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Opioid Litigation Daily Media Report 10/17/17

CBS 60 Minutes Follow-On Coverage

Washington Post, 60 Minutes Investigation Finds Bill Helped Fuel Opioid Crisis
Oct 16, 2017 | NPR
By Mary Louise Kelly

NPR's Kelly McEvers talks to Scott Higham of The Washington Post about the paper's investigation of drug industry efforts to lobby the Drug Enforcement Administration and Congress to weaken enforcement on opioid abuse. Audio Link: http://www.npr.org/2017/10/16/558160364/washington-post-60-minutes-investigation-finds-bill-helped-fuel-opioid-crisis
Trump's drug czar nominee withdraws after his role backing opioid industry exposed
Oct 17, 2017 | USA Today
By David Jackson

Tom Marino, the Pennsylvania congressman who was President Trump's nominee for drug czar, withdrew Tuesday amid a flap over his role in setting opioid policy.
Trump's nomination for drug czar is out after explosive '60 Minutes' investigation on opioid legislation
Oct 17, 2017 | Business Insider
By Lydia Ramsey

Pennsylvania Rep. Tom Marino is no longer President Donald Trump's nomination for "drug czar."
Senate Dem introduces bill to repeal controversial opioid law
Oct 16, 2017 | The Hill
By Nathaniel Weixel

Legislation introduced by a top Senate Democrat would repeal an Obama-era bill that critics say has dramatically restricted the ability of the Drug Enforcement Administration to crack down on opioid distributors suspected of wrongdoing.
Capitalism at Its Worst: The Opioid Crisis
Oct 16, 2017 | NewCo Shift
By John Battelle

Yesterday a major story broke, one that involves hundreds of billions of dollars, a massive and spiraling crisis in one of our economy’s largest industries, the corruption of Congress and a major Federal agency, and the deaths of more than 200,000 citizens of the United States over the past seventeen years.

Beaver County, PA Suit

Pennsylvania county sues 14 drug companies over role in opioid epidemic
Oct 16, 2017 | CBS News
By Staff

A lawsuit has been filed on behalf of Beaver County, Pennsylvania, against 14 drug companies, claiming they play a role in the number of opioid overdoses, CBS Pittsburgh reports.
Western Pennsylvania County Third to Sue Over Opioid Issue
Oct 17, 2017 | Associated Press

A western Pennsylvania county has become the third in the state to sue pharmaceutical companies for allegedly contributing to an opioid addiction crisis that has resulted in thousands of overdoses nationally in recent year.
Beaver County suing opioid painkiller firms, doctors
Oct 16, 2017 | Pittsburgh Post Gazette
By Rich Lord

Beaver County has sued 23 companies and people associated with a surge in the prescribing of narcotic painkillers, its attorneys announced at a press conference Monday.

Other Coverage

Trump to declare national emergency on opioids months after initial promise
Oct 17, 2017 | CNN
By Dan Merica

President Donald Trump told reporters Monday that he would officially make a national emergency declaration to fight the opioid epidemic next week, a move he billed as a "major announcement."
Trump says opioid emergency will be declared next week
Oct 16, 2017 | STAT News
By Lev Facher

President Trump indicated on Monday the White House would formally declare a national emergency over the opioid crisis as soon as next week and signaled he may withdraw his nomination for drug czar.
Marathon County may sue pharmaceutical companies over opioid crisis
Oct 16, 2017 | Wausau Daily Herald (WI)
By Haley BeMiller

The opioid epidemic has claimed hundreds of thousands of lives and cost untold millions spent on drug enforcement and rehabilitation programs. Now Marathon County may join a lawsuit asking pharmaceutical companies that profit from addictive prescription opiates to pay a share of those costs.
Ingham County to consider opioid lawsuit against drug companies
Oct 17, 2017 | Lansing State Journal (MI)
By Beth LeBlanc

Ingham County commissioners are exploring the possibility of filing a lawsuit against the pharmaceutical industry in an attempt to recoup costs associated with the opioid epidemic.
Etowah County Commission, Sheriff join opioid lawsuit
Oct 16, 2017 | Gadsden Times
By Benjamin Nunnally

Etowah County and the City of Gadsden are stepping up their fight against America’s ongoing opioid epidemic with a civil lawsuit against distributors McKesson Corp., AmerisourceBergen and Cardinal Health
Novus Detox Center Hails Missouri Lawsuit Against Opioid Manufacturers
Oct 17, 2017 | Novus Detox Center
By Novus Detox Center

In response to his state’s opioid crisis, Missouri’s Attorney General is suing three pharmaceutical firms for fraud and investigating seven others. Novus Detox Center supports state efforts to hold opioid manufacturers accountable for today’s epidemic.
Saratoga County joins opioid lawsuit
Oct 16, 2017 | Saratogian News (NY)
By Paul Post

Saratoga County is fighting back against the opioid crisis by authorizing legal action against companies and doctors that make, distribute and prescribe such drugs irresponsibly.
Could Opioid Lawsuit Against Pharma Lead To Tobacco-Like Court Settlement?
Oct 16, 2017 | CBS Pittsburgh (PA)
By Jon Delano

Opioids and tobacco do share some things in common.
Evolution Of A Crisis: Opioid Claims Pick Up Speed
Oct 16, 2017 | Law 360
By Adam Fleischer

The evolution of the worst drug crisis in American history is picking up speed, as the legal implications for the drug and insurance industries have become even more pronounced in recent weeks. As discussed in previous articles, the opioid epidemic that is killing more than 91 Americans each day has sprouted over 100 lawsuits across the country against the manufacturers, distributors and pharmacies that are alleged to have either negligently or fraudulently misrepresented and mismanaged the proper means of using, prescribing and dispensing opioids. Over 60 such suits are currently the subject of a motion for consolidation in a federal multidistrict litigation. With the damages and deaths mounting, legislative proposals have come under fire for falling far short of what is needed. New developments in recent days have broadened the liability attacks on the pharmaceutical industry, and have alleged governmental complicity, all of which may have significant impacts on insurers involved in the crisis.
HELP takes another stab at drug prices
Oct 16, 2017 | Politico Prescription Pulse
By David Pittman and Luis Sanchez

The Senate committee will hold its second hearing on drug pricing Tuesday, four months after taking its first stab at the topic. The first hearing, held June 13, tried to establish the factors contributing to a drug’s price from the time it is manufactured up until it reaches the patient. The hearing was rather unremarkable for the pharmaceutical world, with Democrats mostly haggling over Republicans’ partisan tactics to repeal and undermine Obamacare. The partisan rancor has only grown more bitter since then, with President Donald Trump this month taking multiple steps to weaken the 2010 health law.

Broadcast Media Coverage

7 News at 11pm
Oct 16, 2017 | WTRF (ABC)
By Wheeling, WV

Video Link: http://app.criticalmention.com/app/#clip/view/30144220?token=948de61c-8430-49ec-86ad-21c3a4569a3f
Great Day St. Louis
Oct 16, 2017 | KMOV (CBS)
By St. Louis, MO

Video Link: http://app.criticalmention.com/app/#clip/view/30144207?token=948de61c-8430-49ec-86ad-21c3a4569a3f

CBS 60 Minutes Follow-On Coverage

Washington Post, 60 Minutes Investigation Finds Bill Helped Fuel Opioid Crisis

Oct 16, 2017 | NPR

By Mary Louise Kelly

NPR's Kelly McEvers talks to Scott Higham of The Washington Post about the paper's investigation of drug industry efforts to lobby the Drug Enforcement Administration and Congress to weaken enforcement on opioid abuse.
Audio Link: http://www.npr.org/2017/10/16/558160364/washington-post-60-minutes-investigation-finds-bill-helped-fuel-opioid-crisis
MARY LOUISE KELLY, HOST:
I'm Mary Louise Kelly in Washington where in the Rose Garden today President Trump had to defend his nominee to lead the White House Office of National Drug Control Policy. That would be the position known as the drug czar.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: As far as Tom Marino - so he was a very early supporter of mine - the great state of Pennsylvania. He's a great guy. I did see the report. We're going to look into the report. We're going to take it very seriously.
KELLY: The president referring there to a new report by The Washington Post and "60 Minutes."
KELLY MCEVERS, HOST:
The investigation found that a bill sponsored by Tom Marino and pushed by the drug industry helped pump more painkillers into parts of the country that were already in the middle of the opioid crisis. Scott Higham helped write the story for The Washington Post.
SCOTT HIGHAM: Say a distributor in Ohio or in Michigan was sending pills downstream to pharmacies in Florida. And one month, that pharmacy was ordering 10,000 pills, and the next month, that pharmacy was ordering a hundred thousand pills. Well, that's supposed to be reported to the DEA as a suspicious order. And a lot of these companies were not doing that.
MCEVERS: The Drug Enforcement Agency, the DEA, would call that an imminent threat to a local community and freeze drug shipments from the company's warehouse. Marino's bill changed that standard to an immediate threat, which doesn't sound like a big difference, but it is.
HIGHAM: It's almost impossible to show that a company that is a thousand miles away is posing an immediate threat to a community. Now, they may be able to show that a doctor in your hometown or a pharmacist in your hometown is posing an immediate threat, and they can shut that person down. But the big companies, the distributors and the manufacturers - they're not going to be able to go after them.
MCEVERS: Co-Sponsors of Marino's bill say that DEA enforcement was getting in the way of seniors and veterans, people who legitimately needed painkillers. I mean, is that a valid concern?
HIGHAM: Well, you know, you hear that from time to time. I mean, some of this comes from groups that are funded by the industry, but that's not to diminish that there are people out there who sometimes have trouble getting their medications. But what we're talking about here is the abuse and sale of hundreds of millions of doses of oxycodone and Vicodin to the black market.
MCEVERS: Yeah.
HIGHAM: And that's the thing that the DEA was trying to shut down.
MCEVERS: And officials at the DEA opposed these changes for years but eventually backed down. And this bill, you know, in the end sailed through Congress, and President Obama signed it. What happened?
HIGHAM: That's exactly right, Kelly. We've obtained internal memos, emails, other documents from the DEA and from the Justice Department that show that the DEA and the Department of Justice for many years was opposed to this. They had written memos. They had written emails saying this is going to upend our ability to go after these companies. Why are you doing this? And Marino had introduced this legislation in 2014, and the DEA got it killed; and in 2015, and the DEA got it killed.
And then there was a change in leadership. Eric Holder stepped down. Loretta Lynch took over the AG's office. And then there was a new DEA administrator who came in who said that, I think that we need to work with these people. And there was also enormous amounts of pressure being placed on the DEA by Capitol Hill to pass this bill. And it was at the behest of the pharmaceutical industry. In fact, the bill was written by a pharmaceutical industry attorney who used to be a DEA attorney, one of - a senior DEA attorney. So it's, you know, the classic kind of revolving door in Washington.
MCEVERS: Wow. And so what's happened since this bill went into effect?
HIGHAM: So the number of immediate suspension orders has plummeted to zero against major manufacturers and distributors. There have been some immediate suspensions orders filed against smaller companies. But these very big companies, the ones that were backing this bill - they've had no actions taken against them at all.
MCEVERS: Senator Claire McCaskill of Missouri said today she will introduce a bill to repeal the Marino law. And Senator Joe Manchin of West Virginia wrote a letter to President Trump asking him to withdraw his nomination of Marino as drug czar. Do you think either of these efforts will go anywhere?
HIGHAM: Well, we'll see. Not a lot's happening in Washington these days, as we all know. Our reporting shows that a lot of the members of Congress weren't really aware what was in this bill and what the import of this bill was because it was just passed by unanimous consent, which means that, you know, there's no vote. There's really no debate. They took the word of the leadership that this bill was OK. But you know, we'll have to wait and see what happens. And as far as Mr. Marino's tenure, it's now in the hands of the president.
MCEVERS: Scott Higham of The Washington Post, thanks a lot.
HIGHAM: Thank you, Kelly.

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Trump's drug czar nominee withdraws after his role backing opioid industry exposed

Oct 17, 2017 | USA Today

By David Jackson

Tom Marino, the Pennsylvania congressman who was President Trump's nominee for drug czar, withdrew Tuesday amid a flap over his role in setting opioid policy.
"Rep.Tom Marino has informed me that he is withdrawing his name from consideration as drug czar," Trump tweeted Tuesday morning. "Tom is a fine man and a great Congressman!"
The announcement came just a few days after 60 Minutes and The Washington Postreported that, as a U.S. House member from Pennsylvania, Marino was the key lawmaker behind legislation that made it virtually impossible for the Drug Enforcement Administration to freeze suspicious narcotics shipments from drug companies.
His nomination to head the Office of National Drug Control Policy was controversial even before the Post/60 Minutes exposé. Treatment advocates have highlighted Marino's push to lock up low-level drug users against their will, until they agree to treatment.
"One treatment option I have advocated for years would be placing non-dealer, nonviolent drug abusers in a secured hospital-type setting under the constant care of health professionals," Marino said at a May 2016 hearing. "Once the person agrees to plead guilty to possession, he or she will be placed in an intensive treatment program until experts determine that they should be released under intense supervision."
He suggested criminal charges would be dropped once the person completed treatment. "The charges are only filed to have an incentive for that person to enter the hospital-slash-prison, if you want to call it," Marino said.
Sen. Joe Manchin, D-W.Va., who had called for Marino's withdrawal on Monday, applauded the move Tuesday, thanking Trump on Twitter "for recognizing we need a drug czar who has seen the devastating effects of the problem."
Trump struck an equivocal note about Marino's future on Monday when asked about the news reports on the congressman's relationship with the drug industry,
"As far as Tom Marino, so he was a very early supporter of mine, the great state of Pennsylvania," Trump told reporters at the White House. "He's a great guy. I did see the report. We're going to look into the report. We're going to take it very seriously."
Trump, who has pledged to unveil a national plan to combat opioid policy for months, said he will make "a major announcement, probably next week, on the drug crisis."

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Trump's nomination for drug czar is out after explosive '60 Minutes' investigation on opioid legislation

Oct 17, 2017 | Business Insider

By Lydia Ramsey

Pennsylvania Rep. Tom Marino is no longer President Donald Trump's nomination for "drug czar."
The withdrawal came a day after a joint investigation from The Washington Post and CBS' "60 Minutes" concluded that members of Congress — including Marino — alongside the pharmaceutical industry may have helped fuel the opioid crisis.
On Monday, Sen. Joe Manchin, a West Virginia Democrat, sent President Donald Trump a letter asking him to withdraw his nomination for the top drug policy position. Senate Minority Leader Chuck Schumer also joined the chorus of voices calling on Trump to reconsider.
Trump said in a tweet Tuesday morning that Marino had withdrawn his name from consideration.
"Tom is a fine man and a great Congressman!" Trump said.
Trump nominated Marino, a Republican, to lead the White House Office of National Drug Control Policy, a position that is commonly referred to as the nation's "drug czar."
The "60 Mintutes"-Washington Post investigation detailed how Marino introduced a bill in 2014 that made it harder for the Drug Enforcement Administration to enforce laws that would keep opioids from being diverted to people who might abuse them. A version of the bill became law in 2016.
The Post called it "the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market."

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Senate Dem introduces bill to repeal controversial opioid law

Oct 16, 2017 | The Hill

By Nathaniel Weixel

Legislation introduced by a top Senate Democrat would repeal an Obama-era bill that critics say has dramatically restricted the ability of the Drug Enforcement Administration to crack down on opioid distributors suspected of wrongdoing.
Sen. Claire McCaskill (D-Mo.), the ranking member on the Senate Homeland Security and Governmental Affairs Committee, said her legislation is being introduced in response to a joint Washington Post-“60 Minutes” investigation.
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The investigation concluded that a handful of members of Congress who were allied with the country’s major drug distributors — including Rep. Tom Marino (R-Pa.), who is set to become the next chief of the White House Office of National Drug Control Policy — helped to pass an industry-friendly bill that weakened DEA enforcement efforts against distributors.
“Media reports indicate that this law has significantly affected the government’s ability to crack down on opioid distributors that are failing to meet their obligations and endangering our communities,” McCaskill said.
McCaskill earlier this year launched an investigation into the sales and marketing practices of opioid manufacturers. She is trying to determine the role that manufacturers have played in the country's opioid crisis.
The investigation has already shown that a major pharmaceutical company lied and bypassed normal processes to push opioids on to patients who didn't need them.
In August, President Trump declared the opioid epidemic a national emergency, but the administration has been noticeably quiet on the issue since.

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Capitalism at Its Worst: The Opioid Crisis

Oct 16, 2017 | NewCo Shift

By John Battelle

Yesterday a major story broke, one that involves hundreds of billions of dollars, a massive and spiraling crisis in one of our economy’s largest industries, the corruption of Congress and a major Federal agency, and the deaths of more than 200,000 citizens of the United States over the past seventeen years.
Do you know what this story is about?
If not, you’re not alone. #OpioidCrisis isn’t exactly trending on Twitter, though it should be. The story, a joint investigation between 60 Minutes and The Washington Post, exposed an inhuman calculus of greed driving our pharmaceutical industry.
The companies involved — from drug distributors and retail outlets like McKesson and Walgreens to manufacturers like Johnson & Johnson — are making billions in revenue off the opioid crisis, and worse, they’ve spent more than $100 million lobbying Congress to insure that crisis only deepens, and their profits increase. The DEA has been fighting the corporations, but over the past few years, senior officials there have slow-rolled cases, and nearly 100 of them have left the DEA to work for drug companies and their related law firms.
The crisis found its apex with the passage of legislation early last year that essentially made it impossible for the DEA to go after drug distributors for profiting off of illegal diversions of their supply. The main sponsor and “author” of that bill was one Rep. Tom Marino, from Pennsylvania, though the bill in fact was written by a drug industry lobbyist. And guess what? Marino is now Trump’s candidate to be our nation’s drug czar.
60 Minutes profiled one of the DEA’s good guys, a senior DEA official turned whistle blower named Joseph T. Rannazzisi. Rannazzisi was run out of the DEA by Congressional pressure — and is now leading a lawsuit from states and municipalities fighting back. But they face high odds. “This is an industry that’s out of control. If they don’t follow the law in drug supply, and diversion occurs, people die. That’s just it, people die,” he told the Post. “And what they’re saying is, ‘The heck with your compliance. We’ll just get the law changed.’ ”
Obama did sign legislation that changed the law, and now claims, in essence, that he didn’t know what he was signing (the Post didn’t get the former president on the record, but those close to the process claim presidents will sign a bill if it has a majority backing and the affected agency, in this case the DEA, gives it a green light).
In short, no one looks good in this story, nor should they. Our regulatory agencies not only failed, they actively took part in creating that failure. Our drug industry is exposed as a malicious actor that directly places profits over the addiction, misery, and death of hundreds of thousands of Americans. And our Congress, not surprisingly, is exposed as a low rent flophouse with a “For Sale” sign on the front lawn.
Last August, while shooting a round of golf, President Trump declared that America’s opioid crisis was a “National Emergency” — this after he was briefed on the subject by a commission led by New Jersey Governor Chris Christie. National emergencies are a real thing — it clears the way for more money, more action, more policy relief. But for all that to happen, the president has to actually submit the government documentation that makes a crisis real. Somehow, Team Trump has forgotten to file the paperwork.
Trump’s base — the frustrated white working and middle class — are literally being killed by a virulent strain of steroidal American capitalism. After reading the Post’s story, and watching 60 Minutes’ coverage, all we can do is root for Joe Rannazzisi and his colleagues at the state and local level. If they lose, we’ve well and truly lost our way as a country, and as a capitalist society.

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Beaver County, PA Suit

Pennsylvania county sues 14 drug companies over role in opioid epidemic

Oct 16, 2017 | CBS News

By Staff

A lawsuit has been filed on behalf of Beaver County, Pennsylvania, against 14 drug companies, claiming they play a role in the number of opioid overdoses, CBS Pittsburgh reports.
The lawsuit comes after an explosive joint investigation by "60 Minutes" and The Washington Post which revealed how Congress had helped disarm the Drug Enforcement Administration (DEA) with a 2016 law. Whistleblowers said the law impeded the DEA from stopping distribution of large quantities of opioids to suspect pharmacies.
An average of 13 people die of drug overdoses in Pennsylvania every day and many of those deaths are caused by an addiction to prescription painkillers. Those overdoses have cost Beaver County millions of dollars, the lawsuit claims.
Attorney Bob Peirce Jr., who was hired by the county, announced the lawsuit Monday, calling the scale of the opioid epidemicunbelievable.
"The drug companies and the distributors who we are suing knew that these drugs were addictive and they kept pumping them into the mainstream of these small towns and counties," Peirce said.
He said Beaver County, which is just northwest of Pittsburgh, has the ability to recover the money spent by taxpayers, and he noted that unlike the tobacco lawsuit decades ago, damages from the opioid abuse can be cited. "The overtime, the emergency medical responses, the millions of dollars that this drug crisis has cost our counties," he said.
Peirce said the 23 defendants include pharmaceutical companies and doctors who worked for the companies -- doctors who said the opioid drugs were not addictive.
"If you saw '60 Minutes' last night, you saw the three major distributors. We are suing them. You saw some doctors testify that these drugs were not addictive. We are suing those doctors. And there are 14 pharmaceutical companies that manufactured and distributed these drugs under the guise that they were not addictive," Peirce said.
Peirce said he expects by the end of October, there will be lawsuits filed on behalf of other counties in western Pennsylvania. For Beaver County, the law firm's fee will be 25 percent of whatever damages are recovered.
"They don't have to spend any money," said Peirce. "We are bearing the cost of this. We're bearing the cost of the investigation, we're bearing the cost of the litigation and this is something they don't have to do. Now, they're working with us. All of the counties are working with us."

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Western Pennsylvania County Third to Sue Over Opioid Issue

Oct 17, 2017 | Associated Press

A western Pennsylvania county has become the third in the state to sue pharmaceutical companies for allegedly contributing to an opioid addiction crisis that has resulted in thousands of overdoses nationally in recent year.
Attorney Bob Peirce Jr. announced the lawsuit Monday on behalf of Beaver County against 14 drug companies and several doctors the county claims have contributed to 279 overdose deaths there since 2012.
Delaware County, near Philadelphia, was the first to file such a lawsuit in Pennsylvania in September, followed by Lackawanna County.
Peirce says unlike litigation in which some governments sought damages from tobacco companies, Beaver County — and others — can document money spent specifically on emergency responses, autopsies and other costs of overdoses.
Most of the companies being sued have said they're already taking steps to curb opioid abuse.

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Beaver County suing opioid painkiller firms, doctors

Oct 16, 2017 | Pittsburgh Post Gazette

By Rich Lord

Beaver County has sued 23 companies and people associated with a surge in the prescribing of narcotic painkillers, its attorneys announced at a press conference Monday.
Beaver County "spends millions of dollars each year to provide or pay for the health care, pharmaceutical care, and other necessary services and programs" associated with opioid painkillers like OxyContin and Percocet, according to the complaint filed in Beaver County Common Pleas Court.
Attorney Robert N. Peirce, Jr. of Robert Peirce & Associates, and the New York firm of Marc J. Bern and Partners, are representing the county, and all fees will be paid from any eventual recovery.
During a news conference Monday morning at his Downtown Pittsburgh offices, Mr. Peirce said that the biggest challenge will be adding up the damages — including the cost of treatment, first responders, police overtime and incarceration — driven by the opioid epidemic. He said the costs associated with heroin and illicit fentanyl will also be included.
"The statistics have shown that most of the addicts started with painkilling drugs," he said, so the costs caused by heroin and other illegal narcotics can be attributed to the drug companies, he said.
He said Mr. Bern is involved with numerous similar lawsuits nationally. In Pennsylvania, the first such lawsuit was filed by Lackawanna County followed by Delaware County. Beaver County is the third.
Mr. Peirce said he is in talks with Fayette, Washington, Lawrence and Greene counties and expects that they may file similar lawsuits by November. He said he knows that other attorneys have approached Allegheny County to propose a similar lawsuit.
He said he expects that the drug firms will try to have the cases moved to federal court, but he will try to keep them in the county courts.
"The drug companies apparently own the federal government," he said, citing reports Sunday by 60 Minutes and the Washington Post.
“The county has an obligation to help its citizens," Mr. Peirce wrote in a news release issued Friday. "This litigation presents one of the few times that a county will have an opportunity to recover taxpayer funded costs and expenses, and the Beaver County Commissioners are to be commended for taking this action.”
The drug companies and a handful of allied physicians, according to the complaint, "knew that, barring exceptional circumstances, opioids are too addictive and too debilitating for long-term use for chronic non-cancer pain," but marketed them more broadly to "realize blockbuster profits."
The marketing campaign started in the late 1990s, intensified around 2006 and continues, the county's attorneys wrote.
In part as a result, opioid prescribing nearly quadrupled nationwide from 1999 to 2010, to 254 million prescriptions, they wrote. Purdue Pharma's OxyContin alone accounted for $3.1 billion in sales by 2012, according to the complaint, and by 2014 some 2 million Americans were abusing, or dependent on, opioids. From 2000 through 2014, fatal overdoses of opioids, heroin and similar narcotics totaled nearly 500,000 people, the county's attorneys wrote.
In Beaver County, they wrote, drug overdose death rates tripled from 1999 to 2015, at one point giving the county the highest per capita rate in the state, according to a U.S. Drug Enforcement Administration analysis quoted in the complaint.
Beaver County, with just over 170,000 residents, had 102 fatal overdoses last year and the coroner has already made final determinations on 51 such deaths this year, according to the Pennsylvania Opioid Overdose Reduction Technical Assistance Center, run by the University of Pittsburgh’s School of Pharmacy.
Of Beaver County's newborns, 2 percent now require substance-related treatment, according to the complaint. County spending on substance abuse programs exceeds $2 million a year. And drug-driven crime is up, according to the district attorney, the county's attorneys wrote.
The companies named as defendants include Purdue Pharma, Teva Pharmaceuticals, Cephalon, Johnson & Johnson, Janssen Pharmaceuticals, Endo Health Solutions, Allergan, Actavis, Watson Pharmaceuticals, McKesson, Cardinal Health and AmerisourceBergen and subsidiaries of some of those firms. The physicians named are Russell Portenoy, Perry Fine, Scott Fishman and Lynn Webster.
The complaint accuses them of deceptive acts, fraud, unjust enrichment, negligence, misrepresentation and public nuisance, seeking in return compensatory damages, punitive damages and the county's legal costs.
Purdue Pharma denied the accusations in the lawsuit and vowed to mount a defense, adding in a statement that it is "deeply troubled by the opioid crisis" and "dedicated to being part of the solution.

"As a company grounded in science, we must balance patient access to FDA-[Food and Drug Administration] approved medicines, while working collaboratively to solve this public health challenge. Although our products account for approximately 2 percent of the total opioid prescriptions, as a company, we’ve distributed the CDC [Centers for Disease Control and Prevention] Guideline for Prescribing Opioids for Chronic Pain, developed the first FDA-approved opioid medication with abuse-deterrent properties and partner with law enforcement to ensure access to naloxone.”

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Other Coverage

Trump to declare national emergency on opioids months after initial promise

Oct 17, 2017 | CNN

By Dan Merica

President Donald Trump told reporters Monday that he would officially make a national emergency declaration to fight the opioid epidemic next week, a move he billed as a "major announcement.
"The measure comes after Trump, on the steps of his golf club in New Jersey, pledged in August to declare the opioid epidemic a national emergency. The President, though, never backed up that statement by officially doing so, thus far depriving the fight against the deadly drugs a designation that would offer states and federal agencies more resources and power.
"We are going to have a major announcement, probably next week, on the drug crisis and on the opioid massive problem and I want to get that absolutely right," Trump said, billing the official declaration as a large step that took time.
During an impromptu news conference in the White House Rose Garden alongside Senate Majority Leader Mitch McConnell, Trump said he would declare a national emergency when asked why he had not followed through with his initial pledge.
His August statement was heralded by local and state drug treatment advocates who had worried Trump wouldn't follow through on campaign rhetoric to fervently combat the opioid epidemic. Those advocates have largely felt let down by the Trump administration, especially because his failed health care plan would have stripped money for treatment and let state decide whether to cover such services.
Trump's former Health and Human Services Secretary Tom Price, who resigned last month after it was revealed that he had booked extensive private jet travel in his role as secretary, had originally suggested that declaring a national emergency was unnecessary.
"We believe that at this point, the resources that we need or the focus that we need to bring to bear to the opioid crises can be addressed without the declaration of an emergency," Price said in August, "although all things are on the table for the President."
The White House commission examining the nation's opioid epidemic had told Trump that declaring a national public health emergency would be an immediate help in combating the ongoing crisis.
"Our citizens are dying. We must act boldly to stop it," the commission, headed by New Jersey Gov. Chris Christie, said in its interim report. "The first and most urgent recommendation of this Commission is direct and completely within your control. Declare a national emergency."
Christie told The Associated Press earlier this month that it was "not good" that Trump had not declared the opioid crisis a national emergency.
Since 1999, the number of American overdose deaths involving opioids has quadrupled, according to the US Centers for Disease Control and Prevention. From 2000 to 2015, more than 500,000 people died of drug overdoses, and opioids account for the majority of those. New government data show an increase in opioid overdose deaths during the first three quarters of last year, an indication that efforts to curb the epidemic are not working.
Declaring a public health emergency makes the opioid epidemic the government's top priority, infusing much-needed cash into hard-hit areas and bolstering resources.
It is not often that a public health emergency is declared for something other than a natural disaster. The Department of Health and Human Services declared one in Puerto Rico last year after more than 10,000 Zika cases were reported there. Before that, the last emergency declaration, unrelated to a natural disaster, was during the 2009-10 flu season, when there was widespread concern over a potential pandemic.

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Trump says opioid emergency will be declared next week

Oct 16, 2017 | STAT News

By Lev Facher

President Trump indicated on Monday the White House would formally declare a national emergency over the opioid crisis as soon as next week and signaled he may withdraw his nomination for drug czar.
“We are going to be doing that next week,” Trump said in an impromptu Rose Garden press conference. “To get to that step, a lot of work has to be done, and it’s time-consuming work. We’re going to be doing it next week.”
Separately, he said he was aware of a Washington Post report over the weekend that outlined how Republican Rep. Tom Marino (Pa.), now Trump’s nominee to be drug czar, pushed a bill that weakened the Drug Enforcement Administration’s enforcement over suspicious drug manufacturers and distributors. Asked whether he had confidence in Marino, Trump said: “We’re going to be looking into Tom.”
“If I think it’s one percent negative to doing what we want to do, I will make a change, yes,” Trump said, referring to his decision to nominate Marino to run the Office of National Drug Control Policy.
In July, a panel chaired by New Jersey Gov. Chris Christie recommended in an interim report that Trump declare the nation’s ongoing crisis with opioid addiction and overdoses a national emergency.
Tom Price, the health secretary until last month, later indicated the administration did not feel such a step was necessary, only to be undercut days later by Trump telling reporters he planned to make the emergency declaration.
Trump reaffirmed that position on Monday, reiterating the issue’s complexity and stressing how labor-intensive the leadup to the forthcoming actions had been.

“We’re going to have a major announcement probably next week on the drug crisis and on the opioid massive problem, and I want to get that absolutely right,” Trump said. “This country, and frankly the world, has a drug problem. The world has a drug problem. But we have it, and we’re going to do something about it.”

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Marathon County may sue pharmaceutical companies over opioid crisis

Oct 16, 2017 | Wausau Daily Herald (WI)

By Haley BeMiller

The opioid epidemic has claimed hundreds of thousands of lives and cost untold millions spent on drug enforcement and rehabilitation programs. Now Marathon County may join a lawsuit asking pharmaceutical companies that profit from addictive prescription opiates to pay a share of those costs.
The lawsuit is being prepared by three law firms seeking multiple counties in Wisconsin to join the effort to hold drug makers accountable for their role in the crisis.
The civil lawsuit would argue that these pharmaceutical companies lied about the addictive potential of prescription opioids, and therefore bear a share of responsibility for the epidemic, which includes a black market in prescription opiates as well as the surge across the United States in heroin addictions. The suit would seek damages from the companies, asking them to pay the counties involved.
The Marathon County Board will vote Tuesday on whether to proceed with the lawsuit, said County Administrator Brad Karger. The Health and Human Services Committee approved it last week.
If the suit moves forward, Marathon County would follow in the footsteps of Wood County, which OK'd the litigation last month. Wood County Board Chairman Lance Pliml said in an email that Wood County joined the effort to "investigate and potentially prosecute claims against certain major opioid manufacturers for their role in creating the opioid epidemic now facing the county."
Karger said data shows that the drug crisis is overwhelming services. The county is budgeting $1.2 million for rent in other county jails next year, he said, because the Marathon County Jail is chronically overcrowded, and a large share of those incarcerated are there directly or indirectly because of drug addictions. The county will also spend $500,000 more than it did last year on placing children in out-of-home placement, which is largely drug-related, Karger said.
"We’re incurring all these costs, but there are also human costs because there’s real kids and real people involved in this," Karger said. "The drug crisis has just imploded us."
The lawsuit won't cost Marathon County any money. The firms representing this county and others would cover litigation costs and receive a portion of any funds awarded. However, the county would have to take time to provide attorneys with data and documents relevant to the case.
The suit would be against multiple companies, said attorney Erin Dickinson of Whitefish Bay-based Crueger Dickinson, one of the firms that would represent Marathon County.
Cities, counties and states across the country have sued pharmaceutical companies, according to information provided in the Health and Human Services Committee packet.
Dickinson said some Wisconsin counties, including Adams and Price, have already approved a suit, while others are considering it. They anticipate 60 counties across the state could participate, she said.
"They’re drowning in this epidemic," she said.

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Ingham County to consider opioid lawsuit against drug companies

Oct 17, 2017 | Lansing State Journal (MI)

By Beth LeBlanc

Ingham County commissioners are exploring the possibility of filing a lawsuit against the pharmaceutical industry in an attempt to recoup costs associated with the opioid epidemic.
Commissioners at a meeting Monday listened to pitches from two law firms with state and national ties that want to represent the county against pharmaceutical manufacturers and distributors.
“The question isn’t whether to take this issue on, it’s who you’re going to take it on with,” lawyer David Mittleman told commissioners.
Ingham County Deputy Controller Jared Cypher recommended staff work with the county’s own attorneys to determine whether Ingham County should move forward with a lawsuit. If the county chooses to file suit, Cypher said officials could issue a request for proposals to select a law firm.
Commissioner Todd Tennis, chairman for the human services committee, recommended staff also involve other stakeholders, such as the county prosecutor, sheriff and health department, in considering future opioid-related litigation.
“I certainly think this is something we should look very seriously at,” Tennis said.
Dozens of communities around the country have filed suits against the pharmaceutical industry in recent months in an attempt to hold drug companies responsible, at least in part, for the opioid epidemic.
Just last week, Wayne and Oakland county executives announced a joint lawsuit against drug manufacturers and distributors. The lawsuit alleges “deceptive marketing and sale of opioids,” including OxyContin and Fentanyl.
Michigan Attorney General Bill Schuette also recently opened an investigation into opioid manufacturers and distributors as part of a bipartisan effort involving 41 state attorneys general.
Damages sought by communities could include costs related to incarceration, emergency medical response, and autopsy costs.
“We just had a conversation a few months ago about our medical examiner, and the fact that that was going to cost us a lot of money,” Tennis said. One of the drivers of that cost, Tennis said, was a “massive spike” in overdose deaths and the cost of the accompanying autopsies and drug screenings.
Ingham County medical examiner data indicates there have been 34 opioid-related deaths between Jan. 1 and Sept. 6 of this year. Last year, the county recorded a total of 77 opioid-related deaths and, in 2015, data showed about 68 opioid-related deaths.
The Lansing Fire Department has administered Narcan, a drug that counteracts an opioid overdose, 243 times from Jan. 1 through Sept. 6 of this year. Last year, the department reported a total of 255 “Narcan incidences.”
The number of opioid-related deaths and overdoses have risen dramatically over the years.
In 2015, Michigan saw its third straight year of increased drug overdose deaths, as 1,981 people died because of overdoses — 13.5% more than in 2014, according to the Detroit Free Press.
“We’ve definitely got it here,” Commissioner Sarah Anthony said. “Hearing that there’s some energy and desire from our legal community to tackle that is interesting.”
Mittleman, a lawyer with Church Wyble, said he could be a mid-Michigan contact for statewide litigation led by the law offices of Weitz & Luxenberg and the Bernstein Law Firm.
He said he’d already reached out to East Lansing and Lansing, and planned to present to officials in Eaton and Clinton counties as well.
Robert Sickels, a lawyer with Sommers Schwartz, also made a pitch to commissioners for his firm, which is part of a consortium representing communities throughout the United States in opioid litigation.
“The liability picture is different for every community,” Sickels told commissioners. “I think ultimately these claims, because there are so many of them around the country, at least for discovery purposes, will be consolidated.”

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Etowah County Commission, Sheriff join opioid lawsuit

Oct 16, 2017 | Gadsden Times

By Benjamin Nunnally

Etowah County and the City of Gadsden are stepping up their fight against America’s ongoing opioid epidemic with a civil lawsuit against distributors McKesson Corp., AmerisourceBergen and Cardinal Health
The firm is joined on that team by Donald Rhea, attorney for the Etowah County Sheriff’s Office; Mike Roberts, attorney for the City of Gadsden; and Jim Turnbach, attorney for the Etowah County Commission. The effort is endorsed by the city, county and sheriff’s office.
The three companies named in the lawsuit account for $400 billion in combined revenue and control more than 80 percent of the prescription opioid market, according to Mills.
She and Gadsden Mayor Sherman Guyton, Sheriff Todd Entrekin and Commissioner Carolyn Parker all agreed that if containing the epidemic and its symptoms falls to local governments, then distributors — who the legal team says do not regulate their product according to federal requirements — should help pay those costs.
According to Entrekin, Etowah County’s Drug Enforcement Unit is among the state’s leading drug task forces, and local law enforcement works as a team to counter the sale and abuse of opiates. However, it’s not enough with more drugs flooding into the area.
“They’re fighting a war that they can’t win, when drugs are continually coming in and coming in,” said Entrekin. “This is a way to make the people who are putting the drugs on our streets accountable and make them pay for what we’re having to do, and bring some money back to the county, the cities and hopefully put a stop to them doing what they are doing.”
Mills said Congress laid out a system for the distribution of opioid pills with a select set of distributors, with the understanding that those distributors would control the volume of medication entering the market and report any suspicious orders, unusual quantities or other suspicious activity.
“In recent years they have failed to do that, and today the Etowah County community is paying the price,” she said.
An average of 91 people per day die from opioid overdoes throughout the U.S., she explained.
Prescriptions for opiate-based medication to relieve pain peaked nationally in 2010, with 81.2 prescriptions per 100 people, before beginning to decline in 2012, according to a CDC report released in July. However, even after a decrease of about 13 percent through 2015, the numbers are three times higher than they were in 1999.
The National Institute on Drug Abuse reported that opioid overdose deaths have multiplied by 2.8 times, to almost 35,000 deaths in 2015.
Mills said there are 155 prescriptions per 100 people in Etowah County. Guyton said Gadsden averages between three and seven heroin overdoses a day, putting strain on the city’s police and fire departments, and medical first responders.
“One guy was revived three times in one day,” the mayor said.
The need for quick money to fuel addictions has led to higher drug-related crime rates in the area, Guyton said, and the cost of correcting the problem has fallen to taxpayers.
“We’ve got people who pay their bills and do all the work, and now they’re paying the price for this kind of situation,” he said.
Parker echoed Guyton’s concerns, and said the epidemic is “robbing our kids of their innocence.”
Should the lawsuit succeed, money would be funneled into programs that counter the consequences of opioid abuse, like the jail’s drug rehabilitation program, and paying for the opiate antidote Narcan, used to inhibit opiates in an overdose.
Entrekin said Gadsden’s fire department ran through its whole year’s Narcan budget in January alone.
“This isn’t going to be overnight,” he said. “It’s going to take a lot of time to get our people back healthy, and there’s going to be a lot of treatment in this.”

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Novus Detox Center Hails Missouri Lawsuit Against Opioid Manufacturers

Oct 17, 2017 | Novus Detox Center

By Novus Detox Center

In response to his state’s opioid crisis, Missouri’s Attorney General is suing three pharmaceutical firms for fraud and investigating seven others. Novus Detox Center supports state efforts to hold opioid manufacturers accountable for today’s epidemic.
Missouri Attorney General Josh Hawley recently filed a lawsuit against three major opioid manufacturers, accusing them of a “deliberate campaign of fraud”;(1) and he has subsequently expanded his investigation to include seven additional pharmaceutical companies.(2) Novus Detox Center, a preeminent Florida-based drug treatment provider, believes painkiller manufacturers should be held responsible for their role in the U.S. opioid crisis and hopes that Missouri and other states will find recourse through the law.
In 2015, Missouri’s age-adjusted rate of drug overdose deaths was 17.9, with overdoses claiming 1,066 lives statewide.(3) Last year, opioid overdoses alone—including prescription painkillers and heroin—led to 712 fatalities in the St. Louis metro area that spans Missouri and Illinois.(1) Hawley claims that opioid manufacturers have directly contributed to the current crisis by deceiving physicians and patients about the risks of the medications they make and market.
Missouri’s June 2017 lawsuit outlines evidence against Purdue Pharma, Endo Health Solutions and Janssen Pharmaceuticals, and is seeking “hundreds of millions of dollars” in damages against them.(1) In late August, Hawley expanded his investigation to include seven additional firms—Allergan, Depomed, Insys, Mallinckrodt, Mylan, Pfizer and Teva Pharmaceuticals—that he believes may have engaged in “deception, fraud, false promise, misrepresentation, unfair practices, and/or the concealment, suppression or omission of material facts in connection with the sale or advertisement of opioids.”(2)
“Opioid manufacturers have long downplayed or even falsified the risks of their prescription painkillers, spending vast sums on marketing, advertising and lobbying while leaving states to deal with rising opioid use disorders and overdose deaths,” asserted Bryn Wesch, CEO of Novus Detox Center. “If pharmaceutical firms had been transparent about opioids’ potential for misuse and abuse from the outset, we likely would not be dealing with a national epidemic today. Instead, their relentless pursuit of profits and callous disregard for patients’ long-term health and wellbeing continues to destroy lives and impose a growing economic burden.”
Missouri’s legal salvo follows similar cases initiated by Mississippi and Ohio earlier this year(1) as well as a Cherokee Nation opioid lawsuit filed in April. Though some policy experts suggest the allegations may be challenging to prove, oxycodone manufacturer Mallinckrodt has already agreed to pay a $35 million settlement following a U.S. Drug Enforcement Administration (DEA) investigation.(1) Among the evidence cited in Hawley’s lawsuit are drug makers’ dismissal of addiction symptoms as “pseudoaddiction,” Purdue’s “medically inaccurate” Opioid Risk Tool and pharmaceutical firms’ use of third-party advocacy groups to disseminate misleading narratives regarding opioids’ safety.(1)
“The sheer number of patients prescribed opioids—combined with the push for high-dose painkillers and their widespread use to treat chronic pain—has left millions of Americans trapped in a vicious cycle of dependency,” explained Wesch. “It’s vital to help those with substance use disorders obtain the treatment they need to safely taper down from and end their opioid use, and we believe painkiller manufacturers should be helping to fund those treatments. As a growing number of states pursue legal recourse to hold drug manufacturers accountable for their actions and deceptions, I hope we will see more patients gain access to the care they need to reclaim their lives from opioids.
Wesch advocates for patients to receive expert, integrated care throughout their journey to recovery, from safe and effective opioid detox programs to referrals to reputable drug rehab and outpatient services. She is a proponent of medically supervised and individually customized detox treatments coupled with emotional support to help recondition both body and mind, creating a solid foundation for sustainable sobriety and empowering patients to achieve a healthy, drug-free life.
For more information on Novus Detox Center and its medically supervised opioid treatment programs, visit https://novusdetox.com.
About Novus Detox Center:
Novus Detox Center is soon to be operating two inpatient medical detox facilities that are licensed by the Florida Department of Children and Families and have earned The Joint Commission’s Gold Seal of Approval for Behavioral Health Care Accreditation. Renowned for its pioneering approach to Sustainable Sobriety™, Novus provides safe and effective alcohol and drug detox programs that combine next-generation treatment protocols, 24/7 medical supervision and integrated, individualized care. By conditioning the body and mind to re-imagine a fulfilling, drug-free future, Novus empowers patients on their journey to recovery and creates a solid foundation for long-term success. Novus is committed to leading the way in patient experience, both as a detoxification expert and a supportive partner in ongoing health and wellness, and is dedicated to pushing industry standards forward. The original Florida detox facility is located in New Port Richey (outside Tampa) and another is soon to open in West Palm Beach; both feature a wide range of amenities, delicious and healthy meals, and a relaxing, spa-like environment to ensure the withdrawal process is as stress-free and comfortable and as possible. For more information on Novus’ medically supervised detox programs, visit https://novusdetox.com.

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Saratoga County joins opioid lawsuit

Oct 16, 2017 | Saratogian News (NY)

By Paul Post

Saratoga County is fighting back against the opioid crisis by authorizing legal action against companies and doctors that make, distribute and prescribe such drugs irresponsibly.
The county has spent large sums for training and addiction programs, equipment purchases, hiring additional law enforcement and housing persons incarcerated for drug-related offenses.
By pursuing litigation, the county hopes to recover some of these expenses.
“Saratoga County has invested significant resources to combat opioid abuse and addiction,” county Administrator Spencer Hellwig said. “We’ve trained our first responders to take action when they encounter someone experiencing an overdose. We’ve also had to increase our Social Services programs to aide residents who are struggling with addictions. In addition to the irreplaceable cost of life, the strain on time, training, and equipment for our county is not minimal.”
No less than a half-dozen county departments are involved in one way or another with opioids including the sheriff’s office, district attorney, probation, mental health and public health.
“It’s pretty widespread,” Hellwig said.
The board of supervisors, at a recent special meeting, authorized hiring the New York City-based firm, Napoli Shkolnik, PLLC, to pursue litigation on the county’s behalf. The firm, which specializes in opioid cases, has been retained by almost 20 municipalities nationwide including Nassau County and the city of Dayton, Ohio, which has been referred to as the “heroin epicenter” of the country.
Plans call for Saratoga County to join a lawsuit pending in state Supreme Court Suffolk County.
“It’s similar to tobacco litigation,” Hellwig said. “Right now there’s only two law firms in the state involved in this type of litigation.”
The county will only be added to cases Napoli Shkolnik, PLLC purses in New York state. The firm has offices throughout the U.S.
The law firm will only be compensated with a portion of any settlements that may be reached. Taxpayer dollars will not be used to hire the firm.
“Like most areas of the state, opioid abuse has become an epidemic in Saratoga County,” said board of supervisors Chairman Ed Kinowski, R-Stillwater. “The ease of access, and over-prescription of these dangerous drugs has led to the death of too many of our friends and neighbors. The misrepresentation of the nature of these drugs has led to an alarming rise in addiction and overdoses.”
Aside from the direct health impact opioids have on users, the crimes addicts commit to get drugs exact a far-reaching financial toll.
“People who are addicted will do anything, from petit larceny to grand larceny, to get money,” said Karen Heggen, Saratoga County district attorney. “There have been several embezzlement cases where people claim it’s because they or a family member has a drug problem. So it’s impacting communities in many different ways.”
Burglaries and identity theft are common, too, and the problem isn’t confined to Saratoga County by any means.
Fifteen years ago, 80 percent to 90 percent of Washington County drug court cases were from driving while intoxicated, District Attorney Tony Jordan said.
“Today over half are related to narcotics,” he said. “Even the ones that are DWI, probably 75 percent of them have an underpinning of a narcotic addiction, whether it’s heroin, pills or crack cocaine. So what does all of that mean? Unlike DWI, people addicted to heroin or narcotics are also stealing from their family and breaking into businesses. When it comes to non-sex type crimes, easily two-thirds have an underpinning of heroin, opioids or opiate-based drug.”
“It really is scary and it puts a lot more pressure on jails, law enforcement businesses and strain on communities,” he said.
There is no typical path to addiction. But quite often, a person may be given pain killers following surgery or a serious injury. Before long, without realizing it or intending to, they’re hooked.
A state “I-Stop” law, which took effect in 2013, has made it more difficult for people to obtain prescription drugs from physicians. Although well-intended, it has prompted many people to buy drugs illegally or turn to heroin, which is less expensive, as an alternative.
“Heroin isn’t just pure heroin any more,” Heggen said. “It’s being laced with fentanyl and other derivatives that are highly addictive. People are chasing that high to the point where there are a lot more deaths. In the lab reports we’re getting from drug-related deaths, a lot of them are being laced with other things.”
Fentanyl is a manufactured opioid used for long-term pain relief.
“It’s a killer,” Jordan said. “We had our first case where we had an undercover buy, purportedly for heroin. But when it got tested it was 100 percent fentanyl. It’s being substituted for heroin and it’s about 100 times stronger. Kids are making pills out of fentanyl shaped like oxycodone and selling them as oxycodone, so there’s a real public health risk to our youth.”

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Could Opioid Lawsuit Against Pharma Lead To Tobacco-Like Court Settlement?

Oct 16, 2017 | CBS Pittsburgh (PA)

By Jon Delano

Opioids and tobacco do share some things in common.
“Relaxation, pleasurable feelings, stress reductions, all of those things,” said Dr. Jamie McConaha of the Duquesne University School of Pharmacy.
But could local lawsuits against pharmaceuticals lead to a national out-of-court settlement like big tobacco got twenty years ago?
Maybe.
But unlike tobacco with no health benefit, opioids can be useful as pain-killers, McConaha told KDKA money editor Jon Delano on Monday.
“When they are used in the appropriate course of action, when they are prescribed by an appropriate provider for the correct indication, I think they have a place in therapy,” she said. “But the problem is when people begin to abuse these medications or become addicted to them.”
McConaha says it took decades of anti-smoking evidence to convince big tobacco to buy into a master settlement agreement.
“We know a lot more about the long-standing health effects of tobacco than we do of opioids,” she said. “Obviously there is a growing epidemic with opioids. We’ve seen a lot of the devastating consequences of addiction, but I don’t think we have quite as many years of research.”
But if the tobacco model is followed, it could result in better education campaigns to discourage opioid use.
One result of the tobacco settlement was an anti-smoking campaign to reduce the number of smokers paid for by the tobacco industry.
It’s not clear that that would happen with opioids and the pharmaceutical industry.
Would big pharma agree to discourage use of a medically valuable drug?
Science may solve the problem by developing less addictive pain-killers.
But anti-smoking advocates warn that pharma, like tobacco, can find ways around any agreement.
“They still have advertising ads you’ll see in magazines,” says Brittany Huffman with Tobacco Free Allegheny. “They’re still sponsoring different sporting events, other concert series that are going on, and they’re still promoting in stores.”

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Evolution Of A Crisis: Opioid Claims Pick Up Speed

Oct 16, 2017 | Law 360

By Adam Fleischer

The evolution of the worst drug crisis in American history is picking up speed, as the legal implications for the drug and insurance industries have become even more pronounced in recent weeks. As discussed in previous articles, the opioid epidemic that is killing more than 91 Americans each day has sprouted over 100 lawsuits across the country against the manufacturers, distributors and pharmacies that are alleged to have either negligently or fraudulently misrepresented and mismanaged the proper means of using, prescribing and dispensing opioids. Over 60 such suits are currently the subject of a motion for consolidation in a federal multidistrict litigation. With the damages and deaths mounting, legislative proposals have come under fire for falling far short of what is needed. New developments in recent days have broadened the liability attacks on the pharmaceutical industry, and have alleged governmental complicity, all of which may have significant impacts on insurers involved in the crisis.
"60 Minutes" Introduces Pathway to New Evidence

On Sunday, Oct. 15, 2017, the results of a six-month joint investigation by "60 Minutes" and The Washington Post concluded that “the drug industry, with the help of Congress, turned the opioid epidemic into a full blown crisis” by intentionally turning a blind eye to the diversion of pain pills from pharmaceutical distributors to illicit users in communities across the nation. By way of example, the investigation highlights the town of Kermit, West Virginia, population 392, wherein one pharmacy allegedly received over 9 million doses of hydrocodone pills over 2 years.

The investigation involved months of research with former U.S. Drug Enforcement Administration officials who indicated that members of Congress allied with the country’s major drug distributors to achieve a “multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market.” The investigation concluded that the politician working most closely to weaken the DEA laws was Rep. Tom Marino, R-Pa, who was nominated last month by President Donald Trump to head the Office of National Drug Control Policy.

For the drug industry and its insurers, the "60 Minutes" investigation may represent a watershed event. The investigation takes the often vague and ambiguous allegations of “knowing and fraudulent conduct” that have appeared in hundreds of opioid lawsuits, and it lends names, documents, places and dates to what could otherwise be seen as the typically unsupported aspirations of what plaintiffs’ counsel hope to prove. For the insurers of the entities involved, new facts uncovered by "60 Minutes" and The Washington Post are destined to give rise to a number of questions as to whether the repercussions of intentional business schemes and efforts of the drug industry can be covered by general liability insurance, which typically only covers damages caused by accidental conduct.

A New Plaintiff? Labor Union Suits

The last week has also seen a potential expansion of the plaintiff classes pursuing the opioid litigation against the drug industry. On Oct. 13, 2017, the International Brotherhood of Electric Workers Local 38 Health and Welfare Fund, a labor union based in Ohio, filed a purported class action against manufacturers such as Purdue Pharma and Teva Pharmaceutical Industries, as well as wholesale distributors including AmerisourceBergen Corporation, Cardinal Health and others in the U.S. District Court for the Northern District of Ohio. While most of the opioid litigation to date has been filed by municipalities seeking recovery of public expenditures for health or law enforcement expenses, this is believed to be the first suit filed by a labor union.

The suit generally alleges that manufacturers fraudulently marketed prescription opioids as safe for treating chronic, long-term pain, and that distributors failed to monitor, identify, report and refuse to fill suspicious order for prescriptions opioids as required by federal and state law. The labor union alleges that, as the party responsible for funding its members’ health insurance plans, it was faced with a vast over-prescription of opioids, and thereby was forced to unwittingly fund millions of dollars in inappropriate prescriptions on behalf of its members. The suit seeks to certify a class of “all unions and/or health welfare funds who, from October 12, 2011 to the present, paid charges for a member or employee’s opioid prescription that was prescribed and filled in Ohio for a period greater than ninety (90) continuous days.”

For the defendants and their insurers, this new suit raises yet another significant issue relating to both liability and insurance coverage: who exactly has suffered the injury and what is it? For example, the unnecessary funding for opioids that arose from overprescription and illicit diversion is a key aspect of ongoing lawsuits filed by states, counties, and municipalities across the country against the drug industry, as well as claims that the pharmaceutical industry has already settled. To what extent do the costs and expenses at issue in those claims overlap with the costs and expenses at issue in the labor union claims? Furthermore, the real parties in interest who have suffered actual bodily injury from the defendants’ alleged conduct are the individuals harmed by the opioids. At what point do governments’ in loco parentis suits brought on behalf of individuals actually infringe upon the individuals’ rights to bring claims on their own behalf? To the extent that the claims sound more in public nuisance and financial loss, these suits by labor unions and municipalities would appear not to involve compensation for actual bodily injury, as would normally be a fundamental requirement for insurance coverage to exist.

A New Defendant? Insurers and Pharmacy Benefit Managers

Another recent investigation, this one by The New York Times, concluded last month that many insurers and pharmacy benefit managers have helped perpetuate the opioid epidemic by limiting individuals’ access to pain medications that carry a lower risk of addiction than the opioids that are currently a formative part of so many prescription drug plans. These allegations were formalized on Sept. 18, 2017, in a joint letter from 37 attorneys general to the president of America’s Health Insurance Plans.

The attorneys general letter urges that when patients seek treatment for chronic pain, doctors should be encouraged to prescribe effective nonopioid alternatives, ranging from nonopioid mediations to physical therapy, acupuncture, massage and chiropractic care. The attorneys general suggest that part of the reason such alternative prescriptions are not used by doctors is because the plans do not allow proper financial compensation for these sources of pain management, but they do allow for compensation for opioid treatment.

The New York Times piece goes further to explain that it examined prescription drug plans that cover 35.7 million people, and discovered that: 1) only one-third of the plans gave individuals any access to Butrans, which are alleged to contain a less addictive and less risky opioid, buprenorphine, and; 2) every drug plan that covered nonaddictive lidocaine patches for pain treatment also required prior approval for such a prescription, thereby making the access to this nonaddictive option much more difficult than accessing opioids. The investigation also found that the insurers and managers of these drug plans offer highly addictive drugs like morphine at a low cost of $29 for a month’s supply, whereas less addictive drugs like Butrans are either not covered or covered at a much higher cost of $342 a month, thereby driving the prescription of opioids.

Conclusion

In the coming months, insurers and pharmacy benefit managers are expected to undertake new and innovative efforts to control and disincentivize the use and prescription of opioids. In fact, CVS Health has already announced plans to limit opioid prescriptions to seven days or less for certain patients, as opposed to the previous 20-day limitation. As health insurers and pharmacy benefit managers undertake such efforts to curb the opioid epidemic, those that don’t join the efforts, or join too late, are likely to be the focus of new suits as plaintiffs’ counsel seek a wider array of deep pockets to pursue.

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HELP takes another stab at drug prices

Oct 16, 2017 | Politico Prescription Pulse

By David Pittman and Luis Sanchez

The Senate committee will hold its second hearing on drug pricing Tuesday, four months after taking its first stab at the topic. The first hearing, held June 13, tried to establish the factors contributing to a drug’s price from the time it is manufactured up until it reaches the patient. The hearing was rather unremarkable for the pharmaceutical world, with Democrats mostly haggling over Republicans’ partisan tactics to repeal and undermine Obamacare. The partisan rancor has only grown more bitter since then, with President Donald Trump this month taking multiple steps to weaken the 2010 health law.
This week’s hearing aims to dive a little deeper on the drug delivery system — should lawmakers take the opportunity — with executives from PhRMA, the Association for Accessible Medicines, American Pharmacists Association, Healthcare Distribution Alliance and Pharmaceutical Care Management Association all slated to appear.
HELP plans another drug pricing hearing this fall. The House Energy and Commerce Committee — whose health subcommittee chairman Michael Burgess said this summer they would take up drug pricing — is also looking at the issue.
ANOTHER EXAMPLE OF A HIGH PRICE COMING? The HELP hearing may not address issues like those surrounding Luxturna, a novel gene-therapy drug that gained the unanimous approval of an FDA advisory committee last week. The one-time treatment for those with an inherited form of blindness is injected into the eye’s retina. A virus carrying the corrected gene replaces the faulty, blindness-causing gene that helps restore sight. Its manufacturer, Spark Therapeutics, hasn’t set a price yet, but analysts are estimating it’ll cost around $1 million, roughly what some European-approved gene therapies cost overseas. Another FDA-approved gene therapy, Novartis’s Kymriah, was priced at $475,000.
Welcome to Prescription PULSE, where we’re trying our best to fill the Shaquille O'Neal-sized shoes of the vacationing Sarah Karlin-Smith. Send us your feedback and tips to David Pittman (dpittman@politico.com) and Luis Sanchez (lsanchez@politico.com).
THIS WEEK: OPIOID COMMISSION HEARS FROM INSURERS — The president’s opioid commission meets Friday and will discuss what the insurance industry is doing to help combat the epidemic. The commission met with the pharmaceutical industry on Sept. 27, when several public-private partnerships were announced. Members of the commission this time are likely to discuss enforcement of parity laws that require insurance plans that cover mental health care services to do so at the same level as other medical care.
Where’s the emergency declaration? — Trump was asked Friday about the status of his emergency declaration on opioids, which he said was coming more than two months ago. “We are studying national emergency right now,” he said in response, according to a White House transcript. “Believe it or not, doing national emergency, as you understand, is a very big statement.”
— Sens. Lisa Murkowski and Elizabeth Warren sent the White House a letter last week inquiring about the status of the declaration. They'd also like the recommendations of the White House opioids commission implemented.
Some outside advice — Former CDC head Thomas Frieden and researcher Andrew Kolodny have a viewpoint in the latest JAMA offering 10 ways the federal government could mitigate the opioid crisis. Among the suggestions are a narrower label for chronic pain, greater insurance coverage for non-opioid pain management and more cautious prescribing practices.
DEMOCRATS WANT MORE FUNDING FOR OPIOIDS — House Minority Leader Nancy Pelosi told House Energy and Commerce last week that more funding is needed to help states fight the opioid epidemic. Pelosi, during a hearing on the issue, touted the $1 billion in funding that Congress appropriated under the 21st Century Cures Act, but said lawmakers should fully fund all of the programs authorized under the legislation.
Cities suing pharma companies over opioids — States have begun to sue drug companies over opioids, but so too have many counties and cities, following Chicago’s lead from 2014. The cities argue that drug companies marketed and sold too many opioids to too many patients and didn’t provide the proper information about their risks. Citylab highlighted the lawsuits. The success of a West Virginia suit that resulted in a $40 million settlement inspired a number of cities to file lawsuits as well. Seattle, Cincinnati and Dayton are also following their home states’ lead and suing drug companies to combat the opioid crisis.
HITTING THE BREAKS ON THE COMMON RULE — The White House appears poised to delay by a year federal regulations outlining the protections for humans in medical studies. Judging by the title of a rule now being reviewed by the Office of Management and Budget, there will also be three “burden-reducing provisions” implemented during that year delay. Changes to the so-called Common Rule were finalized on the last day of the Obama administration but almost immediately frozen by the Trump White House. The research community was resoundingly against the change to unidentified biospecimens, such as tissue, blood and urine, which were made newly subject to informed consent requirements.
A VOTE OF CONFIDENCE FOR 340B, AND CALL FOR TRANSPARENCY — House Republicans are pushing back on suggestions they're plotting to end the 340B drug discount program, which offers subsides on drugs for charity hospitals, amid an Energy and Commerce subcommittee examination of how hospitals are benefiting from the discounts. At a hearing last week, GOP lawmakers stressed that they see the program's value and are focusing their investigation solely on finding ways to make it more transparent. "The lack of transparency requirements has resulted in inconsistent data and dueling reports from every side of the issue," Chairman Greg Walden said. "Nobody, first of all, is talking about eliminating the 340B program."
But they also warned hospital executives that they may push for changes that would give lawmakers more insight into exactly where the 340B funds are going — and whether participating hospitals are providing enough charity care. GOP Reps. Chris Collins and Buddy Carter focused in particular on whether the drug discounts are driving providers to buy more off-site cancer clinics, arguing that hospitals could use the clinics to prescribe more 340B drugs and boost their profits. Hospital executives at the hearing pushed back against Collins' suggestion, saying the expansion of their cancer services is largely due to growing demand from patients.
— Coincidentally or not, the Association of American Medical Colleges last week hired the firm Welsh Rose to lobby on the 340B program on its behalf.
340B RULE POPS UP AGAIN — The White House is again reviewing a proposed rule that would set a ceiling price for participating drug companies. In May, the Trump administration postponed changes to the program. The rule would also change how civil monetary penalties would be imposed.
Eye on the courts — The Democracy Forward Foundation — whose mission is to “scrutinize executive branch activity across policy areas” — sued the Trump administration Friday for failing to turn over documents related to its delay of those 340B regulations. The organization tried to use the Freedom of Information Act to see what role Joseph Grogan, a former lobbyist with Gilead Sciences and current associate director of health programs at OMB, played in the White House’s decision to forestall penalties on drugmakers who knowingly overcharge for 340B drugs. View the lawsuit here.
FDA holds first Patient Engagement Advisory Committee: The FDA held its first Patient Engagement Advisory Committee meeting on Oct. 11 as part of its effort to develop patient involvement in the agency’s regulatory activities. The committee was founded by the FDA’s Center for Devices and Radiology Health, and its first meeting was comprised solely of patients, care partners and those representing their needs. At the meeting, the agency discussed the clinical trial process with patients and explained how the agency communicates about trial results. FDA Commissioner Scott Gottlieb stated that in the coming months the FDA will create a new team responsible for “the coordination of certain agency-wide and multi-center projects related to patient engagement” with the goal of expanding the relationship between medical product centers and patient organizations.
HAS GOTTLIEB TAKEN HIMSELF OUT OF THE RUNNING AT HHS? — Gottlieb, a well-respected man in health care who has done a praise-worthy job in his short tenure at the agency, says he thinks his talents would be best used if he stays at FDA rather than succeeding Tom Price as HHS secretary. “I feel like I want to continue to follow through on the policies we’ve put out and it’s where I think I can be most effective,” Gottlieb told Reuters in an interview in New York. He didn’t elaborate to the wire service whether he had been approached for the job. “I‘m not going to get into private discussions I might have had around that,” he said.
PHARMA IN THE STATES
Pennsylvania becomes 38th state to pass right-to-try — Gov. Tom Wolf signed a bill that will allow terminally ill patients to try experimental treatment options that have cleared FDA’s Phase 1 safety trials, but that have not yet received final approval. The bill was introduced by state Rep. Robert Godshall, who himself used an experimental treatment for bone cancer. It was approved unanimously by Pennsylvania’s Senate and House. Since Colorado became the first state to pass a right-to-try bill in 2014, 37 more states have passed similar laws. And in August, the Senate approved a national right-to-try bill. A companion bill is currently pending in the House.
The fight over Ohio’s drug price ballot question — Drug companies have spent more than $30 million urging Ohio voters to oppose an initiative pegging how much the state pays for prescription drugs to the amount paid by the Veterans Health Administration, which on average is around 20 percent less. Drug companies argue that it could lead to higher drug prices for the two-thirds of Ohioans who don’t get their medications through state programs. Supporters argue drug companies are trying to confuse and mislead voters.
Three states get grants to tackle high drug prices — The National Academy for State Health Policy awarded $300,000 in grants to Colorado, Delaware and Oklahoma to address high prescription drug prices. In Colorado, the grant will fund a drug price survey with providers to inform a new payment system for physician-administered drugs. Delaware will focus on cutting the net cost per patient by 5 percent within two years through a shared preferred-drug list. Oklahoma will develop a value-based purchasing agreement with a manufacturer. With such an agreement, CMS would only pay for a drug if patients benefit after one month of treatment. The state is currently working to identify the most appropriate drug manufacturer with which its Medicaid program can partner.
QUICK HITS
FDA approves record number of generic applications — The FDA approved a record-setting 763 generic-drug applications in fiscal 2017, the agency says. It marked 112 more approvals than in 2016, which also saw a record high. The number of applications submitted in fiscal 2017 also increased to 1,292 — 439 more than were submitted the previous year. However, the number of complete responses the agency issued decreased from 1,725 in 2016 to 1,603 in 2017.
Pharma protections in NAFTA — NAFTA renegotiations should seek to resolve current pharmaceutical intellectual property issues the United States has with Canada and Mexico, Heritage Foundation economist Stephen Moore argued in a paper. American negotiators should push for five years of exclusivity for small-molecule drugs and 12 years of protection for biologics, Moore argued. Twelve years of exclusivity for biologics is what the Affordable Care Act provided and what the U.S. ultimately pushed for in the Trans-Pacific Partnership trade deal.
DOCUMENT DRAWER
FDA has released draft guidance for post-complete response letter meetings between the FDA and applicants of abbreviated new drug applications.
A PhRMA-funded report found sharing negotiated discounts could save commercially insured patients between $145 and $800 annually.
FDA explains the new user fee structure under the Prescription Drug User Fee Amendments in new draft guidance.
The Center for Drug Evaluation and Research is out with new draft guidance for determining whether an applicant should submit an ANDA or a 502(b)(2) application for FDA approval.
A New England Journal of Medicine perspective looks at how home biomarkers can help in the approval of site-agnostic cancer drugs.
FDA put out draft guidance to update formatting and content recommendations for REMS documents for prescription drugs, including biologics.
FDA has issued draft guidelines for resolving issues between the agency and ANDA applicants that are considering submitting a request for reconsideration at the division level.
PHARMA MOVES
Amgen Chairman and CEO Robert A. Bradway was elected PhRMA’s chairman-elect effective immediately. He replaced Joseph Jimenez, the CEO of Novartis, and will replace Johnson and Johnson Vice President Joaquin Duato as chairman of the board in Feb. 2018. In the same month, Sanofi CEO Olivier Brandicourt will become chairman elect and James Robinson, president of Astellas Americas, will take over as board treasurer.

CATCHING OUR ATTENTION: Take drug development into your own hands: What do drug scientists do when their employer abandons development of a product they’ve worked on for years? If you’re John Hood, you start your own company and pick up development where it was left off. Hood headed up research at TargeGen, which was sponsoring a cancer drug he co-invented called fedratinib when Sanofi bought the company. But it dropped fedratinib in 2013 when side effects started to arise. So Hood started his own company, Impact Biomedicines, to pick up development. Last week, Forbes’ Matt Herper reported Hood raised $22.5 million in venture capital to continue his work. As Herper notes, drugs without the backing of Big Pharma have a mixed track record. The FDA has lifted the clinical trial hold on fedratinib, but manufacturing issues must be ironed out before work resumes. More private financing may be needed to get the drug to market, but Hood says he think he can gain the FDA’s blessing without having to take his company public.

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Broadcast Media Coverage

7 News at 11pm

Oct 16, 2017 | WTRF (ABC)

By Wheeling, WV

Video Link: http://app.criticalmention.com/app/#clip/view/30144220?token=948de61c-8430-49ec-86ad-21c3a4569a3f
Rough Transcript: laurie you may have sn it last night-- 60 minutes talks to the highest-ranking drug enforcement administration official 11:04 PMever to turn whistleblower. tate he describesow the dea's efforts to crack down on the opioid epidemic were derailed. bill whitaker has the sty. (pkg) joe rannazzisi: 12:25:11;12 th is an industry that's-- that's out of control. what they wanna do, is do what they wanna do, and not worry about what the law is. 12:25:35;23 and if they don't follow the law in drug supply / joe rannazzisi is a tough, blunt former dea deputy assistant administrator with a law degree, a pharmacy degree and a smoldering rage at the unrelenting death toll from opioids. his greatest ire is reserved for the distributors - some of them multi-billion dollar, fortune 500 mpanies. they are the middlemen that ship the pain pills from manufacturers, like purdue 11:05 PMpharma and johnson & johnson to drug stores all over the country. rannazzisi accusethe distributors of fueling the opioid epidemic by turning a blind eye to pain illicit use. joe rannazzisi: 11:54:50;23 this is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors' offices, that distributed them out to people who had no legitate need for those drugs. bill whitaker: 10:58:22;27 joseph rannazzisi: 10:58:31;21 bill whitaker: 12:26:39;19 you know the impication of what you're saying, that these big companies knew that they were pumping drugs into american communities that were killing people joe rannazzisi: 12:27:13;03 that's not an implication, that's aact. that's exactly what they did. tate [take vo] vo and locally, lawmakers are 11:06 PMtaking a stand and sharing their thoughts about the epidemic that has plagued our area now for years. west virginia delegate shawn fluharty took the floor in charleston earlier in the legislative session and delivered these statistics. [take: fs] fs [take: reveal] reveal he says the biggest drug dealers in west virginia are the major pharmaceutical companies, [take: reveal] reveal who have raked in nearly $17 billion in profits in recent years [take: reveal] reveal from the 400 million pain killers they've t on our streets, [take: reveal] reveal which has resulted in the deaths of over 200 thousand west virginian's. here's what he says is the solutions to stopping this ongoing issue. [take sot incue: ... outcue: ... duration:0'11"] sot (delegate shawn fluharty, democrat for west virginia's 3rd district: "we need to send a message, we ed to make a statement. you want to make a statement, lock up a ceo, not just the addicts." tate [take vo] vo the delegate even calls out the major medical companies by name, mckesson and corporation, amerisourcebergen, and cardinal health. laurie [take vo] vo and today senator joe manchin introduced legislation repealing the ensuring patient access and effective drug enforcement act of 2016 after the washington post had indicated that the legislation has dramatically restricted the ability of the dea to crack down on opioid disibutors and manufacturers suspected of wrongdoing. laurie [take: fs] fs manchin says, quote: "i horrified by how harmful this bill has been for our efforts to effectively fight the opioid epidemic and now it's time to make it right. i introduced legislation to repeal this horrible bill and reinstate the dea's ability to stop opioid distributors anmanufacturers whare endangering the american people." manchin contues by saying west virginia's families and communities deserve a dea that will protect them, and not pharmaceutical companies.

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Great Day St. Louis

Oct 16, 2017 | KMOV (CBS)

By St. Louis, MO

Video Link: http://app.criticalmention.com/app/#clip/view/30144207?token=948de61c-8430-49ec-86ad-21c3a4569a3f
Rough Transcript: making headlines today. we talked about this on the morning show. new details coming out in the war against drugs. we talked to an opioid and now we're hearing the efforts to crack down on drugs. we're halted by congress. 10:03 AMif all this is true, it's a head scratcher. 60 minutes, talked with the highest ranking dean official ever who turned a whistle-blower. year and a half ago, some members of congress pressured the dea and justice department to agree with a pharmaceutical friendly law. that weekend, dea efforts against drug distribution companies, that were supplying corrupt doctors and pharmacists who peddled narcotics to the underground markets. the whistle-blower, accuses the distributors fuelling the opioid, by turning a blind eye to the pain pills to illegal use. pharmaceutical company, contributed at least $23 million, to laws, four versions of the bill. >> doesn't sit very well. >> no, it doesn't 10:04 AM>> i've been covering the entire opioid. five years ago, we didn't talk about the heroin cris. it's just crazy, if there are things going on with lawmakers that said, let's hold off on punishing the bad doctors and bad pharmacists out there. that's kind of what it sounds like >> i would hope, it's inadvertent. it doesn't sound good. >> no, it doesn't. >> more to come on this, i'm sure. >>> today, a missouri state courts will hear the first case over johnson & johnson's alleged convention. johnson & johnson has paid hundreds and millions of lawsuits related to the issue. last year, jury in st. louis, the powder developed to the development of ovarian cancer in a restaurant worker. why are we talking about this today. this is the first case happening in the state court. that discussion will get under - way relatively soon. basically, can't you remember, the trials are all because johnson & johnson accused of failing to warn consumers the talc powder use could travel to the fallopian tubes and kazo varian cancer.

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