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Opioid Litigation Daily Media Report - 4/6/18

Portland, ME Suit.

Portland, Maine, sues drug makers over opioid epidemic toll
Apr 5, 2018 | Associated Press
By Staff

Maine's largest city is suing a host of pharmaceutical companies over the toll of the nationwide opioid abuse epidemic locally.
Portland Files Suit Against Opioid Manufacturers
Apr 5, 2018 | Maine Public Radio (ME)
By Patty Wright

The city of Portland filed a lawsuit Thursday in Cumberland County Superior Court against 26 opioid manufacturers and distributors. Attorney Adam Lee says the lawsuit alleges that the companies orchestrated a campaign of fraud and misinformation about the addictive qualities of opioids.
City of Portland sues opioid manufacturers, distributors
Apr 5, 2018 | WMTW ABC 8 (ME)
By Paul Merrill

Officials with the city of Portland announced on Thursday that they are suing several major pharmaceutical companies involved in the making and distributing of opioids.
Portland sues opioid manufacturers, joining national legal action
Apr 5, 2018 | Bangor Daily News (MA)
By Jake Bleiberg

In an expected move, the city on Thursday brought a lawsuit against opioid manufacturers.
City of Portland will file lawsuit against opioid manufacturers
| News Center Maine (ME)
By Beth McEvoy

In an unprecedented move, the city of Portland is filing a lawsuit against makers of opioids and prescribers in the face of a pervasive and growing opioid epidemic in Maine.

Commentary and FYIs

Patient Advocacy Groups Take In Millions From Drugmakers. Is There A Payback?
Apr 6, 2018 | Washington Post / Kaiser Health News
By Emily Kopp, Sydney Lupkin and Elizabeth Lucas, Kaiser Health News

Pharmaceutical companies gave at least $116 million to patient advocacy groups in a single year, reveals a new database logging 12,000 donations from large publicly traded drugmakers to such organizations.
Opioids lawsuit makes sense, just as tobacco suits did (Opinion)
Apr 5, 2018 | The Olympian (WA)
By Editorial Board

Thurston County commissioners made a good call recently to join other Washington counties and cities in a federal lawsuit against the makers of opioids.
Big Pharma to blame (Opinion)
Apr 6, 2018 | Youngstown Vindicator (OH)
By Domenica Ghanem

At a recent rally in New Hampshire, President Donald Trump called for the death penalty for drug traffickers as part of a plan to combat the opioid epidemic in the United States. At a Pennsylvania rally a few weeks earlier, he called for the same.
Surgeon general issues rare advisory: more people should carry opioid overdose antidote
Apr 6, 2018 | Vox
By German Lopez

The surgeon general issued the office’s first advisory in 13 years — calling on more people to carry the opioid overdose antidote naloxone.
Doc: Naxolone no opioid solution
Apr 6, 2018 | Boston Herald (MA)
By Lindsay Kalter

The surgeon general recommended yesterday that more Americans carry the opioid overdose reversal agent naloxone — but local doctors say it is more of a Band-Aid than a fix and the medication’s skyrocketing price could limit access to the general public.
Big Employers Spent $2.6B On Opioid Epidemic Costs In 2016
Apr 5, 2018 | Law360
By Danielle Nichole Smith

Large employers’ annual spending on treating opioid addiction and overdoses increased nearly ninefold from $300 million in 2004 to $2.6 billion in 2016, even though opioid prescriptions for covered employees is at its lowest level in nearly a decade, according to a study from two nonprofits released Thursday.
GOP panel proposes lifting Medicaid limits on opioid care
Apr 5, 2018 | The Hill
By Peter Sullivan

Republicans on the House Energy and Commerce Committee on Wednesday night unveiled a proposal to lift limits on Medicaid paying for opioid treatment.
Prescribing Opioids - Let Physicians Be Physicians (Opinion)
Apr 6, 2018 | American Council on Science and Health
By Chuck Dinerstein

Hospitalists are physicians whose practice consists of caring for patients during their hospitalization and then returning their care upon discharge to the patient’s primary care provider. They are the group, along with surgeons, most responsible for prescribing pain medications for hospitalized patients and they released a new consensus to reduce opioid exposure and improve/standardize care. The recommendations are limited to adults with acute pain, not chronic pain, not patients with cancer and not children. The recommendations are broken down into three categories, deciding to use opioids, using them during hospitalization and prescribing at time of discharge.
Colleges Must Do More To Address The Opioid Epidemic (Opinion)
Apr 6, 2018 | Forbes
By Ryan Craig

Over spring break my 12-year-old son Leo pushed me to take him on Los Angeles’ longest bike trail: the San Gabriel River Bikeway in East L.A., which runs for nearly 40 miles from the mountains to the Pacific in Seal Beach.
The Health 202: How a fringe idea to solve the opioid crisis turned mainstream
Apr 6, 2018 | Washington Post
By Paige Winfield Cunningham

The idea that a someone who's not a medical professional could reverse deadly drug overdoses by injecting victims with an antidote was once fringe. Now it’s widely accepted – and got even stronger backing yesterday with a rare announcement from the U.S. surgeon general.

Southeast (FL, NC)

New opioid lawsuit accuses drug companies of 'corporate greed'
| Sun Sentinel (FL)
By Skyler Swisher

Palm Beach County has joined a growing list of local governments accusing drug makers, distributors and pharmacies of putting profits ahead of the public’s health and fueling an opioid epidemic that has cost taxpayers millions of dollars.
Palm Beach County sues Wal-Mart, CVS, drug firms over opioid crisis
Apr 5, 2018 | MyPalmBeachPost.com (FL)
By Wayne Washington

Palm Beach County has filed suit against more than two dozen individuals and firms — including mega-companies like CVS, Wal-Mart and Johnson & Johnson — alleging that their negligence and deceptive trade practices have contributed to the ongoing opioid crisis.
Florida Could Soon File Its Own Opioid Abuse Lawsuit
Apr 5, 2018 | WJCT (FL)
By Sacha Cordner

Florida could soon be filing its own opioid abuse lawsuit against drug manufacturers. They’d be joining a long list of states, counties, and cities that have done the same.
County joins opioid lawsuit
Apr 6, 2018 | Elizabeth City, NC
By Jon Hawley

Pasquotank County has joined nationwide litigation against opioid manufacturers and distributors, whom a consortium of lawyers alleges drove the addictive drugs' proliferation throughout the U.S.

Northeast (ME)

Augusta City Council to Vote on Joining Lawsuit Against Pharmaceutical Companies
Apr 5, 2018 | LegalScoops
By Jacob Maslow

City councilors in Augusta will discuss the potential of joining other counties and municipalities in lawsuits against pharmaceutical companies. The decision will be made on Thursday, and in accordance to Augusta’s agreement with law firms, the city would not have to pay unless the case is won.

Southwest (OK)

Nation files lawsuit against opioid manufacturers
Apr 5, 2018 | MVSOKEMEDIA.com (OK)
By Darren DeLaune

The Muscogee (Creek) Nation filed a lawsuit April 3 against seven opioid manufacturers.

Northwest (WA)

Thurston County Files Lawsuit Against Opioid Manufacturers
Apr 5, 2018 | Nisqually Valley Times (WA)
By Andrew Kollar

Last week Thurston County added their name to the long list of cities, counties and states suing the largest prescription drug manufacturers in the nation for fueling the opioid epidemic.

Broadcast Media Coverage

Morning Report
Apr 6, 2018 | Portland, ME
By WCSH (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34053936?token=425c64d1-086d-4cea-8e9e-ea65943503e7
WMTW News 8 at 6am
Apr 6, 2018 | Portland, ME
By WMTW (ABC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054007?token=425c64d1-086d-4cea-8e9e-ea65943503e7
NEWS CENTER Morning Report
Apr 6, 2018 | Bangor, ME
By WLBZ (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054046?token=425c64d1-086d-4cea-8e9e-ea65943503e7
FOX23 News at Ten
Apr 5, 2018 | Portland, ME
By WFPO (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34054093?token=425c64d1-086d-4cea-8e9e-ea65943503e7
necn NOW
Apr 5, 2018 | Boston, MA
By NECN (NEWSENG)

Video Link: http://app.criticalmention.com/app/#clip/view/34054502?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Fox 29 Morning News
Apr 6, 2018 | West Palm Beach, FL
By WFLX (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34053884?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Fox 61 Morning News
Apr 6, 2018 | Hartford & New Haven, CT
By WTUC (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34053907?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Local 24 News Midday
Apr 5, 2018 | Memphis, TN
By WATN (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34053923?token=425c64d1-086d-4cea-8e9e-ea65943503e7
2News Works for You Today 5A
Apr 6, 2018 | Tulsa, OK
By KJRH (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054021?token=425c64d1-086d-4cea-8e9e-ea65943503e7
7 News
Apr 5, 2018 | Wichita Falls, TX
By KSWO (ABC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054068?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Combatting the Opioid Epidemic
Apr 5, 2018 | National
By CSPAN

Video Link: http://app.criticalmention.com/app/#clip/view/34054133?token=425c64d1-086d-4cea-8e9e-ea65943503e7
11 News at 4:30PM
Apr 5, 2018 | Colorado Springs, CO
By KKTV (CBS)

Video Link: http://app.criticalmention.com/app/#clip/view/34054220?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Newswatch 12 at 5
Apr 5, 2018 | Wausau, WI
By WJFW (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054229?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Public Affairs Events
Apr 5, 2018 | National
By CSPAN2

Video Link: http://app.criticalmention.com/app/#clip/view/34054306?token=425c64d1-086d-4cea-8e9e-ea65943503e7
NJTV News With Mary Alice Williams
Apr 5, 2018 | New York, NY
By WNJT (PBS)

Video Link: http://app.criticalmention.com/app/#clip/view/34054554?token=425c64d1-086d-4cea-8e9e-ea65943503e7

Portland, ME Suit.

Portland, Maine, sues drug makers over opioid epidemic toll

Apr 5, 2018 | Associated Press

By Staff

Maine's largest city is suing a host of pharmaceutical companies over the toll of the nationwide opioid abuse epidemic locally.
Portland officials filed their lawsuit Thursday afternoon in Cumberland County Superior Court. The city's seeking damages from drug makers and some doctors involved in distribution of the drugs.
The city says in a statement its lawsuit's in response to "the substantial impact, including the loss of lives, that the opioid epidemic has had on the Portland community." The city is being represented by an Auburn law firm as well as Napoli Shkolnik of New York, which is also representing other cities around the country who have brought similar lawsuits.
Officials say there were 57 overdose deaths in the city in 2017. The City Council voted to sue last year.

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Portland Files Suit Against Opioid Manufacturers

Apr 5, 2018 | Maine Public Radio (ME)

By Patty Wright

The city of Portland filed a lawsuit Thursday in Cumberland County Superior Court against 26 opioid manufacturers and distributors. Attorney Adam Lee says the lawsuit alleges that the companies orchestrated a campaign of fraud and misinformation about the addictive qualities of opioids.
Lee says the suit alleges that opioid manufacturers and distributors orchestrated a campaign of fraud, deceit, and misinformation to shape the public's perception of the addictive qualities of the drug.
"In a nutshell, the complaint is about corporate greed,” says Lee. “These folks knew what they were doing, and covered up what they were doing. And they did it to the benefit of themselves and the detriment of all of us through the opioid epidemic."
The goal is to help the city of Portland recoup some of the costs of battling the opioid crisis. If the lawsuit is successful, Portland mayor Ethan Strimling says the first priority for the proceeds would be for the city to create more treatment beds.
Portland is the first among about 17 other cities and counties in Maine that plan to file suit. Last year, 51 people in Portland died from opioid related overdoses.

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City of Portland sues opioid manufacturers, distributors

Apr 5, 2018 | WMTW ABC 8 (ME)

By Paul Merrill

Officials with the city of Portland announced on Thursday that they are suing several major pharmaceutical companies involved in the making and distributing of opioids.
The lawsuit was filed in Cumberland County Superior Court.
The city claims opioid makers and distributors put profits above people.
"They understood the implications of the drugs that they were giving to doctors to give to patients, and they didn't inform the public of that ... and now, they must help us recover the costs -- the escalating costs," Mayor Ethan Strimling said.
Several of the companies named in the lawsuit were quick to respond Thursday.
"Our actions in the marketing and promotion of these medicines were appropriate and responsible. The labels for our prescription opioid pain medicines provide information about their risks and benefits, and the allegations made against our company are baseless and unsubstantiated," Janssen Pharmaceuticals Inc. spokeswoman Jessica Castles Smith said.
"Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated. Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation," Healthcare Distribution Alliance Senior Vice President John Parker said.
"[W]e work to educate communities and healthcare providers on appropriate medicine use and prescribing, we comply closely with all relevant federal and state regulations regarding these medicines, and, through our R&D pipeline, we are developing non-opioid treatments that have the potential to bring relief to patients in chronic pain," Teva Pharmaceutical Industries Ltd. spokeswoman Michelle Larkin said.
"We are dedicated to doing our part as a distributor to mitigate the diversion of these drugs without interfering with clinical decisions made by doctors, who interact directly with patients and decide what treatments are most appropriate for their care. Beyond our reporting and immediate halting of tens of thousands of potentially suspicious orders, we refuse service to customers we deem as a diversion risk and provide daily reports to the DEA that detail the quantity, type, and the receiving pharmacy of every single order of these products that we distribute. We are committed to collaborating with all stakeholders, including in Maine, on ways to combat opioid abuse," AmerisourceBergen said in a statement.
The lawsuit seeks damages but does not specify a dollar amount.
Several cities and states across the country have filed lawsuit against opioid manufacturers.

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Portland sues opioid manufacturers, joining national legal action

Apr 5, 2018 | Bangor Daily News (MA)

By Jake Bleiberg

In an expected move, the city on Thursday brought a lawsuit against opioid manufacturers.
With the filing of the suit in Cumberland County Superior Court, Portland joined a national legal push to hold drug companies responsible for the mounting financial and human toll of the opioid crisis.
“This case is about one thing: corporate greed,” states the introduction to the nearly 400-page court document. “[Drug companies] put their desire for profits above the health and well-being of the city of Portland’s residents.”
Selectmen and councilors in several Maine municipalities — including Portland — have voted to bring suit against opioid manufacturers and distributors in recent months, joining a nationwide effort orchestrated by a New York law firm.
The suit names a 26 defendants including individual doctors and drug companies such as Purdue Pharmaceuticals and Johnson & Johnson. It seeks monetary damages.
Mayor Ethan Strimling, attorney Adam Lee and a number of other local officials and community members are slated to hold a news conference discussing the lawsuit Thursday afternoon.
The city will be represented in the case by Auburn lawfirm Trafton, Matzen, Belleau and Frenette, and Napoli Scholnick of New York. The city’s chief attorney previously said that Portland will pay nothing to bring the suit and would keep two-thirds of any winnings, with the rest going to the firms.
In December, the Bangor City Council voted unanimously to bring a similar suit but has not yet filed it. Other communities where government boards have reportedly voted to join the lawsuit include Biddeford, Saco, Sanford, Auburn and Lewiston.

The lawsuit follows Maine’s deadliest year for overdose deaths. In 2017, 418 people died drug induced deaths, including 57 in Portland.

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City of Portland will file lawsuit against opioid manufacturers

| News Center Maine (ME)

By Beth McEvoy

In an unprecedented move, the city of Portland is filing a lawsuit against makers of opioids and prescribers in the face of a pervasive and growing opioid epidemic in Maine.
City officials will file the lawsuit in Cumberland County Superior Court in response to lives lost in the Portland community, shifting blame from users to makers.
Portland officials say defendants include, among others, Purdue Pharmaceuticals and its affiliates, Cephalon, Johnson & Johnson, Janssen Pharmaceuticals and its affiliates, Endo Pharmaceuticals and its affiliates, Actavis and its affiliates, Watson Laboratories, Mallinckrodt, McKesson, Cardinal Health, Amerisourcebergen, and various doctors involved in the distribution of these drugs.
The city is being represented by Trafton, Matzen, Belleau and Frenette of Auburn and Napoli Scholnick of New York City who also represents many other municipalities in several similar suits across the country.
City officials say the lawsuit will not cost the city money.
Janssen Pharmaceuticals spokesperson Jessica Castles Smith responded with this statement:
Our actions in the marketing and promotion of these medicines were appropriate and responsible. The labels for our prescription opioid pain medicines provide information about their risks and benefits, and the allegations made against our company are baseless and unsubstantiated. In fact, our medications have some of the lowest rates of abuse among this class of medications.
Opioid abuse and addiction are serious public health issues. We are committed to being part of the ongoing dialogue and to doing our part to find ways to address this crisis.
The city is holding a press release Thursday at 3:30 p.m. at Milestone Recovery to provide more information.

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Commentary and FYIs

Patient Advocacy Groups Take In Millions From Drugmakers. Is There A Payback?

Apr 6, 2018 | Washington Post / Kaiser Health News

By Emily Kopp, Sydney Lupkin and Elizabeth Lucas, Kaiser Health News

Pharmaceutical companies gave at least $116 million to patient advocacy groups in a single year, reveals a new database logging 12,000 donations from large publicly traded drugmakers to such organizations.
Even as these patient groups grow in number and political influence, their funding and their relationships to drugmakers are little understood. Unlike payments to doctors and lobbying expenses, companies do not have to report payments to the groups.
The database, called “Pre$cription for Power,” shows that donations to patient advocacy groups tallied for 2015 — the most recent full year in which documents required by the Internal Revenue Service were available — dwarfed the total amount the companies spent on federal lobbying. The 14 companies that contributed $116 million to patient advocacy groups reported only about $63 million in lobbying activitiesthat same year.
Though their primary missions are to focus attention on the needs of patients with a particular disease — such as arthritis, heart disease or various cancers — some groups effectively supplement the work lobbyists perform, providing patients to testify on Capitol Hill and organizing letter-writing and social media campaigns that are beneficial to pharmaceutical companies.
Six drugmakers, the data show, contributed a million dollars or more to individual groups that represent patients who rely on their drugs. The database identifies over 1,200 patient groups. Of those, 594 accepted money from the drugmakers in the database.
The financial ties are troubling if they cause even one patient group to act in a way that’s “not fully representing the interest of its constituents,” said Matthew McCoy, a medical ethics professor at the University of Pennsylvania who co-authored a 2017 study about patient advocacy groups’ influence and transparency.
Notably, such groups have been silent or slow to complain about high or escalating prices, a prime concern of patients.
“When so many patient organizations are being influenced in this way, it can shift our whole approach to health policy, taking away from the interests of patients and towards the interests of industry,” McCoy said. “That’s not just a problem for the patients and caregivers that particular patient organizations serve; that’s a problem for everyone.”
Bristol-Myers Squibb provides a stark example of how patient groups are valued. In 2015, it spent more than $20.5 million on patient groups, compared with $2.9 million on federal lobbying and less than $1 million on major trade associations, according to public records and company disclosures. The company said its decisions regarding lobbying and contributions to patient groups are “unrelated.”
“Bristol-Myers Squibb is focused on supporting a health care environment that rewards innovation and ensures access to medicines for patients,” said spokeswoman Laura Hortas. “The company supports patient organizations with this shared objective.”
The first-of-its-kind database, compiled by Kaiser Health News, tallies the money from Big Pharma to patient groups. KHN examined the 20 pharmaceutical firms included in the S&P 500, 14 of which were transparent — in varying degrees — about giving money to patient groups. Pre$cription for Power is based on information contained in charitable giving reports from company websites and federal 990 regulatory filings.
It spotlights donations pharma companies made to patient groups large and small. The recipients include well-known disease groups, like the American Diabetes Association, with revenues of hundreds of millions of dollars; high-profile foundations like Susan G. Komen, a patient group focused on breast cancer; and smaller, lesser-known groups, like the Caring Ambassadors Program, which focuses on lung cancer and hepatitis C.
The data show that 15 patient groups — with annual revenues as large as $3.6 million — relied on the pharmaceutical companies for at least 20 percent of their revenue, and some relied on them for more than half of their revenue. The database explores only a slice of the pharmaceutical industry’s giving overall and will be expanded with more companies and groups over time.
“It’s clear that more transparency in this space is vitally important,” said Sen. Claire McCaskill (D-Mo.), who has been investigating the links between patient advocates and opioid manufacturers and is considering legislation to track funding. “This database is one step forward in that effort, but we also need Congress to act.”
What Drives The Money Flow
The financial ties between drugmakers and the organizations that represent those who use or prescribe their blockbuster medicines have been of growing concern as drug prices escalate. The Senate investigated conflicts of interest in the run-up to the passage of the 2010 Physician Payments Sunshine Act — a law that required payments to physicians from makers of drugs and devices to be registered on a public website — but patient groups were not addressed in the bill.
Some of the patient groups with ties to trade groups echo industry talking points in media campaigns and letters to federal agencies, and do little else. And patients, supported by pharma, are dispatched to state capitals and Washington to support research funding. Some groups send patients updates on the newest drugs and industry products.
“It’s through groups like this that patients often learn about illnesses and treatments,” said Rick Claypool, a research director for Public Citizen, a consumer advocacy group that says it does not accept pharmaceutical funding.
For the patient group Caring Ambassadors Program, industry funds are needed to make up for a lack of public funding, said the group’s executive director, Lorren Sandt. According to IRS filings and published company reports, in 2015 the group received $413,000, the bulk of which came from one company, AbbVie, which makes a hepatitis C treatment and has been testing a new lung cancer drug, Rova-T, not yet approved. She said the money had no influence on the Caring Ambassadors Program’s priorities.
“There aren’t a lot of large pockets of funding outside of the pharmaceutical money,” Sandt said. “We take it where we can find it.”
Other patient groups such as The National Women’s Health Network, based in Washington, D.C., make sacrifices to avoid pharmaceutical funding. That includes operating with a small staff in a “modest” office building with few windows and outdated computers, according to executive director Cindy Pearson. “You can see the effect of our approach to funding as soon as you walk [in] the door.”
Pearson said it’s hard for patient groups not to be influenced by the funder, even if they proclaim independence. Patient groups “build relationships with their funders and feel in sync and have sympathy” for them. “It’s human nature. It’s not evil or weak, but it’s wrong.”
Charity As Marketing
Patients newly diagnosed with a disease often turn to patient advocacy groups for advice, but the money flow to such groups may distort patients’ knowledge and public debate over treatment options, said Dr. Adriane Fugh-Berman, the director of PharmedOut, a Georgetown University Medical Center program that is critical of some pharmaceutical marketing practices.
“[The money flow limits] their advocacy agenda to competing branded products when the best therapy might be generics, over-the-counter drugs or diet and exercise,” she said.
AbbVie — whose specialty drug Humira made up 65 percentof the company’s net revenue in 2017 and is used to treat patients with autoimmune diseases, including Crohn’s disease and certain kinds of arthritis — gave $2.7 million to the Crohn’s & Colitis Foundation and $1.6 million to the Arthritis Foundation, according to the company’s public disclosures included in the database. The list price for a month’s supply of Humira, a biologic drug, is $4,872, according to Express Scripts, a pharmacy benefits manager.
Even though Humira will face competition from near-copycat drugs called biosimilars, it is expected to remain the highest-grossing drug in the United States through 2022, according to drug industry analysts at EvaluatePharma.
The Arthritis and Crohn’s foundations have been largely silent on the cost of Humira and vocal on safety concerns about biosimilars. The Arthritis Foundation has championed state laws that could add extra steps for consumers to receive biosimilars at the pharmacy counter, potentially keeping more patients on the brand-name drug. Experts say those laws could help protect Humira’s market share from generic competitors.
A coalition of patient groups, Patients for Biologics Safety & Access, opposes the automatic substitution of a cheaper biosimilar when doctors prescribe a biologic. In 2015, members of that coalition, including the Crohn’s & Colitis Foundation, the Arthritis Foundation and the Lupus Foundation of America, accepted about $9.1 million from pharmaceutical companies in the database, according to public disclosures. They include AbbVie and Johnson & Johnson, makers of blockbuster biologics.
The Arthritis Foundation did not deny receiving the money but said the foundation represents patients, not sponsors. It is “optimistic” about biosimilars’ ability to help patients and save them money, said Anna Hyde, vice president of advocacy and access. “The Foundation supports the Food and Drug Administration’s scientific standards in evaluating the safety and efficacy of biosimilars, and we support policies that encourage innovation and foster a competitive marketplace.”
The Crohn’s & Colitis Foundation maintains “more than an arm’s-length distance” from its donors in the pharmaceutical industry, who have no say over the foundation’s strategic objectives, said president and CEO Michael Osso.
He added that the foundation’s position on biosimilars is “evolving.”
Lupus Foundation CEO Sandra Raymond said she could not explain how her group, also based in Washington, was involved in the coalition. She confirmed the Lupus Foundation received $444,000 from Pfizer in 2015 but said the money was not linked to any relationship with Patients for Biologics Safety & Access.
“I never went to a meeting,” Raymond said. “A former employee signed us up for a whole host of coalitions. I think we put our name on something or someone did.”
She said the Lupus Foundation was no longer a member of the coalition. Days after Kaiser Health News reached out to the coalition, its website was updated, excluding the Lupus Foundation.
For its part, AbbVie — which overall donated $24.7 million to patient groups in 2015, according to the new database — stipulates that its grants to nonprofits are “non-promotional” and provide no direct benefit to its business, according to a company statement. The company gives to patient groups because they serve as an “important, unbiased and independent resource for patients and caregivers.”
Insulin And Influence
The American Diabetes Association said in an email to KHN that it received $18.3 million in pharmaceutical funding in 2017, accounting for 12.3 percent of its revenue; that was down from $26.7 million in 2015. The money flowed in as insulin makers continued to hike prices in those years — up to four times per product — leading to hardships for patients.
The only “Big Three” insulin maker in the database, Eli Lilly, gave $2.9 million to the American Diabetes Association in 2015, according to disclosures from the company and its foundation. Sanofi and Novo Nordisk are the other two major insulin makers, but neither was in the S&P 500 and therefore not included in the database. Over the past 20 years, Eli Lilly has repeatedly raised prices on its bestselling insulins, Humalog and Humulin, even though the medicines have been around for decades. The drugmaker faced protests — by people demanding to know the cost of manufacturing a vial of insulin — at its Indianapolis headquarters last fall.
The ADA launched a campaign decrying “skyrocketing” insulin in late 2016 but did not call out any drugmaker in its literature. When legislators in Nevada passed a bill last year requiring insulin makers to disclose their profits to the public, the ADA did not take a public stance.
The American Diabetes Association said it doesn’t confront individual companies because it is seeking action from “all entities in the supply chain” — manufacturers, wholesalers, pharmacy benefit managers and insurers.
“As a public health organization, the ADA’s commitment and focus is on the needs of the more than 30 million people with diabetes,” said Dr. William Cefalu, its chief scientific and medical officer. “The ADA requires support from a diverse set of partners to achieve this objective.”
Eli Lilly said it contributes money to the American Diabetes Association because the two share a “common goal” of helping diabetes patients.
“We provide funding for a wide variety of educational programs and opportunities at ADA, and they design and implement those programs in ways that are aligned with their goals,” Eli Lilly said in a statement. “We’re proud to support the ADA on important work that helps millions of people living with diabetes.”
Most patient groups say that funders have little or no influence in shaping their programs and policies, but their agreements are private.
They Weren’t Always Backed By Pharma
Into the ’80s and early ’90s, patient lobbying was generally limited and self-funded with only one or two affluent patients from an organization traveling to Washington on a given day, said Diana Zuckerman, president of the nonprofit National Center for Health Research.
But the power of patient-lobbyists became apparent after a successful campaign by AIDS patients led to government action and a national push to find drugs to treat the then-terminal disease. Zuckerman said she will never forget when two women visited her office and asked how breast cancer patients could be as effective as the AIDS patients.
“At the time, there were no breast cancer patients advocating for money or anything else. It’s hard to believe,” she said. “I still remember that conversation, because it was really a turning point.”
Soon after, breast cancer patients started visiting the Hill more frequently. Patients with other diseases followed. Over time, patients’ voices became a potent force, often with industry support.
Even some wealthy, high-profile organizations take industry money: For example, $459,000 of Susan G. Komen’s $118 million in 2015 revenue came from drugmakers in the database, according to public disclosures. Asked about the pharma money, the foundation said it has institutional processes in place to ensure that “no corporate partner — pharma or otherwise — decides our mission priorities,” including a scientific advisory board — free of sponsor influence — that reviews its research program.
Today, patient advocacy groups flush with more industry dollars fly patients in for testimony and training about how to lobby for their drugs.
Some years ago, as the groups increased in number, Zuckerman said, she started getting email invitations from advocacy groups to attend so-called lobbying days explicitly sponsored by the pharmaceutical industry. The hosts often promised training and usually some kind of keynote speaker at a luncheon in Washington — plus a potential scholarship to cover travel. Now, lobbying days involving dozens of patients from a single group are part of the landscape.
Dan Boston, president of lobbying firm Health Policy Source, said, “It would be naive to think these people on a Tuesday afternoon just happen to turn up in XYZ places,” adding that the money isn’t necessarily a bad thing. Money tends to flow toward citizen groups that already have the same priorities as their funders, he said.
Marching Into The Future
Patient groups have been successful at campaigning for drug approvals, at times sparking controversy.
When scientists within the FDA advised against the approval of Exondys 51, a drug to treat Duchenne muscular dystrophy, parents of children with the rare genetic disorder and patients rallied to lobby for it in Washington. They were seen as pivotal to the FDA’s 2016 decision to grant approval for the drug, made by Sarepta Therapeutics. The decision was controversial in part because the FDA noted that clinical benefits of the drug — aimed at a subset of people with Duchenne muscular dystrophy — were not yet established.
Sarepta Therapeutics, which is not featured in the database, has taken measures to support its patient base. In March, it announced an annual scholarship program — 10 grants of up to $10,000 each for students with Duchenne muscular dystrophy to attend university or trade schools. Sarepta Therapeutics is also among the funders of Parent Project Muscular Dystrophy, a patient advocacy group at the forefront of the push for Exondys 51’s approval.
The Pre$cription for Power database will grow to include new disclosures. Not all drugmakers are willing to disclose their company giving. Eleven of the 20 companies examined — Allergan, Baxter International, Biogen, Celgene, Endo International, Gilead Sciences, Mallinckrodt, Mylan, Perrigo Co., Regeneron Pharmaceuticals and Vertex Pharmaceuticals— declined to disclose their company giving or did not respond to repeated calls.
Paul Thacker, a former investigator for Sen. Chuck Grassley (R-Iowa) who helped draft the Physician Payments Sunshine Act in 2010, said there is reason to question the flow of money to patient advocacy groups. The pharmaceutical industry has fostered relationships in every link of the drug supply chain, including payments to researchers, doctors and professional societies.
“There’s so much money out there, and they’ve created all of these allies, so nobody is clamoring for change,” Thacker said.
Since the Physician Payments Sunshine Act began requiring the industry to report its payments to physicians, the industry is more reluctant to co-opt them, so “pharma has to find other megaphones,” PharmedOut’s Fugh-Berman said.
And in times of public outrage over high drug prices and soaring insurance costs, patients are particularly sympathetic messengers, she said.
“Sick consumers make for good press,” Fugh-Berman said. “They make for good testimony before Congress. They can be very powerful spokespeople for pharmaceutical companies.”
To learn how Kaiser Health News created the Pre$cription for Power database, read the full methodology, here.
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Opioids lawsuit makes sense, just as tobacco suits did (Opinion)

Apr 5, 2018 | The Olympian (WA)

By Editorial Board

Thurston County commissioners made a good call recently to join other Washington counties and cities in a federal lawsuit against the makers of opioids.
There is evidence some of the largest pharmaceutical firms downplayed the addiction risks that go hand in hand with use of certain pain killers.
The lawsuit, like the national tobacco lawsuits that earned hundreds of billions of dollars for states in the 1990s, seeks to reimburse local governments for the costs incurred as a result of the opioid addiction “epidemic,” as Thurston County Prosecuting Attorney Jon Tunheim puts it.
How much damage Thurston County has actually suffered remains to be calculated, according to Scott Cushing, a senior deputy in the county prosecutor’s civil department.
The federal complaint was filed on behalf of the county by a Seattle law firm. The county alleges that at least 106 Thurston County residents died of opioid-related overdoses during 2012-16. This led county public health director Schelli Slaughter to call opioid addiction a public health emergency.
The lawsuit’s cost and risk for county taxpayers appears small. Thurston County entered into a contingency fee agreement with Keller Rohrback L.L.P. of Seattle that will pay the law firm roughly $1 of every $5 recovered in the suit, depending on the amount won, if any.
Keller Rohrback has filed the lawsuit under the state consumer protection law and federal racketeering statutes on behalf of other local governments including King, Pierce and Skagit counties and the cities of Tacoma, Mount Vernon, Burlington and Sedro-Woolley. The Washington attorney general also is pursuing a case.
Thurston County’s lawsuit was transferred this week to the growing portfolio of opioids cases handled by a federal judge in northern Ohio. That Ohio court is handling a consolidation of potentially hundreds of cases nationwide. Also transferred was a claim by the Nisqually Tribe near Yelm.
The targeted parties include OxyContin maker Purdue Pharma, Percocet maker Endo Pharmaceuticals, and Janssen Pharmaceuticals, the Johnson & Johnson subsidiary that makes patches that release fentanyl, and other manufacturers. The top distributors of opioids including Ohio-based Cardinal Health also are named as defendants, based on an allegation that dangerous drugs were marketed aggressively without adequate warnings of risks.
The moves to counter opioids in court may be new but the ravages of opioid addiction are not. Some experts trace the current addiction crisis to the development of new, highly addictive painkillers that became available in the 1990s.
But while the ground is moving on the national opioids crisis, it would be a shame if the only real progress occurred locally or in courts.
President Trump last month encouraged a federal lawsuit along similar lines. However, Trump and GOP allies have sought to undercut the Affordable Care Act’s expansion of Medicaid, which allowed some states like Ohio and its Republican governor, John Kasich, to expand treatment to more destitute addicts.
Despite heavy lobbying outlays by the drug industry, prescribing practices have been reined in by states like Washington. These prescribing protocols may reduce the number of new addicts.
But as prescribed pain drugs have become unavailable or unaffordable for users, addicts are turning to cheaper heroin, a cousin drug made from opium, and dealers are sometimes cutting heroin with the deadly fentanyl. This is driving some of the death toll.
Slaughter says half of those using clean-needle programs in Thurston County are using heroin.
The answer is not to withhold clean needles or leave addicts for dead in city alleys or door stoops, but to ensure there are pathways for drug-dependent residents to find sobriety.
The lawsuit does not provide that pathway, but it is a welcome piece in the larger fight to reclaim our loved ones, neighbors and even strangers on the street who cannot kick these most potent of addictions.

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Big Pharma to blame (Opinion)

Apr 6, 2018 | Youngstown Vindicator (OH)

By Domenica Ghanem

At a recent rally in New Hampshire, President Donald Trump called for the death penalty for drug traffickers as part of a plan to combat the opioid epidemic in the United States. At a Pennsylvania rally a few weeks earlier, he called for the same.
Now his administration is taking steps toward making this proposal a reality. Attorney General Jeff Sessions issued a memo on March 21 asking prosecutors to pursue capital punishment for drug traffickers – a power he has thanks to legislation passed under President Bill Clinton.
Time and again, these punitive policies have proven ineffective at curbing drug deaths. That’s partly because amping up the risk factor for traffickers makes the trade all that more lucrative, encouraging more trafficking, not less.
But it’s also because these policies don’t address the true criminals of the opioid crisis: Big Pharma.
If Trump really wanted to help, he’d put the noose around drug-making and selling giants like Purdue Pharma, McKesson, Insys Therapeutics, Cardinal Health, AmerisourceBergen, and others.
The president knows this, in a way. These companies “contribute massive amounts of money to political people,” he said at a news conference in October 2017 – even calling out Mitch McConnell, who was standing beside him, for taking that money. Pharmaceutical manufacturers were “getting away with murder,” Trump complained in the same speech.
The pharmaceutical industry spends more than any other industry on influencing politicians, with two lobbyists for every member of Congress. Nine out of 10 House members and all but three senators have taken campaign contributions from Big Pharma.
It’s not just politicians they shell out for.
Opioid pioneer Purdue Pharma, the creator of OxyContin, bankrolled a campaign to change the prescription habits of doctors who were wary of the substance’s addictive properties, going so far as to send doctors on all-expense-paid trips to pain-management seminars. The family that started it all is worth some $13 billion today.
From 2008 to 2012, AmerisourceBergen distributed 118 million opioid pills to West Virginia alone. That’s about 65 pills per resident. In that same time frame, 1,728 people in the state suffered opioid overdoses.
McKesson – the fifth largest company in the U.S., with profits over $192 billion – contributed 5.8 million pills to just one West Virginia pharmacy.
Meanwhile, five companies contributed more than $9 million to interest groups for things like promoting their painkillers for chronic pain and lobbying to defeat state limits on prescribing opioids.
These companies don’t stop at promoting opioids. They also spend big on stopping legislation that would actually help curb opioid use.
Insys Therapeutics, a company whose founder was indicted for allegedly bribing doctors to write prescriptions for fentanyl (a substance 50 times stronger than heroin), spent $500,000 to stop marijuana legalization in Arizona in 2016.
In response, cities and states from New York City to Ohio are suing pharmaceutical companies for their role in the deaths of tens of thousands of Americans every year. It’s time for the federal government to get behind them.
But it’s clear who the real profiteers of the opioid epidemic are. If Trump wanted to get real about curbing incentives for selling opioids, he’d turn away from street dealers and target the real opioid-producing industry.
Domenica Ghanem is the media manager of the Institute for Policy Studies. Distributed by OtherWords.org.

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Surgeon general issues rare advisory: more people should carry opioid overdose antidote

Apr 6, 2018 | Vox

By German Lopez

The surgeon general issued the office’s first advisory in 13 years — calling on more people to carry the opioid overdose antidote naloxone.
Surgeon General Jerome Adams’s advisory emphasizes “the importance of the overdose-reversing drug naloxone. For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.”
The last surgeon general’s advisory was issued in 2005, with a focus on drinking alcohol during pregnancy.
Public health experts and officials applauded the move, believing that greater access to naloxone could help reverse more overdoses and save lives.
Help is desperately needed: The opioid epidemic is now the deadliest drug overdose crisis in US history. Nearly 64,000 people died of drug overdoses in the US in 2016, and at least two-thirds of those deaths were linked to opioids such as fentanyl, heroin, and prescribed painkillers. The total drug overdose deaths were higher than the number of deaths linked to guns, car crashes, or HIV/AIDS during any single year in America. Based on preliminary data from the Centers for Disease Control and Prevention (CDC), 2017 was even worse.
At the same time, there’s a sense of skepticism over just how far an advisory like this one can go.
Dr. Leana Wen, the health commissioner of Baltimore, has seen some of this firsthand. In the past, naloxone has typically required a prescription. But in 2015, her office issued a standing order that effectively acted as a blanket prescription for the entire city of Baltimore.
That helped, but major hurdles remain — particularly, naloxone’s cost. “Unfortunately, we are having to ration naloxone because we simply don’t have the resources to purchase this life-saving antidote,” Wen said in a statement. “Every week, we count the doses we have left and make hard decisions about who will receive the medication and who will have to go without.”
This is why those involved in the response to the opioid epidemic have argued for federal action to make naloxone easier to access. What’s more, while naloxone is an important tool in addressing the crisis, it’s only one part of the broader puzzle.Access to naloxone can be limited
There are essentially two major barriers to getting naloxone: It requires a prescription and it’s expensive.
State and local officials, like Wen, have been working to loosen the prescription part through standing orders and other policies that make naloxone available to first responders like police, friends and family of people with addiction, community groups, and so on. There has been progress, but more work remains to be done in this area — some advocates and experts would like to see a version of naloxone made available over the counter, for example.
But it’s the cost of naloxone that’s become increasingly prohibitive. Depending on the type of product, naloxone can run in the tens, hundreds, or even thousands of dollars, in part the result of cost increases over the years. This can make naloxone very expensive for individuals and organizations, including police departments and harm reduction groups, trying to obtain the drug. The drug’s manufacturers offer discounts and work with insurers to try to bring down the price, but, particularly for broader government organizations and community groups, the price is still a big problem.
The federal government could do more to bring down the cost. Wen argued that the feds “can either negotiate directly with the manufacturers of naloxone so that it’s available at a much-discounted rate, or they can provide direct, sustained funding to local jurisdictions like ours so that we can provide evidence-based, effective treatment. We are in the middle of a national epidemic. We should not be priced out of the ability to save lives.”
Congress has approved new funding to address the opioid crisis, but experts and activists generally agree it’s not enough. President Donald Trump’s administration, meanwhile, has done nothing significant on its end to bring down the price of naloxone.
That leaves those working in the opioid space with the surgeon general’s advisory. While it could be a helpful tool for raising awareness, it simply doesn’t address the core problems.Naloxone is only part of the answer to the opioid crisis
To the extent the surgeon general’s advisory helps, naloxone itself can only go so far.
There’s no empirical consensus on just how many lives would be saved by naloxone if access were dramatically increased. But experts have generally told me that while it can help, it can only be part of a fuller response to the opioid crisis.
Thankfully, experts have a pretty good idea of what should be done: more treatment (particularly via medications like methadone and buprenorphine), more harm reduction (including better access to naloxone), fewer painkiller prescriptions (while ensuring the drugs are available to those who really need them), and policies that can help address the root cause of addiction (like mental health issues and socioeconomic despair).
Doing this will require a lot more resources — potentially tens of billions of dollars a year over several years, some experts have told me. And it will require Congress to really think big about the crisis and the gaps it has exposed in how America systematically deals with addiction.
For example, a 2016 surgeon general report found that about 10 percent of people in the US with a drug use disorder get specialty treatment — attributing the low rate to a lack of supply in care. And even when treatment is available, other federal data suggests that fewer than half of facilities offer opioid addiction medications like methadone and buprenorphine, which are considered the gold standard of treatment and, studies show, cut mortality among opioid addiction patients by half or more.
Consider the counterfactual: What if, like addiction, only 10 percent of people with diabetes or heart disease got treatment? It’d be widely considered a public health disaster — and it’d demand a huge revamp of America’s approach to health care.
Some states have confronted this crisis by essentially rebuilding their addiction treatment system. Vermont, for one, built a “hub and spoke” system that closely integrates addiction treatment with the rest of health care.
But Vermont has managed to do that in large part with federal dollars. And this is going to be true for other states, which are often dealing with multiple priorities and cash-strapped budgets. That’s why they need outside support — and that goes beyond naloxone.
Again, it’s not that naloxone can’t help. It’s widely considered part of the solution.
The surgeon general’s advisory, then, is a step forward. But a lot more is needed before America really starts wrapping its hands around the deadliest drug overdose epidemic in US history.

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Doc: Naxolone no opioid solution

Apr 6, 2018 | Boston Herald (MA)

By Lindsay Kalter

The surgeon general recommended yesterday that more Americans carry the opioid overdose reversal agent naloxone — but local doctors say it is more of a Band-Aid than a fix and the medication’s skyrocketing price could limit access to the general public.
“This can’t be viewed as the end or the solution to all this,” said Dr. Scott Wiener, director of Brigham and Women’s Hospital’s Comprehensive Opioid Response and Education Program. “There are so many interventions that need to happen. Safe prescribing, increasing access to practitioners — this is a foundation and needs to be there, but it can’t be the only measure.”
Surgeon General Dr. Jerome Adams issued an advisory yesterday, calling for people to carry naloxone, more commonly known as Narcan.
“For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life,” Adams said.
Naloxone has been largely credited for the 8 percent drop in fatal overdoses in the Bay State last year.
Boston EMS numbers reflect a significant increase in Narcan use over the years.
The medication was used a total of 11,134 times for the first three quarters of 2015, compared to 13,785 times for the first three quarters of 2017. Fourth-quarter data is not yet available for last year.
And though Wiener said he would get behind Adams’ recommendation, there are some important caveats, including the prohibitive price of the medication.
California-based pharma company Amphastar charges $40 for its version of the medication, which is a 95 percent increase since 2014.
Evzio, a newer and more user-friendly version, is up 500 percent over two years and costs $4,500.
“This is inexcusable in the setting of a public health crisis,” said Dr. Sarah E. Wakeman, medical director of the Massachusetts General Hospital Substance Use Disorder Initiative. “To make it truly feasible for more people to carry naloxone, this price-gouging must be addressed.”
Despite price barriers, doctors encourage those who know people with substance use disorders to keep it close by if possible.
Dr. Traci Green, deputy director of injury prevention at Boston Medical Center — who carries naloxone in her backpack — said friends and family of people with substance use disorder can make the biggest difference by having the medication on hand.
“Keep it in the drawer in the kitchen, the back of the medicine cabinet,” Green said. “It’s a critical thing that anyone can do.”

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Big Employers Spent $2.6B On Opioid Epidemic Costs In 2016

Apr 5, 2018 | Law360

By Danielle Nichole Smith

Large employers’ annual spending on treating opioid addiction and overdoses increased nearly ninefold from $300 million in 2004 to $2.6 billion in 2016, even though opioid prescriptions for covered employees is at its lowest level in nearly a decade, according to a study from two nonprofits released Thursday.
The study from the Peterson Center on Healthcare and the Kaiser Family Foundation said that annual spending on opioid addiction and abuse treatment for employers with at least 1,000 employees has risen nearly every year since 2004 to reach $2.6 billion in 2016. However, large employers’ annual spending on opioid prescriptions peaked at $1.9 billion in 2009 and declined to $1.3 billion in the next seven years.

Matthew Rae, a senior policy analyst with the Kaiser Family Foundation and one of the three authors on the study, told Law360 that the reason for the discrepancy wasn’t clear, but that illegal drug use likely contributed to the gap.

“We don’t know from this data, but in general illicit use has to play into at least part of this. And I think we know that,” Rae said, “Lots of people have gotten — not from this work — but in general, I think there’s a hypothesis that opioids were a gateway for some people to use other illicit drugs, which obviously aren’t being covered by large employer plans.”

The nonprofits’ study said that opioid addiction treatment accounted for about 1 percent of outpatient spending and 0.5 percent of inpatient spending for patients with large employer coverage in 2016, up from 0.3 percent of total inpatient spending and less than 0.1 percent of total outpatient spending in 2004.

In 2016, opioid addiction and overdose treatment added an average of $26 for each person covered by a large employer plan to the annual health coverage costs for large employers, the study said.

Rae said that as employers spend more on opioid addiction and overdose treatment, those costs will likely be passed on to their employees.

The study also said that more than half of opioid addiction treatment coverage went toward employees’ children and another 18 percent went to employees’ spouses. Less than a third of the coverage was for the actual employees, according to the study.

Additionally, more than 60 percent of the $2.6 billion spent on opioid addiction and overdose treatment was for young adults even though older adults were more likely to be prescribed opioids, the study said.

The nonprofits based their study on data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database, which collects claims information from employers with more than 1,000 workers. Cynthia Cox, a director at the Kaiser Family Foundation, and Bradley Sawyer, a senior data analysis for the nonprofit, were also authors on the study.

The Kaiser Family Foundation is a nonprofit focused on national health care issues and the U.S.’ role in global health policy, and the Peterson Center on Healthcare is a nonprofit dedicated to fostering better health care for lower costs, according to their websites.

“We know that we have an opioid health epidemic and that a lot of attention has been spent to the role Medicaid plays in treating people with opioid addiction, abuse and misuse, but also large employers are paying, are contributing to treating this epidemic,” Rae said. “I think [the study is] helping to quantify how all the ways which the opioid epidemic is putting stress on the health system.”

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GOP panel proposes lifting Medicaid limits on opioid care

Apr 5, 2018 | The Hill

By Peter Sullivan

Republicans on the House Energy and Commerce Committee on Wednesday night unveiled a proposal to lift limits on Medicaid paying for opioid treatment.
The proposal could be one of the more significant and costly steps that Congress takes to fight the opioid epidemic, but there are concerns about how to pay for it.
Members of both parties have called for lifting these limits on Medicaid paying for treatment at facilities with more than 16 beds, saying they are a major barrier to care as lawmakers work on a package of opioid bills that could reach the House floor by Memorial Day.
The summary of a bill unveiled Wednesday night would lift those limits specifically if the care is for substance abuse treatment and lasts less than 90 days.
But there are areas of contention: Democrats are worried that the new spending on the bill would have to be offset, which could lead to cuts elsewhere that they find harmful.
A spokesman for Democrats on the committee did not specifically endorse the new proposal, which lifts limits known as the “IMD exclusion,” but said members of both parties want to work on the issue.
“Both Democratic and Republican members have expressed a concern with the IMD exclusion and there is interest in working on policy that preserves and expands access to the full range of providers to treat substance use disorder in Medicaid,” the spokesman said.
It is not clear how much the bill will cost, but it could be a hefty sum. The Congressional Budget Office previously said a full repeal of the limits, for mental health and substance use, would cost up to $60 billion over 10 years.
A spokesperson for Republicans on the Energy and Commerce Committee did not give an exact cost for the bill, but indicated it would be less than $60 billion, saying steps like limiting the move to only the area of substance abuse would result in a “reduced CBO score.”
The spokesperson said the bill would have to be paid for but that offsets had not been decided yet.
Eliot Fishman, senior director of health policy for Families USA, a major liberal health-care advocacy group, expressed concerns with the proposal.
He said the money would be better spent not on extended overnight stays at treatment facilities but on care in the community. And he expressed worries about potential cuts from offsets.
“The only way we could get behind this bill is if the offsets were supportable and if budgetary room was made for a major increase in community-based treatment as well,” he said.

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Prescribing Opioids - Let Physicians Be Physicians (Opinion)

Apr 6, 2018 | American Council on Science and Health

By Chuck Dinerstein

Hospitalists are physicians whose practice consists of caring for patients during their hospitalization and then returning their care upon discharge to the patient’s primary care provider. They are the group, along with surgeons, most responsible for prescribing pain medications for hospitalized patients and they released a new consensus to reduce opioid exposure and improve/standardize care. The recommendations are limited to adults with acute pain, not chronic pain, not patients with cancer and not children. The recommendations are broken down into three categories, deciding to use opioids, using them during hospitalization and prescribing at time of discharge.
Deciding to use opioids
Only for patients with moderate to severe pain who have not responded to nonopioid alternatives.
Consider patient-specific risks with opioids, e.g., medical conditions like sleep apnea or a compromised metabolism as well as a history of substance abuse.
Review prescription drug monitoring program database to fully inform your decision
Educate patient and families about risks and side effects in addition to benefits.
As a surgeon, I would summarize all of these recommendations as obtaining consent, identifying the appropriate reason for the treatment, identifying reasons the patient should not be given this treatment and informing them of the risks and benefits. I think this is a significant advance in physician thinking after all medicine is therapy, why does surgical treatment require written consent and medical therapy nothing at all.
Using opioids during hospitalization
Use the lowest dose for the shortest period
Use immediate release formulations rather than long-acting onesUse oral agents rather than intravenous agents whenever possible
Understand the dosage you are using so that when changing from intravenous to oral or from one medication to another you are consistent
Pair opioids with giving non-opioids at the same time – make use of synergistic effects
Simultaneously provide medication to reduce opioid-induced constipationLimit opioid use when other central nervous system depressants are also being used
Work with patients and family to establish realistic goals and expectations for opioid treatment
Monitor the response to opioids including functional changes and development of adverse effects.
All practical suggestions, intervene the least, understand the medications well-enough to get the right amount at the right time in the right form, prevent and watch for known adverse effects (surgeons label these complications); and most importantly, make sure the treatment is effective and that the risk-benefit balance remains benefit.
Prescribing opioids at discharge
Ask patients about opioids they have at home when writing new prescriptions
Prescribe the minimum quantity anticipated to treat the pain symptoms after release from the hospital
Teach the patient and family how to use these agents at home properly, use, storage, protecting against diversion (that is the term being used when someone else is using your medications), not to mix opioids with sleep meds or alcohol, no driving and call if you are having a problem.
Again, practical, easily implemented guidelines.
What I find most interesting is the process leading to this consensus statement. The authors spoke to practicing physicians, engage experts in usage patterns and clinical outcomes, reviewed the literature and then wrote initial guidance. Those guidelines were then reviewed and commented upon by multiple practicing hospitalists, patients and their families. After taking all these views into account, the recommendations went through a Delphi type review. For those unfamiliar with this technique, the individuals writing the consensus do it in a structured way, beginning with an initial statement, all members of the group proposing revisions, rewriting, re-proposing – it is a form of conversation and debate.
I did find this one comment of greatest concern.
“The greatest limitation of this Consensus Statement is the lack of high-quality studies informing most of the recommendations in the guidelines upon which our Consensus Statement was based. The majority of recommendations in the existing guidelines were based on expert opinion alone. Additional research is necessary before evidence-based recommendations can be formulated.”
This is scientism, cloaking practice in a science of numbers. Perhaps rather than rely on quantitation which will take years to do we should employ the “wisdom of the crowd.” In this case, the crowd is practicing physicians, not just academics or thought leaders; but physicians who treat patients and prescribe opioids every day of their working lives. These clinicians can look at a problem and identify sensible, workable solutions. It doesn’t require Congressional inquiries, onerous regulations or mandated retraining. It only requires that we let physicians known there may be a problem and then let them do what they are trained to do – find appropriate medical solutions.

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Colleges Must Do More To Address The Opioid Epidemic (Opinion)

Apr 6, 2018 | Forbes

By Ryan Craig

Over spring break my 12-year-old son Leo pushed me to take him on Los Angeles’ longest bike trail: the San Gabriel River Bikeway in East L.A., which runs for nearly 40 miles from the mountains to the Pacific in Seal Beach. The bike trip began pleasantly but rapidly became a tour of Los Angeles homelessness. Along the route, we passed hundreds of encampments, where thousands of homeless people were trying to get by. From what I saw and overheard, many had substance abuse issues, probably connected to the opioid epidemic currently plaguing America. The scope of human capital wreckage dominated my thoughts for days.
As we biked, I asked Leo what he would do to try to help these people. He said he’d want to help the youngest first, which led to a 5-mile discussion of schools and training. When I got home, after passing out, I looked up the numbers. Opioid addiction among young Americans (under age 25) has increased nearly 6x from 2001 to 2014. According to the New York Times, opioid-related deaths among Americans 24 and under almost doubled from 2005 to 2015 to 3,165 and opioid-related ER visits by young people nearly doubled from 2009 to 2014.
In February I wrote about Janesville, WI: the closing of the GM plant in 2008 and how the community college classrooms into which displaced workers were funneled turned out to be an inadequate reskilling solution: between half and two-thirds of laid-off workers left before completing. As I noted, we’re unlikely to engage those in greatest need of reskilling if college classrooms – environments where they were previously unsuccessful – are the sole, or even initial modality.
Young people struggling with opioid addiction are an even clearer case. Four fundamental elements of college campuses make them suboptimal environments for those struggling with opioids: (1) an anything-goes approach to alcohol and drugs; (2) high pressure; (3) lack of structure; (4) they’re in this environment for at least four years.
Speaking to the New York Times, Dr. Andrew Kolodny, co-director of Opioid Policy Research at Brandeis describes a “a pill-for-everything culture,” where – according to Dr. Joseph Lee, medical director for youth services at the Hazelden Betty Ford Foundation – college students act as mixologists, creating dangerous drug and alcohol cocktails for themselves and friends. According to the Times, “Prescription pills are part of the party mix. Xanax, a highly addictive anxiety drug, has become a popular accompaniment to beer and vodka shots. Adderall is crushed for snorting. And Vicodin is ingested as a relaxant, available from students with prescriptions or on an online black market.” In such a substance hot house, whether due to academic pressure or peer pressure – and exacerbated by the lack of structure and a four-year exposure – it’s nearly impossible for students with a history of opioids to stay clean.
Despite the fact that, according to a 2016 University of Michigan survey of 870 college students, 7% reported misuse of opioids (and that non-college students reported opioid abuse at a rate of close to 13%), that the number of opioid-related claims submitted for college-age patients to Blue Cross Blue Shield has almost doubled since 2010, and that overdose reversal kits of naloxone are commonly found on campuses, colleges have completely failed to address the underlying problem.
A handful of campuses have created the opioid equivalent of sober-living dorms. Some provide counseling or parent support groups. UNC even offers to monitor students through urine tests. But the most robust response has been a private company, The Haven at College, which boasts of “disrupting addiction on college campuses” as the “leading national provider of on-campus addiction treatment and recovery support services at premier universities.” With “recovery residences” at USC, Drexel, University of Redlands, UC Santa Barbara, University of San Francisco, and new programs opening this fall at Miami University (Ohio) and University of Maryland, The Haven has found a major market opportunity.
But none of these programs fundamentally “disrupt” the four elements that make college campuses so inappropriate for students struggling with opioids. First, they’re not treating addiction. The standard of care for opioid addiction is medication like suboxone – administered under the supervision of a qualified medical professional – that fulfills cravings and stops withdrawal symptoms. Second, participants continue to spend most of their time outside the “recovery residence,” subject to the same academic and peer pressure, and the same lack of structure, and exposed to a range of substances. And finally, they’re expected to persist in this environment for years.
So if you read articles like this one in Politico, suggesting that colleges and universities are actively combatting the opioid epidemic, be wary. So far, higher education’s response amounts to nothing more than jerry-rigging a cheap superstructure atop the standard college experience. It shouldn’t be surprising: in Janesville, the community college added advisors, instructors, and more sections in an attempt to accommodate displaced GM workers. What they didn’t do is rethink the model.
If colleges and universities are serious about helping students struggling with opioids (and not simply taking their tuition dollars), they'll begin developing different programs with the following elements:
1) Medical treatment under medical supervision;
2) Separation from other students and much more structure – tapering off as students demonstrate success;
3) Off-ramps leading to good jobs, so students don’t need to spend four years in order to get a win. Most parents of young adults struggling with opioids would trade anything for a clean, employed child; a degree is the least of their concerns. Then provide on-ramps back to degree programs for students who are prepared for the next challenge.
Millions of workers requiring reskilling are ill-served by our current “one-size-fits-all” approach to higher education. Likewise, as a result of the opioid epidemic, millions of young Americans who are spectacularly ill-equipped to succeed are being shoehorned onto college and university campuses. We’re facing major social problems and Band-Aids on the current system are not only insufficient, they’re cruel. It’s mind-boggling how much human potential is being wasted.

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The Health 202: How a fringe idea to solve the opioid crisis turned mainstream

Apr 6, 2018 | Washington Post

By Paige Winfield Cunningham

The idea that a someone who's not a medical professional could reverse deadly drug overdoses by injecting victims with an antidote was once fringe. Now it’s widely accepted – and got even stronger backing yesterday with a rare announcement from the U.S. surgeon general.
Jerome Adams urged Americans to consider getting trained to administer naloxone, a drug used broadly by first responders that has proven highly effective in reversing opioid overdoses. The first advisory from a surgeon general in more than a decade – the last one, in 2005, was to warn pregnant women against imbibing – is the latest indication the Trump administration is trying to take on the opioid epidemic, which killed more than 42,000 people in 2016.
“If you or someone you know is at risk for an overdose, carry and know how to use naloxone,” Adams said yesterday at the National Rx Drug Abuse Summit.
The advisory from his office urges people to talk to their doctors or pharmacists about obtaining naloxone, learn the signs of opioid overdose and get trained in how to administer it if needed. “You have an important role to play in addressing this public health crisis,” the advisory says.
Drug abuse experts and advocates applauded the advisory, saying it draws much-needed attention to a medication that holds great promise for saving lives. Administered through a nasal spray or an injection, and often purchased under the brand names Narcan and Evzio, naloxone is carried by many paramedics, firefighters and police officers, particularly in states such as Ohio that have some of the highest rates of drug abuse.
Naloxone is being embraced in other places, as well. Most states and several cities have made moves allowing anyone to obtain naloxone at a pharmacy without first getting a prescription. It’s covered by most insurance plans and many public-health programs. Even some librarians have learned to administer the drug to people who overdose within public facilities.
“Over the course of the last — I would say — two decades, it has gone from being an unorthodox idea to a very mainstream and acceptable idea,” Robert Heimer, an epidemiology professor at the Yale School of Public Health, told me.
Research supports the idea that family and friends are well able, if trained, to administer naloxone to their loved ones who have overdosed. A 2009 study published in the American Journal of Public Health concluded that based on data from pilot programs, lay people “are consistently successful in safely administering naloxone and reversing opioid overdose.”
“The peers or family members of overdose victims, however, are most often the actual first responders and are best positioned to intervene within an hour of the onset of overdose symptoms,” the researchers wrote.
Dan Bigg directs the Chicago Recovery Alliance, one of the largest syringe exchange programs in the Midwest. Bigg told me he was motivated to start distributing naloxone to lay people in the 1990s after losing a friend to a drug overdose. Naloxone had been on the market for a quarter-century and was never given to “the people who most needed it,” Bigg said.
“I think Jerome Adams is a genius — and a brave genius,” he added.
Yet some big barriers remain when it comes to making naloxone more widely available. For one thing, people need to learn to administer it, much like they would be trained in CPR or in using an EpiPen.
For another thing, the cost has increased dramatically in recent years. The fire department in the District paid about $6 for a pre-filled syringe in 2010 but the price is now around $30, according to a report last year by NPR. The pharmacy chain CVS announced yesterday it will start discounting Narcan for uninsured customers, bringing down the list price from $125 to $94.
Baltimore City Health Commissioner Leana Wen said she is being forced to ration naloxone because the city doesn’t have the finances to buy as much as it needs. Wen said she’d prefer the federal government to either negotiate lower prices with naloxone manufacturers or help local jurisdictions pay for the drug.
“Every week we count the doses we have left and make hard decisions about who will receive the medication and who will have to go without,” Wen said.

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Southeast (FL, NC)

New opioid lawsuit accuses drug companies of 'corporate greed'

| Sun Sentinel (FL)

By Skyler Swisher

Palm Beach County has joined a growing list of local governments accusing drug makers, distributors and pharmacies of putting profits ahead of the public’s health and fueling an opioid epidemic that has cost taxpayers millions of dollars.
“This case is about one thing: corporate greed,” the lawsuit filed Thursday in Palm Beach County circuit court states. “Defendants put their desire for profits above the health and well-being of Palm Beach County consumers. “
About 600 people died of opioid overdoses in Palm Beach County this past year, making it one of the hardest hit counties in the state.
The lawsuit names 29 defendants, including big name companies, such as Purdue Pharma, McKesson Corp., Janssen Pharmaceutical, Walgreen Co. and CVS Health.
The county accuses those companies of spending hundreds of millions of dollars to develop and distribute scientific and educational materials that misrepresented the risks of opioids, such as OxyContin, Fentanyl and Percocet and co-opting doctors to deliver scripted talks and misleading studies.
“The thousands of Palm Beach County families struck by this epidemic deserve to hold someone accountable for deceptive, unscrupulous practices involving opioid dispensing, advertising and prescribing,” County Mayor Melissa McKinlay said in a statement. “I am grateful the day has finally come that we are filing suit and saying enough is enough.”
Industry groups have denied wrongdoing. In response to a lawsuit filed by Osceola County, Purdue Pharma issued a statement that the company followed all federal guidelines, helped law enforcement gain access to the overdose antidote naloxone and developed three new opioid medications with “abuse-deterrent properties.”
The county is represented by The Ferraro Law Firm, P.A.; Napoli Shkolnik PLLC; and Stull, Stull & Brody.

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Palm Beach County sues Wal-Mart, CVS, drug firms over opioid crisis

Apr 5, 2018 | MyPalmBeachPost.com (FL)

By Wayne Washington

Palm Beach County has filed suit against more than two dozen individuals and firms — including mega-companies like CVS, Wal-Mart and Johnson & Johnson — alleging that their negligence and deceptive trade practices have contributed to the ongoing opioid crisis.
The 266-page complaint, filed Thursday in Palm Beach County Circuit Court, is massive not only in size but in scope. It represents the county’s high-stakes effort to recoup money it has spent battling an epidemic that has devastated families here and across the country.
“The thousands of Palm Beach County families struck by this epidemic deserve to hold someone accountable for deceptive, unscrupulous practices involving opioid dispensing, advertising and prescribing,” Palm Beach County Mayor Melissa McKinlay said in a written statement late Thursday. “I am grateful the day has finally come that we are filing suit and saying enough is enough.”
Palm Beach County filed suit even as some commissioners expressed reservations about one of the law firms that will be spearheading the county’s effort.
That firm, Napoli Shkolnik, is joining with fellow New York firm Stull, Stull and Brody as well as the Ferraro Law Firm of Miami, to represent the county in a legal battle that pits the county against some of the most financially and politically powerful firms in the country.
“This case is about one thing: corporate greed,” the complaint alleges. “Defendants put their desire for profits above the health and well-being of Palm Beach County consumers at the cost of Plaintiff.”
Those costs have been cataclysmic both in human and financial terms, the complaint says.
The opioid crisis has affected everything from homelessness and foster care to emergency services and law enforcement.
Palm Beach County’s lawsuit lays blame for the crisis directly on the 29 people and firms it is suing.
“Defendants, through a sophisticated, highly deceptive and unfair marketing campaign that began in the late 1990s, deepened around 2006, and continues to the present, set out to, and did, reverse the popular and medical understanding of opioids,” the complaint alleges. “Chronic opioid therapy—the prescribing of opioids to treat chronic pain long-term—is now commonplace.”
The Palm Beach Post, which has reported extensively on the opioid crisis, was not able to reach defendants Thursday evening to get responses to the complaint, which was filed at 3:45 p.m. and provided to the newspaper 45 minutes later.
In addition to Wal-Mart, CVS and Johnson & Johnson, the 29 defendants include: Walgreens, Purdue Pharma, Teva Pharmaceuticals and Watson Laboratories of Palm Beach Gardens, Cephalon, Insys Therapeutic, Ortho-McNeil-Janssen, Endo Pharmaceuticals and Cardinal Health.
Insys Therapeutics is accused in criminal indictments and lawsuits across the country of bribing physicians to write prescriptions for its fentanyl spray.
Two of its executives, under indictment on RICO charges in Massachusetts, hail from Palm Beach County.
Alec Burlakoff, once a counselor at a private prep school in Boca Raton, is named time after time in court actions as being the brainchild and chief driver in what prosecutors describe as a “sham” speakers program to get “money in doctors’ pockets.”
Sunrise Lee, a regional sales chief, was a former exotic dancer at Rachel’s Gentlemen’s Club in West Palm Beach, according to news reports.
Greenacres’ Bart Gatz is one of the top prescribers and speakers of Insys’ spray, called Subsys, in the country. He said he believes he is one of 10 doctors described in the indictment as “co-conspirators” but did nothing wrong.
In the county’s lawsuit, it alleges a long series of misdeeds by the plaintiffs: deceptive marketing, deceptive sales training, fraudulent marketing, misleading medical education, funding false presentations and publications and unjust enrichment.
With the suit, Palm Beach County joins Delray Beach and Broward County as regional governments that have gone to court in the opioid battle.
Similar suits have also cropped up across the nation as governments turn to companies profiting from the manufacturing, distribution and sale of opioids to recoup money they have spent battling the crisis.
There have been some settlements, but the stakes could still be high. Some lawyers argue that losing a case against such deep-pocketed firms could result in the county having to pay court costs and attorneys fees, which, given the complexity and time required to handle these cases, could be significant.
Some commissioners have sought to protect county taxpayers from that possibility by insisting that firms representing the county agree to cover any and all costs that could arise from an opioids suit.
Others, however, agreed with lawyers who said such indemnification violates Florida Bar rules against firms providing financial assistance to clients and covering the costs of parties that file unsuccessful or frivolous lawsuits.
Of the three teams of firms that were finalists in the county’s bidding process, only the Napoli-Stull-Ferraro team said the bar’s ethics rules don’t preclude it from offering the full indemnification the county sought.
The bar issued an advisory opinion saying the county’s indemnification provisions do violate its ethics rules, generating calls from commissioners Dave Kerner and Mack Bernard for a re-opening of the bidding process so teams that didn’t agree to the provisions could be considered again.
County Attorney Denise Nieman disagreed with the bar’s advisory opinion, and, after sharing the opinion of an ethics expert who also disagreed with the bar, told commissioners they were free to insist upon full indemnification.
She recommended that commissioners not re-open the selection process, saying doing so could force the county to pay for work already undertaken by the Napoli-Stull-Ferraro team and undermine faith in the county’s selection process.
The Post has reported on lurid claims and counterclaims by and against one Napoli Shkolnik attorney, Paul Napoli. And the newspaper has reported on allegations of client poaching and excessive fees filed against another Napoli Shkolnik attorney, Hunter Shkolnik.
Both men deny the allegations against them and say they are prepared to press the county’s case.
Kerner said Thursday’s filing does not moot the question of whether the Napoli-Stull-Ferraro team should represent Palm Beach County.
“If new counsel is retained, they can come in and amend it as necessary,” he said. “Napoli is our attorney for right now, and we’ll have to rely on their advice.”
THE DEFENDANTS
Purdue Pharma LP, Wilmington, Del.
Purdue Pharma Inc., Wilmington
Purdue Frederick Co., Wilmington
Teva Pharmaceuticals USA Inc., Palm Beach Gardens
Cephalon Inc., North Wales, Pa.
Johnson & Johnson, New Brunswick, N.J.
Janssen Pharmaceuticals Inc., Plantation, Fla.
Ortho-McNeil-Janssen Pharmaceuticals Inc., Plantation
Janssen Pharmaceutica Inc., Plantation
Endo Pharmaceuticals Inc., Malvern, Pa.
Allergan PLC, Plantation
Actavis Inc., Parsippany, N.J.
Watson Laboratories Inc., Palm Beach Gardens
Insys Therapeutic Inc., Chandler, Ariz.
Mallinckrodt LLC, Wilmington, Del.
Actavis LLC, Parsippany, N.J.
Actavis Pharma Inc., Parsippany
Endo Health Solutions Inc., Malvern
McKesson Corp., Tallahassee
Cardinal Health Inc., Plantation
AmerisourceBergen Drug Corp., Plantation
Anda Inc., Palm Beach Gardens
Health Mart Systems, Inc., San Francisco
CVS Health Corp., Woonsocket, R.I.
Walgreen Co., Deerfield, Ill.
Wal-Mart Inc., Bentonville, Ark.
Perry Fine, Salt Lake City, Utah
Scott Fishman, Sacramento, Calif.
Lynn Webster, PRA Health Sciences, Salt Lake City

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Florida Could Soon File Its Own Opioid Abuse Lawsuit

Apr 5, 2018 | WJCT (FL)

By Sacha Cordner

Florida could soon be filing its own opioid abuse lawsuit against drug manufacturers. They’d be joining a long list of states, counties, and cities that have done the same.
Just last year, Governor Rick Scott declared Florida’s opioid crisis “a state of emergency,” due to increased overdose deaths. Lawsuits filed around the nation blame the epidemic on overprescribing and the over promoting of opioids. And, Attorney General Pam Bondi says when she files the lawsuit, her ultimate goal is to stop what she calls “bad behavior.”
“We are in the last round of interviewing outside counsel to assist us in the opioid litigation,” she said. “People have been asking whether we’re joining the multi-state [one]. I have been working with my counterparts across the country, but Florida is the third largest state in the country. We will be filing our lawsuit, just as we did in the BP Oil Spill because Florida deserves the maximum compensation for all the deaths that have happened in our state. We’re not going to be joining anyone else. We’re going to be doing our own lawsuit, just as we did in BP.”
Her comments come as U.S. Surgeon General Jerome Adams Thursday urged more Americans to carry naloxone, a drug that can help treat opioid overdoses.

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County joins opioid lawsuit

Apr 6, 2018 | Elizabeth City, NC

By Jon Hawley

Pasquotank County has joined nationwide litigation against opioid manufacturers and distributors, whom a consortium of lawyers alleges drove the addictive drugs' proliferation throughout the U.S.
In a 7-0 vote, commissioners voted to hire McHugh Fuller Law Group, of Hattiesburg, Mississippi, one of six major law firms pursuing damages against manufacturers and distributors, the latter including McKesson, Amerisource Bergen, and Cardinal Health, among others.
An attorney working with the consortium, Garry Whitaker, of Winston-Salem, invited Pasquotank to join the litigation in a meeting last month. Whitaker will serve as co-counsel with McHugh Fuller and as Pasquotank's point of contact with the legal effort, according to county staff.
McHugh Fuller is part of a consortium representing more than 200 governmental entities across numerous states, according to a document Whitaker provided. In suing the companies, the lawyers argue manufacturers and distributors failed to report “suspicious orders” of opioids to pharmacies as required by the federal Controlled Substances Act, and engaged in deceptive marketing to promote the drugs' use despite their health risks.
Pasquotank's decision to join the litigation follows years of rising prescriptions — and subsequent overdose deaths — in the county. Law enforcement and health officials also fault the drugs for driving up the use of heroin, which is an illegal though often cheaper option for opioid addicts.
Apart from the harm that excessive opioid use is causing, Pasquotank commissioners joined the litigation for another reason: it won't cost anything.
The legal firms involved will be paid from any settlement, relief or damages paid to the local governments involved. The attorneys would receive 25 percent of monetary damages, plus litigation expenses, according to the agreement.
County staff also reported the law firms' total fees and expenses may not exceed 35 percent of any recovery.
In an interview last month, Whitaker said it's unclear when the opioid litigation will be resolved. Even though multi-district litigation merges similar cases and streamlines their resolution, the accused companies are fighting to avoid or minimize payouts that could be in the billions of dollars. Published reports note the case is being heard in Ohio by federal Judge Dan Polster.
The Healthcare Distribution Alliance, a trade organization representing the accused companies, rejects the claim that they are at fault in the abuse of prescription opioids. Following Whitaker's presentation, a public relations firm shared the following statement with The Daily Advance from HDA Senior Vice President John Parker:
“The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders.
“Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated. Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

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Northeast (ME)

Augusta City Council to Vote on Joining Lawsuit Against Pharmaceutical Companies

Apr 5, 2018 | LegalScoops

By Jacob Maslow

City councilors in Augusta will discuss the potential of joining other counties and municipalities in lawsuits against pharmaceutical companies. The decision will be made on Thursday, and in accordance to Augusta’s agreement with law firms, the city would not have to pay unless the case is won.
The lawsuits revolve around claims that pharmaceutical companies withheld information to doctors and patients about how addictive the drugs prescribed are.
Opioid addiction and drug overdoses are on the rise in Maine. The number of drug overdose deaths rose to record levels last year when they hit 418 deaths. The 11% rise in overdoses from 2016 are attributed to a rise in heroin-related deaths and prescription painkillers. Heroin, painkillers and illicit drugs were responsible for 354 of the 418 deaths in 2017.
The lawsuit alleges that the public has suffered due to drug companies suppressing the risks of opiate addiction.
Augusta, as well as many other parties that have joined the lawsuit, stand to gain money from a settlement if one is reached. County, state and municipal governments have spent considerable public resources to help combat drug addiction in cities.
Augusta could recoup money spent on ambulances using Narcan, overtime spent on police officers and rescue workers that respond to overdose calls and other drug-addiction related costs. Proceeds would additionally be used to help form treatment programs to lower the risk of overdoses in Augusta.
The city would have no financial obligation to law firms involved in the case. If the case is won, law firms would deduct their fees from the funds awarded in a judgment or settlement. Augusta’s City Council will meet on Thursday night at the Augusta City Center to discuss joining the lawsuit.
County commissioners in Kennebec agreed to join the lawsuit last month. Waterville officials also announced that they would

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Southwest (OK)

Nation files lawsuit against opioid manufacturers

Apr 5, 2018 | MVSOKEMEDIA.com (OK)

By Darren DeLaune

The Muscogee (Creek) Nation filed a lawsuit April 3 against seven opioid manufacturers.
This makes MCN the second of the Five Civilized Tribes to file a lawsuit due to the opioid epidemic, with the Cherokee Nation of Oklahoma being the first.
MCN Attorney General Kevin Dellinger said they filed a complaint in federal court in Tulsa, Oklahoma.
“There has been a lot of talk over probably the last year or so about the opioid epidemic,” he said. “Epidemic really does describe it.”
Dellinger said it has been about a year of looking into the seriousness of the issue and the damage that is has been caused to the tribe.
“Based upon that, we felt it was urgent and very important to the Muscogee (Creek) Nation and looking out for the best interest of our citizens that we needed to take action and file a complaint,” he said.
Dellinger said opioids are a huge issue in Oklahoma, as well as Indian Country.
“Opioids are used to address chronic pain,” he said. “When prescribed properly.”
He said the medication could have catastrophic effects when not used properly. He said opioid use for non-medical purposes can cause damage.
“It can have serious issues on one’s health and lead to even death,” Dellinger said.
In an MCN press release, the seven manufacturers named in the suit are Purdue Pharma L.P., Purdue Pharma Inc., The Purdue Frederick Company, and Endo Health Solutions Inc., as well as distributors McKesson Corporation, Cardinal Health Inc. and AmerisourceBergen Corporation, as well as pharmacies CVS Health Corporation, Walgreens Boots Alliance Inc. and Wal-Mart Stores Inc.
Dellinger said it is possible for MCN to look into doctors who prescribe opioids to their patients.
“I think that is a possibility, but what we’re looking at here is the manufacturer,” he said. “The manufacturers know the effects of opioids.”
He said the manufacturers, over the years through misstatements, led distributors, pharmacies and doctors to believe that opioids do not have negative effects on a person’s health.
“That’s where the issue has started,” Dellinger said.
Cherokee Nation filed a suit against opioid manufacturers in April 2017, becoming the first Native American tribe to do so.
Dellinger thinks the problem is being looked at and it will be up to each tribe to pursue a lawsuit against the manufacturers.
“There are other tribes within the country who have filed as well,” he said. “It wouldn’t surprise me if the other tribes do file.”
He said MCN wants the problem to be resolved for the citizens.
“That’s the first thing we are looking at,” Dellinger said.
Dellinger said there are regulations in place for manufacturers and distributors to take steps and action to prevent the illicit diversion of opioids to the public.
“I think we want those requirements followed,” he said.
He also said for every dollar the Nation spends dealing with opioids, it is money that could have gone towards education, health care, law enforcement and economic development.
“There’s lots of things we could be doing with those funds to help our Nation become stronger,” Dellinger said. “We are seeking damages for those things we have had to address and take care of out of our own pockets.”
Dellinger said no court date has been set. The manufacturers will have an opportunity to respond to the claim.

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Northwest (WA)

Thurston County Files Lawsuit Against Opioid Manufacturers

Apr 5, 2018 | Nisqually Valley Times (WA)

By Andrew Kollar

Last week Thurston County added their name to the long list of cities, counties and states suing the largest prescription drug manufacturers in the nation for fueling the opioid epidemic.
The lawsuit, initiated by Thurston County Prosecuting Attorney Jon Tunheim alleges multiple opioid manufacturers including Purdue Pharma violated the Washington Consumer Protection Act and the Racketeer Influenced and Corrupt Organizations Act for creating a public nuisance and acting in negligence.
Thurston County accused pharmaceutical companies of orchestrating deceptive marketing campaigns and for deceiving doctors and the public to believe that opioids could treat long-term chronic pain without being addictive despite knowing the risks.
A lawsuit filed by Washington state Attorney General Bob Ferguson accused Purdue of similar misconduct and found one physicians practice out of Yelm and Olympia prescribed about 6,300 prescriptions of Oxycontin, Brutans and Hysingla between 2008 and 2016. The unnamed Yelm and Olympia clinics received 537 visits from Purdue sales representatives between that time and prescribed more than three times more Purdue opioids than the second highest prescriber in Olympia.
“Opioid addiction has reached epidemic levels in Thurston County and opioid related deaths have increased dramatically over the past decade,” Tunheim said in a press release. “We believe these companies directly contributed to the creation of this epidemic.”
Drug overdose is the leading cause of death in Americans under 50 years old and more than 300,000 people have died from opioid overdose in the U.S since the year 2000, surpassing the number of car related deaths according to the lawsuit. 106 residents of Thurston County died of opioid overdose between 2012 to 2016 equalling nearly eight deaths per 100,000 people.
“Because of defendants’ misconduct, Thurston County is experiencing a severe public health crisis and has suffered significant economic damages,” the Thurston County lawsuit states. “Thurston County has incurred substantial costs in responding to the crisis and will continue to do so in the future.”
Opioid manufacturers are accused of failure to monitor, detect, investigate and report suspicious orders of prescription opioids through the prescription monitoring program. Thurston County is suing for an undetermined amount of money for damages including increased cost related to public health, opioid-related crimes and emergencies, healthcare, criminal justice and public safety.
Purdue manufacturers Oxycontin, one of the most popular prescription painkillers prescribed after surgeries. According to the lawsuit filed by Ferguson, opioids created a dependence for patients which caused them to find alternatives when prescriptions were cut off. The conclusion was supported by a survey that found 80 percent of heroin users reported using opioids before heroin.
Thurston County Public Health and Social Services Director Schelli Slaughter called the opioid crisis a “public emergency,” referring to data acquired by the Thurston County syringe exchange program.
“Last year, roughly half of the individuals who used our county syringe exchange reported their primary drug was heroin,” Slaughter said. “We know that people from all walks of life are struggling with addiction, and that needs to be addressed not just on the streets, but at the source.”

Thurston County is represented by Keller Rohrback, a Seattle-based law firm nationally recognized for litigations against some of the largest corporate defendants in the country. The law firm also filed suits on behalf of King County, Pierce County, Skagit County, and the cities of Tacoma, Mount Vernon, Burlington, and Sedro-Woolley.

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Broadcast Media Coverage

Morning Report

Apr 6, 2018 | Portland, ME

By WCSH (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34053936?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: major opioid manufacturers for a billion dollars in damages for allegations including fraud, negligent marketing, and being a public nuisance. mayor ethan strimling says if they win the lawsuit, he would suggest the money be spent on recovery programs. and .. the u-s surgeon general is encouraging more than just first responders to learn how to use and carry the overdose reversing medication, narcan. doctor jerome adams issued an advisory yesterday at a drug abuse summit in an effort to make more people aware of the life-saving medicine narcan... also called naloxone. doctor adams calls opioid addiction a public health crisis. a man from lisbon is expected in court

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WMTW News 8 at 6am

Apr 6, 2018 | Portland, ME

By WMTW (ABC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054007?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: in "state of addiction" this morning, the city of portland has filed a lawsuit against a list of major pharmaceutical companies. cristina: wmtw news 8's tyler cadorette is live in portland this morning. tyler, who exactly is the city targeting with this? tyler: we have been following this since yesterday. that suit targets some of the biggest drug companies as well as a handful of doctors. it was filed by the city yesterday afternoon. in it, more than 800 allegations. the lawsuit claims corporate greed is partially reponsible for the deaths of hundreds of mainers as a result of opioids. major ethan strimling says it's a matter of keeping these companies in check amid the growing opioid crisis. >> as we did in the 1980's and 1990's in holding the tobacco companies accountable, today we recognize that the opioid companies must be held accountable. tyler: reaction from the other side, part of a response from the healthcare distribution alliance reads, "given our role the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated." in portland,

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NEWS CENTER Morning Report

Apr 6, 2018 | Bangor, ME

By WLBZ (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054046?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: in damages by contributing to the opioid epidemic. 6:03 AMnow, the city is filing a lawsuit against them. the lawsuit, filed yesterday, alleges fraud, negligent marketing, and public nuisance, among other complaints... in other words, the city alleges major opioid manufacturers knew the dangers of the medications, such as the addictive qualities, and waning effectiveness with increased use. in 2017, 418 mainers died from drug overdoses -- and nearly 85 percent of those were due to using at least one opioid. those numbers are up from the previous year. in the last year-and-a-half... portland police, fire, and public health staff have administered hundreds of doses of naloxone -- the overdose reversal drug. and public works crews report picking up roughly 18- hundred discarded needles across the city in 2017 alone. "we want to go to these companies and hold them accountable becasuse it was not clear, i don't believe, even when it first came out, even though they may have known how addictive these can be and how much they can lead to more significant problems." "i didn't start with illicit drugs, i started with prescription medication. there needs to be a message sent to the opioid manufacturers. the damage has already been done, so it's important for us to hold those people accountable." many of the companies didn't respond to our request for comment -- but a few did -- saying that the claims are unsubstantiated and that they provided the appropriate warnings. mayor strimling says if they win the lawsuit, he would suggest the money be spent on recovery programs. drug treatment

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FOX23 News at Ten

Apr 5, 2018 | Portland, ME

By WFPO (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34054093?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: portland is taking the fight against the opioid epidemic to the drug manufacturers and distributors. the city announced it's suing the drug companies for the doctors as well involved in the distribution of these drugs. and they are joining other municipalities by filing a lawsuit hope getting help dealing with the staggering cost. >> the city of portland has far too much of the burden of opioid epidemic shouldered by the city. this lawsuit is to recoup some of the expenses outlaid by the city and some expenses we anticipate in the future. >> the defendants include perdue pharmaceuticals, johnson & johnson and others, in a statement a trade association representing distributors writes...

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necn NOW

Apr 5, 2018 | Boston, MA

By NECN (NEWSENG)

Video Link: http://app.criticalmention.com/app/#clip/view/34054502?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: lawsuit against makers of opioids and prescribers. city officials will file the lawsuit in cumberland county superior court. portland officials say defendants include, among others, purdue pharmaceuticals and its affiliates, cephalon, johnson & johnson, and various doctors involved in the distribution of these drugs. the city is also being represented by attorneys from new york -- who represent many other municipalities across the country in similar suits. situation.

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Fox 29 Morning News

Apr 6, 2018 | West Palm Beach, FL

By WFLX (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34053884?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: palm beach county suing big household names. you probably shop at these places, buy their products. the county claims the companies and firms are contributing to the opioid cris. andrew ruiz is live to tell us about the accusations. >> this is big companies, including walmart, cvs, johnson & johnson and even pure purdue 8:34 AMpharma, claim they all bear some responsibilities in the opioid cris these communities are seeing. right here in palm beach county lawsuit was filed, 266 payments worth we're trying to get our hands on. in it we were told by the palm beach post said that the mayor says that the residents deserve some accountability or deserve to hold these companies accountable for the responsibility that they bear. the mayor said in a statement saying that they're "deceptive practices involving opioid dispensing, advertising and prescribing" across the country, bribing physicians who write physicians for fentanyl. some of these settlements have resulted in up to $150 million for some of these counties and municipalities. we're working to get our hands on that document as this is a very developing story and we're also trying to reach out to the defendants to see if they have anything

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Fox 61 Morning News

Apr 6, 2018 | Hartford & New Haven, CT

By WTUC (Fox)

Video Link: http://app.criticalmention.com/app/#clip/view/34053907?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: new london is now the latest conecticut comunity to sue big name pharmaceutical companies for their alleged role in the growing opioid crisis.. new london mayor michael passero says the city plans to file a lawsuit in superior court, holding opioid manufacturers and distributors accountable for damages.. mayor passero says there have been 16 opioid- related deaths betwen 20-16 and 20-18, and nearly 20 overdoses during that period.. c-v-s health wil now be offering a big discount on narcan -- to customers who do not have health insurance. the rhode island based company announced it would aply a manufacturers coupon for the opioid reversal drug... it would reduce the cost to 94.99. the list price for a carton of two nasal sprays is 125. cvs' announcement coincides with a rare public health advisory from surgeon general jerome adams. who is now calling on more americans to cary narcan -- especially those with loved ones addicted to opioids. a new report shows the stunning cost of the opioid epidemic.. employers reportedly spent 2-point-6 billion dollars to treat addiction - and overdoses in 20-16. that's an eight- fold increase since 204. more than half of that money, went to treat the children of employees. a local community is teaming up to tackle the opioid crisis. bridgeport mayor joe ganim, the city's police department and numerous suport groups are teaming up to host a round table on the issue. doors wil open at 9 am for a continental breakfast, with the discussion starting at 10. it's taking place at the margaret e. morton government center in bridgeport.

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Local 24 News Midday

Apr 5, 2018 | Memphis, TN

By WATN (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34053923?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: arkansas attorney general leslie rutledge and u-s- senator tom cotton want tougher penalties for drug dealers--- including the death penalty. the duo briefed arkansans on their state and federal efforts--- including law enforcement and parents who have lost children to drugs. rutledge is suing three opioid manufacturers. cotton is sponsoring legislation to allow stricter prison sentences for dealers of fentanyl... which he has called a "weapon of mass destruction." he told the crowd what 100 pounds of the substance is capable of. sen. tom cotton/r- arkansas: "t give you a sense of how potent it is, by some estimates, that's enough to kill up to 18 million people, vastly more than the most powerful nuclear weapon known to mankind." john p: both cotton and rutledge saypelty for drug dealers--- something president trump has mentioned. caitlin: could marijuana help curb america's opioid epidemic? according to two studies... the answer is "yes. researchers compared opioid prescription patterns in states with and without medical cannabis laws-- studies show that states with medical marijuana had 2-point-2 million fewer daily doses of opioids prescribed per year. they also show opioid prescriptions under medicaid dropped by 5- point-88 percent in those states.

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2News Works for You Today 5A

Apr 6, 2018 | Tulsa, OK

By KJRH (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054021?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: the u-s surgeon general is urging more americans to carry naloxone to help battle our opioid crisis. dr. rome adams says people at risk of an opioid overdose, as wel as their family and friends, should kep the chemical on hand. it acts almost like an antidote. in oklahoma, nearly one- thousand people die each year from drug overdoses. nation-wide opioid overdoses kill 1 person about every 12 minutes. a second oklahoma tribe is suing manufacturers and distributors of opioids, and large pharmacies, for their alleged part in an overdose epidemic. the muscogee creek nation claims the companies engage in marketing campaigns that aren't truthful about the risks of using the drugs. the creek nation's lawsuit comes nearly a year after the cherokee nation filed a similar suit.

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7 News

Apr 5, 2018 | Wichita Falls, TX

By KSWO (ABC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054068?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: a second oklahoma tribe is suing manufacturers and distributors of opioids, and large pharmacies for their alleged part in an overdose epidemic. the creek nation's lawsuit says the companies' opioid marketing fails to show the danger of the drug -- which the nation says has led to an epidemic of drug abuse. several defendants are named in the lawsuit, including major pharmacies like cvs and walgreens. the creek nation's lawsuit comes nearly a year after the cherokee nation filed a similar suit. paula: an oklahoma man convicted in the beating death

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Combatting the Opioid Epidemic

Apr 5, 2018 | National

By CSPAN

Video Link: http://app.criticalmention.com/app/#clip/view/34054133?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: they love because of this crisis. but it didn't happen overnight. it happened because these drug companies pushed these bells and light about how addictive those pills were and made billions of dollars doing it. it is time to talk about holding these companies and their executives accountable for the crisis they helped create. in massachusetts, the attorney general is helping lead a 9:08 PMbipartisan coalition and 41 states to investigate drug manufacturers and distributors for their role in the opioid epidemic. more than 30 cities and towns in massachusetts have already filed lawsuits. a number of tribes, including the cherokee nation, have sued in tribal and federal court. maryland is also part of this investigation. baltimore and several county governments in maryland have filed lawsuits against manufacturers and distributors. do you believe that part of tackling this crisis is holding these companies accountable? gov. hogan: there is no question. dowe have directed our attorney general to take action and sue some of these pharmaceutical manufacturing companies. there is liability. some of them have knowingly pushed the sale of some of these drugs, knowing they had to these addictive capabilities and did not disclose it. we painting this with a broad brush -- but the ones you are doing these things should be held accountable. we can take these actions and we should, but it won't stop the people who are dying on the streets. sen. warren: i understand. the investigation is ongoing and we should let the attorneys general to their work. -- do their work.

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11 News at 4:30PM

Apr 5, 2018 | Colorado Springs, CO

By KKTV (CBS)

Video Link: http://app.criticalmention.com/app/#clip/view/34054220?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: counties and cities including some in colorado have even sued major manufacturer s and distributors for promoting addictive painkillers to doctors. the researchers found doctors in states with legal medical or recreational marijuana have prescribed about 6 percent less opioids. researchers focused on medicaid patients - who they say are at higher risk for chronic pain, opioid use, and overdoses. these studies were published in a peer reviewed medical journal.

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Newswatch 12 at 5

Apr 5, 2018 | Wausau, WI

By WJFW (NBC)

Video Link: http://app.criticalmention.com/app/#clip/view/34054229?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: the lac du flambeau chippewa band filed a federal lawsuit over the effects of opioid drugs. the suit targets prescription drug manufacturers, distributors and pharmacies. in a press release, tribal president joseph wildcat senior said the prescription opioid epidemic has been building for years. the suit claims the tribe and its members have experienced substantial economic damages, as well as harm to the health and welfare of tribal members. wildcat says the tribe is seeking the financial resources needed to handle the issue. the cost of treating opioid addiction jumped more than ten-fold in the last ten years. a new report shows privately-insured americans paid 2-point-6 billion dollars in opioid abuse treatments in 2016. that's up from 273 million dollars in 2004. a little more than half of the spending was for the treatment of employees' children. earlier today, the national institutes of health announced it will nearly double funding for research on opioid misuse and addiction. the u-s surgeon general wants more americans to carry a drug that can reverse an opioid overdose. dr. jerome adams says people at risk of an overdose-- as well as their family and friends-- should keep naloxone nearby and learn how to use it. the drug can restore normal breathing when injected or sprayed into the nostrils. it's available over the counter in most states including wisconsin.

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Public Affairs Events

Apr 5, 2018 | National

By CSPAN2

Video Link: http://app.criticalmention.com/app/#clip/view/34054306?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: thank you, chairman harper. i'm sure you know about the multidistrict opioid litigation in the northern district of ohio which consolidates over 400 lawsuits dropped by cities and counties and other states communities against the drug distributors, manufacturers and pharmacy chains. the most important source of information in that major lawsuit is going to be most likely the arcos data. i understand dea initially resisted providing arcos data to the federal judge. dea official testified in 12:33 PMresponse to my question in the health subcommittee hearing last month that the resistance was based upon the need to protect proprietary information. but now the court in this case has recently entered a protective order describing how the party should treat the confidential arcos data when dea discloses it. it's apparent to me that the arcos data will be pivotal and appropriately resolving the case and assigning accountability. do i understand now that dea has agreed to provide nine years of data on opioid sales, including the identities of manufacturers and distributors that sold 95% of opioids in every state in 2006-2014? >> that is correct under the protective order. >> under the protective order. so this will not be the last 12:34 PMmajor challenge to manufacturers and distributors and others that are responsible. will dea likely cooperate in those cases? have you set up a standard, is this a decision going forward that other judges and litigants can count on? >> i would believe it's under the same circumstances and conditions that we would comply the same way with anyone else that came in under the same terms. >> when will that data be provided to the federal court in the northern ohio case? >> i can get back to other day. i think it's very short-term. >> the committee's analysis of arcos data has been very concerning. the trends in west virginia, we have just really skimmed the surface i think. my colleagues have outlined some of these. i'm concerned that there are other regions all across the country where distributors may have applied pharmacies with excessive

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NJTV News With Mary Alice Williams

Apr 5, 2018 | New York, NY

By WNJT (PBS)

Video Link: http://app.criticalmention.com/app/#clip/view/34054554?token=425c64d1-086d-4cea-8e9e-ea65943503e7
Rough Transcript: gov. murphy pledged additional funding to treat opioid addiction . a new study details how much american businesses are paying to cover treatment costs. the nonpartisan kaiser family foundation defines -- finds big companies spend billions to treat opioid addictions and overdoses from 2016. the most recent year data that is available which is nine times the amount spent in 2004 which was just under $300 million. that averages to about $26

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