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Purdue’s strategy to ensure broad access to its blockbuster painkiller OxyContin was explicit: “Offer rebates to remove payer restriction,” according to an internal presentation. The company didn’t want doctors to have to provide additional justification for prescribing a powerful narcotic, and it didn’t want strict limits on the number of pills that could be dispensed. The approach worked. Purdue repeatedly boasted in internal reports that prescribers and patients faced few or no restrictions on access to the drug. What could have been a backstop against overprescribing instead became a sales tool, records show. After striking deals with P.B.M.s, drugmakers touted the favorable coverage — no second-guessing or paperwork requirements from insurers — as part of an effort to get doctors to write more prescriptions.