, 2000 and 17 on March 18th, 2001, this employee was told not to 18 write up the withdrawal data because of negative press 2 o the CEO during this time period, correct? Yes. 21 A. 22 Q. What was Robert -From '99 until this. Yeah. What was Robert Reder's role at 23 A. 24 withdrawal data from the osteoarthritis study was 24 Q. 25 actually different than how the sales force was using 25 Purdue? Coulter Reporting, LLC So if this conduct occurred on May Q. 19 and that it should be deferred, you would have been inappropriately? A. During 2000, very, very late '99 until A. early 2003 I was the CEO, yes. www.coulterreporting.com 502-582-1627 Page: 67 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 267 Page 265 1 A. He was a senior medical officer. 1 Purdue sales representatives distributed the reprint 2 Q. The next paragraph says, "Between June 2 of the osteoarthritis article to some healthcare 3 26, 2000 and June 30th, 2001, Certain Purdue 3 providers and falsely or misleadingly stated that 4 supervisors and employees distributed copies of the 4 patients taking OxyContin at doses below 60 milligrams 5 reprint of the osteoarthritis study article to all of 5 per day can always be discontinued abruptly without 6 Purdue's sales representatives for use in the 6 withdrawal symptoms and that patients on such doses 7 would not develop tolerance." promotion and marketing of OxyContin to healthcare 7 8 providers, including the distribution of 10,615 copies 8 9 9 to certain Purdue sales representatives between And that's not an accurate statement, is it? 1 o February 13th, 2001 and June 30th, 2001." 10 So it looks like on March 28th the 11 11 12 supervisor tells the employee, Don't write up the 13 withdrawal data from the osteoarthritis study, it 12 14 would add to the current negative press and should be A. I don't believe so. Q. And then with regard to "Misbranding of OxyContin: Use of Reduced Abuse Liability Claims 13 in Marketing," it says, paragraph -- "OxyContin 14 package insert approved by the FDA stated: 'Delayed 15 deferred, and between February 13th, 2001 and June 15 absorption, as provided by OxyContin Tablets, is 16 30th, 2001, 10,615 copies of the osteoarthritis study 16 believed to reduce the abuse liability of the drug."' 17 were distributed to sales representatives, correct? A. 18 18 MR. STRAUSER: It says "certain Purdue 19 21 Q. 23 physicians that they called on? "Certain Purdue supervisors and 2 o employees instructed Purdue's sales representatives to Was the purpose of submitting it to the sales representatives so they could show it to the Statement. 19 2 o sales representatives." 22 That's called the Reduced Liability 17 That's what it says. 21 use this statement to market and promote OxyContin." 22 Paragraph 40 says, "Certain Purdue 23 sales reps, while promoting and marketing OxyContin, 24 A. I don't know. 24 falsely told some healthcare providers that the 25 Q. There was only 800 sales reps at 25 Reduced Abuse Liability Statement meant that OxyContin Page 268 Page 266 1 Purdue's highest volume of sales reps during this 2 period of time, correct? 3 4 5 A. To the best of my recollection, that's approximately true. Q. So if you wanted to give a copy to 1 did not cause a 'buzz' or euphoria, caused less 2 euphoria, had less addiction potential, had less abuse 3 potential, was less likely to be diverted than 4 immediate-release opioids, and could be used to 'weed 5 out' addicts and drug seekers." 6 each sales rep for their own use, you'd probably only 6 7 need 800; but they printed off 10,615 copies, correct? 7 It says, "By March 2000, various Purdue supervisors and employees in different parts of 8 A. Distributed, yes. 8 the company had received reports of OxyContin abuse 9 Q. Is it reasonable to conclude that the 9 and diversion occurring in different communities." 10 And that "On or about November 27, 2000, certain 10 sales reps were showing these to the doctors? 11 A. 11 It's reasonable to conclude that some Purdue supervisors and employees amended the Reduced 12 sales reps may have shown them to doctors, yes. To 12 Abuse Liability Statement to say that 'delayed 13 some doctors. 13 absorption, as provided by OxyContin Tablets, when 14 Q. 14 used properly for the management of pain, is believed 15 to reduce the abuse liability of the drug,' and Do you know if Purdue ever got any of 15 this 10,615 copies of the osteoarthritis article back? 16 A. I don't know . If this -- when this 17 was found -- and I don't know when this was found - - 18 by sales or marketing management or the medical instructed Purdue sales reps to use the amended statement to promote and market OxyContin." Do you know why that statement was 18 19 department, it would have been the practice to recover 19 changed? 2 o them, yes. But I don't know if it was found and I 21 16 17 20 21 don't know if it was done. This all came to light in A. I'm not sure -- no, I don't, and I'm not certain where it was changed. In the package 22 2006 or '7, so I don't know. It could have been long 22 insert? I don't know. If it was in the package 23 past, but I don't know. 23 insert, then that had to be submitted to the FDA to 24 25 Q. It says in paragraph 38, "During the period June 26, 2000 through June 30th, 2001, certain Coulter Reporting, LLC 24 get approval in advance of using it, but I just don't 25 know what this refers to. www.coulterreporting .com 502-582-1627 Page:68 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 271 Page 269 1 Well, when Purdue found out that Q. 1 understand the complex processes of treating pain? 2 OxyContin was being abused and diverted, they changed 2 3 their packet insert, kind of cleverly really, if you 3 4 read it right, "When used properly for the management 4 5 of pain." Do you know what they meant by that? 6 I don't know what the people who wrote A. 7 8 it meant by that or what the FDA understood, because I 9 was not involved in rewriting it. the question. It's argumentative. 5 A. 6 Q. Should I answer it? Sure. MR. STRAUBER: You can answer it. 8 A. I don't think so. 9 Q. Did Purdue's own focus group show that 1 o doctors didn't understand whether OxyContin was 11 stronger than morphine? March 2000 through June 30th, 2001, certain Purdue 12 sales representatives, while promoting and marketing 13 MR. STRAUBER: I object to the form of 7 Okay. The next paragraph says, "From Q. 10 11 I don't think so. A. OxyContin, falsely told some healthcare providers that 12 A. I don't know. 13 Q. What about the treatment of pain, did 14 the Reduced Abuse Liability Statement and the amended 14 you feel like doctors understood or physicians 15 statement meant that OxyContin did not cause a 'buzz' 15 16 or euphoria, caused less euphoria, had less addiction 16 utilized for the treatment of pain? understood prescribing practices that should be You'd have to put a time frame to that 1 7 potential, had less abuse potential, was less likely 17 18 to be diverted than immediate-release opioids, and can 18 or ask the question with more color and more details. 19 be used to 'weed out' addicts and drug seekers." Isn't that the reason you-all were Q. 19 2 o claiming that you needed to spend so much money And those statements are not correct? 20 A. 21 A. No, they're not correct. 21 educating physicians is because they didn't understand 22 Q. All right. 22 "Introduction of Misbranded OxyContin 23 24 And that is actually the guilty plea. Some physicians learned how to A. 23 Into Interstate Commerce." 25 pain prescribing? 24 prescribe for pain from materials that we produced or 25 information that sales reps gave them; others knew how Page 272 Page 270 A. Pardon? Q. It points out that Purdue manufactured 1 2 1 3 and sold OxyContin in interstate commerce from various 4 locations -- 5 A. 6 7 2 trying this agent in comparison to how they were 3 treating pain before. 6 in a sense, not ignorance so much as ignoring pain of should be following. 7 patients. Doctors just didn't want to deal with it and left patients inadequately treated. Q. It's the very next paragraph. 8 A. Which is 44? 9 10 Q. Yes. And that's just pointing out A. Let me read it and I'll tell you if I agree. MR. STRAUBER: That's not what it 14 15 says, if you're reading from 44. 18 A. 13 Q. Mr. Shapiro has testified -- 14 A. Oh, okay. 15 Q. I want you to assume he's testified 18 Did Purdue Pharma sell OxyContin all 19 over the U.S.? 20 A. During what time period? 20 Q. 1996 to 2001. 21 22 A. Yes. 22 23 Q. Now, is part of the reason Purdue was 23 able to get away with making these misrepresentations 25 is because Purdue was aware that physicians did not Coulter Reporting, LLC unmistakably to do so. Would you agree with that? 19 21 24 I don't understand the question. 12 1 7 marketing message is to instruct them explicitly and withdraw the question. Q. 11 to instruct them explicitly and unmistakably to do so? 16 that the only way to get a large sales force to use a MR. THOMPSON: You're right. I'll 16 Would you agree that the only way to Q. 1 o get a large sales force to use a marketing message is 11 that Purdue sold OxyContin all over the U.S., correct? 17 1985 in the U.S., there was almost -- it was abysmal interrupt you, sir. Just tell me which number I 9 12 When we entered the pain market in 4 5 Are you reading -- I'm sorry to 8 13 to treat pain and they would be more interested in 24 25 A. I really don't understand it. MR. STRAUBER: Once again, if you're reading from a transcript, please share it with him. Q. I want you to assume he's testified to A. But I don't -- that. www.coulterreporting.com 502-582-1627 Page:69 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 275 Page 273 MR. STRAUSER: Why should he assume it 1 1 three-quarters of them would have been gone. But I 2 when you have a transcript in front of you? 2 don't -- I can't answer that I know of any attempt to 3 MR. THOMPSON: I don't have a 3 assess blame in that sense or to count. Yeah. And that's not really my 4 transcript in front of me. I'm asking from my own 4 5 memory. 5 question. My question is, did anybody at Purdue don't understand that statement, so I really can't 8 agree or disagree with it. Pharma attempt to go back and find out which reps 7 specifically had made comments to physicians that were 8 improper or misleading about the attributes of 9 Do you believe there's evidence of Q. 9 6 Oh, okay. I don't understand . I A. 6 7 Q. OxyContin? 10 improper training that has occurred at Purdue based 10 A. The answer is, I don't know. 11 11 Q. Would you agree that giving -- making upon the Agreed Statement of Facts? 12 12 the statements -- the improper statements that are I would have to review it. My A. 13 recollection as you read -- as we read through it was 14 that one or two things involved improper training, but 13 14 compromise patient care? 15 I can't affirm that until I reread it. 16 17 here today what percentage of your sales force was Some of them, yes. In some patients. A. 15 Did you ever -- do you know as we sit Q. referred to in the Agreed Statement of Facts could 16 Obviously not all patients, but in some patients some 17 of the statements could compromise care. I would like 18 using these improper statements to educate physicians 18 to say suboptimize care, but ... 19 about prescribing OxyContin? 19 And if I understand correctly, you Q. 20 A. No, I don't know. 2 o have not reviewed any of the call notes that were 21 Q. Okay. Whether it was a hundred 21 pulled by Mr. Shapiro when he was doing his investigation? 22 percent, 50 percent, 10 percent; you don't have any 22 23 idea? 23 That's correct. As far as I know. I A. 24 A. I have no idea. 24 didn't -- I was shown a few call notes. I didn't ask 25 Q. Do you know if anybody at Purdue tried 25 were these shown to Mr. Shapiro. Page 276 Page 274 1 to find out how many of their sales force had given 1 2 2 somebody right about that same time that the call note system be changed? physicians improper and incorrect information? Was there a recommendation made by Q. I know, as I said before, that from 3 4 2000 -- sometime in 2000, as we became convinced that 4 A. At about what time? 5 there was a problem, many efforts were launched to 5 Q. About the same time he was doing his 6 train, retrain and to determine whether sales reps 6 7 were following company policy, and that effort goes on 7 A. I believe it was. 8 to this day. 8 Q. Yeah. And do the call notes not 3 9 A. We put in place, for example, a whole 9 investigation and reviewing the call notes. contain as much information as they used to back in 1 o compliance department in 2003 or 2004 with many 1 O two thousand -- 11 employees who reported independently to the board and 11 12 have continued to report independently to the board 12 change was to make the first and second-line 13 to, in a sense, back up the sales department and 13 supervisors audit a substantial percentage of the call 14 marketing department's own efforts to assure proper 14 notes in their span of control. 15 training and compliance with training. But I don't 15 16 know of any attempt to measure who said what and how 16 17 many times. When people were properly trained and 17 them? 1 s they deviated from that or went beyond that, they were 19 20 21 sanctioned, and many of them were dismissed. We also had a whole downsizing in the field force from about 2003 or '4 until about 2007 or 18 That, I don't know. But the biggest A. If the call notes have less Q. information in them, is it more difficult to audit A. I would have -- I couldn't possibly 19 guess. I don't know what they were before or after. 2 o They were very sketchy notes, the ones I saw. I must 21 say, they were selected and shown to me, but the ones 22 '8 in which the 800 eventually went down to something 22 I saw were, in some cases, almost indeterminant. You 23 like 200. So I don't think there are too many 23 could not know what was happening. 24 survivors from this period because they were 24 Q. How many did you see? 25 selectively weeded out and because, on average, 25 A. Six, eight. No more. I think Coulter Reporting, LLC www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page:70 Richard Sackler, M.D. Page 277 1 Page 279 probably fewer than six or eight, but I'll say six. 2 Q. 3 to you? And who were those -- who showed those I was shown them during the A. 4 5 preparation for the deposition. I had never seen them 6 before. 10 11 Were the call notes you were shown the tablet and are using a cotton ball to filter the talc as they draw it up in a syringe for 'main 4 lining.'" My recollection is some were . Q. Did you hire anybody or ask anybody to be audited for accuracy. There were many people in A. No. 8 Q. When did you first become aware that OxyContin was being diverted or being abused? recollection, winter of 2000. That is early in the 12 year 2000. 13 14 the law department and then the compliance department 14 15 who may well have done so, but I don 't know. And would you expect if we did our own In the winter -- to the best of my A. 11 15 Q. in November of 1999? 10 I did not ask would his investigation A. Were you aware that that was a concern 7 9 A. review Mr. Shapiro's investigation for accuracy? 12 13 2 5 8 call notes from Kentucky reps, or do you know? 9 people are finding ways to extract the Oxycodone from 3 6 Q. 7 1 Q. Who is Dr. J. David Haddox? A. Dr. Haddox is both a dentist and an M.D. He's an expert in both analgesic pain -- the use 16 of analgesics and pain management in general, and 1 7 investigation we would have essentially about the same 17 also, I think, is a recognized expert on addiction and 18 18 treatment of addiction. 16 19 number of improper call notes that he found? A. MR. THOMPSON: Do you want to take a 20 21 little break? MR. STRAUBER: Let's take a short 22 23 That would be my expectation. 19 Q. Did he work for Purdue Pharma? 20 A. He did . 21 Q. And what about Rena Golden and Windell 22 break. 23 Fisher, what were their jobs? Rena Golden, I don't know; and Windell A. 24 MR. THOMPSON: That's fine. 24 Fisher was a sales manager, but I don't recall how 25 VIDEOGRAPHER : We are off the record 25 high up he was in sales management. He was a -- I Page 278 1 Page 280 at 5:26 p.m. 1 (RECESS) 2 2 VIDEOGRAPHER: We are back on the 3 3 think he was a regional manager at that point. Q. And what about Jim Speed? A. I recognize the name, but I don 't - - I 4 record at 5: 55 p.m. 4 5 BY MR. THOMPSON: 5 salesperson. I don't know whether he was a manager or 6 not, if he was a district manager or sales manager. 6 7 Q. So let me show you an e-mail. If you'll go to page 2 of this e-mail. 7 can't tell you what his position was. He was a field Is it true that Windell Fisher was a Q. 8 (Passing document.) 8 9 This is from Jim Speed dated Tuesday, 9 territories located in Kentucky? 1 o November 30th. Let's mark this as Exhibit 35. (DEPOSITION EXHIBIT NO. 35 MARKED) 11 12 Q. Dated November 30th, 1999. Second regional manager with oversights for the districts and 10 A. I don't know. 11 Q. Is it true that OxyContin does produce 12 a buzz or euphoria just like -- the controlled-release 13 paragraph, "During physician calls, this issue is a 13 just like the immediate-release? 14 topic of hot discussion between me and the physician. 14 A. 15 While many salespeople have sold controlled-release When used in pain patients -- 15 Q. Yes. 16 opioids as having less abuse potential, the current 16 A. -- or when abused? 17 17 Q. When used in pain patients. 18 feel like we have a credibility issue with our 18 A. I don't -- I can't tell you the 19 19 20 21 situation has placed us in an awkward situation. I product. "Many physicians now think OxyContin is obviously the street drug all the drug addicts are 22 seeking. Issues like purposely crushing the 40 percentages. I'm sure there are some people who might 2 o say that they feel a sense of euphoria . I really 21 don't know what "buzz" means when people say they have 22 a buzz; I'm not familiar. But there may be a brief 23 milligram and 80 milligrams tabs to 'get high' have 23 period of t ime in which they feel some euphoria or 24 been expressed. I have heard from physicians that 24 sensation. 25 pharmacists -- and pharmacists that on the streets 25 Coulter Reporting, LLC Q. And whether you feel a buzz or www. cou lterreporti ng. com 502-582-1627 Page: 71 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 283 Page 281 1 euphoria, does that have to do with how quickly the 1 2 drug works? could be done? Dependency, that is, physiologic A. 2 Not so -- well, that's an element, but 3 4 it has to do also with the dose, and also with the 4 could be done. Addiction remains to be seen. A lot 5 patient's familiarity. If they've been on the same 5 of people would say it's almost impossible to do that. A. 3 dependence I think would be an achievable study that 6 dose for a while, I would think it's far less likely. 6 But Purdue and other industry partners are just on 7 And then there's ind ividual patient variation finally . 7 the -- on the cusp of trying to do that with a number 8 of studies. Q. 8 And with respect to peaks and valleys, 9 do the peaks and valleys that are referred to in all Q. 9 Could you do a retrospective study, or 1 o the marketing materials, or a number of the marketing 1 o could you have done a retrospective study if you had 11 materials, does that have to do with whether somebody 11 wanted to look at patients? 12 experiences a euphoria from taking OxyContin? A. 13 I would have to think about whether I A. 12 If they have any psyche -- 13 could figure out a retrospective study. It would be an interesting - - it's an interesting question, but I 14 psychological experience, like euphoria, it's most 14 15 likely to be at the peak blood level. So the fewer 15 don't know the answer to it. 16 the peaks, the fewer the periods of euphoria . But I'm 16 Q. And what was Robert Reder's role? 1 7 just generalizing. I'm not telling you that we've 17 A. Robert was a senior medical scientist 18 ever measured that. 18 19 Q. When did you first become aware that in the medical department. And I want you to assume he's Q. 19 2 o Purdue had marketed and promoted OxyContin as having 2 o testified that Purdue lacked any evidence that 21 21 22 less abuse potential? A. Not until the investigations were OxyContin had a lower abuse potential. If that's true -- if he testified to 22 done. And I can't tell you which investigation or 23 that -- assume he testified to that -- would you agree 24 when, but I certainly didn't know that people were 24 with that statement or disagree? 25 saying that until I was told by management that they 25 23 If you could just repeat the statement A. Page 284 Page 282 1 had done investigation and found that some people had 1 2 said that. 2 3 Q. so that I can concentrate on it. That he testified Purdue lacked any Q. 3 evidence that OxyContin had a lower abuse potential. Let me -- let me ask you about MR. STRAUSER: Yeah, I object to the 4 patients who have not had a prior incidence of 4 5 addiction or abuse, but just someone who's put on 5 6 OxyContin and has never had an opioid in the past. Do 6 7 you know if they're put on a 20 milligram dose of 7 done, but I don't know that no study was done. I just 8 OxyContin twice a day how long they would have to take 8 can't - - I can't tell you for sure. 9 it before developing dependency? 10 A. question. It's a very odd hypothetical question. I don't know of any study that was A. You're referring to Purdue Frederick 9 1 o and you're referring to the time frame up to 2007 or I can give you a guess, but I don't 11 know. It would -- there's enormous individual 11 2010? 12 variation he.re. So you can't say with any one person 12 Q. Yes. 13 or predict that this person will develop dependency or 13 A. Okay. I just wanted to -- I don't 14 that this person won't at 40 milligrams a day. I 14 know. My answer is the same, but I just wanted to be 15 assume that's the presumptive daily dose you're asking 15 clear that my answer conformed. 16 me about? 16 17 Q. 18 conducted any studies to determine how long a 19 18 non-malignant pain patient who's never had an opioid 22 23 24 25 19 many formulations, and we did them in the course of 21 formulations. These were studies that were pioneered 22 by Purdue with outside investigators, and they 23 attempted to and, I think, quite -- would be Is it fair to say that if Purdue 24 considered today state-of-the art, to discern how 25 easily practiced drug abusers might be able to defeat conducted. Q. We've done studies on abusability of I'm not aware of those studies being developed dependency or addiction? A. A. 2 o trying to develop and then select amongst several 2 o before would have to be on the drug before they 21 Has Purdue Pharma done a study since Q. 17 then? Yes. Do you know if Purdue ever wanted to do a study to make that determination that Coulter Reporting , LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 72 Richard Sackler, M.D. 8/28/2015 Page 287 Page 285 1 the delivery system and abuse it. Have you ever seen the deposition of Q. 2 3 Curtis Wright in the Poston case? He was a doctor who a friend in Utah A. 1 2 was using . And he must -- it looks like he may have 3 asked through his friend for me to send him some Betadine. He was a DPM, Doctor of Podiatric Medicine, 4 A. In the? 4 5 Q. Poston. P-O-S-T-O-N. 5 and they do a lot of surgery, and Betadine is a 6 A. No, I have not. 6 necessary part of any surgical procedure. At least 7 Q. Did you ever discuss with Curtis 7 it's an antiseptic, and antiseptics are a necessary 8 Wright whether studies could have been done on the 8 part. 9 abuse potential of OxyContin prior to the release of 9 1 o OxyContin? Let me give you a copy of this. And Q. 10 this is -- if we can mark this as Exhibit 37. 11 A. No. 11 {DEPOSITION EXHIBIT NO. 37 MARKED) 12 Q. If he testified those studies were 12 (Passing document.) 13 possible and could have been performed prior to the 14 release of OxyContin, would it surprise you? A. 15 This is an e-mail dated May 15th, Q. 13 14 1996. It looks like it was received by P. Goldenheim, 15 M.D. I would have to know more before I'd 16 registered surprise or not. I'd have to know what he 16 17 meant, what kind of studies and -- and so on. Perhaps 1 7 correct? He does work at Purdue Pharma, 18 he said we could have attempted to do it. That would 18 A. Yes. He was -- 19 surprise me less than if he said absolutely it could 19 Q. And it looks like you were also 2 o have been done. So I just have to know what he's 2 o included by fax, Dr. Richard Sackler? 21 21 22 23 talking about. Q. This -- let me hand you this e-mail. 22 Sorry about the delay there. 23 A. That's what it says. Q. And if you go to the third page, it says, "Professor Dayer did not see any major problems 24 (Passing document.) 24 regarding registration of OxyContin in Switzerland. 25 This is an e-mail from -- appears to 25 Some specific points need to be clarified (monitored Page 288 Page 286 1 be Richard Sackler on 8-27-97 to Craig A. McManama in 1 release approval as for DHC may be a possibility). He 2 Utah. That's a doctor; is that right? 2 considers the following subjects as important and would need further investigations:" 3 A. The name is not familiar. 3 4 Q. If you will go to the -- why don't we 4 5 5 mark this 36. 6 opioids because of the rapid onset of action of (DEPOSITION EXHIBIT NO. 36 MARKED) 6 The first paragraph says, "Information about the abuse/addiction potential versus other If you'll go to the bottom of the 7 8 second paragraph, you write to him, "I am drawing your 8 9 9 A. You did . 10 Q. Did -- do you know if you obtained 7 1o Q. attention to our newest product, OxyContin Tablets (controlled-release Oxycodone HCI) and have included OxyContin." Did I read that correctly? 11 some literature. Most important to your practice, 11 approval to sell OxyContin in Switzerland? 12 time of onset of OxyContin is as rapid as 12 A. I believe we did. 13 Immediate-Release Oxycodone, but duration is a full 12 13 Q. And did you provide him with the 14 hours and the patient reaches full blood levels in 14 information about the abuse/addiction potential versus 15 other opioids because of the rapid onset of action of 15 just two doses (one day)," Was it your belief that the time of 16 16 1 7 onset of OxyContin was as rapid as Immediate-Release 17 18 18 19 20 Oxycodone? A. That is what our data showed more or less. Almost as immediate. I believe in the study OxyContin that he requested? A. I'm not clear that he was actually requesting it, just saying that it was his opinion it 19 was necessary for registration, but I don't know 2 o whether anything was produced . I doubt anything was 21 that I was referencing, but didn't reference in the 21 produced here that was not produced for the FDA or the 22 note, I think it was 41 minutes for immediate-release 22 other European agencies who approved OxyContin. If 23 and 45 minutes or something like that for OxyContin. 24 25 Q. 23 anyth ing was produced that was different, that is, Now I recognize who he is. 24 additional studies, they would have also gone to the And who is he? 25 FDA. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 73 Richard Sackler, M.D. 8/28/2015 Page 289 Page 291 Do you know why he was concerned about 1 many valleys, does that cause -- is that more likely 2 the rapid onset of action of OxyContin with respect to 2 to make them become addicted or less likely, do you 3 know? Q. 1 3 abuse and addiction? 4 A. I don't know. 4 5 Q. With respect to the claims about peaks 5 I don't think the -- the valleys were A. about the same, too. So I don't think that the 6 and valleys, did you ever review the information to 6 valleys or the height of the peak would have been any 7 see what peaks and valleys were present in the plasma 7 different. The principal difference, I think, would 8 blood levels with respect to OxyContin? 9 A. In the five months did you say? 10 Q. No. Did you ever review -- 8 have been -- and you're saying "addictive" -- would 9 have been fewer peaks. And all of this presumes that 10 they were abusing the drugs as they were made and 11 A. I'm sorry. My hearing is not perfect. 11 presented. 12 Q. That's okay. 12 And if they use it as made and Q. 13 presented, they would also be taking drugs for I said, with respect to peaks and 13 14 valleys, the claim that peaks and valleys are 14 breakthrough pain potentially, correct? 15 different, did you ever review the literature 15 16 regarding that? 16 prescriptions from a physician. A. 17 I was familiar with some studies that 17 18 demonstrated that. It was, to some extent, an obvious They might well be -- have gotten two A. Right. If they -- you know, the Q. 18 studies show that it lasts from 8 to 12 hours, and if 19 characteristic. Since the drug was taken twice a day, 19 it lasts 8 or 9 hours in a patient and doesn't last 2 o you'd have two peaks; whereas, the immediate release 2 o until 12, he may need an additional prescription -- 21 was taken four to six times a day and so you'd have 21 22 four to six peaks. 22 23 24 25 Q, Do you know if the level of peaks and troughs are similar or different? A. My recollection is that they are about rescue prescription for that also, correct? Possibly. I would have told the A. 23 physician, use the rescue, compute the daily dose and 24 try giving that dose as OxyContin twice a day; that 25 is, half of that dose twice a day. Page 290 1 Page 292 the same. But that's a fuzzy recollection and I would 1 Do you know, was there any study done Q. 2 need to see the data to refresh myself and be sure. I 2 to determine whether patients who were given 3 think you -- my recollection is they were close. 3 Controlled-Release OxyContin and then had to take 4 another one, because it didn't last 12 hours, were controlled-release, because it maintained a higher 5 more likely to develop addiction or less likely to 6 level and didn't have as much trough during the day, 6 develop addiction? 7 would be more likely to cause addiction or less likely 7 4 s Q. Do you know whether the 8 to cause addiction? 9 A. I -- my impression is that the average I know of no such study, and I don't A. 8 recollect that anybody ever suggested such a study or 9 such a hypothesis. I would have had -- I would have 1 o blood level was the same, and I'm not certain -- so 1 o asked them why do you think that they are more prone 11 your question is, given that the average blood level 11 12 or less prone to addiction. I wouldn't think it would is the same -- if I'm correct. And that's a 12 make a difference. Again, not based on a study but 13 recollection . I haven't seen that data for a very 13 based on a conjecture. So I really would have to 14 long time. The only difference -- the difference in 14 understand what is the reasoning why -- why taking the 15 the blood level, the remarkable difference, would be 15 drug three times a day would be more likely to cause 16 half as many or a third as many peaks and valleys. 16 addiction or less likely. And to the extent that somebody was 17 MR. THOMPSON: Could we go off the 17 18 seeking the drug or enjoying that element of the drug, 18 record one second? 19 the peak effect, I would think that the drug would be 19 VIDEOGRAPHER: We are off the record 2 o less attractive. But it's a conjecture, it's not 20 21 knowledge, because I don't think we ever did a study 21 (RECESS) 22 that I'm aware of. 22 VIDEOGRAPHER: We are back on the 23 24 Q. My question is, if somebody has a controlled-release and maintains a higher level during 25 the day with respect to valleys, they don't have as Coulter Reporting, LLC at 6:20 p.m. 23 record at 6:33 p.m . 24 BY MR. THOMPSON: 25 Q. What I'd like to do is have you sift www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 74 Richard Sackler, M.D. Page 295 Page 293 1 through these documents, and with the exception of the 1 conduct has led to an increase in people being 2 GAO report, are all of these documents that are kept 2 addicted in the Commonwealth of Kentucky? 3 in the ordinary course of business at Purdue? 3 A. No. No, they would not all have been kept, 4 Q. Do you agree that education A. 4 5 5 information presented by a drug company to physicians to my knowledge, in the ordinary course of business. 6 We would have had some sort of destruction policy. 7 6 But we have been engaged in litigation for so long and needs to be fair and balanced? 7 A. Yes. 8 so many different matters that basically, at least my 8 Q. And do you agree if a company learns a 9 documents I have, I don't think anything has been 9 1 o sold by the company that they have a responsibility to 1 o thrown away. Q. 11 12 11 educate them properly about the drug? Are these all documents that are generated in the ordinary course of business at 13 Purdue? A. 14 15 physician does not understand a drug that is being Or at -- at Purdue Frederick or in 12 A. Yes. 13 Q. Do you think Purdue has an obligation 14 to provide physicians with truthful information? other companies or some of the overseas companies, 16 yes. 15 A. Yes. 16 Q. Do you believe Purdue provided any of 17 Q. Sure. Purdue Pharma and Mundipharma? 1 7 the physicians in Kentucky with information that was 18 A. Purdue Pharma, Mundipharma, Purdue 18 19 Frederick, whatever. Q. And are all of these business records? 21 A. I don't know. You know, I'm not a 22 lawyer. 20 24 A. No, I don't believe that. Q. And is that because you don't believe 21 for a legal conclusion . MR. THOMPSON: I'm not sure it is. 25 19 20 any of the sales reps engaged in the conduct that 22 is -- any of the sales reps in Kentucky engaged in the MR. STRAUBER: I think that's asking 23 not truthful? 23 conduct that is described in the felony plea 24 agreement? 25 A. That's my belief. I don't have any Page 296 Page 294 1 Q. Can you answer the question? 1 facts to inform me otherwise. A. Okay. Are they business records? I 2 Q. And you never checked, did you? 3 really don't understand what that term means. It's 3 A. I don't know how I would have checked 4 not a term I've ever used, so -- they are what they 4 5 are. 5 Q. Could you have looked at the call 2 6 Q. I asked you about the OxyContin 20 6 that. notes from your salespeople in Kentucky to see what 7 milligram prescription. To your knowledge, was 7 they were telling physicians and whether it was the 8 anything done to determine how many people put on 40 8 same information referenced in the felony plea 9 milligram, 80 milligram or 160 milligram prescriptions 9 agreement? 1 o would become addicted or dependent if they took it for 10 11 a certain period of time? 11 but I believe that all the call notes were reviewed at 12 A. No. 13 Q. Sitting here today, after all you've 12 I could have looked at the call notes, A. least once and probably multiple times by many people. 13 Q. And why do you have that belief? 14 come to learn as a witness, do you believe Purdue's 14 A. Because I know of the number of 15 15 conduct in marketing and promoting OxyContin in investigations and the extensive training and 16 Kentucky caused any of the prescription drug addiction 16 retraining that was done, and I believe it would have 17 problems now plaguing the Commonwealth? 17 surfaced, any evidence of wrongdoing and been 18 A. I don't believe so. 18 actionable. 19 Q. Sitting here today, after all you've 19 But as I've said, I've only seen a few 2 o come to learn as a witness, do you believe that 2 o call notes, and the ones I've seen are so cryptic and 21 Purdue's conduct in Kentucky has led to an excessive 21 imprecise and unclear in their references. Often you 22 or unnecessary amount of opioids being located 22 don't even know who's saying what. These were memory 23 throughout the Commonwealth of Kentucky? 23 joggers that I've seen. They were written by a person 24 A. I don't believe so . 24 who had a conversation who wanted to recall that 25 Q. Do you believe that any of Purdue's 25 conversation two, four, six weeks later. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 75 Richard Sackler, M.D. Page 297 Page 299 And when the call notes say "I told Q. 1 2 the doctor about less abuse" or "I told the doctor the 2 3 drug had less euphoria" or emphasized that, that would 3 4 be improper, correct? 5 6 7 If such call notes existed and they A. were that explicit, yes. I didn't see any like that. Lexington, Kentucky from a K. Boyles. Do you know who that is? 4 A. I don't know either of those people. 5 Q. Under "Notes Memo" it says, "Got to 6 convince him to counsel patients that they won't get 7 buzzed as they will with short-acting." Did it ever occur to you to check and Q. So here's a call on a Marc Dubick in Q. 1 8 see whether the people you hired and paid SO million 8 9 dollars for to do a presentation and defend Purdue in 9 thing to do, counsel the doctor that the patients -- Now, would that be an appropriate 1 o the U.S. Attorney's Office in the Western District of 1 o tell the doctor -- convince the doctor to counsel 11 Virginia gave accurate and truthful information to the 11 patients that they won't get buzzed as they will with 12 U.S. attorneys regarding the call notes? 14 16 14 You can answer. reading from a document, please show the witness. (Passing document.) . 15 It wouldn't occur to me that any A. MR. STRAUBER: Again, if you're 13 the question. 15 17 12 short-acting? MR. STRAUBER: I object to the form of 13 attorney that we hired would give false information to 16 MR. STRAUBER: May I have a copy? 17 MR. THOMPSON: This is the only copy 18 any other attorney, and much less so to the U.S. 18 we have. You'll have to look at it together. 19 attorney and his deputies. 19 20 21 When doing a call note search, did you Q. This is pretty easy to read. So could A. 2 0 you repeat the question? ever find out how they went about it? Yes. Would it be appropriate to Q. 21 22 A. I'm sorry? 22 counsel the doctor -- to convince the doctor to 23 Q. When -- when the people you hired did 23 counsel his patients that they would get less buzz 2 4 their call note search, did you ever find out how they 24 25 25 went about it? with OxyContin versus -- Well, what it says here is that they A. Page 298 1 Page 300 At the time it was described fairly A. 1 won't get a buzz. And I don't think that telling a patient "I don't think you'll get a buzz" is harmful, 2 explicitly, but that was years and years ago. That 2 3 was almost 15 years ago. 3 because if they do, I would think that the patient 4 would report it and he would know, oh -- I don't know MR. STRAUBER: I think any further 4 5 questions along this line will really impinge on 5 why he would have told this to a patient. But I think 6 attorney-client privilege, so I object. 6 that it actually could be helpful, because many 7 8 Q. Was a breakdown of the results ever provided to you? 9 A. In a way, yes. 10 Q. When you say "in a way," how was it 11 provided? 12 A. patients won't get a buzz, and if he would like to 8 know if they do, he might have had a good medical 9 reason for wanting to know that. 10 Well, I was told that -- 12 buzz was one of the things prohibited by the -- in the 13 statement -- Agreed Statement of Facts in the felony 14 think your questions are really leading the witness 15 into attorney-client communications, and I would 15 16 direct him not to -- not to respond to those 16 17 questions. 18 Do you know whether telling patients Q. 11 they won't-- telling doctors patients won't get a MR. STRAUBER: Let me interrupt. I 13 7 MR. THOMPSON: Well, certify the 14 plea? A. Yes. But that isn't what it says. He said -- we don't know what the conversation was 17 between the doctor and the rep. But, as I've 18 testified just a minute ago, I could see that this 19 question and we'll talk to the judge about it. I 19 could have been not only -- not harmless, but helpful. 2 o think I'm entitled to go into it. If the judge says 20 21 no, then of course we can't. 22 23 (Whereupon, the pending question 23 24 was certified to the Court for 24 25 ruling.) 25 Coulter Reporting, LLC Here's one -- MR. STRAUBER: Are you going to mark 21 MR. STRAUBER: That's fine. 22 Q. that as an exhibit? MR. THOMPSON: No, I'm just going to ask him about these. Q. Here is one -- www.coulterreporting .com 502-582-1627 Page:76 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 301 Page 303 1 time period, correct? MR. STRAUBER: The only difficulty I 1 2 have with that is, you're asking him questions about 2 A. Yes. 3 them and then we, going forward from here, have no 3 Q. So by what kind of twisted logic are 4 record of what it is he was looking at. 4 MR. THOMPSON : Well, this is my only 5 6 copy. That's why I don't want to -- you saying that saying this in 1998 wouldn't be 5 improper because the -- because the Agreed Statement 6 of Facts is in 2007? 7 THE WITNESS: You can keep it. 7 8 MR. STRAUBER: Why don't you mark it 8 the question. It isn't a question; it's 9 argumentative, and it's really uncalled for. 9 as an exhibit, don't give me a copy -MR. THOMPSON: If you want to mark it MR. STRAUBER: I object to the form of 10 Q. If you can answer, go ahead. 11 later, you can, but I 'm going to ask him my questions 11 A. I think I should stand on what I said. 12 right now so I can get out of here. 12 Q. Well, let me ask you this. Tell me 10 13 all the bases you have for believing that saying this MR. STRAUBER: I object to this line 13 14 in 1998, to talk of less euphoria with Oxy, would 14 of questions. 15 somehow not be a problem because the agreed statement MR. THOMPSON: You can object. I 15 16 don't have to mark it if I don't want. Q. 17 16 was in 2007? Here is Ellen Ballard in Louisville, 20 21 22 19 don't have a dialogue. I wasn't present. I don't Do you know who that is? 19 A. Yes. Q. And in here it says, "Talked of less 2 o know what he said. And I don't even know whether this 21 was a document upon which the Agreed Statement of euphoria and more convoluta with Oxy." 22 Facts was constructed. For all I know, this document was tossed away as inexact or inexplicit. 23 Would it be inappropriate to tell 23 24 patients they get less euphoria with Oxy? 24 25 A. I don't know what he said in 1998. I A. 17 18 know what he wrote, but I don't have quotes on it, I 18 Kentucky, sales rep Mark Curran. 25 We really don't know what was said. Let me ask you about this document. Q. James Donley is the doctor at the Trover Clinic in Page 304 Page 302 1 1 Madisonville, Kentucky who was called on by Holly As I said, this is a memory jogger. He might have 2 said, "There may be less euphoria," or, "Some people 2 Will. The note's memo says, "Quick, reminded him that 3 have less euphoria," or -- we just don't know what was 3 Oxy gives flat blood levels, so less buzz than 4 said here. 4 Lortab." 5 Q. Okay. A. 5 Is that the type of statement that's prohibited by the Agreed Statement of Facts? If all he said was "There may be less 6 7 euphoria," that could be true, and I don't see the 7 8 harm. If he promised less euphoria, it shouldn't have 8 said. If you're asking me a hypothetical, I would say 9 been said . 9 6 10 Q. I don 't know that that's what she A. that this is not -- neither accurate nor appropriate. 10 It doesn't actually give flat blood levels as you An Agreed Statement of Facts doesn't 11 say you have to promise less euphoria, it says if you 11 know, and as our rep knew and as any doctor who had 12 mention to a doctor or infer that it causes less 12 been properly presented the product would know. But, 13 euphoria, that's improper, correct? 13 nevertheless, even though it is demonstrably wrong, it 14 A. 14 would be still inappropriate to say on two bases; on That was what we agreed to, yes. But 15 this was 1998, long before there was an Agreed 15 the basis of the Agreed Statement of Facts and also on 16 Statement of Facts . 16 the basis it's untrue. 17 Q. What difference does that make? If But, again, I have to emphasize, these 17 18 it's improper in 2007, wouldn't it be improper in 18 are not transcripts. These are about as distant from 19 1998? 19 transcripts as anybody can get. This is a memory 20 A. Not necessarily. 2 o jogger, and I don't know what she said, and I find it 21 Q. Well, the improper conduct that the 21 hard to believe that she said anything like this. 22 Agreed Statement of Facts -- the time period was 1996 22 This was to remind her of a discussion. 23 23 Q. Have you ever spoken to her? No. Okay. This is Dr. David Parks in to 2001, correct? 24 A. Yes. 24 A. 25 Q. And if this is 1998, it's within that 25 Q. Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 77 Richard Sackler, M.D. 8/28/2015 Page 305 Page 307 1 Bowling Green, Kentucky, who was called on by Philip 1 at the package insert and could see was that in the 2 Gross. "Love the idea of getting effective pain 2 package insert or was it reasonably the same as what 3 relief, but not euphoria to get rid of druggies." 4 3 was in the package insert. I'd have to do a textual (Passing document.) 4 analysis. It's close to what was in the package If it was discussed with him that it 5 insert, very close, but it might have drifted away gives effective pain relief but not euphoria and he 6 from the package insert so that at that time it was 7 loved the idea, would that be inappropriate comments 7 inappropriate. But I'm not sure because I have to 8 to make? 8 read the two -- the hypothetical statement you put 9 forward and the package insert to give you an opinion 5 6 Yes. If our rep made it. If the A. 9 1 o doctor made it, I don't think that it's -- it may be 1 o as to whether it has drifted away from the package 11 erroneous, but it isn't improper. And I don't know 11 12 12 who made the statement. insert. It would be pretty easy to tell if we Q. 13 Q. If the rep made it -- 13 looked at the Agreed Statement of Facts because they 14 A. Or, in fact, even what statement was 14 outlined the comments they felt were improper between 15 made. I have not -- I don't remember seeing any of 15 16 these notes, by the way. But these are typical. They 16 17 17 are fragments of fragments of fragments of a 18 conversation that are designed to remind the rep of a 19 1996 and 2001, correct? I didn't memorize the Agreed Statement A. of Facts either. But, yes, if that statement was an 18 example of an inappropriate statement, obviously it conversation that he or she had two, three, four, 19 would -- we agreed it was inappropriate. 2 o five, six weeks prior. So they mean a lot, but 20 21 without asking the person who wrote them what it 21 required your -- your representatives or salespeople 22 meant, we don't, sitting here, have any idea what it 22 to do call notes and instructed them to do them within 23 means. 23 minutes of completion of the call, correct? 24 Q. If the -- if the Purdue sales rep 25 calls on a doctor in Kentucky and explains to him that And these call notes, you-all actually Q. 24 A. That's correct. 25 Q. And that's because the information Page 306 1 Page 308 1 recorded is generally more accurate when it's recorded Oxy has less potential for abuse due to its sustained 2 release, would that be improper and the type of 2 immediately after the sales call while the events of 3 statement that was agreed was improper in the Agreed 3 the call are fresh in the representatives' minds, correct? 4 Statement of Facts when Purdue pied guilty to a 4 5 felony? 5 6 A. THE WITNESS: Could he just restate 7 8 9 Okay. State the hypo -- the hypothetical question? Q. Sure. If Purdue called -- I want you I don't think that that would be true A. 6 in the way these call notes were used -- written or 7 used when reviewed. I don't think it would have 8 mattered if they had done it that evening. But when the system was -- or when 9 1 o to assume a hypothetical. If Purdue called on a 10 that policy was established, whoever established it 11 doctor and said that OxyContin has less potential for 11 12 abuse due to its sustained release, would that be the 13 type of statement that would be inappropriate? 14 A. And when was that said? You're going 15 to set a time limit to it or a time period to that 16 hypothetical? 17 Q. No. I'm just trying to get an idea of probably had a different use in mind and expected them 12 to be much, much more -- much closer to a "he said, I 13 said," "he said, I said," "he's interested in this, I 14 have to get him an answer for that." And the notes I've seen so far depart 15 16 so far from that that I don't think it mattered 17 whether they did it in a minute, an hour or a day. So 18 what statements you consider inappropriate versus 18 long as the conversation was fresh in their mind, they 19 appropriate. 19 sketched some notes to remind them of the conversation Would that be an inappropriate 20 21 statement for a rep to tell a doctor? 2 o a few weeks later, two to six weeks later. 21 Q. When you disciplined people, how did 22 A. Today, yes. 22 you make a determination which ones needed to be 23 Q. Would it have been inappropriate from 23 disciplined -- sales reps needed to be disciplined? 24 25 1996 to 2001? A. I'm not sure, because I'd have to look Coulter Reporting, LLC 24 25 A. I didn't discipline anybody and so I was not asked to make a determination. www.coulterreporting .com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 78 Richard Sackler, M.D. Page 309 Page 311 Do you know if the people who did make Q. 1 2 that determination relied on the call notes in 2 3 determining whether discipline should take place? 3 4 A. I don't know. 4 5 Q. Do you know if the reps in Kentucky 5 I would have to study the package A. 1 insert. Let me -- let me go back and talk Q. about what -- maybe this will help us here. Under "Misbranding of OxyContin" there 6 were disciplined for having inappropriate call notes 6 were several things that were brought up that were -- 7 that reflected their conversations with physicians? 7 were inappropriate'-. And it says, "With the intent to defraud or mislead" -- 8 A. I don't know. 8 9 Q. If a sales rep went to a doctor and 9 MR. STRAUBER: Are you reading from 1 o said "Discussed lack of buzz and, thus, won't be drug 1 o the Agreed Statement of Facts? 11 seeking," would that be an inappropriate comment to 11 12 make? 12 Could you form the comment for me, A. 13 MR. THOMPSON: I'm reading from page 5 of the Agreed Statement of Facts . 14 since it's a hypothetical, as a sentence and then I'll 14 15 respond to it? 15 A. If a sales rep went to a physician and Q. What number is that? A. 13 MR. STRAUBER: It's Exhibit 33. I'll have to find it now. Is this it? 16 Q. Yes. 1 7 said, "You don't get a buzz with OxyContin," would 17 A. And where are you reading from, 18 that be an inappropriate comment? 18 please? 19 Q. 16 19 A. Yes. 20 Q. If a sales rep went to a physician -- 2 o intent to defraud or mislead" -- I'm sorry. Let's MR. STRAUBER: I have to -- you're 21 Page 5, paragraph 20. "With the 21 back up. 22 going through a whole line of questioning where you 22 23 have documents, you purport to be reading from them, 23 24 you're not showing them to me, you're not showing them 24 25 25 to the witness. I don't think it's a fair line of "Purdue's supervisors and employees, between December 12th, 1995" -- MR. STRAUBER: Again, you lelt out the word "certain." Page 310 1 Page 312 inquiry. MR. THOMPSON: I'm asking him what 2 2 3 types of questions a sales rep says. Whether I've got 4 notes or documents or I've got them in my head doesn't 4 5 matter. I get to ask my questions. You can follow up 5 6 if you want. 8 9 documents in front of you that you're reading from. Q. read it in its entirety, then . MR. STRAUBER: Okay. 3 MR. STRAUBER: You appear to have 7 MR. THOMPSON: Sorry. Well, I 'll just 1 If a salesman went in and discussed "Beginning on or about December 12th, Q. 1995 and continuing on or about June 30th, 2001, 6 certain Purdue supervisors and employees, with the 7 intent to defraud or mislead, marketed and promoted 8 OxyContin as less addictive, less subject to abuse and 9 diversion, less likely to cause tolerance and 1 o abuse potential and benefits of Oxycodone -- 10 withdrawal than other pain medications." 11 OxyContin -- I'm sorry -- and it not giving a 11 12 euphoria, would that be inappropriate? 13 12 MR. STRAUBER: Objection. 13 Did I read that correctly? I think so. It's getting late, so I A. might have missed, too. 14 A. I believe that would be inappropriate. 14 15 Q. If he tells them that there's less 15 by the U.S. Attorney's Office that formed the basis of Q. And it was a review of the call notes 16 euphoria with OxyContin, he or she, the sales rep, 16 this plea agreement, correct? 1 7 says there's less euphoria with OxyContin, would that 17 A. I don't know that. 18 Q. Did you ever review any of the 18 be inappropriate? 19 A. Less amount of euphoria or less likely 2 o to be euphoria or something else? 19 documents filed by the U.S. Attorney's Office in the 2 o case where Purdue pied guilty to the felony? 21 Q. Either of those. 21 A. No, I didn't. 22 A. I believe that today that would 22 Q. All right. And it says here -- A. They didn't footnote these documents, 23 24 25 definitely be inappropriate. Q. Would it have been inappropriate between 1996 and 2006? Coulter Reporting, LLC 23 24 so I don't even know if they -- the documents -- they 25 reviewed millions of documents. I don't know whether www. cou lterreporting. com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:79 Richard Sackler, M.D. 8/28/2015 Page 313 1 they referenced any of the documents to this. I 2 certainly couldn't have reviewed millions of 2 3 documents. No one person could have done that. 3 Q. 4 Page 315 MR. THOMPSON: I wasn 't going to. 1 Under number -- subparagraph "e" it MR. STRAUBER: Could you identify it so we'll know what it is? MR. THOMPSON: I thought I did. It's 4 5 says, "Told certain healthcare providers that 5 6 6 to Blue Cross/Blue Shield. OxyContin did not cause a 'buzz' or euphoria." And that would be improper, correct? 7 A. 8 It depends on -- oh, did not cause. 8 Q. I'm looking at the third paragraph. Q. 7 9 Yes, that would be inappropriate. 10 the reply of the United States to Defendant's response "Purdue states an analysis of the notes that Purdue's 9 sales representatives kept from their visits to "Caused less euphoria, had less 10 physicians revealed that less than .2 percent 11 addiction potential, had less abuse potential, was 11 contained any evidence of statements that were 12 less likely to be diverted than immediate-release 12 arguably improper." 13 opioids, and could be used to 'weed out' addicts and 13 14 drug seekers." 15 A. In its totality, it's inappropriate. 16 Q. And one of the things that it points 17 15 arguably improper? 16 out in here, when we went on, was the osteoarthritis 17 18 study. 19 As they say, actually, here in their A. response, "were even arguably improper." 18 Do you remember us talking about that? 19 Were you aware that they had claimed 14 that two-tenths of one percent of the sales notes were But the U.S. attorney says, "This bare Q. statistical reference does not provide a complete 20 A. I do. 2 o picture of the magnitude of the unlawful activity 21 Q. Here's Carol Neilheisel, sales rep. 21 described in the information in the Agreed Statement 22 This is William Yates, doctor, Florence, Kentucky. 22 of Facts. In fact, these very same notes show the 23 And the note's memo says, "Brought osteoarthritis 23 pervasive nature of the false and misleading 24 studies that show non-addiction. Discussed how he 24 statements. 25 could use Oxy to deter addictive behavior. Less "For example, according to the notes, 25 Page 314 Page 316 1 pills, less potential for abuse." 1 in at least 41 states physicians were informed that 2 (Passing document.) 2 addicts would not like OxyContin or that OxyContin 3 Would you agree that those comments 3 could be used to weed out drug seekers because addicts 4 would not like it. In at least 49 states physicians 4 would be improper and inappropriate? A. 5 6 If they were quotes of the transcript or of what he said, yes, this is inappropriate. 5 were informed that OxyContin produces no 'buzz' or 6 euphoria, and in 50 states physicians were informed that OxyContin had less abuse potential than other 7 Q. And -- 7 8 A. In its totality it's inappropriate. 8 opioids." MR. STRAUBER: Are you planning to 9 1 o mark this as an exhibit? MR. THOMPSON : I was not going to mark 11 12 13 it, no. Q. And it says here, "Purdue states 14 that" -- I'm reading from the reply of the United Would all of those comments be 9 1 o improper? 11 A. Those comments would be improper, yes. 12 Q. This says, "In addition, once Purdue 13 learned of the investigation, it conducted training 14 that cautioned sales representatives to avoid 15 States to Defendant's response to Blue Cross/Blue 15 including references to the false and misleading 16 Shield of Tennessee, another private third-party's 16 statements in their call notes. Eventually Purdue 1 7 request for restitution. (Passing document.) 18 1 7 changed the call notes system altogether to preclude 18 such references by allowing sales representatives to 19 A. This is a new document, right? 19 choose only from preselected menu items that, not 20 Q. Uh-huh. 2 o surprisingly, omitted the false and misleading 21 A. Is this an exhibit or not? 21 statements that the employees had previously -- that 22 Q. I just want to ask you about some of 22 the employees previously -- had previously 23 spontaneously recorded in the notes." 23 24 25 the information in here. MR. STRAUBER: You're not going to mark this as an exhibit either? Coulter Reporting, LLC 24 Were you aware of that? 25 MR. STRAUBER: I object to the form of www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 80 Richard Sackler, M.D. Page317 1 Page 319 that question. You're showing the witness an argument MR. STRAUBER: Can I hear the question 1 2 written by the government and submitted to the Court 2 3 in a brief that this witness has never seen. There 3 4 are government arguments and you're asking if he was 4 20, are those the improper and misleading statements 5 aware of it. 5 that were made with intent to defraud by Purdue's The statements outlined in paragraph Q. 6 sales force? Does that set them forth? MR. THOMPSON: I'm asking if he was 6 7 again? I just missed it. aware of that activity. I don't know. To me this is almost a A. 7 8 A. What activity? 8 legal question, and I'd like to know whether our 9 Q. That "Once Purdue learned of the 9 attorneys would agree with this or not. These are 1 o investigation, it conducted training that cautioned 1 o some of the statements that are in here. I think 11 sales representatives to avoid including references to 11 there are others. So I'm not sure that you mean is 12 the false and misleading statements in their call 12 13 notes." That's number one. 13 Were you aware they did that? 14 this all and nothing else. I don't mean -- I just mean under Q. 14 paragraph 20 -- 15 A. I don't think they did that. 15 A. 16 Q. And it says, "Eventually Purdue 16 Q. Okay. -- would that constitute -- 1 7 changed the call notes system altogether to preclude 17 A. Examples of? 18 such references by allowing sales representatives to 18 Q. -- examples of inappropriate and -- 19 choose from preselected menu items that, not 19 A. That's what -- 2 o surprisingly, omitted the false and misleading 20 Q. -- misleading statements? MR. STRAUBER: I object to the 21 statements that the employees had previously 21 22 spontaneously recorded in their notes." 22 question. It's been a long exam, we're late in the 23 day, and now you seem to be going over the Agreed Were you aware that that had occurred? 23 24 MR. STRAUBER: Well, I object. You're 24 Statement of Facts again and asking the witness what 25 assuming that something occurred based upon an 25 the Agreed Statement of Facts says. What it says is Page 318 1 A. 3 5 1 MR. THOMPSON: All right. 2 4 Page 320 argument of one party to a litigation in a brief. MR. THOMPSON: Yes. 2 Can I verify that this occurred? I MR. STRAUBER: I don't know where this 3 4 is getting us. At this late hour I think it's 5 starting to border on harassment. can't. Q. written in the Agreed Statement of Facts. The statements referenced in the 6 Agreed Statement of Facts under "Misbranding of 6 7 7 OxyContin" -- MR. THOMPSON: Can you read my question back? 8 A. I don't even see a date on this. 8 (Record read.) 9 Q. The statements -- 9 THE WITNESS: Should I answer? 10 A. I'm sorry. Can we -- are we on the 11 12 same document, or not? Q. No. I'm asking about the Agreed 13 Statement of Facts now. 14 A. Oh, okay, we're back on that. Okay. 15 Q. The statement under "Misbranding of 16 OxyContin" -- MR. STRAUBER: I object, but you can 10 11 answer, yes. 12 A. Yes. 13 Q. If a sales rep told a doctor that 14 using OxyContin would provide smoother blood levels, 15 would that be an appropriate statement? 16 A. I don't know -- if smoother blood 17 A. What page or what number? 17 18 Q. Page 5. You've read paragraph 20 in 18 might be an inappropriate statement, but I'm not sure 19 20 21 22 23 its entirety, correct? A. I had read it, but it might help me to read it again. But why don't you pose your question? Q. Are those the statements that were levels was not in the package insert, it may not -- it 19 that it wasn't in the - - in the package insert. 2 o Although it might be inappropriate, I don't know. 21 22 It would have been true depending upon what was meant by "smoother." "Smoother" is not a 23 medical term or a pharmacokinetic term. It's an 24 A. Of Purdue Frederick? 24 opinion of -- it's a term that somebody might apply to 25 Q. Yes. 25 a graph. It's a smoother line; it's not a smoother improper and constituted the guilty plea? Coulter Reporting, LLC www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 Page: 81 Richard Sackler, M.D. Page 321 1 Page 323 line. But it's not really a clear statement and, 1 A. 2 thus, I can't say it's clearly right or clearly wrong. I did. 2 Q. What was that title? 3 It would have been fine if that terminology was in the 3 A. I was a senior vice president. 4 package insert. I don't know whether it was. 4 Q. And do you know when you relinquished 6 All right. What information did you Q. 5 5 review to prepare for your deposition today? that title? I don't recall, but it probably was A. 6 7 A. Documents. 7 8 Q. Which documents? 8 Purdue Pharma or before. A. Not too many of the ones you've shown 9 10 10 corporations. There are not-for-profit corporations 11 and there are for-profit corporations. Am I supposed to answer this? I mean, 12 13 Yes. Any other documents that you Q. Would I be correct that Purdue 12 I don't -- 14 15 There are different types of Q. 9 me. This Agreed Statement of Facts we reviewed in 11 part. 13 either simultaneous with ending my presidency at Frederick and Purdue Pharma are for-profit 14 corporations? reviewed? They're for-profit businesses, but not A. 15 16 A. That I recall and can describe to you? 16 all of the companies that you've named are 17 Q. Yes. 1 7 corporations. 18 A. No. 18 19 Q. You did say you reviewed six -- less 2 o Frederick or Purdue Pharma are for-profit not 21 A. Yes. 21 22 Q. And that was the first time you'd seen 22 call notes? A. 24 25 Would I be correct that Purdue 19 2 o than eight call notes; is that right? 23 All right. That's a good distinction. Q. not-for-profit? They're for-profit. A. MR. THOMPSON: Can we go off the 23 Yes . This was the second time. And 24 as I said, they are both -- both experiences are the record a minute? VIDEOGRAPHER: We are off the record 25 Page 322 Page 324 1 same. They are so fragmentary that they can mean -- 1 at 7 : 18 p.m. 2 it's impossible to know really what was said. That's 2 (RECESS) 3 why you had to pose hypothetical statements . 3 VIDEOGRAPHER: We are back on the Q. 4 5 Yes. Purdue Pharma, LP., Purdue Pharma, Inc., The Purdue Frederick Company, Purdue 4 record at 7:39 p.m . 5 BY MR. THOMPSON: 6 Pharmaceuticals, LP., P.F. Laboratories, Inc., do you 6 7 know if they have the same directors or are there 7 I'm going to hand you a document that is at the top -- 8 different directors for those entities? 8 let's mark this as Exhibit 38. All right. Let's go back through -- Q. 9 A. I don't know. 10 Q. Do you currently practice medicine? 10 11 A. No. Not practice in the sense that I 11 recognize that? 12 have an office or see patients by appointment, no, I 13 don't. 14 15 Q. When is the last time that you practiced medicine? A. I recognize the name. Okay. 13 Q. All right. Was this an e-mail that 14 you sent to Michael Friedman? 15 16 In 1974 during my residency. 16 17 Q. From 1999 to 2002 you were the 17 19 A. From the very last days of '99 until 2 O March of 2003 . 21 22 23 24 25 Q. Were you also at some point the president of Purdue Frederick? A. I don't think so, no. Q. Did you have any office title at Purdue Frederick? Coulter Reporting, LLC It's from Richard Sackler. Do you Q. 12 A. 18 president of Purdue Pharma, LP.? (DEPOSITION EXHIBIT NO. 38 MARKED) 9 A. Yep. Q. And it says here under "importance" down below, "Importance: Low." But down below it 18 says, "Why don't you guys plan a presentation about 19 addiction that could be given first by RR or BK ... " Now, who are those individuals? 20 21 A. Robert Reder or Bob Kaiko. 22 Q. " ... and eventually by our senior 23 24 25 managed healthcare people." Next paragraph, "I think that Paul has a good point, but we should consider that 'addiction' www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 82 Richard Sackler, M.D. Page 325 1 Page 327 may be a convenient way to 'just say no,' and when 1 Q. And is that a Purdue Pharma affiliate? It's an affiliated company, yes. 2 this objection is obliterated, they will fall back on 2 A. 3 the question of cost. Unless we can give a convincing 3 Q. Does the Sackler family own PF Canada? 4 presentation that CR products" -- that's 4 A. Yes. Yes, we do. 5 controlled-release products, is that what that is? 5 Q. He says under the first paragraph, "In A. Yes. 6 my opinion, the action that will produce the greatest Q. -- "are less prone to addiction 7 sales gains are the acquisition of IMS's practice 6 7 8 potential, abuse or diversion than IR products" -- is 8 quartile data and the resulting improvement in 9 that immediate release? 9 10 A. Yes. 10 11 Q. -- "I think that this can be done, but 11 12 I defer to BK and RR and other experts." targeting of our sales and marketing activities." What does that mean? In the United States from the A. 12 inception of the launch of OxyContin, we focused our 13 salesmen's attention to physicians who were, based on 13 A. Yes. 14 Q. What were you trying to accomplish 14 their history, physicians whose practice and their 15 there by trying to show that controlled-release 15 practice was to use -- write a lot of prescriptions 16 products are less prone to addiction, abuse or 16 for opioids. We didn't go to people who didn't write 17 diversion than immediate-release products? 17 them, we went to people who did. Well, I wasn't trying to show A. 18 19 And I don't recall whether this 18 anything. I was basically asking the question. And 19 practice was or was not done in PF, but I might have 2 o if the answer were yes, we can put together a good, 2 o learned in a meeting that they were not doing it and 21 21 effective and medically correct presentation, I they could not purchase the same data source from IMS 22 thought it would be useful to do so. But I was asking 22 in Canada, but they appear to have had something that 23 them can we do that, do we have the information, do we 23 would have been similar where they divided physicians 24 have the data, and obviously if we had contrary 24 into quartiles. 25 information or data, then obviously I couldn't do 25 Q. And if you look at your response to Page 326 1 Page 328 that. Are you aware of any presentation Q. 2 1 him on 9-27-96, you say, "Your most important question 2 to me was: Have physicians been reluctant to use Oxy p.r.n." -- 3 showing that controlled-release products are less 3 4 prone to addiction, potential abuse and diversion than 4 5 immediate-release products was ever done? 6 5 No, I don't think so, but I don't A. 6 What does Oxy p.r.n. mean? I assume that Oxy referred to A. OxyContin. P.r.n. would mean as needed. 7 remember how this came to an end. I put on low in 7 8 importance to indicate it was not something that was 8 Oxycodone." 9 10 11 12 urgent, it was an idea I had, and I said, Can we do -- "in place of IR forms of Q. 9 And that's Immediate-Release 1 o Oxycodone, correct? this. Then another e-mail I'm going to hand Q. you, we'll mark this as Exhibit 39. 11 A. Right. 12 Q. "I've not asked this question, but 13 (DEPOSITION EXHIBIT NO. 39 MARKED) 13 judging from the very strong sales performance and 14 (Passing document.) 14 continuing growth, I would guess that this has not 15 Q. And this is dated -- it looks like at 16 the bottom "Analgesic Plans, Dr. Richard Sackler at 17 Norwalk." been a problem. I think that were this the case, it 1 7 fast as IR Oxycodone, that is, 45 minutes versus 41 And is this an e-mail that you sent? 18 15 16 would be because of the very rapid rate of onset (as 18 minutes for the IR form - not even close to a 19 A. Yes. It's quite a dense e-mail. 19 significant clinical or statistical difference)." 20 Q. And if you go back to page 3, the 20 21 e-mail that preceded it was from John Stewart. And was it your understanding when you 21 wrote this that OxyContin Controlled-Release did not 22 have a significant clinical statistical difference 22 A. 23 Q. Who is John Stewart? 23 with rate of onset when compared to Oxycodone 24 A. He was the general manager in Canada, 24 Immediate-Release? 25 Yes. PF Canada. Coulter Reporting, LLC 25 A. That's correct. This was drawn from a www.coulterreporting.com 502-582-1627 Page: 83 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page 329 Page 331 study that was done. "Onset" is not defined here, but 1 2 it was a medical term in the trial that, I believe, 2 A. Yes. 3 John Stewart had either been given or was familiar 3 Q, Did I read that correctly? 1 fondest dreams." 4 with which basically recorded the first instance where 4 A. You did. 5 the patient said, Oh, I'm beginning to feel better, my 5 Q, All right. And then the last one I 6 pain is less. That was meant by "onset." That was 6 7 the meaning of "onset" in that trial. And that was 7 A. 8 what I was quoting from. 8 Q. Q, 9 And it says here, "The fast rise want to ask you about -- There's no question? No. When you say it outperformed your 9 10 character (now a patent in the U.S.) of the drug 10 fondest dreams, you're talking in terms of market 11 combined with familiarity and a marketing program that 11 share and what it was earning; is that correct? 12 emphasized that IR was the old was" -- I think that's 12 A. It's the overall sales trajectory. 13 supposed to be "way" -- 13 Q. And then I've got one more e-mail to 14 A. Yes. 15 Q. -- "and OxyContin Tablets are the new 14 ask you about. Who was -- I'm sorry. Let's mark this 15 as No. 40. 16 way to treat moderate to severe pain has resulted in 16 1 7 our success." 17 Did I read that correctly? 18 A. 19 22 Q. Did you read the sales bulletins when 18 you were the -- when these were sent to you? You read -- you read very correctly 19 2 o what is written here. 21 (DEPOSITION EXHIBIT NO. 40 MARKED) Q. I was senior vice president. Not A. 2 o generally. I might have scanned this. I didn't read When it says "the fast rise character," you're referring to OxyContin having a 2 3 fast rise as far as when relief occurs, correct? 21 them carefully. They were very carefully crafted by 22 sales and marketing people and others and I didn't 23 usually read them. 24 A. Yes. 24 Q. Who is Russ Gasdia? 25 Q, And then down below that, if you go to 25 A. Russ was then either a district Page 332 Page 330 1 about the fourth paragraph, "The overall schema that 2 Marketing here has worked our for three of the 1 2 3 four" -- I think that's "out of three of the four" 3 4 4 should probably be. But it's written, "The overall manager or a regional manager. And this is January 25th, 1999. Q. "Prescription Sales Force." Does that mean it went out to 5 schema that Marketing here has worked our for three of 5 everybody? 6 the four is: Oxy - 1. IR old way, OxyContin Tablet, 6 7 new way, emphasizing the b.i.d. was q, 4h." And 7 salesmen who were doing -- who were selling the 8 prescription products. 8 that's -9 A. Versus. Versus. 10 Q, " ... b.i.d. versus q. 4h and 9 No. It probably means it went out to A. Well, would it have gone to everyone Q. 1 o selling OxyContin? 11 underscoring the similarity of onset. Other 11 A. I believe so, yes. 12 differential benefits are emphasized, such as range of 12 Q. And the first paragraph says, 13 doses, the very small tablets, et cetera," 13 "... effective with the first quarter 1999, MS Contin 14 sales volume and growth" -- And then Oxy - 2, your second point 14 15 with regard to Oxy, is, "In cancer and severe 15 First paragraph. I see "As was A. 16 non-malignant pain, the one to start with and the one 16 1 7 to stay with. Here we are going directly after the 17 18 18 meeting ... " MSC and Duragesic business." What is MSC? 19 announced ... " Okay? "As was announced at the national Q. 19 A. Right. 20 A. MS Cantin. 20 Q. I skipped that. 21 Q. And Duragesic, who made Duragesic? 21 A. Okay. Right. 22 A. J & J. 22 Q. " ... effective with the first quarter 23 Q. And you say, "Clearly" -- this is 23 1999, MS Contin sales volume and growth as well as 24 highlighted -- or capitalized. "Clearly this strategy 24 quota will be calculated at .50 cents for every 25 has outperformed our expectations, market research and 25 Coulter Reporting, LLC $1.00." www.coulterreporting.com 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page: 84 Richard Sackler, M.D. 8/28/2015 Page 333 A. 1 2 show me where. MR. STRAUSER: I have the same 3 4 Page 335 I'm not following you. Can you just 1 don't recall the details of the incentive compensation 2 well enough to be sure. problem. I don't know where you're reading from. And then it says, "As pointed out, Q. 3 4 your priority is to sell, sell, sell" -- and that's in bold -- "OxyContin," 5 Q. The first paragraph. 5 6 A. Okay. I'm looking for "effective." 6 A. Right. 7 Q. And is that what the sales force was 7 Oh, I see. Okay. Sorry. These are small and I can't 8 read them that fast. I'm now following you . Q. 9 8 instructed to do? Let me give you this one and we'll That's what he said they were A. 9 1 o instructed to do. But they were instructed to do 1 O make it the exhibit. 11 A. Okay. I'm following you now. 11 their best to sell OxyContin, I guess. This was a 12 Q. Sure. So let's read the first 12 sales force related kind of rah-rah piece. 13 paragraph. "As was announced at the national sales 13 14 meeting, effective with the first quarter 1999, 14 paragraph, "Remain focused on positioning OxyContin as And it also says, in the last Q. 15 MS Contin sales volume and growth as well as quota 15 the opioid to start with and stay with in chronic, 16 will be calculated at .50 cents for every $1.00," 16 malignant and non-malignant pain states. In addition, 1 7 continue to aggressively position OxyContin for use in What does that mean? 17 18 A. 18 osteoarthritis, low back pain, post-neuropathic I - - I can't be sure, but I think that 19 we were reducing the bonus for MS Contin. I'd have to 19 neuralgia and post-surgical applications where 20 read the whole thing to be sure of that. Would you 20 appropriate. Finally, continue to highlight the 21 22 23 21 advantages of OxyContin, especially for use in the like me to read it all? Q. That's all right. I'm going to read it with you here. 22 elderly. If you have any questions regarding the 23 bonus calculations for the first quarter of '99, please contact your district manager." 24 A. Oh, okay. 24 25 Q. The next sentence says, "OxyContin 25 That tells me he was a regional A. Page 334 Page 336 1 sales volume and growth as well as quota will be 2 3 1 calculated at $1.15 for every $1.00." A. 3 here today do you know how many patients who took OxyContin in Kentucky became dependent or addicted? 4 sales growth and increasing the incentive by a small 4 amount on OxyContin sales growth. 5 6 7 And then the next paragraph says, 6 "Early estimates indicate that the fourth quarter 1998 Have you made any effort, or as we sit Q. 2 Again, it was de-emphasizing MS Contin 5 Q. manager then. 7 A. No. Q. Do you believe that an inappropriate number of patients or an excessive number of patients 8 bonus payout will be another record payout. Remember, 8 who took OxyContin in Kentucky became addicted or 9 this record payout came at a time when we were 9 dependent? 1 o utilizing a factor of .55 cents for every MS Contin 10 A. No. 11 dollar and $1.15 for every OxyContin dollar. As we 11 Q. Do you know or has Purdue made any 12 continue to drive more business toward OxyContin, each 12 13 of you will benefit significantly from the factoring 13 on OxyContin wound up becoming dependent and moving on 14 of $1.15 for every $1.00 of OxyContin." 14 to heroin at some point? Again, is that referring to 15 16 de-incentivizing MS Contin sales and incentivizing 16 1 7 OxyContin sales? 17 15 18 A. Yes. We were moving the incentive effort to ascertain how many people who were started No . A. MR. THOMPSON: I think that's all the questions I have, Dr. Sackler. Thank you very much . THE WITNESS: Are we finished? Or 18 19 program to focus on OxyContin. And every time you 19 maybe not. I don't know. 2 o take an incentive program, reduce it, you have, at 20 MR. STRAUSER: No questions. 21 least in some of the people who are affected, some 21 VIDEOGRAPHER: That is the conclusion 22 strong negative feelings, and that's probably why 22 of this deposition. We are off the record at 7: 58 23 there was a small increase to OxyContin . It looks 23 24 like it was 15 percent. But I'm interpolating here. 24 25 I don't recall . I certainly didn't read this and I 25 Coulter Reporting, LLC p.m. (Deposition concluded at 7:58 p.m.) www.coulterreporting.com *** * * 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Page: 85 Richard Sackler, M.D. Page 337 1 STATE OF KENTUCKY 2 COUNTY OF JEFFERSON 3 )( )( I, LAUREN I. GOOTEE, Notary Public, State of 4 Kentucky at Large, hereby certify that the foregoing 5 deposition was taken at the time and place stated in 6 the caption; that the appearances were as set forth in 7 the caption; that prior to giving testimony the 8 witness was first duly sworn by me; that said 9 testimony was taken down by me in stenographic notes 1 o and thereafter reduced under my supervision to the 11 foregoing typewritten pages and that said typewritten 12 transcript is a true, accurate and complete record of 13 my stenographic notes so taken. 14 I further certify that I am not related by blood or 15 marriage to any of the parties hereto and that I have 16 no interest in the outcome of captioned case. 17 My commission as Notary Public expires March 26, 18 2017. 19 Given under my hand this the _ _ _ day of 20 _ _ _ _ _ _ __, 2015, at Louisville, Kentucky. 21 22 23 24 LAUREN I. GOOTEE NOTARY PUBLIC 25 Coulter Reporting , LLC www.cou lterreporting .com 502-582-1627 Page: 1 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 WORD INDEX <$> $1.00 332:25 333 :16 334:2, 14 $1.15 334:2, 11, 14 $250,000 186:22 <0> 0.1 164:10 165:4 02-03-97 62:18 06901-3431 8:4 07-CI-01303 1:2 9:14 <1> 1 2:8 29:2, 4 32:21 63:22 75:9 106:10 122:9 144:3 174:1 175:16 213:5 216:20 222:1 330:6 1.0 135:12, 19 1.3 104:7, 8 1.4 152:10 1:11 154:8 10 2:1 3:3 42:21 64:14 74:18, 19 75:22 104:21 105:J 111:3,9,12,16 113:12 117:19 140:23 141 :J 142:10 147:25 156:24 174:9 238:7 259:17 273:22 10,615 265 :8, 16 266:7, 15 10:06 46:6 10:18 46:9 10019 7:16 101 1 :22 10-23-96 4:21 202:5 Coulter Reporting, LLC 105 215:15 106 261:16 10th 74:22, 23 75:11 11 3:7 6:13 28:21, 25 77:4, 5 125:J 142:16 244:14 261:14 11:45 106:2 11:57 106:5 11-2-94 4:8 11-30-93 3 :3 11-3-97 62:22 1-14-97 6:2 118 7:9 12 3 :9 86:5, 6 114:10 143:16 145:16, 17 146:4, 6, 16 148:4 174:13 179:5 217:6 232:23, 25 237:12 242:l 8 260:19 261 :20 286:13 291:18, 20 292:4 12:32 128:16, 19 120 204:23 12-14-93 3 :2 12-29-94 3:12 1-25-01 5:14 1-25-99 6:9 12-8-99 5 :16 12-hour 133:12 145:23 149:7 12th 242:21 256:23 311 :23 312:4 13 103:7, 8 141:19, 22, 25 152:5 232:20, 20 130,000 220:15 1301 7:15 13103 3:10 13800 7:5 9:3 13th 206:9 261:2 264:16 265:10, 15 14 40:6 109:12, 13 125:2 171:25 233:4 140 215:15 141 44:18 14109 3:13 14th 48:17 70:4 15 35:5 110:17, 18 298:3 334:24 150,000 220:15 15110 3:15 15th 35:17 287:13 16 30:17 35 :5, 5 117:J 5 122:9 235:2 255:10 160 75:22, 25 174:9 294:9 16117 3:17 17 117:13 122:4, 5, 9 171 :25 213:13 17122 3:21 17th 222:17 223:1 225:8, 11 18 64:17 106:15 127:8, 9 18127 3:22 18th 264:16, 17 19 24:9 134:17, 19 19134 4:2 1952 20:12 1974 322:16 1980 47:14 1985 272:5 1990 15:10 1990s 20:16 1992 35:18, 19 74:21 1993 70:4 71 :8 109:23 110:3, 14,16,24 117:14 1994 103 :11, 14 131:21 135:8 148:8 www.coulterreporting.com 1995 173:23 181:3 237:12 242:22 311 :23 312:5 1996 3:21 16:10 38:20 122:19 176:1 177:12, 16 178:9, 20 215:18 216:20 244:14 270:21 287:14 302:22 306:24 307:15 310:25 1997 51:19 52:21 58:2 84:10 96:J0 101:13 106:8 206:9 215:2, 5 255 :10 256:6, 23 1998 251:20 302:15, 19, 25 303:4, 14, 17 334:7 1999 16:21 30:J 81:11 252:19, 21 254:10 278:12 279:6 322:17 332:2, 13, 23 333:14 19th 18:3 lM 164:10 <2> 2 2:9 9:14 29:J 3, 14 32:21 33:1, 4 38:15 63:23 75:8 108:J l 109:22 122:23 123:18 135:10, 19 144:3, 6 171 :23 175:22 220:3 246:6 278:7 315:JO 330:14 2.16 202:21 2.3 71:8,10 2.62 202:21 2:03 154:1 J 2:28 171:10 2:29 171 :13 20 75:21, 24 85:24 105:2 129:20 135 :] , 2, 5 140:24 142:9 147:25 156:24 169:4, 13 174:9 215:9 237:11 282:7 294:6 311:19 318:18 319:4, 14 200 1:22 274:23 2000 34:23 164:4 166:11 215:20 231:20 258:20 260:5 264:13, 16, 16, 16 265:3 266:25 268:6, JO 269:11 274:4, 4 279:11, 12 2001 34:23 166:11 172:17, 21 173:7 213:5, 9 216:22, 25 218:18 237:13 248:J 249:2 254:J0 261:3, 22 264:9, 17 265:3, 10, JO, 15, 16 266:25 269:11 270:21 302:23 306:24 307:15 312:5 2002 68:16 69:13, 15 213:5 215:2, 5 322:17 2003 5:5 16:3 212:17 214:2 230:14, 18 264:14 274:10, 21 322:20 2004 232:21 258:J 274:10 502-582-1627 Page:2 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 2005 45:12 222:17 223 :1 225:8, 11 226:7 2006 43 :14, 20 229 :5 266 :22 310:25 2007 230:8 274:21 284:1 o 302:18 303 :6, 16 2008 52:17 2009 16:10 2010 284:11 2012 219:6 20135 4:3 2014 14:23 15:6 2015 1:4 9:4, 12 40:7 337:20 2017 171:21 337:18 2020 258:2 2028 258:2 20th 18:3 164:3 243:9, 15 21 141:11, 12 252:9 21141 4:7 21202 8:9 2-12-97 54:24 214 171:19, 24 22 154:21,22 22154 4:8 2-22-96 4:18 2-27 55:5 2-27-97 56:5 57:3 22nd 135 :8, 13, 14 177:11,15 178:20 264:16 23 106:8 164:1, 2 170:11 243 :9 2300 7:19 23164 4:10 24 173: 1 7, 18 244:13 24173 4:12 24th 35:18 25 173:14, 15 177:6, 7, 8 Coulter Reporting, LLC 181:1 251:19 254:12 250 7:18 25177 4:16 25th 249:2 332:2 26 200:18, 19 252:18 255:25 260:5 265:3 266:25 337:17 26200 4:19 26th 248:1 27 171:20 188:18 200:17, 21, 22, 24 202:3 268:10 27200 4:19 27th 181:3 258:19 28 1:4 204:14, 15 254:21 255:25 28204 4:21 28th 9:4, 12 124:18 232:21 261 :22 265:11 29 2:8, 9 205:23 212:3, 4, 6, 7 256:5 29205 5:2 298 6:13 29th 30:1 2nd 86:7 110:14, 16, 24 210:8 <3> 3 2:11 32:10, 11 33:1 41:17 64:11 90:20 92:8 94:14 109:22 144:14 149:22 164:15, 22 326:20 3,000 136:21 194:1,4,15 3.000 64:8 3.2 71 :23 72:5, 6 3:27 209:12 3:30 209:7 3:42 209:15 30 64:17 74:25 217:23 218:3, 4, 23, 24 259:13 3-0 218:6 300-plus 215:18 30218 5:3 308 44:21 30-day 11 :18 30th 14:23 15:6 237:13 254:J o 265:3, 10, 16 266:25 269:11 218:J o, 12 312:5 31 220:1, 2 258:24 3-11-97 54:19 3-12 62:17, 21 67:23 31220 5:6 3-12-97 54:23 62:17 3-15-97 2:21 31st 16:21 124:17 32 2:11 225:25 226:1, 3 259:20 261:17 3-2 62:18 3-2-1997 62:16 32226 5:10 3-22-93 3:17 3-22-94 4:3 133:6 3-2-97 54:18 32nd 7:22 33 226:2, 3 311:14 33,400 215 :20 3-31-95 4:15 38:3 33226 5:12 34 247:22, 23 251:18 260:4 3-4 156:11 158:10 161:15, www.coulterreporting .com 17, 25 162:4 163:14, 19 34247 5:14 3-4h 155:7, 25 162:19 35 215:23 261:25 278:10, 11 350 7:22 35278 5:16 36 286:5, 6 36286 5:19 367.170 225:2 37 287:1 o, 11 37287 5:21 3-7-96 4:16 38 2:13 261:19 266:24 324:8, 9 38324 6:2 3-8-97 64:20 39 2:17 74:25, 25 326:12, 13 39327 6:5 3rd 62:20 <4> 4 2:13 37:25 38:1 39:18, 19 43:21 46:12 331:15, 16 40202 7:5, 23 40203 1:23 40331 6:8 40507-1758 7:19 40601 7:10 41 286:22 316:1 328:17 4-13-94 4:2 42 181:4 4-20-2000 4:12 4-22-97 106:12 4-23-97 3 :15 4-2-93 3:17 43 2:19 44 270:9, 15 44,500 215 :20 4-4-95 4:14 4-4-97 2:24 45 286:23 328:17 4-6 161 :15 4-7 4:12 48 2:21 49 316:4 492 45:10 4h 330:7, JO 4th 68:16 75:11 173:22 67:1 80:3 94:14, 15 103:22 118:1, 1 129:9 140:14 144:17 152:10 157:1 161:25 163:11 164:13, 15 274:21 4,718,000,000 45:17 4,718,767,000 43:21 4.3 119:11 4.6 175:15 40 75:21, 25 94:6, 19 148:1 174:9 216:21, 24 259:13 267:22 278:22 282:14 294:8 <5> 5 2:17 39:20, 21 42:24 43:5 62:23, 25 74:14 89:4 117:18 131 : 7 144: 18 156:6 164:8 175:16 180:10 223:7, 8 311 :11, 19 318:18 5.4 72:10 5.851 181:6 5.852 182:5 5:26 278:1 5:55 278:4 50 17:14 47:9 56:20 85:22, 22 167:2, 4 185:25 216:1 273:22 502-582-1627 Page: 3 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 297:8 316:6 332:24 333:16 500 175:1 502 1:23, 24 505 246:6 50s 150:2 5-15-96 5:21 5-17-05 5:10 5-28-97 3:7 77:13 5-31-99 2:11, 13 536 44:13 54 2:22 55 334:10 5-6-96 5:23 582-1627 1 :23 587-6299 1:24 5-milligram 74:12 <6> 6 2:19 35:24 36:10 43 :2, 6, 7, 8 45:22 149:23 157:1,4,5, 7 159:7, 19 160:22 162:22 163 :6, 12, 14, 20 217:6 222:24 224:23 242:19 6.2 129:10 215:5 6:20 292:20 6:33 292:23 60 94:6 259:9 260:21, 24 267:4 6007 257:25 6-12-97 3:9 6-13-97 5:3 6-16-97 5:2 6-22-94 4:5 6-24-92 2:16 6-2-97 90:18 210:7 670,000 215 :5 68 238:6 6-8-94 4:6 69 12:15 Coulter Reporting, LLC 6-9-99 4:23 204:17 6h 158:8 6h, 156:7 <7> 7 2:21 47:25 48:1 213:6 266:22 7,500 136:21 193:2, 8 7,502,367,000 44:7 7.0 131:8 7.2 132:17 7:18 324:1 7:39 324:4 7:58 336:22, 24 70 185:25 259:7 260:22 70,500 215:22 700 7:9 215:20 70s 24:15 713 144:2 7-15-92 2:15 7-16-90 2:8 73 3:2 74 3:3 75 47:9 750 8:8 7-5-07 2:19 77 3:7 7th 63:20 178:9 230:7 <8> 8 2:22 54:13 69:24, 25 122:22 123 :17 145:17 146:4 163:7 274:22 291:18, 19 80 75:22, 25 174:9 245:22 278:23 294:9 800 265:25 266:7 274:22 80-plus 246:8 80s 24:15 8-10-92 3:5 8-17-93 3:20 8-23 220:7 8-23-96 220:5 8-27-97 286:1 8-29-97 5 :19 8-30-93 3 :19 8-4-92 3:6 86 3:9 4:8 87,222,000 45 :5 8th 135:13, 18 136:6 138:12 219:6 230:8 <9> 9 3:2 73:6, 7, 8 213:3 291:19 9:11 9:5 9:12 9:12 90 40:24 41:4 142:18 213:7 900 8:8 90071 7:22 90s 21:8 24:10 92 110:7 9-21-95 154:25 9-25-95 4:10 9-27-96 328:1 93 124:17 9-30-96 6:5 94 136:6 141:15 142:20 94,000 215 :22 9-4-96 5:8 95 47:1 124:17, 18 243:10, 15 96 38:5 45:11 84:14 264:9 960 45:4 97 48:17 84:15 86:8 210:8 99 264:13, 23 322:19 335 :23 <A> A.J 5:22 a.m 9:5, 12 46:6, 9 106:2, 5 AB 39:14 www.coulterreporting.com Abbott 4:25 8:6, 6 9:25 44:14 177:20, 22 204:18, 23 205:8 Abbott's 204:22 205 :2 able 129:11 234:3 236:9 241:20, 22 270:24 284:25 AB-rated 38:18, 19,21,24 175:24, 25 176:2, 5, 12, 17 abrupt 257:15 258:15 abruptly 235:13 239:16 240:1, 6 259:24 260:21 267:5 absolute 202:25 203:4 Absolutely 61:11 73:22 90:8 235:17 239:13 285:19 absorption 267:15 268:13 abstract 120:10 262:3, 6 ab usability 284:18 abusable 52:3 66:6, 7 247:6 Abuse 5:6 34:12 38:11 47:20 49:6 50:4, 21 51 :18, 21 52:5, 23 56:22 58:1, 6, 22, 23 60:19, 20, 24, 25 61 :8, 20 71:8 134:8, 15 151:18 175:9 198:4 212:15 218:11, 14 231:1, 10, 12, 17, 19,22 233:10 237:5, 21 238:5 239:9 242:5 246:25 252:13 254:5, 14 267:12, 16, 25 268:2, 8, 12, 15 269:14, 17 278:16 281:21 282:5 283:21 284:3 285 :1, 9 288:5, 14 289:3 297:2 306:1, 12 310:10 312:8 313:11 314:1 316:7 325:8, 16 326:4 abused 58:11, 15, 24 59:3 61:10, 14 71:19 269:2 279:9 280:16 abuse-Jacksonvil le 5:18 abuser 238:6 abuse-resistant 53:25 abusers 284:25 abusing 291:10 abysmal 272:5 accept 240 :2 0 acceptability 149:2 acceptable 88:2, 3 97:1 acceptance 81 :4 accepted 57 :9 89:24 114:1 236:10 access 199:7 accompany 258:5 accomplish 63:5 190:8 325:14 accountability 59:20, 24 accounting 213:7 accounts 189 :9 accumulate 179:13 502-582-1627 Page:4 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 accuracy 214:8 216:8 261:4 277:11, 13 accurate 16:18 17:12,18 21:16 58:8 123:12 125:16, 18, 19 133:13 167:14 172:9, 11 186:17 213:22, 25 214:7 215:6 216:4 217:14 218:19 228:9 243:22 263:20, 20 267:8 297:11 304:9 308:1 337:12 accurately 165:17 244:4 accustomed 101:11 acetaminophen 104: 11, 1 5, 17 achievable 283:3 achieve 26:10 68:10 74:14 221:11 achieved 188:22 220:13 achieving 260:18 acknowledges 59:8, 13 acquired 20:8, 12 acquisition 327:7 AcroContin 36:15, 24 37:4, 8 46:16 Act 224:25 225:3, 8 ACTION 1:2 9:14 83:18 288:6, 15 289:2 327:6 actionable 296:18 Coulter Reporting, LLC actions 20:20 21:1 85:3 166:7 active 16:1,5 104:17 actively 185 :15 221:11 activities 3 0: 14 327:9 activity 16: 6 165:24, 25 315:20 317:7, 8 actual 252:8 acute 157:6 ad 189:13 add 53:24 93:22 130:13 138:8 178:17 244:8 262:3 263 :2 265 :14 added 68:3 121:14, 17 165:4 201:4, 18, 25 244:12 addicted 291 :2 294:10 295:2 336:4, 8 addiction 18 :2, 18 38:10 68:15, 21, 24 69:12 143:10 231 :JO, 15 238:24 239:2 242:4 246:13 268:2 269:16 279:17, 18 282:5, 21 283 :4 288:5, 14 289:3 290:7, 8 292:5, 6, 11, 16 294:16 313:11 324:19, 25 325:7, 16 326:4 addictive 233 :9 237:20 246:24 291:8 312:8 313:25 addicts 242:8 268:5 269:19 278:21 313:13 316:2,3 Adding 52:24 addition 75:22 163:10 178:23 183:9, 18 188:12 196:20 198:14 228:11 316:12 335:16 additional 121:12 131:18 186:12 288:24 291:20 additions 139:17 additive 53 :9 Address 5:6 85:10 212:16 ADE 50:13 adequate 189:11 adequately 46:24 47:8, 17 214:19 AD Es 50:10, 11, 17, 18 adhered 130:6 Adjust 92:23 administer 74:12 l 60:9, 10, 11 Administration 131:5 administrative 45:9 admit 122:8 134:18 admitting 224:10, 18 adopt 228:5 adopters 190:7 advance 149:20, 25 150:4 191:9 268:24 advantage 46:22 65:5 128:1, 6 235 :21 Advantages 142:25 335:21 adverse 50:13, 14 233:21 www.coulterreporting.com 255:17, 19, 22 259:15, 16 260:23 261 :12, 14, 18 262:11 advertisements 189:12 advertising 76:10, 14, 19 118:25 119:8 138:20, 22 191:2 242:23 advised 64:21, 24 88:21 108:2 advising 86:24 208:16 aellis@kytrial.co m 7:6 affairs 16:17 affect 150:14 256:14 affidavit 15: 1 affiliate 327:1 affiliated 256:24 327:2 affirm 273:15 agencies 288:22 agency 48:25 . 50:12, 15, 17, 17 52:11 54:7 124:25 129:22 130:21 214:15 221 :24 222:2 agent 2:22 51 :3 53:10 94:10 145:12 272:2 agents 119:3 127:21 aggressive 144:19 217:18 aggressively 335:17 ago 29:25 35:6 77:3 153:8 155:20 193:l 209:17 298:2, 3 300:18 agree 19:8 63:18 84:20 85:1 158:21 184:2 216:10 217:16 222:2 241 :2 270:13 272:9, 19 273:8 275:11 283:23 295:4, 8 314:3 319:9 Agreed 5:12 11:19 84:25 112:23 121 :13 169:3, 6, 7, 16 225:17, 20 226:1 227:24 228:5, 8 229:14 232:13, 17, 20 241:14 251:19 252:9 254:12 256:19 261 :25 263:15 264:10 273:11 275:13 300:13 302:10, 14, 15, 22 303:5, 15, 21 304:6, 15 306:3, 3 307:13, 16, 19 311:10, 12 315:21 318:6, 12 319:23, 25 320:1 321 :] 0 agreement 60:14 84:21 97:23 165:14, 18, 25 166:1, 6, 12, 12 168:10, 20 l 77:20, 22 205:7, 10 222:18 224:11, 19 227:1 228:2 232:10 243:21 251:14 295:24 296:9 312:16 agreements 14:7 41:25 ahead 9:20, 23 15:20 70:20 81:24 95:23 124:18 127:7 137:15 141:10 163:25 220:1 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 254:24 256:4 303:10 al 1:4 Albright 4:23 alerted 240:25 Alfonse 203:13, 13 Alfonso 4:10, 12,21,24 5:8, 14 6:5 161:11 203:14, 15 204:21 226:20 248:7 249:2 250:17 allegations 229:21, 23 Allocation 190:22 204:23 allow 90:22 98:12 146:7 202:24 allowed 34:2 100:19 112:15 193:18 allowing 133:14 262:11 316:18 317:18 allows 13 3: 13 alludes 81:19 alongside 25: 1, 13 alternative 37:5 127:14 alternatives 81 :1 altogether 316:17 317:17 amend 17:21 amended 16:9 268:11, 16 269:14 America 5 :13 American 162:7 192:12, 14,16 Americas 7:15 amount 216:17, 18 218:9 294:22 310:19 Coulter Reporting, LLC 334:5 308:14 320:9, ample 89:19 11 321 :12 analgesia 150:1 325:20 Analgesic 6:6 answered 49:24 26:13, 17 27:18 68:23 224:1 117:5, 7 124:24 answering 132:13 136:19 141:4 145:11 279:15 answers 170:20 antagonist 54:2 326:16 Analgesics 2:15 ANTHONY 7:4 26:22 28:3 10:11 antiinflammator 214:14 279:16 Analog 150:2 y 180:15, 17 analysis 180:5 antiseptic 287: 7 214:11 217:5 antiseptics 244:25 257:1, 2, 287:7 Antonio 3:15 12 258:11 307:4 315:8 106:11 anesthesiology anxiety 255:24 108:24 anxious 258:3 Angeles 7:22 Anybody 50:16 animal 73:24 65:24 88:8, 11 124:9 94:2 148:12 announced 151:9 166:4 332:16, 17 167:11 168:12, 333:13 16 195:8 announcing 199:23 224:22 128:11 263:12, 17 annual 164:23 273:25 275:5 215:3 277:10, 10 292:8 304:19 answer 12:19 15:19, 21 21:17 308:24 23:5 34:6 anymore 40:18 42:13 68:17, 19 66:17 Apologies 70:20 97:6 137:15, 17 197:14 147:11 153:4 apologize 81 :1 156:17, 21 Appalachian 161:2 165:6 192:20 169:1, 18 170:3, apparently 13 171:16, 17, 53:20 18 172:4, 16 appeal 65 :3, 7, l 76:19 196:11 12 66:21 67:6 appear 15:3 199:18 219:15 224:2 234:15 48:9 63:11 264:2 271 :5, 7 139:21 162:4 275:2, 10 310:7 327:22 283:15 284:14, appearance 15 294:1 160:1 297:15 303:10 www.coulterreporting.com Page:5 Richard Sackler, M.D. approved 84:5 APPEARANCE 112:15 125:1, S 8:1 337:6 11 130:11 appeared 146:6 134:13 156:5 appears 43 :4, 8, 267:14 288:22 16, 20 62:4 87:25 120:18 approving 122:10 127:14 226:9 227:23 approximately 129:7 134:22 140:23 141 :14 9:5 40:14, 24 159:14 222:25 46:23 47:1 239:22 285:25 167:2, 4 182:6 215:21 217:6 application 238:6 266:4 17:25 123:24 April 106:8 applications 110:14, 16, 24 246:9 335:19 164:3 173:22 applied 98:19 area 115:5 apply 37:5 areas 15:25 179:12 320:24 arguably appointed 315:12, 15, 17 226:22 argue 57:25 appointment 322:12 argument 317:J 318:1 appreciated 57:9 argumentative 271:4 303:9 approach 68:2 92:6 97:22 arguments 245:11 317:4 approaches arises 78:9 arising 78:11 106:23 l 84:19 Arizona 195:4 appropriate 66:12, 13, 20 around-the-clock 82:20 97:24 158:17 100:6, 7, 8 115:3 116:2, 3 arrange 15 8 :2 199:6 200:2 184:11 217:21 245:21 arrive 38:21 39:14 176:2, 13 299:8, 21 304:9 art 284:24 306:19 320:15 arthritis 80 :9 335:20 Article 3:21 appropriately 40:5 218:25 80:16 approval 69:17 231 :20 254:22 125:2, 6 126:15, 258:18, 24 259:20 260: 7, 9, 20, 21 127:15 17 262:10, 18 131:24, 25 265:5 266:15 181 :19 246:5 267:2 268:24 288:1, articles 90:12 11 91:19 93:11, 16 approve 54:9 150:22 502-582-1627 Page:6 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 101:22 103:1 260:19 ascertain 168:8 241 :22 336:12 asked 49:2 61:5 72:18 108:20 115:2 129:11 138:1 141 :24 142:7 168:25 169:5 232:15 263:1 287:3 292:10 294:6 308:25 328:12 asking 66:20 69:4 160:25 180:22 201:21 208:1 210:18, 20 216:8 253 :] 9 262:1 273:4 282:15 293:23 301 :2 304:8 305:21 310:2 317:4,6 318:12 319:24 325:19, 22 asks 160:24 161:2 234:2 as-needed 145:13 assembled 55:9 assert 151 :11 asserting 160:25 assess 275:3 assigned 205:1 assist 196:22 197:5 Assistant 7 :8 Associate 8:3 associated 45:1 82:13, 19 107:4 143:7 170:10 202:25 association 78:8,9 183:20 192:17 associations 82:22 143:8, 9 assume 3 5 :21 59:8 64:9 74:6 Coulter Reporting, LLC 87:11 144:13 244:12 272:15, 23 273:1 282:15 283 :] 9, 23 306:10 328:5 assumed 246:24 assuming 123:19 164:10 203:3 317:25 assumption 201:2 assure 274:14 ATC 157:6 attached 13:13 17:16 132:22 143:2 167:7 attachments 201:19 attempt 168:8 274:16 275:2, 6 attempted 284:23 285 :18 attendance 111 :4 attended 67 :4 85:23 111 :7 145:22 195:1 202:14 attention 31 :1 204:5 206:1 222:11 286:9 327:13 attitudes 107 :4 ATTORNEY 1:4 7:8, 8 10:14 23:12 33 :24 166:20, 23, 25 222:14 223:1 228:3 230:25 264:10 297:17, 18, 19 315:18 attorney-client 298:6, 15 attorneys 9:17 34:16 230:22 240:25 297:12 319:9 Attorney's 167:19, 22, 24 237:15 241:9 297:10 312:15, 19 attractive 222:12 290:20 attracts 218:14 attributed 125:4 attributes 81 :3 275:8 audience 222:4 audit 276:13, 16 audited 277:13 augment 13 8 :8 AUGUST 1:4 9:4, 12 74:21, 23 75:10, 11 117:13 Australia 17:2 Australian 30:24 author 77: 7, 12 140:1, 9 220:5 authored 139:22 authorities 64:22, 24 authority 49:22 authors 139:4, 6,12,19 availability 144:18, 21 217:24 218:13 220:23 available 58:16, 19 105:15 117:7 130:7 178:14, 24 203:5 218:10 260:17 Avenue 7:9, 15, 22 average 164:20 185:21, 24 274:25 290:9, 11 avoid 316:14 317:11 www.coulterreporting.com avoided 78:17 avoided.' 25 8: 15 aware 11:4 14:25 29:21 31:16, 17, 22 33:6, 9, 18 47:22 50:15 59:1 60:22 61:2 68:18 69:5, 7, 8, 10, 14 77:2 78:5 84:15 86:23 89:9 94:12 101 :2 141 :] 148:8 166:3 167:18, 21 168:2, 11 175:11,17 l 76:8, 20 196:10 199:8 208:4, 8 220:22 224:6, JO, 16, 17, 22 225:6,10 231:24 232:11, 14, 15 238:11, 25 239:4, 11 240:4 242:9 249:1 254:6, 16 256:7 258:16, 20 260:1 263:21,24 270:25 279:5, 8 281:19 282:22 290:22 315:13 316:24 317:5, 7, 14, 23 326:2 awareness 181:8,9 awkward 278:17 <B> b.d 148:21 b.i.d 127:14 330:7, JO back 18:1, 21 22:13 24:9 41 :23 46:8 51:1 54:15, 16 63:20 64:20 65:23 67:2, 9 80:9 84:20 92:1 94:20 95:3 99:13 106:4, 25 108:3 110:3 111 :3 117:25 120:14 128:18 137:19 146:14 147:19 154:10, 13, 24 158:8, 20 159:3 161:6, 14 163:22 171:12 173:9 178:5,16 l 79:4, JO 190:11 197:19 198:16, 21, 21 203:13 209:14 221 :17 222: 1 232:9 233 :24 241 :5 246:8 248:20 251:13 266:15 274:13 275:6 276:9 278:3 292:22 311:3, 21 318:14 320: 7 324:3, 6 325 :2 326:20 335:18 backup 190:6 bad 61:21 63:2 82:22 98:21 Baker 4:23 balance 152:7, 8 186:1 balanced 295 :6 ball 279:2 Ballard 301 :17 balls 222:6 Baltimore 8:9 bare 315:18 barrage 108:1 barrier 107:23 base 213:19 221:1 based 76:23 94:5 185:14, 17 210:21 214:4 248:10 273:10 502-582-1627 Page:7 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 292:12, 13 317:25 327:13 baseline 148:25 bases 303 :13 304:14 basically 53:5 122:15 186:8 193:1 220:12 293:8 325:19 329:4 basing 47:10, 12 basis 74:8 145:13, 23 167:10 169:23 304:15, 16 312:15 Bates 26:14, 15 47:24 55:12, 14, 15 bear 12:6 223:17 becoming 129:20 336:13 began 16:2 beginning 92:3 237:12 252:19 312:4 329:5 begins 36:12 54:15 223:11 behalf 9:24 10:1, 4, 8, JO, 11, 14 167:19 168:4 194:24 196:15 behaved 166:10 behavior 168:4, 9 313:25 belief 39:12 89:16, 17 90:4 247:8 286:16 295 :25 296:13 believe 18:14 24:3 28:10 30:5 32:7 35:14 41:4 42:1 49:11 54:15 57:25 58:9, 13 61 :3 63:4 65:19 70:23 72:24 Coulter Reporting, LLC 74:7 98:15, 24 100:5, 7, 20 103:22, 25 104:2, 3, 9 106:16 117:4 125:17, 20 162:8 172:6 187:16 199:19 208:3 209:19 211:19 214:16 217:17, 20, 22 223:11 225:16 226:16 228:10, 15, 25 229:4 232:7 233:17, 23 245:12 267:10 273:9 Betadine 5:20 287:4, 5 better 25 :22 32:6 81:9 blocking 68:11 blocks 53 :11 blood 145:15, 132:14 142:9 150:10, 11 151:10 234:20, 24 236:6 329:5 235:4 239:7 243 :3 244:1, 2 18,19,20 150:8 252:11 254:2 281:15 286:14 289:8 290:10, beware 196 :5 beyond 80:5 107:19 128:1,6 11, 15 304:3, JO 320:14, 16 170:8 235:21 274:18 BfArM 49:14, 20 50:22 56:20 58:16 65:25 337:14 Blue 314:15, 15 315:6, 6 board 13 :2, 6 17:17, 24 22:9 B-f-A-r-M 125:24, 24 276: 7 286:20 49:21 288:12 294:14, 18,20,24,25 295:16, 19, 20 296:11, 16 304:21 310:14, 22 329:2 332:11 336:6 believed 25 :19, 22 89:1, 2, 7, 15, 15, 15 101:6 104:1 206:4 245:23 267:16 268:14 BfArM, 48:24 BGA 67:4 bias 203:18 Bible 76:20 big 130:6 147:17 bigger 97:9 biggest 149:20 219:8 227:25 228:5 230:1, 15, believing 153:13 303:13 Bench-Top 71 :9 beneficial 132:14 benefit 128:5 132:11 149:12 163:9 334:13 benefits 132:23 185:23 310:10 330:12 benign 102:9 Bermuda 187:2 best 25:18 116:2 120:12 125:2 148:15 172:22 213:11 226:19 266:3 279:10 335 :11 276:11 Billion 40:6 41:6, 13, 17 42:2, 9, 18, 21, 24 213:6 bio 147:22 bioeq uivalent 148:1 birthday 177:13 bit 17:3 46:2 65:23 70:3 95:4, 18 145:25 146:7 174:11 190:3 241 :] 254:25 BK 64:21, 23 155:19 324:19 325:12 blame 275:3 blank 160:7 block 53:19 54:3 blocked 54:8 www.coulterreporting.com 25 274:11,12 Bob 56:17 132:12 324:21 Bobillier 5:21 Body 255:20 Boehringer-Inge! heim 162:8 bold 335:5 Bonus 6:9 185 :20 186:2 333:19 334:8 335:23 bonuses 216:18, 25 books 189:13 border 320:5 bottle 130:6, 7 bottom 48: 16, 23 70:9 98:9 106:10 123:9 129:10 133 :9 134:7 143:21 157:22 164:12 165:5 204:20 212:5 214:2 220:7 224:24 286:7 326:16 Bowling 305:1 Boyles 299:2 bracketed 200:25 brackets 201 :2, 6,8,25 brand 205 :14 branding 31:19 break 46:2, 3, 4 137:16 154:4, 14, 16 169:2 209:6, 8 262:15 277:21, 23 breakdown 298:7 breaks 154:14 breakthrough 145:2, 3, 8, 12 160:13, 13 291:14 Brent 2:20 brief 129:21 223:12 280:22 317:3 318:1 briefly 23:1 bring 206:1 bringing 246:21 broad 181 :8 broaden 220:25 broadest 125: 10 broad-ranging 191:19 broke 210:4 211:25 brought 123:21 142:12 155:19 159:4 166:24 224:25 241 :8 246:2 263:14 311:6 313:23 build 222:6 Building 7 :9 18:21 125:20 buildup 143:10 231 :10 built 107 :10 bulk 136:20 246:20 bullet 180:20 Bulletin 6:8 70:7 bulletins 331:17 bunch 143:7 190:24 502-582-1627 Page: 8 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 buprenorphine 61:19,22 burden 23: 11 139:12 bureau 193:18, 20, 23 194:1, 6, 8,16 business 30:25 31:8 36:4, 7 44:2 107:14 136:20 164:22 293 :3, 5, 12, 20 294:2 330:18 334:12 businesses 189:3 323:15 buy 190:5 buyers 188:24 190:7, 12 buzz 242:3 268:1 269:15 280:12, 21, 22, 25 299:23 300:1, 2, 7, 12 304:3 309:10, 17 313:6 316:5 buzzed 299:7, 11 <C> C90-0708 139:2 CA 7:22 calculated 332:24 333 :] 6 334:2 calculation 43:9, 17 Calculations 2:20 335:23 call 166:13 167:13 168:2 203:25 213:20 215:16, 19, 21 234:1 252:16 255:14 275:20, 24 276:2, 6, 8, 13, 15 277:7, 8, 18 296:5, JO, 11, 20 297:1, 5, 12, 20, 24 299:1 Coulter Reporting, LLC 307:20, 22, 23 308:2, 3, 6 309:2, 6 312:14 316:16, 17 317:12, 17 321:20, 23 called 17:4 18:22 54:2 76:4 83:11 145:2 150:1 185:7 187:3 188:15 194:22 197:23 200:5, JO 218:25 236:21 246:6 247:2 265:23 267:17 304:1 305:1 306:9, JO calling 200:14 calls 31:25 200:12 203:19 209:18, 20, 25 210:2 215:23, 24 216:1,2,12 278:13 305 :25 campaign 78:20 133:19, 23, 24 134:3, 5 163:10 181:8 182:8, 8, 18 183:5, 9 191:17, 20 192:2 campaigns 183:18 Canada 221: 1 326:24, 25 327:3, 22 cancer 17:9 18:8 70:15, 16, 22 78:18, 24 79:5, 8 81 :5, 11 82:6, 6 85:17, 20 86:2, 13, 16 87:5 88:14 90:21 91 :1 92:6, 12 93:18 94:3 95:10, 16, 20 97:18, 22 98:11 99:3, 6, 14 100:4 101:12 l 03:23 116:10 136:1, 3, 7,10,14 138:8 143:7 144:25 174:8, 15, 18, 20 175:13 193:3 206:21 215:1 330:15 candidates 215:17 Capital 7:9 capitalized 330:24 Capitol 7:9 caps 50:8, 19 capsule 117:19 capsules 156:24 caption 337:6, 7 captioned 337:16 capture 199:18 captures 81 :2 care 100:4, 19 101 :2 116:10 127:16 183:8 213:17 214:3 235:18 253:18 275:14, 17, 18 careful 91 :17 93:9 101:19 102:24 107:22 208:5 210:12 carefully 59:5 331:21, 21 caregivers 182:12 Carol 313:21 carried 22:4 carry 216:9 cartoon 252:16 case 11 :2 19:14 31 :11 37:7 57:25 58:13 79:23, 25 97:17, 18 124:13 140:13 166:24 167:3, 5 168:23 186:19, 20, 24 187:16 196:3 204:7 www. cou lterreporti ng. com 211:18 223:19 236:2, 11 240:16, 17 245:2 246:7 251 :3 285:3 312:20 328:15 337:16 cases 116:3 223:22 224:2, 8 276:22 catalog 50:18 catch 30:8 121:7 220:6 category 123 :11 cause 98:2 233:10 237:22 238:15 242:3 268:1 269:15 290:7, 8 291 :] 292:15 312:9 313:6,8 caused 34:18 80:20 194:16 233:21 242:4 268:1 269:16 294:16 313:10 causes 78:12 302:12 causing 83 :8 143:13 cautioned 316:14 317:10 ceased 230:14, 18 ceiling 106:17, 18 108:16 Center 110:21 central 164:9 cents 332:24 333:16 334:10 centuries 18 :3 CEO 226:22 228:24 229:13 230:14, 18 231 :7, 11 264:11, 14, 20 certain 19 :2 54:5 73:1,1,2 113:10 115:4 125:18 148:9 185 :3 209:25 237:18 239:22, 24 240:4, 14, 21 242:1, 2 255:10 256:6, 23, 25 258:16 260:5 261:3 265:3, 9, 19 266:25 267:19, 22 268:10, 21 269:11 290:10 294:11 311 :25 312:6 313:5 certainly 29:20 41:5 58:18 74:1 94:2 111:6 113:7,8 120:6, 22 137:23 149:15 151:20 165:8 185:21 186:19 189:19 195:5 235:10 244:9 245:21 281 :24 313:2 334:25 Certificate337 2:1 certified 298:24 certify 298:18 337:4, 14 cetera 41 :24 91:19 93:12 119: 7 330:13 cetera, 101 :22 Chadbourne 7:15, 21 chain 2:24 5:8 54:11, 15 55:17, 20 59:5 219:25 chairman 230:15 challenge 162 :2, 20 challenging ll:15 chance 56:20 238:24 239:2 change 82: 18 91:17 93:9, 17, 18 100:2, 2, 5 502-582-1627 Page: 9 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P ., et al. 8/28/2015 101 :19 102:24 103:3, 4, 4 107:24, 25 153:6 156:11, 14 157:9, 9, JO, 12 159:6, 19 161:9 163:12 210:12 246:21 249:22 276:12 changed 37 :3 83:4 186:5 249:15, 19, 24 268:19, 21 269:2 276:3 316:17 317:17 changes 243:24 247:1 changing 241 :JO channels 181:11 character 100:3 103:4 329:10 character, 329:22 characteristic 235:16, 24 289:19 charge 33:7 62:6 72:12, 15 118:10,12 226:8, 18 charges 34:17 chart 83:13 charts 135:22 209:3 cheap 163:6 check 111 :5 297:7 checked 296 :2, 3 Chickering 5 :2 chief 62:8 228:21 229:3 Children 219:1 choice 79:22 114:14 choose 316:19 317:19 chosen 123 :3 Coulter Reporting, LLC chronic 37 :2 80:9 105:8, 19 181:16 335:15 chronic-use 114:9 C-11 68:2 Circle 7:5 9:3 CIRCUIT 1:1 9:13 circulated 129:17 circulation 129:5, 7 circumstance 98:22 178:2 cited 108:22 cites 223 :2 0 CIVIL 1:2 9:7, 14 claim 132:15 133:25 134:9 233:5 244:4 254:22 260:2 289:14 claimed 224:2 315:13 claiming 271 :20 claims 34:3 76:10, 14, 16, 19 120:13, 16 121:9, 12, 18 131:19 132:12, 18, 23 236:19 267:12 289:5 Clan 40:6 clarified 287:25 clarify 29:15 77:22 115:10 clarity 130:25 225:10 Class 152:17, 19, 20, 25 153:7, 7, 8 189:6, 6 247:4, 5, 7 classic 181 :21 classified 49:3, 25 Claudia 5:21 claws 222:5 Claydon 5 :22 clear 43:15 75:5 83:15 91:21 93:14 99:24 101:4 102:1 110:13 114:3, 23 176:21 208:14 222:20 240:12 241:13 250:10 284:15 288:17 321:1 cleared 101 : 7 clearly 101 : 7 150:10 151:7 200:9 208:24 211 :23 321 :2, 2 330:23, 24 cleverly 269:3 client 169:21 clinic 75:23 303:25 clinical 26 :8 53:1 76:14 121:16 140:15, 16 144:1 145:22 148:20 159:24 177:18 207:23 232:22 233:8 235:4 242:15 252:8 255:12 256:13 257:2, 13 258:14 328:19, 22 clinically 220:20 235:7 clock 145:8 160:10 close 13 8 :21 213:12 251:1 290:3 307:4, 5 328:18 closed 65:2 67:5, 17 closer 162:25 308:12 Club 183:21 clue 57:20 co-authors 140:12 www.coulterreporting.com codeine 79:24 87:19 152:17 coincide 181 :13 Coletto 5 :19 collaborative 139:25 collect 184:12 color 271 :18 column 122:24 123:14 combination 22:22 94:11 152:15, 17 153:24 180:12 combinations 78:11,19 152:14 153:16 180:12 combine 67:21 combined 329:11 combining 22:20 133:11 come 28:18 40:25 139:9 196:7, 11 294:14, 20 comes 62:11 136:21 161 :13 234:25 comfort 248 :9 comfortable 108:17 152:14 coming 94:20 99:13 227:8 comment 2:18 38:17 46:15 175:23 211 :5, 11 234:3 259:21 309:11, 13, 18 commenting 120:2 comments 203:17 229:17 242:22 243:21 261:10,11 275:7 305:7 307:14 314:3 316:9,11 Commerce 269:24 270:3 commercially 203:2 220:21 commission 44:14 337:17 commitment 183:8 committed 30:6 225:3, 8 committing 31:18 common 53:22 58:24 80:13 85:20 89:13 96:13 114:17 115:24 193:11, 15, 16 199:1 COMMONWEA LTH 1:1, 4 9:13, 14 294:17, 23 295:2 communicate 114:22 209:22 communicated 211:13 225:7 communication 76:22 242:24 communications 256:14 298:15 communities 184:8 268:9 community 116:11 220:18, 19 companies 12:24 13:3, 13, 24 14:2, 8, JO, 12 19:6, 9, 20 20:1 24:13 41 :24 139:12 183:1, 3 185:9 196:3, 7, 7 . 219:12, 18, 22 222:11 225:14 293:15, 15 323:16 Company 5 :13 7:12, 13 12:21 13:15, 16 20:12, 502-582-1627 Page: 10 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 13,14 21:14,23 31:18 33:17, 21 34:8 36:1 40:25 41 :2 56:11 112:25 131 :3 147:2 162:5, 7 169:9, 16 172:8 176:25 181 :14 186:10 191:18 196:3 197:23 224:12, 19 229:13, 25 230:9, 10 238:1 241:16 256:24 268:8 274:7 295:5, 8, 10 322:5 327:2 company's 213:8, 18 comparative 76:16 119:13, 22 131:14 132:10 180:3, 5, 11 234:13 compare 150:15 244:1 compared 109:17 140:25 202:17 328:23 comparing 127:20 131:16 148:20 comparison 272:2 Compendium 2:15 compensated 185:16 compensation 335:1 compete 39:15 competing 70:12 com petition 24:12, 21 26:18 27:25 28:16 36:23 123:4 136:16 Coulter Reporting, LLC competitive 127:17, 18 235:19 competitors 37:7 217:11 compilation 130:11 complained 146:13 258:1, 1 complaint 16:9 193:16 complete 76:25 129:22 203:5, 9 315:19 337:12 completed 114:11 140:21 259:6 completely 55:19 65:16, 20 114:13 149:15 156:17 completion 307:23 complex 21:17 77:23 271:1 compliance 274:10, 15 277:14 complicated 158:3, 22 complication 147:16, 17 compound 137:13 246:17 comprehensive 76:25 compressed 124:2, 14 compromise 100:18 101 :1 275:14, 17 compute 291 :23 computed 62:19 computer 189:13 concentrate 284:1 concentration 243:1 concept l 75:14, 18 179:12 199:18 concepts 121 :20 concern 25:15 28:6 59:2 214:17, 21 222:8 258:8 279:5 concerned 57:6 78:23 143:4 237:5, 8 289:1 concerning 232:3 concerns 18:18, 20 19:4 24:24 25:7 109:1 conclude 60:20 266:9, 11 concluded 128:4 151:4 336:24 conclusion 84:18 126:18 127:10 149:6, 17, 18 293:24 336:21 conclusions 144:2 258:11 condition 115:22 179:2, 4 180:1 234:12 259:25 261 :1 conditioned 240:15 conditions 71 :5 80:13 115:17 127:21 144:25 conduct 34:10 68:14, 24 69:11 89:6 165:13 168:19 169:5, 13, 22 237:15 240:21 252:6 254:18, 20 264:8, 15 294:15, 21 295:1, 21, 23 302:21 www.coulterreporting.com conducted 68:14, 23 69:10 71 :24 75:4, 13 120:9 121 :14 175:1,19 181:14,25 282:18, 23 316:13 317:10 conferences 32:1 confident 60:1 Confidential 4:7 11:10,14 confirm 157:19 confirmed 142:8 confirming 194:11 conflation 93 :23 conformed 284:15 confusing 21 :17 161:3,5 confusion 23 :4, 16 98:3 208:23 228:4 Congressional 5:5 conjecture 290:20 292:13 connected 201:19 connection 116:12 co-nonexecutive 230:15 Conover 121 :13 consecutive 55:16, 16 consensus 115 :2 consequence 98:24 consequently 257:14 consider 65 :4, 13, 25 184:13 306:18 324:25 considerably 101:9 consideration 28:17 70:24 75:21 120:21 137:24 138:16 189:12 considered 26:19 28:1 151:22 219:11, 17 284:24 considering 219:18 considers 288:2 consistent 74:11 149:16 151:5 156:4 157:4 172:11 243:22 consistently 227:15 consists 147:9 constant 164:21 165:1 constipation 53:22 constitute 214:3 319:16 constituted 318:23 constructed 303:22 consultant 213:20 consulted 29 :21 consulting 13:6 consults 13: 7 consumer 181:10, 13 183:7 contact 335:24 contain 276:9 contained 95 :1 246:12 315:11 contend 240:13 contentious 116:5 contents 76:13 context 17 :4 18:21 30:23 36:1 81 :18, 21 82:2, 3 125:7 126:2 201:17 208:24 502-582-1627 Page: 11 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Contin 6:9 16:14 17:4 18:22 20:4 24:10, 11, 14, 21 25:1, 1, 11, 12, 13, 23 26:17 27:24 29:10 31:1 32:6 36:19, 23 37:1, 6 38:10, 19 39:15 47:2, 8, 13, 17 70:11, 21 86:12, 17 87:1, 5, JO 91:23 94:1 95:8, JO, 15, 24 96:17 107:12 108:17, 18, 19 121:2 123:6 131:13, 16 136:16, 17, 18, 25 137:4, 7, 8 l 75:3, 13, 25 176:21 180:13 186:13 188:23, 25 190:13 210:10 217:9 227:5, 8 330:20 332:13, 23 333:15, 19 334:3, 10, 16 continue 49:17 93:3, 6 114:12, 16 147:20 156:22 182:5 334:12 335:17, 20 CONTINUED 3:1 4:1 5:1 6:1 8:1 21:10 34:23 123 :] 8 166:11 274:12 continues 162:24 236:8 continuing 50:19 60:18 237:13 312:5 328:14 contract 221:10 contraindication s 234:7 Coulter Reporting, LLC contrary 65 :22 325:24 contribute 130:24 contributed 214:25 contribution 43:21, 24 control 63:13 64:7, 14, 17, 18 65:1 140:3 145:21 149:1 150:24 195:13 202:17 276:14 controlled 17:7, 8 49:3 50:1 58:6, 11 61:15, 21,23 116:24 Controlled-Relea se 2:9 3:24 24:23 25:9 26:13, 17, 19 27:17, 25 28:3, 12, 12, 14 36:5, 8, 16, 18 37:10, 14 46:17 50:3 52:3, 6 61:7 84:11 88:23 89:8 98:16 104:11, 13, 18 107:2 127:11 144:10 146:3 148:4 149:4 152:12 153:14 181 :20 214:13 278:15 280:12 286:10 290:5, 24 292:3 325:5, 15 326:3 328:21 controlled-releas ed 26:21 controls 58:7, 12 64:4 66:7, 11, 20 controversial 115:5 246:J0 convenience 133:12 174:13 convenient 114:4 325:J conventional 127:15 191:21, core 76:21 140:15 185:3, 7, 23 23 30:1 conventions corporations 12:16 323 :J 0, JO, 11, 14, 17 correct 11 :11, 22, 23 12:17 17:6, JO 18:23, 24 21 :11 24:13 29:10, 11 30:3 33:9 35:22 38:5, 6 40:18, 256:13 conversation 56:18 211:J 296:24, 25 300:16 305:18, 19 308:18, 19 conversations 309:7 conversion 16:14 29:9 83:13 90:9 133:14 209:3 convey 211 :12 conveys 17:12 convince 200:1, 1 299:6, 10, 22 convinced 149:14 274:4 convincing 118:25 325:3 convoluta 301:22 CONWAY 1:4 . cooperative 191:1 coordinate 76:13, 18 coordinated 124:20 221 :11 copies 68:22 103:12 171:6,8 189:3 265:4, 8, 16 266:7, 15 co-promotion 44:14 copy 11:19 27:5, 7 28:23 32:12, 15 48:5 77:9 132:20 170:16, 21 202:5 212:19 219:22 266:5 287:9 299:16, 17 301:6, 9 www.coulterreporting.com 8 204:4 Cornelia 16:22, 22 43:22 44:15, 19, 20 45:18, 20 49:10, 23 50:24 51:5, 19, 20 53:13 56:12 58:2, 12 59:16 63:9 64:18 65:11 68:13 70:12, 13 75:1 79:11 84:11 86:15, 18 87:1, 22 88:24 91 :8, 23 92:13, 17 93:4, 5, 13 96:21 99:6 100:J 101 :14, 16, 22 102:4 103:3, 20 105:24 108:5, 6 110:25 111 :4 112:13 118:8 122:21 123:7, 8, 16 124:5,11,12 125:21 126:23 127:2, 12 132:8 133:20 135:8, 18 136:23, 25 137:4, 11 139:23 141:16 142:18 144:5 146:4 151:23, 25 152:20, 21 155:4 156:3, 8 157:17 160:15, 16, 19, 23 162:6 164:6, 11, 18, 19 165:8, 9 166:8, 25 172:16 174:4 175:4, 6, JO 179:9, 16 182:14,16 184:8, 15 185:18 187:3, 7, 8 188:14 196:23 199:5 202:7 205:5 206:12 208:10 210:1 211:12 212:9, 14, 22 213:10, 12, 12 221:15, 16 222:19, 21, 22, 22 223:4 228:6, 14, 18 229:3, 6 230:19, 20 233 :J 2, 14, 16, 22 235:8, 11 236:1, 21 237:16 240:11 244:6, 17 246:14 247:9 248:3 249:18 250:19 251 :24 252:21 253 :20, 21 261:7 262:9 263:4, JO, 15 264:12, 20 265:17 266:2, 7 269:20, 21 270:J J 275 :23 287:17 290:12 291 :14, 21 297:4 302:13, 23 303:1 307:15, 23, 24 308:4 312:16 313:7 318:19 323:12, 19 325:21 328:10, 25 329:23 331:11 correcting 90:6 correction 139:16 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 correctly 28:4 30:10 37:11 39:2 43:23 45:12 50:6 56:24 95:14 121 :24 125:12 163:17 181:23 190:19 203:7 207:1, 7, 25 212:13 225:4 256:2, 17, 18 275 :19 288:8 312:11 329:18, 19 331:3 correlate 200:11 correlation 200:4, 9 correspond 65:1 67:2 cost 34:22 79:21 l 76:25 203 :3 204: 7, 8 325:3 costs 67:22 cotton 23 8 :9 279:2 Coulter 1 :21 Counsel 8:3 68:18 299:6, 9, 10,22,23 count 216:11 275:3 counted 12:18 14:6 185:13 counting 45:12 countries 116:21 country 186:17 194:23 COUNTY 337:2 couple 113:8 l 73:19 coupons 198:24 course 56:18 85:19 131:5 149:21 186:5 284:19 293:3, 5, 12 298:21 COURT 1:1 9:13 73:6 Coulter Reporting, LLC 173 :17 177: 7 197:12 298:24 317:2 courts 223:3, 15 cover 70:6 132:22 241:24 CR 38:12 56:23 60:23 65:6 127:11 259:7, 10 260:21, 24 325:4 crafted 331 :21 Craig 286:1 create 181:8, 12, 21 195:13 205 :20 208:22 242:16 created 187:25 188:25 189:2 190:14, 16 248:10 creates 156:23 238:23 creation 21 :2, 5 182:13 187:21 creative 175:14, 17 credibility 278:18 crippling 80:14 82:9 crisis 198:5, 8, 12 critical 106:22 criticism 196:8, 12 Cross 314:15 315:6 cross-title 27:20 crucial 38:25 l 76:6, 15 crushed 71 :24 crushing 238:8 278:22 cryptic 296:20 CT 8:4 Cullen 77:24 86:4, 7, 24 101:18 206:17 Cullen's 90:18 cups 163:11, 13 cure 38:23 176:4 curious 129:1 Curran 301 :18 current 12:4 13:24 75:21 127:25 135:24 235:20 262:3 263:2 265:14 278:16 currently 12:25 41 :6 90:23 98:13 131:15 136:17 140:22 155:3 220:25 322:10 Curtis 112:6 126:19 285:3, 7 curve 157:11 cusp 283:7 customary 195:18,20 cut 67:25 83:16 243:25 <D> d, 239:21, 24 daily 83:15 94:13 146:16, 20 148:3 282:15 291 :23 damaging 61 :15 Dan 10:1 DANFORD 7:16 10:1, 1 11:18 28:23 45:24 55:7, 22 105:25 danger 81 :14 dangerous 81 :6, 14 162:22 207:4, 18 DANIEL 7:16 Darke 6:6 data 50:4, 9, 20 131:19 135:23 140:22 178:6, www.coulterreporting.com Page: 12 Richard Sackler, M.D. II, 13, 21 179:13, 14, 19 214:4 215:2 217:5 235:4 242:15 244:10, 12, 23 245:1, 4, 16 252:8 261:5, 7, 24 262:1, 24 264:18 265:13 286:19 290:2, 13 325 :24, 25 327:8, 21 database 60:19, 24 61 :9 178:17 245:9 DATE l:4 19:3 28:13 39:23 51:21 62:15 111:6 135:14 187:17 202:22 248:5 318:8 dated 2:8, 11, 13,15,19,21,24 3:2, 5, 7, 9, 12, 15, 17, 19 4:2, 5, 10, 12, 14, 16, 21, 23 5:2, 8, 14, 16, 19, 21 6:2, 5 15:6 16:21 25:24 30:1 35:17 38:3 54:16, 17 57:2 58:2 70:4 74:21 90:18 106:8 117:12 77:13 103:10 110:24 154:25 164:3 173:22 177:11 181 :3 202:5 210:7 222:17, 25 248:1 278:9, 12 287:13 326:15 dates 222:21 daughter 75:18 David 5:17 279:13 304:25 day 9:4 94: 7, 14, 15, 19 98:4, 4 104:21, 23 146:15, 16 149:2 161:6 209:1, 25 259:7 267:5 274:8 282:8, 14 286:15 289:19, 21 290:6, 25 291:24, 25 292:15 308:17 319:23 337:19 Dayer 5:23 287:23 days 66:18 124:18 125:2 259:8 322:19 day-to-day 16:6, 11 29:6 30:14 ddanford@stites. com 7:20 DDMAC 243:17, 17, 18 244:14 DEA 214:14, 17, 20 218:11 dead 52:23 deadline 159:23 deal 200:25 272:7 Dear 56:17 63:20 DEA's 214:10 217:4 death 82:13 151:21 debate 14 7 :2 decades 100:15 December 5:5 70:4 124:17, 18 212:17 232:21 237:12 243:9, 15 251:20 311 :23 312:4 decen tivized 186:12 decide 63 :16 71:25 114:14, 15 119:24 120:1 146:25 502-582-1627 Page: 13 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 decided 72:1 91:6, 11 99:19 251:8 deciding 28:17 decipherable 19:17 decision 65 :8 76:6 136:2 164:9 decisions 121:12 Declaration 15:7 16:8 29:5 declared 208:25 dedicated 30: 7, 12 deducted 44:12 deduction 44:3 de-emphasizing 334:3 deep 33:24 deeply 26:9 defeat 284:25 defend 166:24 167:3, 4 297:9 defendant 225 :1 DEFENDANTS 1:4 7:12 8:6 10:2, 4, 8 12:6 19:13 Defendant's 314:15 315:5 defending 167:25 defer 325:12 deferred 262:4 263:3 264:19 265:15 defined 252:24 329:1 defines 253:17 definitely 49:25 52:8 194:14 310:23 defraud 33 :8 224:13, 20 228:13 237:19 242:2 311 :8, 20 312:7 319:5 deftly 124:19 Coulter Reporting, LLC degree 248 :9 257:14 degrees 194:10 de-incentivizing 334:16 delay 285:23 Delayed 267:14 268:12 deleted 244:15 Delivered 190:22 deliveries 184:11 delivery 285:1 demand 190:2 192:3 demanding 124:23 demonstrably 304:13 demonstrate 89:19, 23 105:15 236:9 demonstrated 143:15 144:1 148:3, 25 289:18 demonstrating 233:9 demonstration 242:16 252:7, 8 DENHAM 7:6 10:13, 13 11 :13 denied 227:16, 19 247:2 Denmark 63:17 dense 326:19 dentist 279:14 depart 308:15 departed 98: 7 department 39:6, 7, 10 72:14 91:9,10 99:18 118:7 120:4 131:1, 2 153:25 159:11 226:18 231 :2 262:18 266:19 274:10, 13 277:14, 14 283:18 departments 121 :20 department's 274:14 departure 221:12, 18 depend 149:24 dependence 18:19 143:13 257:14 283:3 dependency 68:15, 21, 25 69:12 105:20 143:10, 11 198:22 231:10 282:9, 13, 21 283:2 dependent 258:13 294:10 336:4, 9, 13 depending 147:4 157:1 320:21 depends 15:22, 23 73:12 104:20 151:18 313:8 Depictions 242:14 254:11 DEPONENT 1:4 DEPOSITION 1:4 9:1, 5, 15 29:3, 4, 13, 14 30:18 32:11 38:1 39:21 43:2 48:1 54:13 69:6 73:8 74:19 77:5 86:6 103:8 109:13 110:18 117:15 122:5 127:9 134:19 135:1 141:12 154:22 164:2 168:23 173:18 177:8 200:19, 22 www.coulterreporting.com 204:15 205 :23 218:24 220:2 226:3 241:17 247:23 253:10, 10, 12 277:5 278:11 285:2 286:6 287:11 321 :6 324:9 326:13 331:16 336:22, 24 337:5 depositions 241 :22 depression 255:24 deputies 297:19 Deputy 7:8 dermatologists 193:14 deschedule 53:6 de-scheduled 68:3 descheduling 2:22 51:2, 4 describe 108:20 216:13 321:16 described 169:5, 13 231:22 252:8 254:11 261:25 295:23 298:1 315:21 describes 204:21 describing 104:16 description 216:11 design 120:17 designate 11 :13, 17 designated 187:14, 14 designating 11:9 designation 246:5 designed 192:6 305:18 desirable 88:4 desired 26: 11 68:10 132:18 desires 125: 7 Desk 130:8 Despite 80:4 destruction 80:20 293:6 detail 22:2 78:21 186:5 202:22 206:17 detailing 83 :20 details 71 :22 139:10 205:9 271 :18 335:1 deter 313 :25 determination 165:23 169:14 282:25 308:22, 25 309:2 determinative 131:5 determine 47:16 71:18 89:6 118:19 124:10 165:12 167:12 169:15 172:6 193:24 204:10 274:6 282:18 292:2 294:8 determined 60:6 determining 65:24 309:3 deterrent 58:22 Deutschmarks 64:10, 10 develop 44:2 53:25 68:8 75:21, 24 95:1 153:22 207:22 239:18 240:2, 7 267:7 282:13 284:20 292:5, 6 developed 21:22 24:15 74:10 83:13 94:8, 25 121 :] 2 150:2 182:1 a 185:3 236:12 257:13 282:21 502-582-1627 Page: 14 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 developing 24:10, 22 25:8 26:8, 21 28:2 57:6 79:24 91:18 93:10 101:21 102:25 105:19 189:10 210:13 215:15 282:9 development 16:16 24:16 48:14 62:6 65:18 67:22 109:16 123:2 153:17 157:24 221 :22 229:3 developments 102:5 deviated 274:18 device 196:7 devices 196:9 devoid 179:2 devote 38:25 176:6, 15 devoted 16:6 DHC 288:1 dialing 49:8 dialogue 95 :2 244:20 303:19 diarrhea 255:24 die 82:14 differ 12:19 233:14 235:10 243:23 difference 22:6, 9 150:17, 21 203 :4 242:17 290:14, 14, 15 291 :7 292:12 302:17 328:19, 22 differences 22:8 different 12:15 13:13 19:13 23:2, 2 24:1 55:23 78:22 140:25 147:7 156:25 157:16, 16 180:21 193:13 221:20 Coulter Reporting, LLC 236:23 262:25 268:7, 9 288:23 289:15, 24 291:7 293:8 308:11 322:8 323:9 differential 330:12 differen tia te 107:12 143:12 differentiation 107:13 differently 121 :2 179:22, 23 difficult 52:25 238:3 241:2 276:16 difficulty 49:5 301:1 dinner 202:15 dinners 204:1, 7, 11 direct 120:23 191 :1 199:8, 13, 17 298:16 directed 42:4 120:22 181:9 213:20 232:6 direction 118:16 169:20 directly 16: 10 29:6, 16 80:20 119:2 261 :11 330:17 director 14:17, 24 15:8 189:8 230:10 263:23 directors 22:10 322:7, 8 dis 216:10 disagree 47:4, 6 216:24 217:2, 16 250:15 273:8 283:24 disagreed 96:10 discern 284:24 discipline 166:8, 9 308:24 309:3 disciplined 308:21, 23, 23 309:6 discontinuation 257:16 discontinued 235 :14 259:24 260:25 267:5 discount 191:8 discounts 164:21 discourage . 105:7 108:1 discovered 53:19 68:10 73:23 discovery 68:11 discuss 28:21 57:14 138:11 158:1 207:24 254:23 285:7 discussed 76: 7, 11 86:10 95 :6 112:5, 23 113:14 131:12 174:6 199:4 206:17 210:9 250:1 305:5 309:10 310:9 313:24 discussing 14: 1 24:16, 16 46:16 57:12 69:22 111:10 169:3, 12 210:5, 8 discussion 81 :22 130:20 137:25 148:17 177:16 206:6 257:11 278:14 304:22 Discussion, 103:21 discussions 25:16 49:13 56:19 89:13 disease 133 :18 disguised 85 :5 dismiss 166:9 www.coulterreporting.com dismissed 150:23 151 :2, 3 274:19 dispenses 14:13 dispute 167:9, 10 disseminate 11 :16 distance 27:4 171:3 distant 304:18 distinction 12: 7 19:14 20:9 22:17 80:19 184:10 323:18 distributed 265:4, 17 266:8 267:1 distributes 14:13 Distribution 3:5, 17 5:3 14:3 19:21 35:20 39:8 188:20 189:11 265:8 District 15 :2 230:22 251:21 280:6 297:10 331 :25 335 :24 districts 280 :8 DIV 1:1 diverse 78:11 221:8 Diversion 5:6 34:13 38:11 60:20, 25 l 75:9 212:16 218:11 231:1, 11, 13, 17, 19,23 233:10 237:21 246:25 268:9 312:9 325:8, 17 326:4 divert 218:14 diverted 61 :9 242:6 268:3 269:2, 18 279:9 313:12 divided 85:17 146:16 327:23 Division 9:13 125:8 242:23 243:18, 20 DK 64:23 Doctor 83:24 116:1 149:21 150:6 151:11 189:22 208:18, 20 247:5 286:2 287:1, 4 297:2, 2 299:9, 10, 10, 22, 22 300:17 302:12 303:25 304:11 305:10, 25 306:11, 21 309:9 313:22 320:13 doctors 17:17, 23 18:6 74:3, 4 80:22 86:15, 16 92:13, 16, 16 94:3 97:8 115:25 119:7 139:6 163:7 192:6 194:16 196:8 204:4, 11 236:5, 11 263:8, 13, 18 266:10, 12, 13 271:10, 14 272:7 300:11 doctor's 82:15 245:10 doctrine 92:20 96:6 144:24 document 2:17 26:24 27:9 29:1 30:16 35:25 43:3, 11 46:13 48:4, 7 55:11, 14, 15 56:1, 4 65:16 69:2, 21 70:1 74:20 76:17, 21 77:6 103:9 106:7, 9 110:5, 12,19 117:16 122:6, 14 126:14, 16, 18 128:20 131:3, 4 502-582-1627 Page: 15 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 134:21 140:J 5 141 :13 147:21 154:23 163:23, 24 173:11 177:9 181 :5 201:14 204:16 205:24, 25 210:15, 21, 22 211:20, 22 212:J, 20, 21, 25 213:2 219:24 222:23 229:J 8, 21, 23, 25 230:2, 5 241:5, 14 247:24 248:J 251:16 252:24 253:6, 9, 17 264:4 278:8 285 :24 287 :J 2 299:14, 15 303:21, 22, 24 305:4 314:2, 18, 19 318:11 324:7 326:14 document, 230:4 documentation 130:2 documented 95:2 documents 59:9 98:3, 5 126:5 129:23 147:13, 297:20 327:20 332:7 Dolan 4:24 dollar 42:9 334:11, 11 dollars 41: 7, 13, 17 42:2, 19, 22, 25 167:3, 4 297:9 Dolt 7:4 9:2 DONALD 7:13 10:3 donated 192:14 Donley 303 :25 door 128:J0 dosage 146:16 148:7 235:13 244:3 dosages 246:12 dose 74:13 83:15, 16, 16 92:9, 23 94:14 96:7 104:20, 21, 22, 24 106:19 112:4 113:13 144:14, 25 146:16, 20, 20 148:J,3 158:9 160:11 240:16, 23 247:15 260:25 281 :4, 6 282:7, 15 291 :23, 24, 25 15 166:18 201 :J, 9 206:3 211:2, 3 231:3 232:J 2 241 :JO 250:2, 4 293:1, 2, 9, 11 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www.coulterreporting.com 10 drive 334:J 2 driver 25:17 28:7 drop 77:19 148:24 149:5 Drs 139:3 140:4 drug 17:4 18:16, 22 21:21 31:19 33:7 49:3 50:J, 13, 14, 18 56:21 59:20, 23 64:7, 13 66:6, 7 67:20 71:19 295:5, 9, 11 297:3 309:J 0 313:14 316:3 329:10 drug, 268:15 drug.' 267:16 druggies 305:3 Drugs 5:5 50:22 51:15 107:2 114:9 152:18 161:14 180:15, 17 192:7 218:J 5 247:13 248:J0 250:20 251 :4 291:10, 13 73:11 74:J 78:24 80:23 81:3,8,16 83:5, 24 88:14, 14 93:18, 18 94:4 drug's 218:12 drum 192:3 dstrauber@chad bourne.com 95:16, 20 96:15 99:15 100:3, 4, 8, 13, 20 101:12 102:10 l 03 :4, 5 107:J, 8, 21, 23 119:25 123 :24 Dubick 299:1 due 56:19 107:19 145:2 257:23 261 :12, 14 306:1, 12 duly 10:18 337:8 Duragesic 70:J0 71:2 107:13 131:11, 14 180:13 217:11 330:18, 124:J0 125:8 131 :4 132:2 143:7 146:12, 24 147:5 152:2 153:9 157:15, 17 175:3 178:23 180:16 189:9, 13 207:4, 18 211:15, 19 213:7 214:15 217:11 224:13, 20 228:12, 13 235:16, 24 236:5, 20, 21 238:6 239:19 240:3, 8 242:8, 23 258:15 268:5 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LLC 333:6, 14 effective, 97: 17 effectiveness 32:2 98:18 152:8, 9 234:13, 14 250:3 effects 53:21 91:12 143:10 144:20 233:21 235:5 239:8 252:11 262:11 efficacious 124:11 Efficacy 3 :24 60:3 105:15 132:13 133 :11 140:24 141 :2 143:15, 25 149:7 151:22 211:19 efficient 184:17 effort 34:22 106:24 124:21 139:25 154:1 167:12 172:6 181:12 182:5 263:13 274:7 336:2, 12 Efforts 5:6 39:1 99:19 174:24 176:7, 16 188:20 199:4 212:16 217:7 274:5, 14 eight 146:13, 21 250:24 257:3 259:18 276:25 277:1 321 :20 eighth 142:6 either 37:17 60:2 66:6 109:22 138:12 151:5 172:13, 15 195:25 299:4 307:17 310:21 314:25 323:7 329:3 331 :25 elaborate 146:7 elderly 335 :22 election 114: 14 element 137:23 281:3 290:18 eleven 257:4 elicit 99:16 eliminated 114:6 elimination 243:24 Ellen 4:16 301 :17 ELLIS 7:4 10:11, 11 27:5, 9 32:13, 16, 20, 22 33:2 43:6 48:6 54:25 55:3, 10, 25 109:21 126:13 171 :5 201 :5, 9, 16,22 225:19, 23 226:1, 7 251:15 else's 88:11 E-MAIL 1:24 2:11, 24 3:7 5:8 16:20 29:12, 24 30:3 32:22 54:11, 15, 16,17,17 55:4, 17, 20 56:5 57:2 62:11 77:7, 14 84:24 85:10 86:3, 8 90:18 92:25 106:11 109:5, 9, 15 158:3, 25 201:10, 11 202:4 203:8 210:7 219:25 221 :6 278:6, 7 285:22, 25 287:13 324:13 326:11, 18, 19, 21 331:13 e-mailed 261 :23 e-mails 48:21 69:23 81:19 201:19 www.coulterreporting.com embarrassed 126:1 emphasis 161:4 emphasize 189:14 304:17 emphasized 38:18 83:20 85:5 175:24 297:3 329:12 330:12 emphasizing 29:16 330:7 employed 23 :18, 21, 24 34:1 253:23 employee 73:16 261:23 264:17 265:12 employees 22: 7 35:13 75:14 88:22 140:11 165:12, 14, 15, 23 166:1,2,9 169:7, 11, 12, 15, 15, 22, 25 l 72:8, 8 187:11 237:19 241 :20, 21 242:1 252:15 255 :II 256:7, 24 257:1 258:17 260:6, 9 261:3 263:19 265 :4 267 :20 268:7, II 274:11 311:22 312:6 316:21, 22 317:21 Enclosed 204:20 encounter 78:25 encourage 30:23 191 :9 192:8 encouraged 31:13 189:18 encouraging 67:16 202:23 encroachment 80:20 ended 2:17 16:3 38:16 130:5 131:6 175:22 186:22 Endo 30:19 end-of-life 18:16 82:5 83:5 88:14 93:18 95:20 100:4 103:5 116:10 117:1 143:6 ends 201 :11 energize 125:22 Enforcement 214:15 engaged 165:13, 24 169:22 225 :1 254:18 293:7 295:21, 22 engagements 196:1 engaging 168:9, 19 enhance 178:13, 24 enjoying 290:18 enormous 34:20 282:11 enormously 16:7 enrolled 261:10 ensure 92:10 189:11 enter 174:7 entered 222:19 246:19 257:21 272:4 entering 224:18 enthusiasm 125:20 enthusiastic 32:2 66:2 entire 36:25 37:9, 14, 20 230:5 260:15 entirety 312:2 318:19 entities 11 :3 12:12, 13, 20 19:13 23:2 502-582-1627 Page: 17 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 40:21 42:7 322:8 entitled 255 :J 9 298:20 entity 12:9 43:9, JO 169:10, 17 170:2 environment 150:13 165:J envisioned 36:24 equal 50:21 74:4 81:8, 17 82:25 132:J 3 251 :J 256:11 equally 85:17 equivalence 144:3, 6 equivalent 66:4 104:21 144:J 0 149:7 eroded 176:22 erosion 36:22 37:6 erroneous 55:19 89:16, 17 305:11 error 52:19 85:14 89:20 102:11 183:13 especially 105 :9, 14 180:11 335:21 ESQ 7:1, 4, 6, 13, 16, 21 8:2, 6 essence 163:6 essentially 146:10 160:6 277:17 establish 38:23 152:23, 25 153:11 176:4, 15 established 20:15, 18 39:14 94:4 117:5 308:J0, 10 estimated 216:19 estimates 334:7 Coulter Reporting, LLC et 1:4 41:24 91:19 93:12 101:22 119:7 330:13 ethical 190:J 0 EU 63:14 euphoria 239:9 242:4, 4 252:12 254:4 268:J, 2 269:16, 16 280:12, 20, 23 281:1, 12, 14, 16 297:3 301 :22, 24 302:8, 11, 13 303:14 305:3, 6 310:12, 16, 17, 19, 20 313:6, 10 316:6 euphoria, 302:2, 3, 7 euphoric 254:14 Europe 53:15 European 63:14 288:22 evaluation 202:18 evening 108:25 308:8 event 124:20 259:15 260:23 events 195:24 233:22 308:2 Eventually 24:20 26:18 27:24 61 :] 4, 20 68:7 84:9 136:18 195:12 274:22 316:16 317:16 324:22 everybody 85 :2 150:6 166:8 193:22 248:20 332:5 evidence 28:J 3 109:22 11 0:J 4 122:8 134:18 168:3 273:9 283 :20 284:3 296:17 315:11 ex 1:4 exact 157:J 5, 17 158:12 exactly 52:J 0 56:2 113:9 127:6 exam 319:22 Examination 2:J 10:21 examined 10:J 8 example 106:16 107:7 116:22 130:22 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3:J 4:1 5:1 6:J 122:9 exist 12:22 21 :11 43:13 102:8 187:23 225:12 234:14 existed 18:J 2, 14 102:11 193:21 246:20 297:5 exists 234:14 245:JO expand 104:J 2 137:J0 174:7 183:J0, 14 206:19 213:18 expanded 246:JJ expanding 81 :9 91 :13 99:20 expansion 182:9 197:6 expect 11 :8 277:16 expectation 151:6 153:5 205:19 277:19 expectations 80:6 107:19 330:25 expected 56: 7 85:21 215:23 216:J 258:12, 14 308:11 expended 76:24 expense 44:16, 21 45:7, 15 205:2 expenses 45: 16 experience 47:12 50:13 61:18 65:14 74:1 J 78:J0 149:21 151:7 193:13 255:18 261:12, 14 281 :14 experienced 38:12 257:15 259:3, 10 experiences 50:14 255:20, 22 259:16 281:12 321:25 experiencing 239:J 7 240:J, 6 259:24 expert 279:J 5, 17 experts 79:8 106:16 115:14 193:23 325:12 expire 19:J 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 24:12, 19 expires 337:17 explain 44:25 97:19 147:18 161 :1 178:18 183:7, 13, 16 201 :22 explained 23 :1 56:19 98:24 206:18 explains 127:24 161:16 305:25 explicit 297:6 explicitly 247:2 272:11, 17 298:2 explore 85:11 exploring 183:19 expressed 214:17 278:24 expressing 214:20 expression 119:4 125:20 240:21 extended 80:17 114:16 246:8 extension 114:5, 8, 20 179:6 extensive 54:1 78:10 130:2 246:9 296:15 extensively 76:7 206:19 extent 53:15 289:18 290:17 external 34:16 extra 27:5 extract 23 8 :3, 6 279:1 extracting 49:5 71:19 extreme 38:22 39:13 82:5, 5 151 :24 extremely 32:1 65:21 68:8 71 :4 81 :5, 14 100:9 114:17 Coulter Reporting, LLC Page: 18 Richard Sackler, M.D. 244:15 252:10 fall 20:22 21 :3 128:4 149:9, 14 150:20, 24 325:2 277:1 281 :15, fallen 87:25 153:8 157:10 16 291:9 false 240:10, 13 159:24 181:19 field 118:19 <F> 122:14, 15 297:17 315:23 232:22 233 :8, face 26:18 18 243:19, 20 204:22 236:3 316:15, 20 27:24 253:7, 17 256:14 274:21 317:12, 20 245:14 255:11 267:14 268:23 280:4 facility 216:2 falsely 252:10 fifth 64:16 fact 49:6 74:10 254:2, 13 269:8 288:21, 75:20 148:19 83:9 153:7 257:18 267:3, 25 188:17 207:8 24 269:13 FDA's 125:6 figure 169:6 209:23 237:9 180:2 242:22 184:21 192:25 familiar 60:10 247:2 263:20 FDA-submitted 283:13 77:14 130:9 file 124:17 264:11 305 :14 166:22 177:2 60:1 315:22 197:25 198:15, fear 211:18 filed 15:1 factor 202:20 feared 79:8 224:1, 7 312:19 17 219:2, 9 218:13 334:10 255:3 280:22 222:5 filing 123 :23, 23 filings 124:25 factoring 334:13 286:3 289:17 fears 109:4 factors l 50:13 329:3 feasible 68:1 fill 139:10 151:18 familiarity February 160:6 filter 279:2 Facts 5:12 281 :5 329:11 177:11, 15 l 78:20 256:23 final 255:14 125:18, 20 Families 40:7 261:2 264:16 258:17 169:3, 6, 8, 17 family 12:16 Finally l 56:23 225:18, 20 13:8, 24 42:16 265:10, 15 federal 223 :2 251:8 281:7 226:2 227:24 56:12 327:3 228:5, 8 229:15 far 96:12 feel 22:16 23 :8 335:20 232:13, 17, 20 143:3 182:22 24:6 81 :2 find 33:25 241:15 250:23 241:21, 23 108:15, 16 62:13 64:2 251:20 252:9 275:23 281 :6 234:17 249:6 104:25 138:25 254:12 256:20 308:15, 16 271:14 278:18 168:17 188:19 198:19 223:18 262:1 263 :15 329:23 280:20, 23, 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M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 firms 26:20 28:1, 11 196:23 197:4 First 6:9 10:17 20:5, 13 27:18 36:20 38:8 46:19 49:8 51 :25 54:17, 24 56:17 63:3 64:6, 15, 16 73:24 74:25 76:3, 9, 10 77:21 78:5 85:12 93:24 95:5, 25 121:19 123:3 130:15 139:14 159:21 160:24 167:7 170:10 173:23, 25 177:14 187:5, JO 191:4 206:16 216:21 217:7, 9 220:13 224:25 230:21 231 :18, 24, 24 240:16 246:17 247:25 248:7 250:1, 2 276:12 279:8 281:19 288:4 321 :22 324:19 327:5 329:4 332:12, 13, 15, 22 333:5, 12, 14 335:23 337:8 Fisher 279:22, 24 280:7 five 46:23 185:12 187:5, JO 214:13 248:2, 5 289:9 305:20 five-year 63 :12 64:3 121:22 fixed 58:22 FL 5:18 flash 221:12 flat 304:3, 10 Fleischer 5 :22 Coulter Reporting, LLC FleishmanHilliar d 197:24 Floor 7:22 Florence 313 :22 Florida 195:4 fluctuation 145:4 148:5, 11 fly 194:23 focus 70:23 108:9, 24 132:19, 22 174:24 175:2, 18 181:15 188:21 189:4 271 :9 334:19 focused 99:20 166:4 179:3 213:14 327:12 335:14 focusing 182:8 focussed 91 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189:3 204:12 251 :9 HENNEBERRY 7:21 10:7, 7 Hentzsch 16:23 30:1, 24 hereto 337:15 heroin 58:25 116:16 336:14 herpetic 120:14 hesitant 65 :17 hey 158:12 190:23 hid 85:5 hierarchy 250:12 251:3 high 67:22 125:10 126:6 246:12 257:19 278:23 279:25 high-dose 79:22 80:2 higher 61:16 79:4 94:21 107:21 290:5, 24 highest 145:7 186:16 266:1 highlight 57:21 335:20 highlighted 27:12, 13, 16 30:2 54:25 55:3 201:14, 16 330:24 highlighting 201:18 highly 61:13 116:4, 4 150:12, 15 hire 112:20, 24 277:10 hired 112:18 127:1, 3 166:19, 24 167:13 170:5 187:23 188:1 196:21 197:5 198:1,9 297 :8, 17, 23 hires 187:14 hiring 198:5 History 3:22 18:2 97:2 129:25 186:20 327:14 hit 126:6 502-582-1627 Page: 22 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 hold 131:15 164:23 170:25 holding 27:2 32:20, 21 holdouts 84:22 Holly 304:1 homes 213:21 hook 181:12 hope 37:21 205:14, 22 hoped 220 :24 hopefully 118:24 195:13 Hospice 116:10 hospices 213:21 hospital 215:25 232:2 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213:17 232:12, 16 315:2 ignorance 272 :6 ignoring 272:6 II 1:1 51:15 121:10 152:20 153:7,8 189:6 206:8 210:5 214:14 247:4, 5, 7 III 51:14 66:6 152:17, 19, 25 153:7 189:7 ill 108:2 illegal 165:24 Illicit 217:25 image 107:24, 25 image-related 81 :3 imagine 161 :22 immediate 117:19 144:8 149:3 163:1, 2, 9 286:20 289:20 325 :9 immediately 102:2 105:21 161:8 187:25 308:2 immediate-releas e 17:5 52:4 107:4 144:10 145:11 148:5, 21 149:8 159:7 160:9, 23 232:25 233:6 235:5 238:24 239:3, 8 242:6, 19 243:5 244:16 252:12 254:3 268:4 269:18 280:13 286:13, 17, 22 313:12 325:17 326:5 328:9, 24 impact 163 :13 202:19 231:22 www.coulterreporting.com imperative 152:22 153:11 impinge 298:5 implementation 120:6 implication 144:12 238:19 implications 129:23 implied 99:15 261 :11 importance 38:22 39:13 176:3, 14 220:23 324:16, 17 326:8 important 23:16 34:20 69:19 81:25 85:3 90:16,22 91:16 93:8 98:12 100:11 101:19 102:23 138:25 176:21 185:8 210:11 286:11 288:2 328:1 importantly 151 :6 impose 140:1 impossible 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258:11 259:1, 20 260:19 286:10 287:20 including 37:4, 9 53:22 189:5 193:3 241:23 247:3 257:6 265:8 316:15 317:11 income 40:21 185:20, 22, 25 186:1 inconsistent 130:5 156:6 incontinence 151:15 incorporate 53:12 incorporated 53:8 incorrect 201 :5 256:8 274:2 incorrectly 190:17 increase 51 :12 107:21 118:24 164:9, 14, 15, 16, 18 199:21 204:6, 8, 22 214:25 218:12 221:23 295:1 334:23 increased 146:20 165:4 186:13 203:1, 3 215:4, 11 216:19 217:24 218:10 increases 92:11 164:23 increasing 96:7 146:19 202:20 203:19, 25 334:4 Coulter Reporting, LLC incredible 188:21 incredibly 124:2, 14 indefinite 160:12 independently 274:11, 12 indeterminant 276:22 indicate 326:8 334:7 indicated 121:11 174:12 indicating 15:4 56:6 110:1 117:10 126:12 142:1 260:23 indication 80:15 105:16 114:24 indications 125:10 160:8 indisputable 151:9 individual 245:1 281:7 282:11 individuals 48:18 68:20 194:21 226:24 228:16 231:23 232:16 324:20 industries 191:14 industry 41 :22 76:23 123:11 186:10 191:13, 23 195:19, 21 199:2 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inquiry 77:25 310:1 insert 74:2 76:10, 12, 13, 15, 19, 20, 24 83:20 90:9 101:16 121:16 123:10 129:12, 14, 17, 19 130:6, 11, 16, 20 134:12, 13 155:4 156:5, 7, 12, 15, 25 157:9 236:25 237:3 243:23 246:2 247:1 267:14 268:22, 23 269:3 307:1, 2, 3, 5, 6, 9, 11 311:2 320:17, 19 321:4 inserts 129:21 130:1, 12 inside 34:15 insist 84:3 insisted 83 :23 insomnia 255:23 258:2 259:18 instance 23: 17 170:9 329:4 instances 227:10 instituted 191 :19 instruct 168:12, 16 272:11, 17 instructed 89:20 267:20 268:16 307:22 335 :8, JO, 10 insubstantial 145:2 insurance 41 :23 integral 78:13, 15 Integrated 3 :24 integrity 163 :15 intended 83 :8 249:16 intensity 149:1 intent 33:8 37:13, 19 224:13, 20 228:12 237:19 242:2 311:7, 20 312:7 319:5 intention 153:6 intentionally 78:17 interest 117:18 218:14 220:18 337:16 interested 272:1 308:13 Interesting 203 :17 283 :14, 14 Interestingly 108:20 interject 207:6 internal 35:12 122:14 193:23 internally 194 :5 International 4:7 141:6 internationally 61:16 502-582-1627 Page:24 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 Interoffice 3:12 investigations interpolating 34:15 281:22 296:15 334:24 investigations: interpret 244:4 interrogatories 288:3 103:J0 68:19 interrupt 270:6 298:13 Interstate 269:24 270:3 intervals 156:25 interview 198:JJ interviewing 138:20 interviews 174:25 175:J intimately 118:14 intravenous 238:5 introduced 65:20 74:J 97:20, 23 introducing 135:24 Introduction 269:23 introductory 104:22 invested 44: J investigate 115:7 investigated 230:1 264:9 investigating 53:J 230:23 231:J investigation 33:25 34:JJ 35:2 89:6 168:17 169:20 231:4, 5 275:22 276:6 277:J 1, 12, 17 281:23 282:J 316:13 317:J0 Coulter Reporting, LLC investigator 255:16 investigators 284:22 investment 54:4 203 :21, 24 involve 12:25 involved 14:2 15:13, 25 16:4, JO 19:7,20,23 20:1 21:14, 19, 20, 21 26:7, 9 29:6, 16 47:13 49:13 94:3 98:4 118:J 4, 15 120:2 155:12 182:23, 25 183:J,3,4 191 :25 227:23 269:9 273:14 involving 36:4, 8 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:23 322:6 laboratory 245:13 lack 109:16 309:10 lacked 283:20 284:2 lacks 46:21 Lacouture 114:21 ladder 136:19 Lake 7:5 9:3 Lane 4:8 Lang 6:3, 6 108:8 languish 124:24 large 107: 11 188:25 190:14 194:7 218:9 236:2 240:15 272:10, 16 337:4 www.coulterreporting.com larger 85:19 91:2, 2 99:8 164:22 193:9, 11 207:20 lasted 145 :16 lasting 145:16 lasts 291:18, 19 late 24:15 136:19 138:11 159:3, 18 l 66:11 264:13 312:12 319:22 320:4 Launch 3:22 4:14, 14, 19 30:8 35:1 38:3 39:1 84:11 90:18 101:15 103:23 134:3, 4 142:17, 19 173:9 176:7, 16 178:20 181:3, 4, 9, 13, 22 182:6 183:10 188:18 190:21 191:5 192:2 200:17 202: 7 226:14, 15, 18 242:24 243 :] 6 244:24 327:12 launched 34:14, 22 38:4, 20 78:16 83:19 84:14 85:15 174:8 176:1 178:10 182:8 185:21 189:19, 20 206:12 274:5 launching 16:2 123:2 ' LAUREN l:21 337:3, 24 Lavey 197:1 law 231:2 277:14 lawyer 166:19 167:13 253:9 293:22 lay 133:25 laymen 18:16 lead 63:17, 17 133 :15 220:24 leaders 100:7 leading 298:14 learn 294:14, 20 learned 34:11 35:2 85:24 175:3,12 221:25 271:23 316:13 317:9 327:20 learns 295:8 leave 229:8 leaving 112:22 229:11, 12 231 :11 led 61:20 69:18 107:13 149:17, 25 294:21 295:1 left 112:25 229:6 231:7 272:8 311 :24 legal 33:24 121 :19 228:21 293:24 319:8 lengthy l 70:17 lessons 221 :25 Letter 2:19 5:10 108:8 109:6 222:17, 25 225 :20, 23 226:6 232:1, 2, 5 letter, 226:5 letters 227:4, 7, 12 243:19 level 16: 1, 1, 5, 5 94:.21 145:18, 19, 20 149:22, 23 183:8 235:4 239: 7 252:11 254:2 281:15 289:23 290:6, 10,11,15,24 levels 34:12 112:4 113:13 145:15 242:17 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 243 :4 244:2, 2 286:14 289:8 304:3, JO 320:14, 17 Lexington 7:19 299:2 lgootee@coulterr eporting.com I:24 liability 45 :14 47:20 51:18, 21 52:5, 23 58:1 267:12, 16, 17, 25 268:12, I 5 269:14 liable 49:6 liberty 55:18 license 24:11, 18 37:18 222:12 licensed 194:11 licensing . 14: 7 222:3, 9, JO lie 151 :9 life 30: 7, 9, 12, 13 65:15 66:18 72:18, 20, 22, 25 81:6, 15 93:19 132:14 133:15 198:16, 20, 21 236:4 life-destroying 80:14 light 57:22 266:21 lighten 139:12 likelihood 175:14 limit 83:6 94:8, 16 96:6 98:25 127:16 I 62:10, 14 174:22 200:11 235:19 306:15 limited 28:21 50:4 Linda 4:17 Line 6:13 70:11, II 142:6 164:12 165:5 Coulter Reporting, LLC 171:19, 25 188:23 298:5 301:13 309:22, 25 320:25 321:1 lines 240:18 linger 125 :I lining.' 279:4 link 78:18 199:9, 13, 14, 17 linkage 200:3 linked 78:18 list 9:20, 21 35:20 39:8 logarithmic 243:2 logic 303:3 London 4:8 187:2 long 100:14 126:25 130:2 153:7 178:15, 17 179:13 245:15 258:14 266:22 282:8, 18 290:14 293:7 302:15 308:18 319:22 40: 7 129:5, 6, 7 133:10 177:17, 18 I 79:15, 25 I 80:10 204:2 215:15, 19, 21 223 :22 257 :3 261 :I 3 listed 250:25 longer 46:2 124:5, 8 long-term 50:5, 20 71 :5 178:6, 10,14,21 179:2, 3, II, 14, 19 180:1 245 :25 look 28:9, 24 255:21 36:10 38:I 5 44:6 46:14 55:14 56:7 70: 7 75 :I 86:3 91:15 III:16 listing 115 :22 literature 18:4 75:2, 3, 6, 12, 16 83:12 152:23, 25 153:12, 17, 22 191:15 246: 7 286:1 I 289:15 litigation 30:19 45:15, 16 293:7 318:1 little 17:3 33:5 36:1 46:1 54:20 62:13 70:3 74:14 95:4, 18 145:25 I 59:15 I 74:11 206:14 241 :I 254:25 277:21 LLC I:21 LLP 7:15, 21 8:8 170:1 local 58:20 located 280:9 294:22 locations 270:4 113:12 119:10 126:17 129:25 149:22 152:4 218:6 244:22 245:1 283:11 299:18 306:25 327:25 looked 40:15 109:19 166:13 170:9 192:25 237:15 244:25 296:5, JO 307:13 looking 27:22 41 :21 44:22 48:19, 19 62:18 75:7 86:9 134:11 213:4 301:4 315:7 333:6 looks 36:1 I 39:6 48:17 62:16 68:6 www. cou lterreporting. com Page: 26 Richard Sackler, M.D. 101 :24 106:13 111 :9 120:15 122:13 129:4 159:1 179:18 203:12 221:5, 19 265:11 287:2, 14, 19 326:15 334:23 loose 200:3, 8 Lortab 133:17 304:4 Los 7:22 lose 137:9 losing 137:2 lost 79:25 97:4 165:20 lot 41:22 50:9 76:23 115:22 126:5 150:11 211:3 241:4,8 246:1 283:4 287 :5 305 :20 327:15 lots 61 :21 Louisville I :23 7:5, 23 9:3 301:17 337:20 Love 305:2 loved 305:7 low 56:22 79:4, 5 92:21 120:14 178:5, 16 I 79:4, 10 255:13 259:23 324:17 326:7 335:18 lower 50:21 IOI :9 137:4 247:15 283:21 284:3 lowering 94:13 lump 19:15 23:3 lunch 128:12 154:5 Lydia 4:14 M.D 1:4 9:2 I 0:17 279:15 287:15 M.D.s I 08 :I 5 Madisonville 304:1 magazine-like 122:14 magnitude 315:20 Mahoney 4:24 mail 191:1 mailed 191 :4 Main 7:18 184:2 213:7 279:3 Maine 231 :21 maintain 163:15 maintained 148:25 290:5 maintaining 20:25 145:6 maintains 50:17 290:24 maintenance 162:23 163:14, 20 major 44:3 162:24 255:21 287:23 majority 17 :II, 13 41:5 100:17 185:20, 22 making 34:3 49:13 I 60:16 186:22 190:24 209:18 219:18 222:13 236:19 260:1 270:24 275:11 malignant 17:10 18:9 70:15 71:6 95:20 107:23 138:16 181:17 Lyons 196:25 193:3 335:16 manage 34:10 100:9, JO 194:8 <M> managed 39:4, 10 324:23 502-582-1627 Page:27 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 management 15:15 16:12, 16 19:5 29:8 34:12 109:3 144:19 182:11 183:20, 23 192:17 198:5, 9, 12 214:19 266:18 268:14 269:4 279:16, 25 281 :25 management's 228:1 manager 17: 1 56:15 72:15 279:24 280:1, 5, 6, 6, 8 326:24 332:1, 1 335:24 336:1 managers 251:22 Mandema 139:3 140:5 Manners 5 :22 manufacture 21:24 manufactured 21:22 270:2 manufacturing 14:3 21:21 manuscript 139:9, 22 Manuscripts 139:2, 5 140:7, 12 207:23 Marc 299:1 March 48:17 62:19 63:20 68:16 131:21 178:9 258:19 261:22 264:17 265 :] 1 268:6 269:11 322:20 337:17 Mark 4:12, 24 5:14 29:13 32:9 37:24 39:17 44:4 45:21 47:24 54:12 73:4 Coulter Reporting, LLC 74:17 77:4 86:4 103:7 105 :23 109:11 110:17 122:1 127:7 134:17, 24 141:7, 10 154:21 164:1 173:13 177:5 200:16 204:14, 21 212:23 218:22 220:1 225:19 226:19 247:20 248:7 249:2 250:17 251:15 278:10 286:5 287:10 300:21 301 :8, JO, 16, 18 314:10,11,25 324:8 326:12 331:14 MARKED 29:4, 14 32:11, 23, 25 38:1 39:21 43:2, 5 45:22 48:1 54:13 73:5, 8 74:19 77:5 86:6 103 :8 105 :24 109:13 110:18 117:15 122:5 127:9 134:19 135:1 141:12 154:22 164:2 173:l 8 177:8 180:25 181 :] 200:19, 22 201:1 204:15 205:23 218:24 220:2 226:4 247:23 251:17 278:11 286:6 287:11 324:9 326:13 331 :16 market 24:24 25:10, 12 36:23 47:21 52:22 60:23 61:8 66:14 79:1, 3, 7 80:6, 8 84:13 85:7,8,18 90:21, 22 91:1, 2 97:9, 10 98:11, 12 99:3, 6, 9, 14 103:24 132:2, 16, 20 133:1, 2 135:22, 25 136:1, 3, 7, 10,12,14,24 137:3, 8, 9, 11 138:1, 7, 8 146:25 147:3 152:15 164:5 174:8, 14, 15, 24 188:25 189:4 190:14 193:2, 7 197:1, 6 204:25 206:19 207:20 214:6 217:8 220:11 221 :21 222:3, 10 245:19 246:13, 19, 19,20,22 248:3 251:10 267:21 268:17 272:4 330:25 331:10 marketed 70:10 121 :13 146:12 157:15 184:3 216:21 233:22 237:20 281 :20 312:7 marketing 15:14 16:11, 17 21 :2, 14 29: 7 31:19 34:3 35:9 39:7, 10 65:18 70:9 72:12, 14, 16 77:18 91:6, 7, 9, JO, 11 99:18 103:15 106:15 107:15, 17 117:21 118:7, 13, 23 119:23, 25 121:1, 18, 20, 21, 23 122:16 129:11, 13, 17 130:13 131 :8 www.coulterreporting.com 132:8, 11, 18 133:1, 19, 24 135:10 138:19 147:6 158:6, 7, 11 160:2,14 161:12, 13 174:3, 20 178:8 179:15 180:10 191:16, 19 196:22, 23 197:5 199:4 203:15, 16 206:16 207:22 208:5 209:1 216:5, 13, 25 217:17,20 226:9, 18 227:4, 12, 13, 17 242:23, 24 248:5, 15 249:4, 5 260:11,15,16, 18 262:10,17 263:14, 18, 22 265:7 266:18 267:23 269:12 272:10, 17 274:14 281 :] 0, 10 294:15 327:9 329:11 330:2, 5 331 :22 Marketing, 117:17 135:19 267:13 Marketing's 177:17 206:17 marketplace 174:6 206:12 218:10, 13 markets 53:14 85:10 marriage 337:15 material 74:2 120:11 155:6, 21 200:24, 25 209:2 256:12 262:10 materials 89:19 90:16 106:21 118:14 119:6 130:18 167:24 190:23 195:10 226:9 242:25 243:16, 21 263:22 271:24 281:10, 11 matrix 49:6 matter 9:12 65:2 67:5 68:7 310:5 mattered 308:8, 16 matters 293 :8 maximum 94:13 McGill 150:1, 2 McManama 286:1 MD 8:9 mean 46:2 59:18 67:15 73:12 88:5, 6, 25 96:10 98:6, 6 105:13 106:18 151:18, 24 152:2 155:16 162:11 182:24 187:24 188: 7 208:24 209:22 224:8 238:1 244:22 250:5, 6 305 :20 319:11, 13, 13 321:12 322:1 327:10 328:4, 6 332:4 333:17 meaning 87:24 94:1 96:3 97:3 139:21 156: 7 158:9 182:18 211:14, 16, 17 226:14 236:23 237:25 249:15, 20, 21 329:7 meaningless 203:1 means 51:4 57:17 59:8, 15 73:21 98:15 99:4 127:20 148:9, 11 155:8, 502-582-1627 Page:28 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 9 156:9 199:25 248:17 249:25 280:21 294:3 305:23 332:6 meant 33:16 57:22 79:19 83:6 85:1,2 88:17 106:20 127:19 158:17 160:7 163:4 211:23 222:10 234:9 267:25 269:6, 8, 15 285 :17 305 :22 320:22 329:6 measure 240:15 274:16 measured 125 :3 281:18 measures 72:25 measuring 149:20 media 181:11, 12 Medical 3:24 62:8 112:1, 12 116:5, 11 120:4, 5 121:5 126:19 130:21 131 :1 132:5 140:17, 18 153:24 157:24 159:11 196:7, 9 214:12 220:19 233:15 235:2 258:19 265 :1 266:18 283:17, 18 300:8 320:23 329:2 medically 325:21 medication 37:4 114:16 145:15 158:12 259:11 medications 233:7, 11 237:23 312:10 medicine 189:19 234:7, Coulter Reporting, LLC 11, 18 287:4 322:10, 15 medicines 192:7 Medtronic 109:1 meet 76:11 114:21 115:9 222:14 246:6 Meeting 2:15, 17 3:3,5,10,17, 20 4:3, 6, 8, 15, 18 5:3,23 30:25 31:6 35:18 38:16 67:4 74:22 77:24 85:24 l 10:22, 23 111:4 117:13 120:21 121 :6 135:20 141 :6 142:12, 14 148:13 158:2 l 75:22 177:11 206:9 210:6 252:1 327:20 332:18 333 :14 meetings 31 :25 32:1 49:13 86:9 135:17 141:6 195:4 196:16 202:15, 19 member 63:13 members 113:16, 24 222:15 Memo 2:8, 13, 21 3:2, 5, 9, 15, 17, 19 4:2, 5, 10, 12,14,16,21,23 5:2, 14, 16, 19, 21 6:2, 5 25:24 38:3 48:9, 16, 17 59:4 70:4 74:21 103:10 117:8,12 128:22, 24 154:25 299:5 304:2 313 :23 Memorandum 2:15 3:12 35:17 77:22 109:23 110:4, 16 204:21 memorize 307:16 memory 22:11 23:15 52:16 211 :22 273:5 296:22 302:1 304:19 mental 96:5 98:25 mention 302:12 mentioned 118:5 menu 316:19 317:19 Merck-Medco 6:4 merged 225:15 mess 251:9 message 84:8 272:10, 17 met l 77:15 methods 236:J 0 Michael 2:9, 24 3:8, JO, 13, 15 4:23 5:15, 16 6:3 35:7, 8 38:17 68:J 77:15, 17, 20 85:25 86:4, 7, 23 90:17 101:18 103:13 106:13, 14 170:5 172:17 175:23 198:12 202:9 205:4 226:16, 21 228:17, 23 324:14 middle 55:5 72:15 98:10 142:3 216:17 223:13 224:24 mid-term 221 :9 Mike 72:11, 17 77:23 118:4 www. cou lterreporting .com 119:11, 12, 18, 21 120:11, 25 129:10 132: 7, 11,15,18 135:21 l 73:24 174:3 206:17 207:20 Miller 5 :22, 23 milligram 75 :22, 23, 25 79:4, 6 105:3 117:18, 19 140:23, 24 141:J 142:9, 10 144:3 148:J 156:7, 24, 24 174:9, 10 238:7 278:23 282:7 294: 7, 9, 9, 9 milligrams 74:14 89:4 94:7, 19 104:21 105:1 144:4 145:7 259:8, 10 260:24 267:4 278:23 282:14 million 43:21 44:13, 18, 21 45:10 64:11, 14, 17, 18 164:10, 12 165:4 167:3, 4 213:6 215:5 216:20, 21, 24 297:8 millions 312:25 313:2 mind 76:16 90:24 98:14 100:3 105:22 117:25 139:8 207:22 215:8 216:9 236:7 248:8, 11 250:11 308:11, 18 minds 308:3 minds.' 256:16 Mine 27:13 54:21 249:18 minimal 58:1 minimize 189:20 minimum 137:13 minor 147:16 minute 110:10 121 :6 233:24 300:18 308:17 323:24 Minutes 2:J 5 3:3, 6, 10, 20 4:3, 6, 7, 15, 17, 21 5:23 74:22 117:13 138:J 4 142:13, 14 148:16 l 77:10 202:4 286:22, 23 307:23 328:17, 18 Minutes, 135:20 Misbranded 269:23 misbranding 33:7 224:13, 20 228:12 236:18, 19, 21 237:3 242:13 254:21 267:11 311:5 318:6, 15 misconception 91:21 101:5, 8 102:1, 8, 9 106:22 misconceptions 107:1, 3 misconduct 223:3, 15 misdemeanor 226:25 misdemeanors 228:18 misinterpret 31:9 mislead 33:8 34:18 224:14, 21 228:13 237:19 242:2 311:8, 20 312:7 misleading 239:12 244:5 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 254:22 275:8 315:23 316:15, 20 317:12, 20 319:4, 20 misleadingly 267:3 mis perception 90:7 93:15 95:22 99:24 misrepresentatio n 238:12, 14 misrepresentatio ns 270:24 missed 312:13 319:2 missing 137:25 mission 125:23 misspoke 110:15 122:23 mistake 135:16 misunderstood 130:23 MITCHELL 7:6 10:13 11:12 mitchell.denham @ag.ky.gov 7:10 mitigate 34:21 model 114:5 moderate 3 7 :22 80:12 100:9 329:16 molecule 46:21 245:22, 24 moments 29:25 Monday 16:21 money 39:23, 25 40:2 41 :22 42:8 44:1 184:12 186:7 189:15 190:24 192:14 221:23 271 :20 monitored 57 :8, 16 114:13 287:25 monitoring 60:19, 24 61 :8 Coulter Reporting, LLC month 40:5 move 69:5 narcotics 24 7 :5 191:4 200:14 122:8 134:18 narrow 162:24 245:17 261:22 movement national 189:8 months 35:4 145:3 332:17 333 :13 106:15 125:1, 3 moving 334:18 nature 88:13 182:7 191 :4 336:13 236:14 315:23 220:14 261 :20 MSC 70:12 Natz 3:17 289:9 330:18, 19 nausea 255:23 Montreal 150:3 MST 36:19 NDA 123:21, morphine 17:4, 58:23 22, 23 124:4, 23 16 18:7, 16, 19 multiple 34:14 125:10 128:8 28:12 37:10 147:9 261 :11 232:22, 22 46:22, 24 50:1 296:12 233:4 246:6 58:25 73:10, 11, multiple-dose nearly 214:3 19, 23 74:5, 13, 120:12 215:4, 20 14 77:3 78:7 Mundipharma necessarily 79:10, 14 80:25 13:5, 7, 9, 11, 12, 23:21 69:16 81:9,17 82:4,4, 16 17:1 63:19 219:7 261:19 11,15,23,25 293:17, 18 302:20 83:1, 14, 16 Mundipharma-G necessary 84:3, 17 85:4 ermany 56:10 114:22 115:7 87:15, 21, 24 m usculoskeletal 245:6 287:6, 7 88:12, 13, 13, 23 174:16 288:19 89:8, 9 90:2, 6, necrosis 58:21 25 91 :4 93:3 <N> need 29:15 96:14, 19 97:2, naloxone 52:24 46:2, 4 95 :15, 12 98:8, 17 53:8, 9, 13 21 102:1 99:2, 5, 11 67:21 68:3, 10 108:18 109:2 100:21 101:4, 7, naltrexone 54:2, 131 :18 144:14, 10 107:7 116:7, 2 17, 19, 21 13, 25 136:15 name 9:18 145:21 154:15, 143:2, 3 144:4 10:24 12:7 16 158:1 175:6 206:5, 24, 13:12 15:3 160:22 163:14 25 207:15, 16 19:8 22:20 177:21 178:21 208:7, JO, 20 197:2, 25 280:3 179:19 181:22 209:1 211 :16, 286:3 324:12 221:24 251:15 name-brand 17, 18 212:11, 266:7 287:25 12 247:9, 11, 12, 218:17 288:3 290:2 15, 17 248:22 named 21:23 291:20 249:7, 12 250:5, 172:5 323:16 needed 71:25 9,11,19,21,24 names 9:20, 23 72:2 100:10 251 :4, 8 256:9, 14:15 68:20 155:10 157:5 11 271:11 170:9 232:12 158:19 177:25 morphine, narcotic 17:5, 6 178:9 179:24 82:10, 11 89:18 56:21 64:7 190:8 271 :20 Mortimer 3 :12 65:1 67:20 308:22, 23 103:18 68:3 82:21 328:6 motivated 125:9 214:14 218:17 needing 178:9 motivating 31 :4 247:4, 7 needless 150:5 needs 295:6 www.coulterreporting.com Page:29 Richard Sackler, M.D. negative 143:8, 9 150:23, 25 207:19 262:3 263 :2 264:18 265:14 334:22 negotiated 41:25 negotiating 37:17 240:25 Neilheisel 313:21 neither 304:9 nervousness 255:23 258:1 259:18 net 41 :22 42:1 44:10 neuralgia 120:14 335:19 Never 13:22 14:6 21:20 38:13 54:4 68:14, 23 85:4, 4 90:3 98:7 168:24 189:24 212:21 224:3 236:9, 16 277:5 282:6, 19 296:2 317:3 nevertheless 304:13 New 2:11, 13 7:16, 16 20:16, 17 44:2 52:7, 7, 12,13,14 58:23 78:20 123:24 125:8 134:5 181:19 187:14 202:16, 20 252:19 253:1, 23, 24 314:19 329:15 330: 7 Newcomer 40:6 newest 183:11 286:9 newsletter 35:12 newspaper 122:13 231 :21 newsworthy 502-582-1627 Page: 30 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 220:12 niche 174:17, 20 nine 45:12 146:13 259:18 no, 325:1 non-addiction 313:24 non-cancer 70:22 87:7, 8, 17 90:21 91 :2, 14 95:12, 19 96:21, 23 97:8 98:11 99:9, 21 131 :20 206:19 207:20 213:15 214:24 215:1, 4 251:10 non-GMP 120:11 nonmalignant 181 :17 non-malignant 70:16 71:5 78:25 79:3, 6 80:6, 8, 18, 23 81:10 85:7, 17, 18 92:16, 17 93:1 97:10 105:8, 19 107:14 108:1 113:17, 25 115:16, 18, 21 116:9 121 :11, 15 136:12 137:10 138:1, 7, 8, 11, 18 l 74:16 178:3 179:8, 15, 20 193:4 246:11, 18, 22 282:19 330:16 335:16 non-narcotic 64:7, 13 nonscheduled 50:22 nonsteroidal 180:14, 17, 23 normal 119:25 133:15 145:9 Coulter Reporting, LLC 148:2 158:10, 13, 17 normally 120:3 146:8 Norwalk 4:10 62:12, 14 77:13 86:4 326:17 NOS 226:3 Notary 337:3, 17, 24 note 11 :8 67:18 200:23 276:2 286:22 297:20, 24 noted 210:11 261:10 notes 166:14 167:13 168:2 275:20, 24 276:6, 8, 14, 15, 20 277:7,8,18 296:6, 10, 11, 20 297:1, 5, 12 299:5 305:16 307:20, 22 308:6, 15, 19 309:2, 6 310:4 312:14 315:8, 14,22,25 316:16, 17, 23 317:13, 17, 22 321:20, 23 337:9, 13 note's 304:2 313:23 noteworthy 220:9 not-for-profit 323:10, 21 Notice 9:6 notified 198:4 230:21, 25 232:2 notion 81 :2 96:5 130:3 notional 94:5 164:23 November 124:16 141 :15 142:18, 20 268:10 278:10, 12 279:6 NS 91:23 NSAID 180:23 NSAIDS 180:13, 16, 18 number 12:6, 12, 20 26:14 31:13 40:20 43:23 44:23 48:18 69:21 72:3 78:22 89:14 l 02:15 104:6 110:8 124:9 145:7 154:14 167:7 173:12 177:17, 19 189:6, 20, 21 196:21 199:9, 14, 19 200:5 202:16 203:1 209:20, 21, 25 210:2 215:3, 12 216:24 217:2 236:3 238:21 270:6 277:18 281:10 283:7 296:14 311 :13 313:4 317:13 318:17 336:7, 7 numbers 55:15 202:25 215:8 216:9 nurse 150:8 nurses 175:15 182:20 213:20 nursing 213:21 <O> OA 140:21 object 15 :17 19:12 22:19 25:3 31:20 79:8 91:24 137:12 153:2 165:16 167:15 170:14 211 :9 239:20 246:15 252:23 262:13 263:25 271 :3 www.coulterreporting.com 284:4 297:13 298:6 301 :13, 15 303:7 316:25 317:24 319:21 320:10 objection 22:22, 24 34:5 41 :8 42:11 60:8 65:9 70:18 86:19 96:13 139:24 147:8 176:18 310:13 325:2 objections 11 :24 objective 181: 7 189:18 objectives 220:17 obligation 295:13 obliterated 325:2 observe 83:24 observed 246:2 obsolete 24:25 25:11 123:3 obsoleted 123: 7 137:7 obstacle 225 :2 obtain 49:4 obtained 288:10 obvious 189:24 289:18 obviously 66:13 275:16 278:21 307:18 325:24, 25 OC88-1105 120:9 OC92-1102 140:21 OC93-0101 139:3 occasion 220:13 occasionally 196:1 occasioned 66:1, 16 145:3,4 occur l 62:22 297:7, 16 occurred 33:20 90:3 264:15 273:10 317:23, 25 318:3 occurring 60:21 61 :1 198:4 268:9 occurs 329:23 October 242:21 odd 284:5 offer 61 :24 offering 191 :2, 7 Office 2: 11, 13 7:8 10:14 167:20, 22, 24 237:15 241:9 297 :] 0 312:15, 19 322:12, 24 Officer 3:24 62:8 67:4 121 :5 126:19 130:22 132:5 140:18 228:21 229:3 233:16 235:3 265:1 officers 206:4 offices 9:2 184:7 185:10 Oh 10:5 27:20 48:20 54:23 55:5 62:24, 24 82:13 89:17 92:5 96:16 108:13 119:14 135:14 141 :20 149:22 151:10 174:2 182:22 220:7 223:7, 8 239:23 272:14 273:6 300:4 313:8 318:14 329:5 333: 7, 24 Okay 15:23 19:25 21:7, 13, 24 22:9, 17 23:6, JO 24:7, 8 27:15 29:19, 24 31 :12 33 :3, 14, 15 37:13 44:10, 12 46:20 47:19 502-582-1627 Page: 31 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 48:15, 20, 20, 21 49:15 50:8 52:18 55:6 56:8 62:14, 21, 25 64:1 65:14 66:25 67:24 69:25 71 :10 72:8 75:11 76:5 77:19 79:15 80:3 84:6, 10 88:20 104:3 105:12, 17 106:21 108:13 111:12, 14, 21 113:22 118:3 119:16 126:8 132:4 135:5, 7, 16, 16 137:22 140:20 141 :23 142:5 143:17, 17, 19 153:10 155:11 159:2, 14 161:13,24 162:9 172:2, 9 174:2 182:22 184:13 197:11 200:16 201:24 202:1, 9 207:11 209:17 212:7 218:6, 8 220:7 224:15 237:1 240:10 244:11 248:22 250:13, 14 253:24 255:2, 9 269:10 272:14 273 :6, 21 284:13 289:12 294:2 302:5 304:25 306:6 312:3 318:14, 14 319:15 324:12 332:16, 21 333 :6, 7, 11, 24 old 78:20 134:5 329:12 330:6 older 217:8 Coulter Reporting, LLC omitted 92 :2 239:21 316:20 317:20 once 21:19 40:9 58:5 169:20, 20 187:25 195:8 272:21 296:12 316:12 317:9 oncologists 86:11, 13, 25 92:4, 9, 12 93 :25 94:17, 24 95:7 96:16 98:19 106:16 108:15 109:16, 19 136:22 213:24 oncology 108:9 213:20 one-and-a-half-t o-one 96:12 one-on-one 174:25 ones 51:25 168:18 190:5 241:23 276:20, 21 296:20 308:22 321 :9 one-shot 221 :12 ongoing 72: 19 onset 286:12, 17 288:6, 15 289:2 328:16, 23 329:1, 6, 7 330:11 Oops 173:25 open 114:5, 7, 19 l 79:6 opening 2:22 51:2 operate 125:7 ophthalmologists 193:14 opiate 121:10 133:16, 17 136:20 246:12 opiates 113 :16, 24 115:4 opinion 65 :22 100:7 116:1 153:18 288:18 307:9 320:24 327:6 opinions 62:10 113:15, 24 115:22 opioid 17:6 26:13, 17, 21 27:17 28:3 53:20, 23 54:3, 8 87:15 96:19 100:10, 15 109:4 133:11 143:12 145:7 180:16 233:21 235:5 237:9, 10 246:11 257:6, 23 282:6, 19 335:15 opioids 26:19 27:25 37:23 52:3 53:11 58:15 59:3 80:16 92:21 100:14 115:16, 21 134:8, 15 144:24 180:12 185:11 189:1, 7 190:15 215:16, 17 238:24 239:3, 8, 10 242:6 252:12, 14 254:4, 15 268:4 269:18 278:16 288:6, 15 294:22 313:13 316:8 327:16 Opportunities 217:25 218:11 opportunity 78:21 opposed 187: 15 188:1 190:25 option 114:12 options 36:14 orally 54:6 74:15 www. cou lterreporting. com order 11:10, 20 54:20 62:14 114:3 131:19 137:2 189:25 190:3 191:3 229:12 orders 184:11 191 :8 ordinary 293 :3, 5,12 Organization 97:21 183:21 194:7 organizations 192:1 organize 55:7 original 20:11 55:15 201:3 originally 129:20 orthopods 109:2 osteo 114:25 osteoarthritis 111:10 112:4 l 13:14 114:4, 24 178:5, 16 179:4, 11 255:1, 13, 14 257:1, 4, 21 258:18 260:7, 17 261:5, 17 262:2, 24 265:5, 13, 16 266:15 267:2 313:17, 23 335:18 ought 241:1 outcome 337:16 outlined 307:14 319:3 outperformed 330:25 331 :9 outset 19:12 241:17 outside 195:2 284:22 overall 126:18 127:10 159:13 330:1, 4 331:12 overlook 83 :9 overly 217:18 Overseas 40:23 162:5 293:15 oversights 280:8 overview 135:21 overwhelming 100:16 185:22 owned 13:24 14:22 20:14 56:11 162:8 owner 131 :3 owners 131 :2 owns 12:16 Oxy 64:25 301:22, 24 303:14 304:3 306:1 313:25 328:2, 4, 5 330:6, 14, 15 Oxycodone 2:9, 25 3:5, 24 24:23 25:8 28:14, 15, 18 36:24 37:4, 7 46:16, 17 49:5, 9 52:2 53:2 59:2 67:21 68:16, 25 69:13 71:19 73:9, 19 74:22 75:3, 13 78:6, 8, 10, 13, 14, 19 79:10, 14 82:3, 17, 18, 20 84:16 87:14 91:18 93:10 94:7, 9, 18, 19 96:18 101:20 102:25 104:17 107:9, 10 114:25 117:19 127:11, 15 133:12 135:21 144:3, 7, 11 148:21, 21 149:8 151:10 152:13, 15 153:8, 16 155:16, 17, 22 159:8 160:9, 19, 23 162:11, 12 181:20 210:13 502-582-1627 Page: 32 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 232:25 233 :6 235:6 238:4, 7 243:1,3,6, 7,8 246:17 247:15 248:24 249:6 250:22 251 :] 256:9, 11 259:7, 10 260:21, 24 279:1 286:J 0, 13, 18 310:10 328:8, 10, 17, 23 Oxycodone.' 244:16 Oxycodone-cont aining 58:5, 14 OxyContin 3:3, JO, 19, 22 4:3, 5, 10, 14, 17, 17, 19, 21,24 5:3,6,18 6:9 14:J, 3, 8, 13 15:16 16:3, 6, 11, 14 19:7, 10, 21 20:21 21:2, 15 22:14 25:8 26:8 28:18 29:7, JO 30:6, 15 31:3, 6, JO 33:8 36:5,8, 15 37:14, 18 38:2, 4, 12, 23, 23 39:1, 13, 24 40:3, 6, 11, 22, 25 41:7 42:16 43:17 45:15, 17 47:13, 20 49:2, 25 52:6 54:1 56:20 57:16 58:J, 21 59:2 60:23 61:7, 13, 16,25 62:7 64:3 65:6,18 68:22 70:3, 9, 11 73:10 77:2 78:15, 16, 18, 19 79:10, 23 80:24 81:J0 83:3, 17 84:11 85:16 86:J 0, 17, 24 87:16 88:22 89: 7 90:19, 25 Coulter Reporting, LLC 91 :13, 22 92:10 93:2 94:21 95 :6 96:11, 17, 20 97:10, 22, 24 98:16 99:2, 20 101:3 103:23 104:4, JO, 13, 18 105:J, 6, 8, 20 106:17 107:12, 20 108:15,21 112:J O 119:9, 13, 22 123:2, 21 128:21 131 :13, 16 132:13,16, 21 133:6, 7, 10, 15 134:14 135:6, 20, 24, 25 136:13 137:6, 8 142:17, 25 146:2 152:11, 16 153:1,6,14 154:20 155:J 2, 13, 14 156:5 159:13 162:2, 10,21,25 163:7, 16 164:5,8 173:9 174:7, 7, 8, 12,18,20 175:15 176:4, 4, 7,15 177:2,10, 15 178:19,19 179:19 180:J0 181:9, 13, 20, 22 182:6 183:1 J 184:3, 8, JO, 15, 23 185:4, 17 186:7, 14, 20, 22 188:21 189:4, 16 191:3, 20 192:4 194:17, 18 196:17, 22 197:J, 3, 21 198:5, 22, 25 199:5, 7, 10, JO, 15, 15,20,22 200:6, 16 202:4, 7, 17, 20 204:12, 18, 23 205:1, 3, 8, 17, 21 206:4, 8, 11, 18, 20, 25 207:16, 24 208:6, 19 209:21 210:5, 9 212:12, 15 213:14, 18 214:4, 11, 13, 24 215:3, 13 216:5, 19, 21 218:9, 16, 17 219:J, 11, 13, 17,19,23 220:10, 20 222:7 227:13, 17 228:13 231:1, 23 232:4, 22, 23 233:5, 9, 20 235:5, 19 236:18 237:6, 20 238:4, 8, 16, 17, 23 239:3, 7, 18 240:2, 7 242:3, 13, 18, 19 243:2, 5, 16 248:2 251:7 252:10 254:3, 14, 21 255:13 256:15 257:16, 22, 25 258:8, 13 259:23 265:7 267:4, 12, 13, 15, 21, 23, 25 268:8, 13, 17 269:2, 13, 15, 23 270:3, 11, 18 271:J0 273:19 275:9 278:20 279:9 280:11 281:12, 20 282:6, 8 283:21 284:3 285:9, 10, 14 286:9, 12, 17, 23 287:24 288:7, 11, 16, 22 289:2, 8 291:24 292:3 294:6, 15 299:24 306:11 310:11, 16, 17 311:5 312:8 313:6 316:2, 2, 5, 7 318:7, 16 320:14 327:12 www.coulterreporting.com 328:6, 21 329:15, 22 330:6 332:10 333:25 334:5, 11, 12, 14, 17, 19, 23 335:5, 11, 14, 17, 21 336:4, 8, 13 OxyContin, 309:17 OxyContins 214:18 OxyContin's 174:14 187:6 213:5 217:7, 10, 24 226:10, 12 243:3 OxyIR 155:21 156:6, 23 oxymin12 202:10, 11 oxymorphone 75:4, 13 <P> P.F 7:13 21:23 322:6 p.m 128:16, 19 154:8, 11 171:10,13 209:12, 15 278:J, 4 292:20, 23 324:1, 4 336:23, 24 p.r.n 155:7 157:5 328:3, 4, 6 package 74:2 76:9, 12, 15, 19, 20, 24 83:19 90:8 101:16 121:16 123:J0 124:23 129:12, 14,16,19,21 130:J, 4, 6, 10, 12,16,20 134:12, 13 155:4 156:5, 7, 12, 14, 24 157:9 236:25 237:3 243 :23 246:2 247:J 267:14 268:21, 22 307:J, 2, 3, 4, 6, 9, 10 311:J 320:17, 19 321:4 packet 269:3 Page 6:13 28:9 35:24 36:10 38:8, 15 46:18, 19 55:6, 19 62:23, 24, 25 63:22, 24 67:1 70:8 74:25 75:7, 8, 9 76:1, 3, 8 90:15 103:22 106:J0 108:J0, 11, 12 111:3, 9, 12, 16 113:12 118:J, 1 122:22, 23 123:17, 18 126:17 127:11 129:9 131:7 133:5, 5 135:10, 19 140:14 141 :19, 22, 25 142:16 143:16, 19 152:10 154:24 157:21 171 :19, 22 173:25 174:J 175:21,22 181:4 188:18 213:3, 13 215:9 217:3, 23 218:J, 3, 4 220:3, 7 222:1, 24 223:7, 8, 9 224:23 243:12 278:7 287:22 311:11, 19 318:17, 18 326:20 pages 55:9, 13, 16 126:12 337:11 paid 44:13 45:5 140:5 167:2, 3 186:17 502-582-1627 Page: 33 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 195:18 216:25 297:8 pain 17:10 18:9, 11 36:25 37:3, 9, 15, 20, 22, 22 71:5 74:15 78:9, 11, 18,22, 24,25 79:6, 8 80:6, 8, 9, 12, 14, 15, 19, 19,23 81:5,J0, 12 82:9 85: 7, 7, 17, 18, 18, 21 87:5, 7, 17 90:21, 22 91 :J, 2, 4, 14 92:6, 11, 12, 17, 21 93:1 94:20 95:11, 12, 16,19,20 96:7, 21, 23 97:8, JO, 22 98:11, 12, 20 99:3, 6, 9, 11, 21 100:9, JO, 14, 17 102:10 103:24 105:8, 19 107:23 109:3 113:17,25 114:4 115:3, 6, 16,18,21,24 116:2, 9, JO, 18, 19, 20 ll 7:1 120:14, 14, 14 121:11, 15 127:21 131 :20 136:1, 3, 7, 10, 12, 14 137:10 138:1, 7, 8, 9, 11, 17, 18 140:21 145:2, 3, 5, 8, 13, 21 146:3,14,17 148:22 149:J, 1, 19,20,22,23 150:1, 10, 16 151:8, 12, 16, 19 152:1 155:13 157:2, 6 160:13 174:8, 13, 15, 16, 18,21 175:13 l 77:19, 22 178:3, 5, 16 Coulter Reporting, LLC 179:4, 9, 10, 16, 20 180:1 181:16 182:J0, 10,13,24,25 183:9, 11, 20, 22 189:2 190:15 192:J, 3, 6, 8, 12, 13, 14, 17, 20 193:3, 4, JO, 11 206:21 207:5, 19, 20 214:19, 25 215:1,1,4 218:18 233:7, 11 237:22 246:11, 18, 22 254:5 255:24 257:24 258:5 268:J 4 269:5 271 :] , 13, 16, 22, 24 272:J, 3, 4, 6 279:15, 16 280:14, 17 282:19 291:14 305:2, 6 312:J0 329:6, 16 330:16 335 :J 6, 18 pain, 150:7, 9 213:15 pains 116:3 paper 139:13 245 :9, 9 paragraph 28:9, 21, 25 36:11 38:16 46:J 5, 19 48:23 56:18 57:24 60:17 61:12 71:8 75:3, 9, 12, 20 76:4, 9 77:21 78:5 80:J, 3 85:12 90:20 91:16 93:8, 24 95:5, 25 98:J0 105:11 107:16 lll:13,15 112:2 115:8 119:12 123 :J 4, 15 129:10 141:22 142:4, 21 , 22 143:20, 22 147:23 148:19 149:6 169:4, 13 l 73:23 , 25 174:J, 2, 24 175:22 177:14 182:4 183:17 188:19 206:16, 23 207:14 213:4,16 215:10 216:17 217:4 218:7 223:10, 14, 21, 23 224:24 232:J 9, 19, 20 233:4, 12 235:2 237:11 243:9 244:13 248:1, 7 251:19 252:9, 18 254:12, 21 256:5 258:24 259:20 260:4 261:21, 25 265:2 266:24 267:13, 22 269:10 270:8 278:13 286:8 288:4 311:19 315:7 318:18 319:3,14 324:24 327:5 330:J 332:J 2, 15 333:5, 13 334:6 335:14 paragraphs 70:5 172:5 173:20 Pardon 55:2 111 :21 270:1 parenterally 58:24 Park 4:8 Parke 7:15 PARKER 8:12 Parks 7:21 304:25 parlance 89:13 part 60:13 61:20 78:13, 15 www.coulterreporting .com 85:14 90:16 94:24 107:11, 19 108:21 111 :2 116:21 118:23 126:20, 20 127:22 137:24 140:8 141:18 174:19 l 76:8, JO 185:13 204:3 223:4, 15 227:20 245:12 248:4 256:19 270:23 287:6, 8 321 :11 participants 198:20 participated 257:20 258:20 261:16 participating 258:J 7 particular 46:22 53:15 231:3 particularly 86:11, 25 95:7 96:16 parties 196:21 337:15 partner 14:20 15:8 183:J 1 Partners 182:9, 13, 16, 17, 19, 21, 23, 24, 25 192:1, 3, 5 283:6 parts 14:10 147:J0 268:7 party 318:1 Passing 27:9 29:1 43:3 46:13 48:4, 7 70:1 74:20 77:6 103:9 106:9 110:5, 12, 19 117:16 122:6 126:14, 16 128:20 134:21 141 :13 154:23 163:24 173:Jl 177:9 181:5 204:16 205:24 212:1, 20 219:24 222:23 247:24 278:8 285:24 287:12 299:15 305:4 314:2, 18 326:14 patent 45 :15 222:4, 9 329:10 patient 79:5, 7 80:2, 21 82:5, 9, 12, 14 88:2 95:21 97:1 100:19 101 :2 115:4 121:15 133:14 145:6, JO 146:21 150:10, 14 189:5, 21 240:16, 18 257:7, 25 258:1 259:4, 5, 9, 12, 15 260:25 275:14 281:7 282:19 286:14 291 :19 300:2, 3, 5 329:5 patients 17:10, JO 31:8 32:3 36:25 37:3, 9 46:23 47:1,8, 16 54:8 59:14, 23 60:5 66:14 70:15, 16, 22, 23 79:22 80:10, 12, 25 82:8, 22 83:14 87:5 94:21 95:16 100:J0, 17, 19 105:19 112:4 113:14 115:25 121:10 131:19 133:16 136:17, 18 143:J, 3 144:2 145:23 146:5, 12 148:22 151 :8 182:12 183:9 502-582-1627 Page: 34 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma LP., et al. 8/28/2015 189:21 192:8 199:6 200:2 232:3 234:12 235:13 239:16, 18, 25 240:2, 7 242:18, 19 255:13, 25 257 :3, 4, 13, 16, 20, 21 258:2, 8, 12 259:4, 17, 18, 19, 22 260:20 261:10, 14, 16, 19 267:4, 6 272: 7, 8 275 :15, 16, 16 280:14, 17 282:4 283 :11 292:2 299:6, 9, 11, 23 300:7, 10, 11 301:24 322:12 336:3, 7, 7 patient's 149:24 281 :5 Paul 2:21, 25 5:17, 17 6:3 48:10, 12 49:12 68:1 112:23 157:20, 22 158:22 170:6 173:3 228:17 229:1 324:24 pause 81:23 pay 31:J 195:15, 16 paying 31:2 payout 334:8, 8, 9 Payouts 6:9 PDD 141:8 PDD1701546226 35:25 PDDl 701801141 106:12 PDDl 701824723 141:11 PDD2952080643 9 54:14 PDD8801123847 47:24 Coulter Reporting, LLC PDD9520509356 70:5 PDD9520805292 26:15 PDD9520821306 134:22 PDD9521410329 74:24 PDD9524706426 38:2 peak 239:7 252:11 281:15 290:19 291:6 peaks 243:4 244:15 281:8, 9, 16 289:5, 7, 13, 14,20,22,23 290:16 291 :9 pending 11 :2 298:23 people 18:20 34:15 51:9 75:18 87:25 96:J 0, 22 98:5 103:17 115:6, 19,19 118:25 120:1 130:22 146:8 155:11 172:4 l 76:25 184:6 187:13 188:9 195:2 198:25 207:4, 17 208:16 229:25 261 :6 269:7 274:17 277:13 279:1 280:19, 21 281 :24 282:1 283:5 294:8 295:J 296:12 297:8, 23 299:4 302:2 308:21 309:J 324:23 327:16, 17 331 :22 334:21 336:12 people's 88:J 5 perceive 104:4, 10 152:11 153:14 perceived 86:10, 24 87:14 88:22, 24 95 :6 96:19 percent 17:14 40:24 41:5 46:23 47:1,9 56:20 85:24 164:10, 13, 15, 15,22 165:4 185:25 186:J 213:8 238:7 255:25 259:17 273:22, 22, 22 315:10, 14 334:24 percentage 40:JO 47:7, 16 74:4 89:6 168:8, 18 202:24 273:17 276:13 percentages 280:19 perception 87 :3 91:17 93:3, 9 95:9 100:5 101:20 102:10, 24 210:J 0, 12 251:9 Percocet 70:J 0 71 :2, 3, 3 74:12 87:18 89:4 92:8 94:6, 18 104:11, 14, 19, 22 107:10 119:13, 22 131 :11 132:J 0, 13 133:17 138:17 152:12 153:14 Percodan 138:17 perfect 54:6, 7 289:J J perfection 54:10 Perfectly 234:22 performance 328:13 performed 285:13 www.coulterreporting.com period 2:18 11:18 16:2, 9 21 :18 23:20 34:23 38:17 80:17 113:5 114:JO, 16 124:2, 14 175:23 202:19 219:16 230:13 254:9 264:9, 20 266:2, 25 270:20 274:24 280:23 294:J J 302:22 303 :1 306:15 periodically 50:16 periods 255:16, 18, 23 257:22 261:15 281:16 Periods, 255:20 periods.' 256:J permitted 253:25 persisted 203 :4 person 26:6 112:9 118:16, 17 138:13 226:22 282:J 2, 13, 14 296:23 305:21 313:3 personal 116:5 149:21 174:25 personality 78:13, 14, 15 80:24 81:7, 16 82:18 83:4 93:17 107:8, 9, 11, 20 personality' 78:14 personally 34:8, 9 person's 263:3 perspective 53:J 210:6 persuaded 96:15 pertaining 255:12, 15 259:2 pervasive 315:23 PF 36:20, 20 221 :13 326:25 327:3, 19 Pfizer 195:24 PFRC 3:17 110:20 Ph.D. 26:3 PHARMA 1:4 7:12,12 9:15 . 13:J 14:18, 21, 24 15:8, 9 17:16 19:23 20:8, 10, 15, 22 21:3, 9, 19, 21, 25 22:3, 7, 16 23:7, 9, 19, 24 24:6 33:22 34:J 40:3, 11 41:2, 3, 12 42:4, 5 68:13, 20 69:15 75:19 100:19 101:2 126:23, 25 127:J, 3 140:8, 11 146:23 152:24 165:5, 11,15,22 166:2 168:7 169:9 170:J, 6 l 72:8, 21, 24 173:7 187:11, 14, 21, 23 188:J, 7 192:13 193:17 196:15 198:2, 5 219:4 221 :J 5 225 :JO 226:23 241:21 248:15 252:20 253 :3 263:23 264:12 270:18 275:6 279:19 284:16 287:16 293:17, 18 322:4, 5, 18 323 :8, 13, 20 327:1 502-582-1627 Page: 35 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 pharmaceutical 20:14 26:20 28:1, 11 185:1 188:23 190:12 191 :13 196:6 214:6 217:10 PHARMACEUT ICALS 7:13 322:6 pharmacies 184:7 190:1 pharmacist 189:23 252:1,2, 5 pharmacists 188:24 189:2, 15 190:4, 13, 16 191 :3, 7 213:21 278:25, 25 pharmaco 116:21 Pharmacoecono mic 131:11 l 77:24, 25 pharmacokinetic 320:23 pharmacologist 26:9 pharmacopeia 116:22 pharmacy 189:22 Pharma's 40:16 68:19 Phase 4:21 5:3 30:8 77:24 91:12 99:19 124:1 202:4 206:8 210:5 Philip 305:1 phrase 12:8 physical 68:15, 21,25 69:12 257:14 physically 32:17 171:4 258:13 physician 82:12 89:20 114:13 Coulter Reporting, LLC 130:3 146:18 160:15, 19 161:3 193:15 200:6, 6 215:19, 23, 24 234:2 238:15 278:13, 14 291:16,23 295:9 309:16, 20 physicians 18:11 31:7, 13, 23, 24 51:10, 15 74:11 76:22 77:2 78:6 81 :8, 16 82:7,24 83:9, 21 84:2, 9, 16 86:11, 25 87:4, 6, 9, 17, 20 88:22, 24 89: 7, 13 90:5 91 :3, 17,22 92:7 93:2, JO 95:7, 9, 12, 16 98:13 99:9, 10 100:20 101:3,20 102:25 104:4, JO 105:7 115:14 116:9 130:7, JO 136:21 143:3 152:11, 14 153:13, 13 175:15 182:20 184:7, 22 185:3, 4, JO 192:10 193:2, 2, 8, 12, 13,19 194:1,5, 23, 25 195:2 196:4 200:1, 1 202:14 203:20 206:5 209:4 210:1, 9, 12 213:18 214:3, 11, 18 215:12, 15, 22 216:11 220:22 234:1 237:5, 8 247:8, 12, 16, 17 248:8, 9 249:6 250:8, 11, 19 256:8, 10, 16 265:23 270:25 271 :14, 21, 23 273:18 274:2 275:7 278:20, 24 295:5, 14, 17 296:7 309:7 315:10 316:1, 4, 6 327:13, 14, 23 328:2 physician's 90:24 130:8 physiologic 283:2 PI 4:10 155:4 157:9, 12 picking 154:13 pickup 158:24 picture 17:12 122:17 315:20 piece 78:21 83:12 209:2 335:12 pieces 90: 11 91:18 93:11, 15 101:21 103:l 210:13 PIKE 1:1 9:13 Pikeville 232:3 pills 246:11 314:1 Pilot 125:8 pioneered 284:21 Pipeline 3 :13 221:22 PKY 43:5 PKYl 738172006 43:8 place 98:22 152:13, 16 153:15 194:12 195:3 221 :3 251:3 274:9 309:3 328:7 337:5 placebo 105 :2 140:24, 25 141:2 142:10 150:16 151:10 www.coulterreporting .com placebo-control 113:13 placebo-controlle d 112:3 placed 278:17 places 247:3 250:21 plaguing 294:17 PLAINTIFF l:4, 4 7:1 Plaintiffs 45:22 47:25 74:18 86:5 103:7 Plan 4:19 84:19 l 09:17 121:22 136:7 153:5 181:3, 4 188:18 190:21 200:17 324:18 planned 124:20 131 :] 2 planning l 12:22 314:9 Plans 6:7 326:16 plasma 145:15 157:11 242:17 243:1, 3 289:7 platform 107:11 play 21:25 played 18:2 22:3 119:8 plea 34:24 60:14 165:14, 18, 25 166:1, 6, 12, 12 168:10, 20 169:24 222:18 224:11, 16, 19 226:25 227:24 228:2, 11, 24 230:17 232:9 251 :13 269:25 295 :23 296:8 300:J 4 312:16 318:23 plead 228:2 please 10:24 62:15 63:12 64:2 84:3 102:5, 14 122:23, 24 147:14 158:2 168:15 222:21 223:17 262:16 272:22 299:14 311:18 335:24 pleased 146:17 pied 33:6 60:15 224:12, 19 226:24 228:17 306:4 312:20 PLLC 7:18 plus 150:11 170:15 171:3 pockets 221 :24 Podiatric 287 :4 Point 7:5 9:3 20:7 22:16 23 :8 90:13, 14 149:19 157:11 164:6 170:5 176:22 184:21 187:13 198:3 217:16 225:15 245:22 262:5 263:4 280:1 322:21 324:25 330:14 336:14 pointed 109:15 262:23 335 :3 pointing 108 :8 206:3 270:10 points 70:8 108:3, 22 126:6 223:2 260:19 270:2 287:25 313:16 policy 221:18 274:7 293:6 308:10 polite 66:9, 23 political 115: 10, 11, 12 Poll 181:14, 25 182:1, 2 polluted 82:21 popular 18:14 116:22 502-582-1627 Page: 36 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 populations 189:5 Portenoy 196:14 portion 12:6 27:12, 16 30:2 252:6 portions 11 :9, 14 pose 132:16 318:21 322:3 posed 38:18 175:24 position 15 :9 24:24, 25 25:1, 9, 11, 13 77:23 79:23 105:6 120:23 121 :1 230:8 248:10 256:15 280:4 335:17 positioned 90:23 98:13 133:10 positioning 36:15 87:17 91:3 99:10 132:23 174:14 206:18 207:21 335:14 positive 31 : 7 87:6, 10 95:11 150:24 205:2 possibilities 139:8 possibility 52:25 139:8, 14 183:19 231:25 288:1 possible 49:4 67:21 76:25 105:5 125:11 136:15 152:l 6 190:2 231:17, 19 235:13 261:12, 15 285:13 possibly 43:12 162:1,20 257:5 276:18 291:22 Coulter Reporting, LLC post 109:3 Poster 219:1 post-marketing 60:19, 24 114:20 131:10, 12 post-meeting 202:18 post-neuropathic 335:18 Poston 285:3, 5 P-O-S-T-0-N 285:5 Postoperative 177:19, 22 post-surgical 120:13 335:19 potency 73 :22 84:3 131:15 144:13 208:17, 25, 25 249:10, 25 potent 73 :22 83:10 85:4 87:24 88:5, 7, 9, 9 89:1, 2, 3, 10, 18, 25 90:2 96:25 98:6, 6 101: 7, 8 106:24 209:1 247:12, 13, 17 248:23 249:6, 11, 20 250:6, 7, 20, 24 251:1 potent, 249:17 251:2 potential 31 :2 50:21 56:22 91 :2 99:9 118:2 119:11, 15, 21 121 :22 134:7, 15 138:20 139:4, 6, 18 189:4 199:25 237:6 239:9 242:5, 5 252:13 254:5, 15 268:2, 3 269:17, 17 278:16 281:21 283 :21 284:3 285:9 288:5, 14 306:1, 11 310:10 313:11, 11 314:1 316:7 325:8 326:4 potentially 36:5 238:23 246:24 291:14 power 90:24 99:2 131:6 212:10 powerful 73:11, 11, 13, 21 89:8 99:5, 15 104:19 123:10 206:25 207:3, 9, 16, 17 208:6, 9, 12, 13, 15,19,24 211:12 212:12 251:2, 7 powerful, 251 :2 PowerPoint 195:12 PPLP 221:13 PR 221:9, 21, 23 practical 94:16 200:11 practice 89:2 94:8 145:9, 10 194:11 200:2 220:23 225 :] 241:16 266:19 286:11 322:10, 11 327:7, 14, 15, 19 practiced 284:25 322:15 practices 245:13 271:15 practicing 194:12 Pratt 8:8 preceded 326:21 precise 133:13 168:14 precisely 178:12 182:3 194:13 195:25 www.coulterreporting.com 198:10 211:18 230:24 preclude 316:17 317:17 predict 282:13 prediction 145:20 predominantly 91 :13 99:20 185:17 preface 124:7 preference 204:3 preferences 115:13 prejudices 115:14 preliminary 140:22 preparation 30:20 166:16 181:20 277:5 prepare 321 :6 prepared 262:6 preparing 226:8 prescribe 18:6 51:11, 14, 16 82:10 99:25 115:15 184:22 185:4 200:7 215:16 271:24 prescribed 116:8, 16, 20 199:11, 16 prescribers 185:7, 8 214:4 222:6 prescribing 17:17, 24 18:8, 11 31:15, 16 95 :23 100:21 109:4 179:19 184:23 213:19 214:11 215:17 220:25 221 :] 248:12, 13 271:15, 22 273:19 Prescription 5:5 6:8 135:23 203:3 204:8 213:8 248:11 291 :20, 21 294: 7, 16 332:3, 8 prescriptions 83:2 119:1 157:6 189:6, 16, 22 191:10, JO 194:17, 17 196:9 199:22 202:16, 20 203:2, 23, 24 204:6 209:21 213:6 215:1, 3 238:16, 17 291:16 294:9 327:15 preselected 316:19 317:19 present 115:25 130:18 141:15, 18, 20 162:2, 20 192:10 289: 7 303:19 presentation 35:10, 14 108:23 132:19 133:6, 8 297:9 324:18 325:4, 21 326:2 presentations 195:11, 12 presented 36:14 135:23 202:22 244:3 291:11, 13 295:5 304:12 presenting 120:21 193:12, 16 Presently 40:12 220:22 preserved 11 :25 presidency 323:7 president 69:15 228:21, 23 229:2 322:18, 502-582-1627 Page: 37 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 22 323:3 331:19 Press 5:8 53:25 61 :21 220:4 221:2 262:4 263:2 264:18 265 :14 pressure 150:8 presumes 291:9 presumptive 282:15 pretty 299:19 307:12 prevalence 181:16 183:6 prevent 17:23 145:8 prevented 18:10 previous 125:2 259:7 previously 120:9 148:22 159:4, 6, 19 169:5 204:24 316:21, 22, 22 317:21 price 162:24 163:7 164:9, 17, 20 165:1, 4 priced 79:4, 5 137:3 prices 165 :2 pricing 79:2 primarily 17:9, 12 primary 109:1 120:4 174:14 213:17 214:3 principal 25:17, 17, 17 119:3 131 :2 199:25 291:7 principally 16:15 107:23 122:15 143:7 146:6 192:6 print 171 :5 181 :11 printed 130:3 266:7 Coulter Reporting, LLC prior 69:13 129:20 222:18 224:6, 11, 18 231 :11 244:23 282:4 285:9, 13 305:20 337:7 priority 335:4 private 30:9, 13 314:16 privilege 298:6 probably 94:12 99:13 128:11, 13 141 :20 150:18 153:19 266:6 277:J 296:12 308:11 323:6 330:4 332:6 334:22 Problem 5:6 32:24 34:21 35:3 38:10 130:24 146:24 156:23 161:9, 16,19,20,22,24 162:18 181:21 198:4 212:16 221:22 258:J0, 14 274:5 303:15 328:15 333:4 problems 38:J 1 181:16 183:6 198:22 232:3 234:7 287:23 294:17 Procedure 9: 7 65:3, 13 287:6 proceed 57:10 proceeds 254:23 process 126:21 processes l 66:10 271 :1 produce 25:18 80:13 280:11 327:6 produced 54:J 2 55:11, 13, 20 113:10 117:20, 22 201:6, JO, 12, 14 271:24 288:20, 21, 21, 23 produces 316:5 Product 3:13 4:17, 17 17:25 19:24 20:1 24:14 25:18, 23 32:4, 6 37:1 45:1, 14 52:22 67:20 68:8 71:4 76:21 78:22 79:3 81 :5, 7, 15 83:19 87:18 88:8 90:23 91:3 94:24 97:20 98:12 99:10 108:16, 19 112:24 118:25 121:13 123:4 124:24 125:1, 5 127:24 130:17 138:16 140:19 142:9, JO 143:15, 25 148:4, 6 149:7, JO 150:22 160:3 169:19 l 76:22, 24 177:3, 11, 15 178:10, 19, 20 181:22 185:22 188:23 189:19 190:24, 25 191 :9 199:24 213:7 217:8 220:13 222:3 233 :22 236:4 278:19 286:9 304:12 production 14:2 15:13 21 :2, 15 22:J products 20:16, 18, 18 44:2 45:3 52:11 58:5, 15 68:16, 22, 25 69:13 92:8 125:3 130:12 136:15 www. cou lterreporti ng. com 148:25 149:4 159:8 160:23 222:11 247:6 325 :4, 5, 8, 16, 17 326:3, 5 332:8 product's 151: 7 Prof 5:23 professionals 18:15 175:2 181:10 182:11 Professor 287:23 profile 145:19 Profit 2:20 43:9, 16, 21, 24, 24 44:7, 9, 11 45:16 190:16 profits 40:25 189:2 program 34: 13 59:14 62:7 76:15 140:16 153:5 182:J 0 183:4 187:3 191:12 193:21 194:22 205:15 329:11 334:19, 20 programming 191:13 programs 189:10, 13 202:15 207:22 progresses 133:18 prohibited 115 :20 300:12 304:6 Project 3:3, 3, 5, 19, 19 4:3, 3, 5, 6 22:4 26: 7, 7 52:25 70:3 74:22 117:13 128:21, 25 132:6 135:6, 17, 20 159:12, 12, 13 160:19 projected 64:6, 17 projection 63:12 64:3 220:14 promise 302:11 promised 302:8 promote 37:14, 20 184:10 267:21 268:17 promoted 37:8 74:7 136:12 155:24 184:3 185:15 186:21 199:20, 21 214:18 237:20 281:20 312:7 promoting 16:11 21:14 85:3 199:J0, 15 206:20 213:14 215:12 267:23 269:12 294:15 Promotion 4:24 5:9 15:14 29:7 44:17, 19 76:22 83:20 90:9 119:9 127 :17, 18, 20 204:J 8 214:24 220:4 235:19 248:13, 14, 19, 19 265:7 promotional 74:2 78:17 83:12 90:11, 16 91:18 93:11, 15 98:7 101:21 103:J 118:14 130:18 163:10 188:20 189:3 190:23 210:13 217:6 243:20 256:12 prompt 61:24 156:18 prompted 109:5, 8 promulgated 97:21 245:14 prone 292:10, 11 325:7, 16 502-582-1627 Page: 38 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 326:4 proof 225:1 proper 92:9 109:3 190:10 192:7 206:21 274:14 properly 55:9 97:23 268:14 269:4 274:17 295 :11 304:12 proportion 202:24 proportional 148:2 proposal 57:8 61:25 proposed 57:10 121:17 181:15 242:24 243:16 proposition 160:25 213:23 proscribed 115:20 prospects 31 :2 protection 50:3 protective 11 :20 protocol 112:3 113:12 114:3, 6, 22, 23 129:18 proud 73:23 prove 236:16 proved 89:3 provide 229:10, 17 233:8 288:13 295:14 315:19 320:14 provided 56:21 67:22 78:21 219:3, 8 220:1 243 :1, 4 256:25 267:15 268:13 295:16 298:8, 11 providers 238:3, 23 239:1, 16, 22, 25 240:5, 14, 22 242:3, 10 254:13 265 :8 267:3, 24 Coulter Reporting, LLC 269:13 313:5 provides 146:3 providing 188:13 214:5 231:3 provisions 11:14 prudent 145 :9 psyche 281 :13 psychological 281:14 Public 181 :6, 7 182:7 183:18 197:4 246:7 337:3, 17, 24 publication 122:12 140:2 publications 256:13 Publications, 139:1 publicity 182:6 publicized 181:18 published 120:10 153:25 219:5 231:21 258:19 publishing 258:21 pull 106:21 147:20 pulled 167:13 168:3 275:21 pump 109:1 purchase 327:21 purchasers 41:23 PURDUE 1:4 3:22 5:13 7:12, 12, 12, 13, 13 8:2 9:15 10:2, 4, 6, 8 11:2 12:4, 7, 9, 12, 13, 20,21,25 13:1, 3, 14, 18 14:7, 12,17,21,24 15:8,9,15 16:12, 15 17:15 19:6, 6, 9, 13, 20, 22, 22, 25 20:5, 7, 9, 10, 11, 15, 21,22 21:3,5,9, 10, 13, 19, 19, 20, 21, 25, 25 22:3, 7, 7, 15, 15, 15, 20 23:7, 7, 7, 9, 9,18,19,24,24 24:5, 5, 6 29:8 33:6, 10, 12, 16, 17, 21, 22 34:1 35:11, 11, 15 36:21 40:2, 3, 10,16,17 41:2, 3, 12 42:4, 5, 7 43:9, 13 55:13 59:11 60:14 68:13, 18, 20 69:15 75:18, 19 100:19 101:2 109:2 110:21 112:22 119:19 126:22, 24 127:1, 3 132:6 139:5, 23 140:5, 8, 11 145:14 146:23 152:24 165:5, 10, 11, 14, 15, 22, 22 166:2, 2 167:5,11,19, 25 168:4, 6, 7, 7, 17 169:8,9,16, 17, 22 170:1, 2, 6, 7 172:7, 8, 20, 22, 23 173:7, 7 182:9, 14 183: 7, 10, 19 184:14 187:6, 10, 11, 14, 15,21,22 188:1, 2,4,5, 7,22 192:11, 13 193:17 194:24 195:15, 17 196:15, 25 198:1, 2, 5, 24 201:20 209:23 213:14 214:2 215:11, 13, 18, 22 216:5,18 www.coulterreporting.com 217:5 218:12 219:4 221:14, 14 222:19 223:4, 16 224:1, 10, 17 225:3, 7, 9, 11 226:22, 23 227:3, 11, 15 228:24 229:6, 11, 12 230:23 231 :5 232:8, 12, 21 233:7 237:4, 16, 18, 25 238:1, 1,11,21,25 239:24 241:15, 15, 17, 18, 19, 20, 21, 25 242:1, 22 244:14 245:19 248:15 249:3 251 :20 252:2, 5, 15,20,24,24 253:3, 4, 7, 14, 14,17,18 254:10, 23 255:1, 11 256:6, 25, 25 258:16 260:5 261 :3, 23, 23 262:9 263:12, 23 264:12, 25 265:3, 9, 19 266:14 267:1, 19,22 268:7,11, 16 269:1,11 270:2, 11, 18, 23, 25 273 :10, 25 275:5 279:19 281:20 282:17, 24 283:6, 20 284:2, 9, 16, 22 287:16 293:3, 13, 14, 17, 18, 18 295:13, 16 297:9 305:24 306:4, 9, 10 312:6, 20 314:13 315:8 316:12, 16 317:9, 16 318:24 322:4, 4, 5,5,18,22,25 323:8, 12, 13, 19, 20 327:1 336:11 Purdue, 19:9, 16 33:15 Purdue's 19:5 213:7, 17 214:23 217:17, 20 219:10 228:20 238:5 239:6 242:15 252:19 253 :24 254:1 260:15 261:6 262:17 263:19 265:6 266:1 267:20 271 :9 294:14, 21, 25 311:22 315:8 319:5 PurdueUS 2:11, 13 purport 309:23 purported 168:3 purpose 76:12 77:22 92:25 238:4 265:21 purposely 278:22 purposes 119:23 157:16 pursuant 9:6 11:10 33:11 pursue 61 :24 65:17 147:14 put 47:20 60:22 69:21 82:10 101:16 106:23 132:2 137:6 151:9 162:9 166:19 173:12 180:20 193:20, 22 198:15 210:6 212:17 253:9 271:17 274:9 282:5, 7 294:8 307:8 325:20 326:7 502-582-1627 Page: 39 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 putting 61 :7 82:15 119:6 194:15 245:19 246:13 <Q> q.i.d 127:15 148:22 QQL 131:10 qualifications 193:24 quality 72:18, 20, 22, 25 · 132:14 133:15 142:15 Quarter 6:9 200:14 332:13, 22 333:14 334:7 335:23 quartile 327:8 quartiles 327:24 question 2:18 11:25 15:18 20:24 25 :4, 5 31:21 33:24 38:17 39:25 41 :] 42:3, 12 50:24, 25 55:22, 23 63:11 68:5 70:19 73:21 91:25 97:5 100:22, 24 132:12 137:13, 19 138:2, 3 147:9 152:5 153:3, 4 156:17, 21 160:24 161:2, JO 165:7, 17, 19 166:4 169:1, 25 170:15 171:15 172:3, 12, 14 175:5, 23 178:22 180:7 190:11 196:3 197:9, 17, 19 210:18, 21 211:10 216:14 219:14 224:15 236:8 239:21 Coulter Reporting, LLC 246:16 252:23 262:14, 15 264:1 270:17 271:4, 18 272:12 275:5, 5 283 :14 284:5, 5 290:11, 23 294:1 297:14 298:19, 23 299:20 303:8, 8 306:8 317:1 318:21 319:1, 8, 22 320: 7 325 :3, 19 328:1, 12 331:7 questioning 309:22 questions 12:9 72:18, 20, 23 115:7 125:13 126:3 137:17 147:9, 14 169:4 170:19 298:5, 14, 17 301:2, 11, 14 310:3,5 335:22 336:17, 20 quibble 216:14 241:3 quibbling 216:7 quick 126:4 304:2 quickly 68:9 281 :] quite 65:23 96:14 102:12 138:10 194:7 208:12 284:23 326:19 quota 332:24 333 :15 334:1 quote 193:20 219:21 quoted 122:17 quotes 207:9 208:12, 14 212:9 303:18 314:5 quoting 329:8 <R> R.B 5:22 R.P.R l:21 R.S 35:21 111:7 141:15 radio 181 :11 rah-rah 335:12 raise 236:8 raised 67:11 68:6 77:23 236:7 raising 66 :21 68:5 Ramseyer 2: 19 ran 26:6 random 55 :13 Randy 2:19 range 42:1 55:12 148:7 330:12 rank 248:9 rapid 286:12, 17 288:6, 15 289:2 328:16 rate 150:9 203:25 328:16, 23 rates 68:15, 22, 25 69:13 ratification 220:21 ratifications 32:7 ratio 16:14 29:9 79:9, 9, 10, 13, 14 Rationale 26:12, 16 27:12, 17 Raymond 3:12 103:18 reach 54:9 reached 205:7 reaches 286:14 read 9:20, 21 27:3 28:4, 9, 20 30:2, JO, 16, 18 37:11 39:2 43:23 49:16, 18 50:6 56:24 www. cou lterreporting. com 57:19, 23 59:5 62:15 65:10 72:4, 8 90:17 92:2 93:25 102:12, 18 107:6 109:20 111:22 113:21 119:11 120:8 121:7,24 125:12 129:1 130:10 136:9 137:18, 21 138:3, 5 147:20 156:16 157:21 163:17 168:25 170:16, 24 171:15, 16, 17 l 79:21, 23 181:23 197:18, 20 198:11 203:7 207:1, 2, 12, 25 210:23 212:13 225:4 229:22 230:3, 4 239:23 241 :22 248:4 255:4, 256:2, 261:8 254:24 5, 5, 8 17, 18 269:4 270:12 273 :13, 13 288:8 299:19 307:8 312:2, 11 318:18, 20, 21 320:6, 8 329:18, 19, 19 331:3, 17, 20, 23 333 :8, 12, 20,21,22 334:25 reader 113:19 244:4 reading 26:24 69:2 76:2 88:18 91:25 93:6 95:14 98:3 102:14, 16, 17 104:5 105:10 119:14 142:1, 3 156:22 163:3 170:17 183:13 190:17, 19 202:13 207:7 210:22 218:1 223:5, 9, 13 239:21 240: 18 241 :14 256:3 258:24 270:5, 15 272:22 299:14 309:23 310:8 311:9, 11, 17 314:14 333:4 reads 206:23 212:10 261:21 real 98:2 146:24 147:2 realization 185:2 realize 249:15 realized 67: 11 164:20 really 62:19 66:16 79:7 80:18 81:25 89:14 94:23 98:18, 21 105:2 115:19 118:1 139:22 145:16 149:11 156:20 161:21 171:3, 18 l 72:24 211:19 216:7, 12 219:9 227:20 236:19 240:15 269:3 272:20 273:7 275:4 280:20 292:13 294:3 298:5, 14 301 :25 303:9 321:1 322:2 reason 22:23, 25 28:1 a 53 :17, 18 55:11 94:7 96:4 114:2 116:7 124:8 126:4 138:12 156:13 176:21 177:25 216:24 217:2,15 502-582-1627 Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. Page:40 Richard Sackler, M.D. 8/28/2015 229:10 236:1 270:23 271 :19 300:9 reasonable 51 :13 71 :21 126:2 204:4 234:21, 22 240 :20 243 :22 266:9, 11 reasonably 243:22 307:2 reasoning 250:18, 18 292:14 reasons 63 :2 129:15 146:19 189:24 245:15 rebate 41 :25 191 :2, 6 rebated 41 :23 rebates 164 :21 Rebates, 44:10 recall 19:4 22:2 25:2, 15, 16 35:5 38:9, 13 60:16 66:5 105:4 109:7 113:9 127:6 141 :3 146:23 151:1 158:25 175:10, 20 177:23 178:1, 2 185:13 188:10 193:17, 25 194:2, 24 198:3, 8,10 205:9 206:7 208:8 210:25 211 :3 214:20 216:23 219:10, 16, 21 222:13, 16 227:3, 6, 7, 9, 11, 14 230:24 231:8,9,14 232:1, 5 264:3, 7 279:24 296:24 321:16 323 :6 327 :18 334:25 335:1 receive 37:10 Coulter Reporting, LLC received 24: 1 185:23 220:12 227:4 259:9 261 :4 268:8 287:14 receiving 136:17 204:5 232:1 259:7 reception 31: 7, 24 32:3 220:11 RECESS 46:7 106:3 128:17 154:9 171:11 209:13 278:2 292:21 324:2 recipients 249:16 reclassified 153:8 recognize 220:19 280:3 recommended 90:2, 10 94:13 127:16 132:25 193:19, 22 recommending 57:15 157:9 record 9:11, 18 19:16 46:5, 9 105:25 106:1, 5 113 :10 128:14, 15, 19 137:21 138:5 154:3, 7, 11 171 :8, 9, 13 192:23 197:20 209:11, 15 245:9, 9 255:5, 8 277:25 278:4 292:18, 19, 23 301:4 320:8 323:24, 25 324:4 334:8, 9 286:24 324:11, 12 recognized 88:8 89:3 94:15 150:18 209:3 336:22 337:12 recorded 256:1 257 :5 308:1, 1 266:3 273:13 277:9 279:11 289:25 290:1, 3, 124:16 129:16 131:11, 17 132:4, 25 140:16, 20 142:23, 24 154:25 221:6 243:24 recommendation 228:1 276:1 Recommendatio ns 4:12 74:9 refer 23: 7 24:5 79:13 114: 7 237:11 241:18 247:25 249:9 reference 65:24 130:9 286:21 315:19 referenced 165:13, 24 166:1 168:19 169:7, 23 170:1 172:4 178:15 192:2 232:12, 16 296:8 313:1 318:5 references 139:11 296:21 317:11,18 14, 17, 21 13 6 235:21 329:4 226:19 230:13 recommend 57:7 157:10 159:6, 19 221 :9 reduction 128:1, 316:15, 18 recollection 112:17 113:8 138:15 147:12, 16 184:1 185:14 213:11 227:22 292:8 267:12, 17, 25 268:11 269:14 337:10 reducing 333:19 316:23 317:22 records 245:10 247:8 293:20 294:2 recover 266:19 recruit 131 :18 Reder 2:25 3:5 5:17 6:3 72:19 111:24 114:21 121:2, 4, 8, 11, 279:17 recollect 111 :6 119:7 213:1 reduced 235:14 324:21 R-E-D-E-R 155:1 Reder's 264:24 283:16 reduce 53:21 189:25 267:16 268:15 334:20 www.coulterreporting.com referencing 286:21 referred 115:13 275:13 281 :9 328:5 referring 19:9 32:5 34: 7, 8, 9, 24 37:16 41:2 102:8 123:6 135:22 153:12, 17 159:23 162:16 167:17 205:16 210:15 284:9, 10 329:22 334:15 refers 134:16 241:15 253:15 268:25 reflected 83 :12 309:7 reflects 165 :17 refrain 180:4 refresh 211 :21 290:2 regard 66:22 76:9 267:11 330:15 regarding 68:15, 21, 24 69:12 106:11 229:11 258:18 261 :24 287:24 289:16 297:12 335:22 regardless 163:8 204:1 240:22, 23 regimens 157:17 regional 280:1, 8 332:1 335:25 registered 285:16 registration 67:3 287:24 288:19 regret 125:21 regrettably 113:1 126:25 regular 160:8 184:23 regulated 49:10 152:19 regulators 58:17 regulatory 16:16 48:25 49:22 64:22, 24 121:19 129:23 130:22 131 :2 147:17 236:23 reinforced 174:17 reiterate 183 :6 rel 1:4 relate 116:14 related 150:18 211:17 214:18 234:16 257:6 261:19 335:12 337:14 relating 120:13 relation 19:6 197:4 Relations 181 :6, 8 182:7 183:18 502-582-1627 Page: 41 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 relationship 200:13 relative 131:15 249:9, 25 relaunch 81 :11 relaxed 49:4 Release 5:9 17:7,8 117:19 144:8 181 :] 7 187:6 220:4, 10, 17 221:2 226:10, 13, 14 285:9, 14 288:1 289:20 306:2, 12 325:9 released 54:3, 5, 7 120:11 releases 163 :1, 2,10 relevant 36:20 172:7 relied 309:2 relief 74:15 120:13 146:3, 17 148:23 150:1 174:13 305 :3, 6 329:23 reliever 150:16 218:18 relinquished 323:4 relive 66: 17 reliving 65:15 reluctant 328 :2 Remain 335:14 remained 261:20 remains 283:4 remarkable 290:15 remedial 166:7 remember 47:18 59:4, 5 60:4 66:17 69:14 113:7 147:18 156:18, 20 161 :21 165:6, 7 178:12 180:3,6 186:4 192:19 193:4 Coulter Reporting, LLC 195:22 203:11 204:13 206:6 228: 7 230:17 231:6 251:6 305:15 313:19 326:7 334:8 remind 154:15 190:23 304:22 305 :] 8 308:19 reminded 177 :4 188:24 190:13 207:21 304:2 removing 55:19 157:11 Rena 279:21, 23 rep 23:21 266:6 300:17 301 :] 8 304:11 305:9, 13, 18, 24 306:21 309:9, 16, 20 310:3, 16 313:21 320:13 repeat 20:23 25:4 97:5 100:22 283:25 299:20 repeatedly 52:1 rephrase 86:21 118:21 211:7 replace 70:11 replaced 176:23 replied 101 :25 132:12 reply 205:13 314:14 315:5 Report 5:5 50:15, 16 85:23 149:24 150:14 203:5, 10 245:2 255:15, 21 258:9, 9 274:12 293:2 300:4 reportable 50:14 reported 59:21, 25 60:7 103:17 147:22 234:8 255:17, 22 257:18 259:12, 14,16 260:22 261 :14 274:11 REPORTER 73:6 173:17 177:7 197:12 Reporter's 2:1 Reporting 1:21 49:11 262:11 reports 50:4, 12 61 :20 175:9 236:3 260:20 268:8 reposition 251: 7 represent 130:24 167:14 254:2 representative 89:17 190:22 200:5 215:13, 23 216:1 representatives 15:15 16:13 29:8 185:10 l 89:11 l 99:9, 14,20,21 203:19, 25 205:20 213:19 215:11, 19, 21 237:25 238:2, 12, 22 239:1 242:14 252:20, 21 253 :2, 23, 25 265:6, 9, 17, 20, 22 267:1, 20 269:12 307:21 308:3 315:9 316:14, 18 317:11, 18 representing 163:11 reprint 60:5, 11 260:16 265:5 267:1 reproducible 150:12 reps 23:18, 18, 23 34:1 78:21 108:22 166:14 168:8,18 186:11, 21 www.coulterreporting.com 188:1 204:4, 23 254:6, 10 265:25 266:1, JO, 12 267:23 268:16 271 :25 274:6 275:6 277:8 295:21, 22 308:23 309:5 reputation 115:19 request 314:17 requested 64:4 68:19 133:1 232:11 242:22 288:16 Requesters 5:5 requesting 288:18 require 53:16 required 69:17 150:20 162:5 257:7 307:21 requirement 61:3 requirements 61 :4 149:11 209:24 requires 224 :25 requiring 37:23 reread 273:15 Rescue 4:10 144:18, 22 146:24 147:5 154:20 155:7, 13,24 157:1,4 158:10, 14, 18 160:4, JO, 12 161:15 162:23 163:15, 20 291:21, 23 research 16:13, 16 29:9 48:13 59:14 110:21 120:5 132:20 146:2 149:25 154:1 157:23 159:12 174:24 214:6 229:2 330:25 researched 68:9 84:4 145:24 researcher 112:1 reserved 82:7 116:9 207:5, 18 residency 322:16 residual 107:3 resistance 78:25 resolved 259:8 . resorts 195 :3 resource 184:14, 16, 18 resources 34:15, 21 184:19 respect 18 :19 20:21, 21 21:1 30:14 33 :20, 21 38:10 57:16 73:9 169:11 227:12, 16 281 :8 289:2, 5, 8, 13 290:25 respected 62:9, JO respite 255:16, 18, 20, 23 256:1 257:22 respites 259:13, 16, 17 260:23 respond 11:17 255:6 298:16 309:15 responded 262:5 responding 102:21 response 32:3 51:17 53:3 57:l 62:2 63:l 67:14, 19 221:6 314:15 315:5, 17 327:25 responses 99:17 170:11 responsibilities 16:15 502-582-1627 Page:42 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 responsibility 21:9 120:4 295:10 responsible 118:18 130:21 215:14 rest 49:16 57:19, 23 90:17 93:7 191:11 240:15 restate 165:19 306:7 restitution 314:17 restless 25 8 :2, 3 restrained 12 6: 1 restrict 103:23 restricted 51 :8 restricting 138:16 restrictive 51 :5 result 58:21 78:8 107:3 125:6 203:25 248:11 257:15 resulted 58:6 87:16 96:20 254:5 257:18, 24 329:16 resulting 79 :21 239:8 252:12 327:8 results 71 :9, 13 109:19 132:19, 20, 21, 22 '142:8 145:22 181:18 202:13, 21 255:12,21 258:23 259:22 298:7 retail 188:20, 24 190:13 191:3 retained 68:14, 20, 23 69:11, 11 196:25 252:2, 5 retrain 166:7 274:6 retraining Coulter Reporting, LLC 296:16 retrospect 89:23 retrospective 236:13 283:9, 10, 13 return 203 :21, 24 257:24 258:5 revealed 315 :10 reversal 53 :10 Review 3:24 90:12 91:19 93:11, 16 101:21 103:l 120:15 126:19 129:11, 14, 18 139:4, 16 155:21 166:18 212:18 235:3 244:21 257:9 261 :4, 9, 24 273:12 277:11 289:6, 10, 15 312:14, 18 321:6 25 3:7, 9, 13, 15 4:12, 23 5:8, 20 6:2 8:2 9:1, 16 10:5, 17, 25 15:7 25:24 62:12 63:21 67:2 77:12 103:19 115:2 203:18 204:17 205:12 220:5 286:1 287:20 324:10 326:16 richard.silbert@ pharma.com 8:4 Richard's 77:25 Richards, 78:1 Richest 40: 7 rid 305:3 rifle 108:4 right 13:23 14:1 18:5, 23 20:3 22:13 24:9 28:20 33:12 34:23 reviewed 112:24 121 :19, 21 128:23 35:16 38:15 39:7, 17 41:12 42:6 44:5, 18, 129:1 140:22 167:23 168:22 212:15 241:9 275:20 296:11 308:7 312:25 313:2 321:10, 22 45:2,4,10 46:11 57:18 63:24 64:21 15,19 reviewer 112:12 reviewers 129:18 reviewing 112:10 243:16 261:7 276:6 reviews 233 :16 243:20 revise 114:22 rewarded 187 :2 rework 76:12 rewriting 114:3 269:9 RICHARD 1:4 2:9, 11, 13, 22, 70:2 72:17 77:10 78:4 79:17 99:22 101:13 103:6 109:24 111 :9 113:11 119:5 122:20 123:25 124:12 126:13 128:9 132:9 135:15 139:1 144:6 147:24 151:13 152:4 154:13 156:2 158:1 160:6 163:22 166:11 172:1 178:7 180:15, 18, 22 181:2 187:24 191:25 204:9 www.coulterreporting.com 205:6 208:4 210:18 216:16 223:19, 23 232:9 233:19 247:3 250:1 251 :13 258:25 269:4, 22 270:16 276:2 286:2 291:17 301:12 312:22 314:19 318:2 321 :2, 5, 20 323 :18 324:6, 13 328:11 331 :5 332:19, 21 333:22 335:6 rights 20:8 rigorous 245 :8 rise 329:9, 21, 23 risk 20:17, 17 57:11 164:13, 14 risks 57:9 RK 64:23 Robert 2:8, 24, 25 5:17, 17 6:3, 3 25:25 57:2 62:2, 5 63:1 72:19 111:24 121 :2, 4, 8, 11, 14, 17, 21 124:16 129:16 131:11, 17 132:4, 25 140:16, 20 154:25 158:1, 2 159:2, 4, 9 160:18 221 :6 264:22, 24 283:16,17 324:21 ROI 203:20 role 12:4, 25 21:25 22:3 26:5 28:22 103:14 119:8 158:5 230:11 249:2 264:24 283:16 room 150:6 Roth 60:5, 10 Round 158:2 route 161:17, 25 162:19, 23 Roxane 13:18, 19, 21 161:17, 19 162:1,3,4,7, 20 Roxane's 156:11, 14 162:15 RR 111:23, 23 324:19 325:12 rubric 88:2, 4 rule 11:19 Rules 9:7 ruling 298:25 run 50:20 running 146:23 259:11 rush 255:2 Russ 6:9 331 :24, 25 Russell 196:14 <S> SACKLER 1:4 2:9, 11, 13, 22, 25 3:7, 9, 12, 12, 13, 15 4:12, 23 5:8, 20, 23 6:2, 6 9:1, 16 10:17, 25 12:16 13:8, 24 15:7 16:21 23:1 25:25 35:21 39:22 41:9 42:15 46:11 55:1 56:12 62:12 77:13 103:18, 19, 19 110:17 111:7 115:2,8, 9 141:15 152:4 154:13 202:3 204:18 205 :12 220:5 286:1 287:20 324:10 502-582-1627 Page:43 Richard Sackler, M. D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 326:16 327:3 336:17 safe 119:25 124:10 232:24 245:23 safer 100:13 233:5, 21 258:9 safest 145:10 safety 32:2 60:2 105:15 133:11 152:9 178:6, 10, 14, 21, 23 179:2, 11, 14, 19 234:16 said, 308:13, 13 said: 202:10 salary 185 :23 186:1 sale 19:21 39:23 40:3, 21 42:16 Sales 6:8, 8 15:15 16:12, 17 21:3, 14 23:18, 18, 21, 23 29:8 31:25 34:1 35:9 40:11, 16, 17 41:16, 17, 20, 22 42:1, 9 44:9, 10, 17, 19, 24 45:4 51:12 61:17,22 63:6, 9 77:18 83:2 85 :16, 25 86:2 87:11 90:5 92:3, 9 95:18, 21 97:11 103:15 108:23 109:16 118:11, 18,25 123:5 125:22 135:22 155:6, 21 158:6, 7 165:12 176:22, 24, 24 184:3, 24 185:1, 10, 16, 24 186:6, 17 187:7, 9 188:13 189:10, 14 190:21, 21 191 :2 199:9, 14, Coulter Reporting, LLC 20, 21 200:5 205:3, 17, 20, 21 206:16 208:5 213:5, 8, 19 215:10, 13, 14, 18, 22, 25 216:6, 19 220:14, 16 221 :23 226:9 237:25 238:2, 12, 22, 25 239:6, 12 242:14 251 :21 252:20, 21 253:2, 25 254:6 260:15, 18 262:12,25 265 :6, 9, 17, 20, 22, 25 266:1, 6, 10, 12, 18 267:1, 20, 23 268:16 269:12 271:25 272:10, 16 273:17 274:1, 6, 13 279:24, 25 280:6 295 :21, 22 301:18 305:24 308:2, 23 309:9, 16, 20 310:3, 16 313:21 315:9, 14 316:14,18 317:11, 18 319:6 320:13 327:7, 9 328:13 331:12, 17, 22 332:3, 14, 23 333:13, 15 334:1, 4, 5, 16, 17 335:7, 12 salesman 89:19 185:21, 24 220:16 310:9 salesmen 188:16 216:25 332:7 salesmen's 327:13 salespeople 119:2 122:16 168:4 185:20 193:19 209:18, 24 233:25 278:15 296:6 307:21 salesperson 29:18 209:20 234:2 280:5 San 3:15 106:11 sanction 166:8, 9 sanctioned 274:19 sat 108:9 satisfy 169:21 Saturday 108:25 save 171 :14 255:8 saw 35:14 59:6 65 :5, 16 166:17 232:8 276:20, 22 SAYERS 8:6 9:24, 24 saying 31 :23 52:12 53:5 58:10 63:2 66:10 87:8, 20 93:14 95:13 96:1,22 97:7 98:19 144:9 150:10 157:14 158:11 159:4, 14, 16 160:3, 21, 22 179:18 190:23 211:6, 6 245:18 249:14 250:10 253:20 281:25 288:18 291 :8 296:22 303:4, 4, 13 says 15:7, 11, 12 16:8 26:12, 16 27:12, 23 28:10 29:25 30:2, 3, 5 38:7, 16 39:9 44:6 45:6, 19, 20 46:15, 21 48:23 49:2, 20 52:22 www.coulterreporting.com 56:9, 17 57:5, 24 58:4, 14, 20 59:7 60:17 61:12 62:18 63:20 64:19, 21 65:10 67:19 68:1 70:9 71:8, 8, 24 72:11, 17 75 :2, 21 76:9 77:7, 12, 21 79:2 80:4, 22 82:18 84:15 85 :12 86:9, 20 87:3, 14 90:20 91:11, 16 95:5 96:18 98:9 99:1, 7 101:18 102:23 103:22 106:11, 25 108:14 111 :1, 16 112:2 115:1, 8 117:17 120:25 123:1, 9, 17 127:24 131:10 132:7, 17 133 :9 134:2, 7 135:9, 10 136:13 138:19 139:18 140:15 141:17 142:21, 25 143:23 144:6,17 147:22 152:10 153:11, 13 155:3, 19 156:10, 23 157:3, 22, 25 158:8, 16 159:3 161 :14 162:18 163:5, 5 164:8 168:10 172:12 173:23 174:12, 23 175:12 177:14 178:3 181:7 182:5, 5, 15 183:5, 17 188:19 189:23 190:12 191:1 202:9, 13 203:17 204:17, 20 205:11,13 206:15 213:16 214:10 217:4, 23 220:3, 9 221 :20 224:25 232:21 233:3, 4, 13 235:2 237:12, 24 238:21 239:5, 15 240:14 241 :25 242:14, 21 243:9 244:13, 18 248:6, 7, 18, 22 251 :6, 20, 25 252:18 253:1, 13, 24 254:9, 21 256:5 259:20 260:5, 14 261 :2, 9 262:19, 22 263:5 265:2, 18, 19 266:24 267:13, 22 268:6 269:10 270:15 287:21, 23 288:4 298:20 299:5, 25 300:15 301 :21 302:11 304:2 310:3, 17 311:7 312:22 313:5,23 314:13 315:18 316:12 317:16 319:25, 25 324:16, 18 327:5 329:9, 21 332:12 333 :25 334:6 335:3, 13 Scale 150:2 175:16 243:2 scanned 331:20 scary 103:5 scenario 37 :5 162:22 Schedule 51 :14, 15 66:6 121:10 124:18 133:13 214:14 502-582-1627 Page:44 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 scheduled 64:25 259:13, 15, 17 260:23 scheduling 65:25 66:3 schema 330:1, 5 scheme 186:6 scientific 16:13 29:9 229:3 scientist 283:17 scope 214:12 score 149:2 search 75:2, 3, 6, 13, 16 297:20, 24 second 27:11, 16 28:9 44:8, 9 46:14, 19 63 :22 70:8 75:2, 6, 9, 12, 20 76:4, 8 77:3 97:25 108:12 121:3 133:7 139:14 141 :25 147:19 158:21 173:23 174:1, 2 193:16 207:7, 14 213:4, 16 214:1 215:9 224:24 236:3 240:17 246:23 250:4 259:9 278:12 286:8 292:18 321:24 330:14 secondarily 118:15 130:19 secondary 28: 7 174:15 second-line 276:12 section 111 :22 121 :16 242: 12 255:15, 19 257:11 258:23 259:21 see 27:11, 18, 20 31:6 32:19 36:12 39:8, 9 43:17 44:9, 9, 25 48:20, 21 Coulter Reporting, LLC 56:20 62:21, 22 71:10 77:19 81:4 108:18 110:10 119:14 122:17 123:13, 20 133:8 135:13 163:9 171:1, 2, 3 188:18 195:13, 24 199:6 208:18 211:20 217:12 221:18 223 :19 248:25 250:19 251:11, 12 262:7, 8 276:24 287:23 289:7 290:2 296:6 297:6, 8 300:18 302: 7 307:1 318:8 322:12 332:15 333:7 seeing 54:19 191:10 193:5 213:1 305:15 seek 107:20 seekers 242:8 268:5 269:19 313:14 316:3 seeking 278:22 290:18 seeking, 309:11 seen 12:15 30:17 35:10 40:8, 9 82:4 85:23 166:15 168:24 191:18 200:25 211 :3 212:21, 24 218:25 229:14 245:4 253:10, 11 277:5 283:4 285:2 290:13 296:19, 20, 23 308:15 317:3 321 :22 Segar 76:11 segment 206:19 select 284:20 selected 138:23 203:20 204:1, 3 276:21 selecting 26 :9 138:21 selectively 274:25 sell 14:8 18:23 20:3, 8 24:11 25:13 40:17 51:9 65:19 78:22 97:9 112:16 118:11 184:8, 9, 14 186:13 199:5 204:12 205:8 270:18 288:11 335:4, 4, 4, 11 seller 218:18 sellers 187:1 selling 19:23 20:1 31:14 41:7 123:10 186:14 190:24, 25 204:24 332:7, 10 Send 5:20 287:3 Sender 205:12 sending 139:5 185:9 senior 16:15 19:5 29:20, 22 88:21 112:1 121:5 132:5 140:18, 18 245:7 265:1 283:17 323:3 324:22 331:19 sensation 280:24 sense 34:18 92:20 130:4 134:4 148:18 234:9 250:6 272:6 274:13 275 :3 280:20 322:11 sent 48:17 67:23 71:14 www.coulterreporting.com 106:11 129:2 135:14 139:3, 15 255:11 260:6, 9 324:14 326:18 331:18 sentence 27:18 49:9, 20 71 :23 72:5, 11 75 :20 76:4 82:13 104:7 105:13 120:8, 25 127:23 159:22 163:3, 5 l 73:24 212:10 213:16 214:1, 10 309:14 333 :25 sentences 92:1, 2 213:4 214:23 separate 23 :15 September 181:3 219:6 series 69:22 170:19 serious 26:18 27:24 78:9, 12, 12 82:8 service 214:5 set 16:9 19:1 78:11 118:16 124:16 125 :9 171:18 186:6 193:18 306:15 319:6 337:6 setting 182:22, 24 183:4 settlement 34:14 229:25 Seventy 150:3 severe 37:2, 22 80:12, 14 82:8 87:5 91:5 95:10 99:11 100:9, 9, 17 207:5, 19 261:18 329:16 330:15 shame 100:15 shaped 107:8 240:19 Shapiro 166:19 169:2 272:13 275:21, 25 Shapiro's 168:22 277:11 share 25:10, 12 85:8 97:9 136:24 137:3, 9, 11 138:7 164:22 272:22 331:11 shared 18:15 shed 57:21 sheet 191:2 shell 20:13 Shepherd 7 :4 9:2 Shield 314:16 315:6 Shionogi 2:16 35:18 36:1 37:17 shipping 44:13 shoot 71:13,15 short 71:4 113:5 221:8 277:22 short-acting 239:10 252:13 254:3, 15 299:7, 12 shorten 254:24 shortest 125 :11 shortly 142:17 shots 108:4 show 16:20 26:24 29:12 47:23 54:11 69:2 147:13, 14, 25 206:24 207:15 212:11 234:24 247:8 265 :22 271 :9 278:6 291:18 299:14 313:24 315:22 325:15, 18 333:2 showed 105:18 145:15, 19 146:2 148:4 502-582-1627 Page:45 Richard Sackler, M .D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 150:21 166:16 175:14 202:14 238:5 277:2 286:19 showing 232:23 243 :1 266:10 309:24, 24 317:1 326:3 shown 127:24, 25 128:5, 8 235:19, 21 244:10 263:9 266:12 275:24, 25 276:21 277:4, 7 321 :9 shows 192:23 shut 66:23 sic 203:13 side 53:21,22 143:10 144:19 sift 292:25 sign 151:22 signal 221 :21 222:2 signed 169:16 230:7 Significant 3:22 12:8 19:15 38:9 106:15 128:1, 6 142:8 185:6 203:2 235:21 258:5 328:19, 22 significantly 140:25 142:9 215:11 216:20 223:14, 24 252:10 334:13 signifying 88:1 SILBERT 8:2 10:5, 6 similar 5:9 13:14 140:23 141 :2 220:4 235 :6 254:11 289:24 327:23 similarity 330:11 simple 129:21 Coulter Reporting, LLC simply 146:18 257:24 simultaneous 323:7 single 23 8: 7 single-dose 120:10 sir 110:2 212:3 216:14 270:6 sit 13:2, 6 19:7 230:4 245:3 273:16 336:2 Sitting 294:13, 19 305:22 situation 116:13 278:17, 17 six 144:1 147:2, 6 148:6 156:8 158:9, 13 160:4, 10 163:11 217:7, 9 227:7 233:1, 2 276:25 277:1, 1 289:21, 22 296:25 305 :20 308:20 321:19 size 187:6 skeptics 89:25 90:1 sketched 308:19 sketchy 276:20 skip 55:12 skipped 92:1 332:20 slides 195:11 slotted 78:24 slow 113:19 slowed 123:5 Small 44:8 59:13 119:16 330:13 333: 7 334:4, 23 smaller 91 :1 99:3, 6 115:9 176:25 smart 113:4 smash 106:22 smoother 320:14, 16, 22, 22,25,25 so-called 185 :3 192:12 193:20 societies 192: 12 Society 192:13, 15,21 sold 81 :5 112:15 175:4 185:18 186:7, 22 270:3, 11 278:15 295 :10 solicitous 66 :9 solution 181:21 238:9 solve 158:22 somebody 112:21, 24 151:19 187:23 194:4 196:1 222:22 262:23 276:2 281:11 290:17, 23 320:24 somewhat 74:15 106:14 son 75:17 soon 35:2 136:15 158:23 159:3, 18 sorry 10:5 17:8 20:23 23:16 25:8 43:7 44:23 46:18 48:21 54:21 60:9 64:23 70:17 72:6 74:23 75:5, 10, 11 76:1 77:11 107:25 109:8 110:15 111:14 113:19 119:16 122:23 141 :9, 25 143:16 148:10, 11 152:8 155:17, 18 171 :22 174:1 175:5 www. cou lterreporting. com 176:10 197:10, 14 211:7 218:1 223:7, 8, 21 226:11 233 :2 243:8, 11 254:19 261:18 270:5 285:23 289:11 297 :22 310:11 311:20 312:1 318:10 331:14 333:7 sort 17:15 36:4 54:19 80:8 159:23 234:8 243 :25 293:6 sound 219:2 sounds 38:6 205:13 source 39:9 327:21 sources 58:24 South 7:22 Southern 15 :2 span 276:14 speak 31:24 139:13 194:23 speakers 193:18, 20, 23 194:1, 5, 8, 16 196:15 speaking 195:25 special 204:5 specialties 214:12 specific 200:13 215:14 241:1 287:25 specifically 78:18 117:24 136:3 169:4 208:15 275:7 specify 12:9 14:4 spectrum 36:25 37:9, 15, 20 speech 122:11 123:18, 19 Speed 278:9 280:2 spend 221:23 271:20 spent 34:20 217:5, 8, 10 spirit 31 :3 213:25 spoke 112:21 195:1 196:1, 15 spoken 304:23 sponsored 183:22 195:24, 24 239:5 251 :21 sponsoring 183:20 spontaneously 236:5 316:23 317:22 spoon 71 :9, 13, 15 stabilized 148:22 Stables 6:6 staff 222:15 stage 81 :6, 15 Stamford 8:3, 4 stamp 47:24 55:15 stamps 26:15 stand 243 :19 303:11 standard 79:6 104:22 125:10 175:13 191:12, 24 210:2 245:12 standards 216:11 245:13 246:4 standing 22:22 stands 50:13 156:6 180:23 Stanski 139:3 140:4 start 54:14 91 :3 92:21 98:1 99:10 121:22 133:16, 20,22,23 152:13, 16 502-582-1627 Page:46 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 153:15 171:15 206:20 247:14 330:16 335:15 started 11 :8 25:19 81:20 85:11 166:10 187:18, 21 194:22 195:17 336:12 starting 320:5 state 9:17 10:10, 12, 24 11:3 145:5 169:19 233:19 242:17 306:6 337:1, 3 stated 64:2 72:19 113:15, 23 114:19 115:4 120:12 121:1,8,21 129:16 131:17 132:10, 15 140:20 214:2 218:12 252:10 254:13 256:7 260:16 261 :5, 11 267:3, 14 337:5 Statement 5:12 33:11 47:4 65:10 69:9 70:24 125:16 169:3, 6, 8, 17 180:3 225:17, 20 226:2 227:24 228:5, 8 229:14 232:13, 17, 20 236:1, 15 239:14 240:10 241:14 243:3 244:15, 17 251:19 252:9 254:12 255 :] 6, 25 256:20 258:12 261:25 263 :15 264:11 267:8, 18, 21, 25 268:12, 17, 18 269:14, 15 Coulter Reporting, LLC 273:7, 11 275:13 283:24, 25 300:13, 13 302:10, 16, 22 303:5, 15, 21 304:5, 6, 15 305:12, 14 306:3, 4, 13, 21 307:8, 13, 16, 17, 18 311:10, 12 315:21 318:6, 13, 15 319:24, 25 320:1, 15, 18 321:1, 10 statements 230:2 235:3 236:20 242:9 259:2, 21 263:18, 22 269:20 273 :] 8 275:12, 12, 17 306:18 315:11, 24 316:16, 21 317:12, 21 318:5, 9, 22 319:3, 4, 10, 20 322:3 state-of-the 284:24 States 5:12 42:14 78:23 80:15 81:10 85:21 117:6 314:13, 15 315:5, 8 316:1, 4, 6 327:11 335:16 stating 108:23 236:24 statistical 315:19 328:19, 22 statistically 142:8 status 49:4 56:21 61:18, 21, 25 67:20 140:15 stay 92:10 98:1 133:17, 20, 22, 24 206:21 208:16 330:17 335:15 steady 242:17 stenographer 197:12 stenographic 337:9, 13 step 97:25, 25 136:19, 20, 20 stepladder 97:21 steps 256:12 Stewart 6:6 326:21, 23 329:3 stigma 17:16 18:7, 10, 12, 14 46:22 88:12 143:2,5 211:17 stigmatize 82:3 stigmatized 82:4 83:5 97:2 116:8 247:10 251:5 Stimulate 220:18 stirring 238:8 Stites 7:18 stock 190:1,5, 6 191 :9 stop 25:20 137:20 154:15, 18 239:16, 25 240:5 stopped 260:21 stopping 94:4 story 263:21 straight 100:25 strategies 121 :23 Strategy 3 :13 118:13 120:5 135:24 137:24 174:20 176:9, 11 181:21 221:15 330:24 STRAUBER 7:13 10:3, 3 11 :7, 23 12:2, 5 www.coulterreporting.com 15:17, 21 19:11 22:19, 25 25 :3 26:23 27:3, 7, 10 31:20 32:12, 14, 18,21,25 33:3, 10, 14 34:5 39:19 41:1,8 42:3,11 48:5, 8 55:8 56:2, 6 60:8 65 :9 69:1, 20, 25 70:18 76:1, 5 77:9, 11 86:19 91:24 103:12 110:8 135:4 137:12 139:24 147:8 153:2 154:3 165:16 167:15 170:14, 19 171:2, 19, 22, 25 172:2 176:18 183:12 200:18, 23 201:7, 13, 21 202:1 207:6, 11 209:7 210:14, 20 211 :9 212:2, 7 226:5 239:20 241:13 243:6 246:15 247:22 251:18 252:23 253:6, 11, 16 262:13 263:25 265:19 270:14 271 :3, 7 272:21 273:1 277:22 284:4 293:23 297:13 298:4, 13, 22 299:13, 16 300:21 301:1,8,13 303:7 309:21 310:7,13 311:9, 14,24 312:3 314:9, 24 315:2 316:25 317:24 319:1, 21 320:3, JO 333:3 336:20 stream 66:1, 15 Street 1:22 7:18 8:8 278:21 streets 278:25 strength 74:9 107:22 174:9, 10 250:3 strengths 50:1 190:1 stress 90:24 99:1 strictly 79:12 236:24 strong 31 :7 57:25 73:19 74:5 77:3 83:1, 21,23,23,25 84:1 86:12, 17 87:1, 9 88:23 89:9 90:6 91:22 93:2 94:1 95:8, 15, 15,18,20,24 96:3 97:12 98:7, 8 108:17 113:15, 23 206:5 210:10 211:6, 15 237:9 247:9 250:6, 9, 11 328:13 334:22 stronger 81 :8, 17 82:25 83 :6 88:4, 6, 16 96:13, 14 97:14 98:5 250:5 256:11 271 :11 stronger, 208:13 Stuart 4:23 stuck 119:20 130:4 student 18:4, 13 studied 18:1 151:4 studies 47:10, 15,19 51:18,22 52:5, 23 59:15 68:14, 21, 22, 24 69:10, 12 72:19, 21, 24 73:2, 24, 502-582-1627 Page:47 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 25 89:5, 12 90:12 91:19 93:12, 16 101 :22 103:2 104:25 105:14, 18 115:7 118:2 119:11, 15, 21 120:1, 17, 23 121:16, 18, 23 124:9 131:10, 12,18,22 132:18, 24 133:1 139:2 145:14, 19 147:23 149:17, 19 150:21, 24, 25 151:7 153:25 155:12 162:2, 21 163:16 177:19, 21, 25 178:13, 14,15 179:5,10 180:3, 11 233:8 234:6, 24 236:13, 13 242:15 244:21, 23,25 245:4,15, 18 246:13 282:18, 22 283 :8 284:18, 21 285:8,12,17 288:24 289:17 291:18 313:24 studies, 177: 18 Study 71 :9, 14, 15,18,22,24,25 72:2, 9 111 :JO 112:3 113:13, 17, 25 114:20 119:13, 23 120:7, 8, 10, 12 121:14 131:14, 14, 15 132:11 140:21 148:20, 24 149:3, 6, 14 150:17, 18, 23 151:1, 2 166:3 179:2, 3, 12 180:1 207:23 238:5 245:7 Coulter Reporting, LLC 255:1, 12, 14 257:1, 2, 4, 5, 7, 9, 21 258:18, 21 259:3, 6, 11 260:7, 17 261:5, 14, 17, 20 262:2, 24 263:22 265:5, 13, 16 282:25 283:3, 9, 10, 13 284:6, 7, 16 286:20 290:21 292:1, 7, 8, 12 311:1 313:18 329:1 stuff 89:18 196:20 241:10 Stumbo 5:10 222:15 223:1 225:7 subcategories 178:5 subcategory 179:8 subject 37:6 51:2 77:25 204:18 220:4 233:10 237:21 245:8 246:25 312:8 subjects 114:11 148:2 154:4 288:2 submission 112:10 167:12, 19 submissions 159:24 submit 140:2, 2 submitted 52:11, 15 124:17, 24 140:2 167:22, 24 232:21 268:23 317:2 submitting 265:21 suboptimize 275:18 subparagraph 313:4 subparts 169:14 subsequently 25:19 52:2 53:14 127:2 136:2 substances 107:2 substantial 36:22 89:14, 14 204:22 276:13 s ubstan ti ally 63:5, 9 subtext 134:4 subtract 43 :25 subtracted 45:17 succeed 124:21 success 30:6, 25 107:19 151:8 188:21 220:11, 20 260:18 329:17 successful 39:1 68:8 80:5 176:7, 16 185:19, 19 219:11, 17, 21 successfully 143:1 suddenly 145:1 suffer 36:22 suffered 61 :22 suffering 183:9 sufficient 169:19 190:6 sufficiently 57:25 suggest 157:18 244:2 suggested 114:2 115:9 121 :9 259:22 292:8 suggesting 120:3 164:21 suggestion 157:3 160:17 244:8 suggests 235:4 suit 224:25 www.coulterreporting.com Suite 1:22 7:9, 19 8:8 suits 222:4 sulfate 17 :5 144:4 175:6 summarized 259:21 Summary 3:24 60:2, 3 143:14, 23 255:21 summer 75:14 superior 233 :20 236:9 supervision 337:10 supervisor 261 :24 262:4 263 :3 265 :12 supervisors 237:18 239:6, 12 242:1 255 :11 256:6, 23, 25 260:6, 8 261 :3 265:4 267:19 268:7, 11 276:13 311:22 312:6 supervisory 16:1, 5 supplemental l 70:11 supply 190:3, 6 198:25 205:15 support 120:13, 17 131:19 152:23, 25 153:12 l 77:19, 22 178:14 236:14 supported 121:18 supporting 121:9 supportive 149:18 supposed 118:24 208:21 321:12 329:13 sure 14:19 22:12 23:13 25:4 27:1 38:19 41:14 49:18 55:8 56:3 57:9 61 :3 66:19 78:20 90:4 92:5 95:3 97: 7 99: 1, 14 109:14, 17 113:3 118:22 127:19 131:7, 23 137:14 138:24 139:7 142:14 146:1 148:14 156:18, 19 165:21 166:13 170:18 171:14 172:15 l 73:8, 21 175:25 180:9 185:5 186:3, 25 187:17 200:11 211 :2 219:16 223:5 227:18 253:19 255:7 262:17 268:20 271 :6 280:19 284:8 290:2 293:17, 25 306:9, 25 307:7 319:11 320:18 333:12, 18, 20 335:2 surely 88:8 129:15 178:16 surfaced 296:17 surfacing 155:20 surge 205:15, 16,20 surgeons 109 :3 surgery 109 :3 287:5 surgical 287:6 surprise 192:18, 24 194:3 229:24 231 :5 237:8 285:14, 16, 19 502-582-1627 Page:48 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 surprised 106:14 138:10 229:20 surprising 69:18 257:12 surprisingly 236:2 316:20 317:20 survey 89:22, 23 181:14, 15, 18 183:7 185:13 survivors 274:24 suspect 59:19, 23 150:5 240:19 suspected 257:17, 23 suspects 15 8 :3 sustained 188:22 202:18 306:1,12 sustained-release 189:J 190:15 swing 254:4 switch 70:2 94:22 98:21 234:21 switched 96:16 switching 87 :4 95:10, 17 Switzerland 287:24 288:11 sworn 10:18 337:8 . symposia 91 :19 93:11, 16 101:21 103:J 207:23 256:13 symposiums 90:12 symptom 115:24 193:12 259:14 symptoms 60:6 239:17 240:J, 6 255:25 257:5, 15, 17, 23 258:4, Coulter Reporting, LLC 6, 7 259:3, 5, 6, 8, 11, 12 260:20 261:13, 15 267:6 syndrome 255:17 257:8 259:3 260:22 syndromes 78:9 syringe 238:10 279:3 system 36:18 60:19, 24 61 :8 255 :20 276:3 285:1 308:9 316:17 317:17 <T> tables 90:9 tablet 71 :20, 24 104:23 140:23, 24 141 :2 146:8, 11 174:9, JO 238:4, 8, 8 279:2 330:6 Tablets 4:5 5:3 36:19, 24 37:2, 4, 6, 8 43:17 70:9 74:10 75:22, 23, 25 104:23 123:2 135:6, 20, 24, 25 136:13, 16, 19 146:9 148:1 164:9 206:9 210:5 220:10, 20 222:7 257:16, 22, 25 258:8, 13 267:15 268:13 286:9 329:J 5 330:13 tabs 278:23 take 20:16, 16, 17 25:11 28:24 46:3, 4 98:10 113:11 128:3 145:12 146:8, 10, 21 149:10 150:8 151:19 156:8 158:9, 12, 13, 14 160:3, 4 184:11 195:3 209:5, 8 245:15, 16 256:12 277:20, 22 282:8 292:3 309:3 334:20 taken 9:2, 5 20:20 54:6 55:18 66:22 127:16 154:14 166:7 235:18 241 :23 289:19, 21 337:5, 9, 13 takes 124:4, 8 152:1 talc 279:3 talk 12:11 19:18 22:14 41:16 67:10 95:3 119:J0 185:10 197:15 211 :21 225:17 236:18 298:19 303:14 311:3 talked 77:1 150:19 165:22 180:2 196:21 210:17 301:21 talking 12:9 36:3 41 :9 63:7 87:11 89:10 91:7,20 110:9 116:14 154:19 164:17 165:J0 206:2 209:J 8 211 :4, 24 226:6 250:3 253:3, 7 264:4 285:21 313:19 331:10 talks 191 :16 tamper 81:7,15 tapering 260:25 target 136:3, 7, 16 193:1 targeted 135 :25 136:9, 14 188:14 189:5 targeting 188:12 327:9 www.coulterreporting.com taught 92:18 239:6 TDM 64:8 teach 92:3, 9 93:J teaching 239:J 1 Team 3:3, 3, 5, JO, 19, 19 4:3, 3, 5, 6, 14, 14, 17, 17,21 5:3 38:3 70:3 74:22 76:6 77:24 86:9 91:12 99:19 117:13 125:5, 6, 19 128:21, 25 132:21 135 :6, 17, 20 173:10 l 77:3, 11, 15 l 78:19 202:4 206:9 207:21 208:5 210:5 Teamlink 3 :21 team's 180:10 teamwork 125 :5 teeth 222:5 telephone 51:16 174:25 tell 9:22 12:24 14:15 24:4 27:14 32:18 43:10, 12 49:18 60:25 61:9 100:3 117:3 149:13 170:23 195:23 238:22 239:1 255:7 263:13, 17 270:6, 12 280:4, 18 281:23 284:8 299:10 301:23 303:12 306:21 307:12 telling 82:9, 14 90:5 146:20 190:20 253:16 281:17 296:7 300:1, 10, 11 tells 265: 12 310:15 335:25 tern porarily 61:16 204:25 tenfold 215 :4 Tennessee 314:16 tension 190:3 tenure 112:21 term 22:15 81:1 83:6 97:14, 15 100:14 178:15 249:9 294:3, 4 320:23, 23, 24 329:2 terminology 321:3 terms 23:4 59:19, 23 144:12 151:15 201:18 331:10 terrible 66:10 terribly 150:12 territories 280:9 territory 215: 14 tertiary 28: 7 test 22:11 106:23 testified 10: 18 73:18 97:13 167:8 272:13, 15, 23 283:20, 22, 23 284:2 285:12 300:18 testify 45:19 testimony 11 :2 85:8 172:9 337:7, 9 testing 175 :14, 18 tests 23:15 text 27:22, 23 242:25 244:2 260:6, 9 textbook 191 :24 textual 307:3 Thank 12:2 27:10 48:8, 21 62:25 69:25 71:12 72:6 76:5 104:8 502-582-1627 Page:49 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 142:5 143:17, 24 154:17 202:1 209:23 218:8 223:24 243 :] 4 336:17 that, 189:24 theme 78:17 98:1, 7 themes 118:J 6 therapeutic 143:18 144:2 therapy 37:2 79:21 127:25 235 :20 239:16, 25 240:5 thing 46:12 92:19 97:19 107:6 234:8, 10, 25 246:23 299:9 333:20 things 23:2 24:22 120:3 126:9 180:9 199:3 234:19, 23 236:24 241 :8 243 :24 263:14 273:14 300:12 311 :6 313:16 think 17:12 18:12 32:16 38:20 41 :14, 21 42:23 43:15 44:5 45:22 47:7 51:9 52:23, 24 57:19, 21 61 :6 62:19, 24 70:25 73:14, 18 81:8, 16, 25 82:24 83:25 84:2, 7 86:16 87:9, 21 93:25 95:14, 17, 24 96:23 97:11 100:18 101:J 102:2, 19 115:18 116:13 120:20 122:J 5 125:22 126:2 127:23 130:9, Coulter Reporting, LLC 17 137:24 138:15 145:9 146:5 151:11, 21 153:10 157:13 158:23 161 :4, 22 162:14 165:17 166:5, 21 170:12 171:J 176:J 178:8, 22 182:17,19 183:12, 25 185:5, 24 188:17 189:17 191:21 192:5 193:7 194:4, 8, 15, 19 195:8 199:17, 23 205:13 207:4, 17 208:20, 22 210:9 213:24, 25 220:9 222:20 225 :9 227:18 232:7 244:7, 8 245:6 247:16 248:7, 17 250:8, 9 256:3, 10 262:1 271 :2, 8 274:23 276:25 278:20 279:17 280:J 281:6 283:3, 12 284:23 286:22 290:3, 19, 21 291 :4, 5, 7 292:10, 11 293:9, 23 295:13 298:4, 14, 20 300:1, 2, 3, 5 303:11 305:10 308:5, 7, 16 309:25 312:12 317:15 319:10 320:4 322:23 324:24 325:11 326:6 328:15 329:12 330:3 333:18 336:16 thinking 57:5 121:22 161:23 219:12 thinks 82: 13 208:20 third 36:J 1 65:15 97:25 111 :J 3 122:24 141 :22 142:21 143:20, 22 196:21 223:10 236:4 287:22 290:16 315:7 third-party 192:1 third-party's 314:16 Thompson 2:1 7:1, 4 9:2, 19, 22 l 0:9, 9, 23 11:7, 11, 16, 21, 24 12:3 19:11 22:19, 23 25:6 26:23 27:1, 6 28:25 32:9 33:13 37:24 39:20 41:3, JO 42:5 45:21 46:1, JO 69:1, 4, 20, 24 73:4, 7 74:17 76:2, 3 77:10 86:21 91:25 92:5 105 :23 106:6 109:11, 24 122:7 126:11 128:13 134:17 137:14, 18 141 :9 154:6, 12 163:25 170:14, 18, 21 171:7 177:5 183:15 197:18 200:20, 23 201 :24 202:2 204:14 207:10, 12 209:9, 16 210:14, 17, 23 212:5 218:22 225:21, 25 www.coulterreporting.com 247:20 251:17 253:1, 8, 13, 19 270:16 273 :3 277:20, 24 278:5 292:17, 24 293:25 298:18 299:17 300:23 301 :5, JO, 15 310:2 311:11 312:1 314:11 315:1, 4 317:6 318:2 320:2, 6 323:23 324:5 336:16 thoroughly 230:1 thought 26:20 28:J 31:2, JO 66:12, 19 67:12 74:4 75:10 82:25 85:16 96:4, 11, 12 97:4 136:18 157:8 161:20 183:15 184:17 199:23 211:13 234:9 244:5 315:4 325:22 thousand 276:10 thread 81 :J 9 threat 38:J 8, 24 132:16 175 :24 176:5 threatening 80:24 83:7 88:1 three 103: 17 113:9 124:18 127:5 136:20 146:15, 15 147:J, 5 155:9 156:J 158:14, 18 160:5,11 166:17 182:7 185:12 190:1 191:4 215:25 228:16 250:24 259:1, 8, 21 292:15 305:19 330:2, 3, 5 three-month 202:18 three-quarters 275:1 three-year 221 :JO thrown 293: 10 thrust 93:21 165:20 tied 216:19 tiger 222:5 time 15:22 16:2,9 21:18 22:18 23:20 24:17, 18 28:6 30:13 31:17 34:11 35:9 36:3 48:13 49:1 53:24 56:16 57:8 58:11 59:1 61:3 62:13 63:3 66:5 68:9 72:14 80:17 84:8 87:24 88:7 97:20 103:25 109:18 111 :25 112:9 113:6 114:17 117:6 123:3 124:J, 3, 14 125:2, 8, 11 126:25 129:18, 22 130:1 137:5 144:23 154:4, 15 155:20 161 :12 162:8 165:3, 9 167:7 170:5 171 :14 179:5 185:11 186:5 188:J 0 195:17 197:16 205:1 209:8, JO 219:10, 16 226:10, 11, 17, 17, 25 228:24 230:7, 12, 14, 16 231:16, 24 502-582-1627 Page: 50 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 237:14 245:25 255 :8 262:16 264:4, 8, 9, 20 266:2 270:20 271 :17 276:2, 4, 5 280:23 284:10 286:12, 16 290:14 294:11 298:1 302:22 303 :1 306:15, 15 307:6 321 :22, 24 322:14 334:9, 19 337:5 time, 15:24 timely 3 8 :22 39:13 176:3, 13 times 19:14 23:2 84:1 89:25 102:15 104:23 146:15 149:10 172:7 189:21 200:5 208:12 211 :4 217:6 250:24 274:17 289:21 292:15 296:12 tiny 130:3 tip 260:15, 16, 18 tissue 58:20 80:21 title 36:17 190:21 198:17 322:24 323:2, 5 titled 3 :21 5 :5 titrate 92:10, 19, 21 94:20 144:24 titrating 96:7 titration 133:14 144:15 206:22 today 11 :1 100:12 144:23 188:10 206:2 209:2 229:16 230:4 245:3 273:17 284:24 294:13, 19 Coulter Reporting, LLC 306:22 310:22 321 :6 336:3 told 32:5 67: 7, 8 82:12 101:8, 9 189:14 195:20, 22 238:2, 21, 25 239:15, 24 240:5, 22 242:2 244:14 263 :9 264:17 267:24 269:13 281 :25 291:22 297:1, 2 298:12 300:5 313:5 320:13 tolerance 105:20 143:10 231:10 233:11 237:22 239:19 240:3, 8 267:7 312:9 Tolerance, 254:23 tomorrow 161 :8 tone 125:19, 25 126:2 Tony 170:22 201 :24 top 34:11 44:6 57:2 67:18, 25 84:23 102:19 110:20 123:18 133:6 142:1 143:21, 22 158:20 177:12 181:7 187:1 205:11 324:7 topic 278:14 topics 177:16 Toppers 187:3 top-telling 218:17 tore 54:22 tossed 303:23 total 64:9 148:3 193:12 213:8 215:10, 19,21 216:17, 18 totality 313 :15 314:8 totally 55 :13 140:3 205:1 toxic 94:10 toxicities 245 :25 Toxicity 71 :9 traditional 221:13 traditionally 87:19 trail 66:16 Train 194:22 196:2 274:6 trained 195:9 196:4 214:19 237:24 238:1, 11 274:17 Trainer 196:2 Trainers 194:22 195:1 training 15 :14 16:12, 17 24:2, 3 29:7, 17 118:15 239:6 251 :21 252:6, 15 253:25 254:1 273 :10, 14 274:15, 15 296:15 316:13 317:10 trajectory 331:12 Tramadol 132:15 transcript 11 :9 272:22 273:2, 4 314:5 337:12 transcripts 304:18, 19 transferred 21 :9 trauma 145:4 174:16 treat 71 :2, 4 78:11 92:17 272:1 329:16 treatable 80:16 treated 46:24 47:2, 8, 17 83:14 114:12 www.coulterreporting.com 116:4 143:1 146:14 192:9, 9 258:8 272:8 treating 70:22 92:20 100:14 102:10 116:2 145:22 151:8, 11, 16 271:1 272:3 treatment 36:25 114:24 189:1 190:15 213:15 214:24 257:7 259:23 271:13, 16 279:18 tremendous 199:24 220:11, 20 trend 137:5 trial 50:20 60:2 114:10, 11 141:4 159:24 329:2, 7 trials 76: 14 114:9, 18 144:1 232:23 246:3 257:13 tried 249:25 251:7 273:25 tries 118:11 189:25 trip 222:14 trips 187:2 trough 239: 7 252:11 290:6 troughs 289:24 Trover 303 :25 true 31:5 58:18 124:22 165:3 186:14 224:4 230:2 233 :23 236:20 237:2 244:19 266:4 280: 7, 11 283:22 302:7 308:5 320:21 337:12 truly 100:8 trusts 14:22 truthful 295 :14, 18 297:11 try 25 :1 34:21 46:1 70:5 156:17 223:17 232:10 254:24 291:24 trying 21:16 56:3 65:25 66:9 69:5 97:9 119:24 120:16 123:13 125:21 126:6 146:25 152:24 153:22 201:22 211:11 216:14 219:22 272:2 283:7 284:20 306:17 325:14, 15, 18 tthompson@kytr ial.com 7:6 Tuesday 117:13 278:9 tumor 80:21 turn 28:8 35:24 38:7 71:7 101:11 117:25 122:22, 23 123:17 130:21 131:7 140:14 142:16 157:21 189:2 190:16 213:3, 13 222:24 243:11 turned 65:19 169:20 231 :5 turnover 64:13 TV 181:11 twice 32:23, 25 73:19, 22 77:2 83:1, 9, 21, 22, 25 85:4 89:9 90:2, 6 93:2 98:8 101:8 104:21 146:16 208:9, 25 282:8 289:19 291 :24, 25 502-582-1627 Page: 51 Richard Sackler, M.D. Commonwealth of KY, ex rel. v Purdue Pharma L.P., et al. 8/28/2015 twice-a-day 146:20 twisted 303:3 two 14:22 22:20 23:1, 3, 15 26:15 36:14 48:21 52:20, 21 55:13 84:10 92:1, 2 103:12 104:16 112:4 113 :9, 13 124:2, 14 136:20 137:16 138:4 139:7 146:9, 11 147:6 156:25 157:10, 15, 16 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