Monday, July 24, 2017

Government Struggles to Hold Opioid Manufacturers Accountable



For the first time ever, the U.S. DEA targeted a prescription drug manufacturer for their role in black market opioids and damages incurred. Mallinckrodt Pharmaceuticals, one of the largest national manufacturers of the highly addictive generic painkiller oxycodone, one of the leading drugs responsible for the more than 15,000 overdose deaths in 2015, was accused of shirking its responsibility to report suspicious drug orders.

Who’s to Blame For The Opioid Epidemic?


Created at Mallinckrodt’s Hobart, NY facility, oxycodone shipped via its distributor network, including KeySource, Sunrise Wholesale and Cardinal Health, who later supplied the pills to retailers, including pharmacies and hospitals accused of illegally diverting the drugs. Discovered in a 2009 Tennessee Drug Task Force sting and linked back to Mallinckrodt’s distributors Florida retailers, 2010-2011 DEA investigations uncovered large amounts of Mallinckrodt oxycodone – such as the 41 million KeySource Medical oxycodone tablets delivered to Florida retailers in 2010 – about 2.5 pills for every man, woman and child in the state. Accused of splitting orders to conceal shipment amounts, KeySource was ordered by the DEA to halt, later relinquishing its distribution license. Distributors Sunrise Wholesale and Cardinal Health likewise delivered vast quantities of Mallinckrodt’s oxycodone to pharmacies in Florida. 500 million Mallinckrodt pills ended up in Florida from 2008-2012 — 66% of state oxycodone sales. A 2011 subpoena following this the discovery further revealed, 6 weeks after the Tennessee task force alerted Mallinckrodt to the drugs found in the 2009 sting, Mallinckrodt shipped another 2.1 million tablets their Sunrise distributor, 92,400 tablets of which were sold to Dr. Barry Schultz, the Delray Beach doctor whose oxycodone was found in Tennessee. Schultz was later convicted of drug trafficking and manslaughter (for a related overdose death). In one day, he prescribed 1,000 tablets to a single patient. Ultimately, the DEA and federal prosecutors alleged Mallinckrodt ignored its responsibility to report suspicious orders, in violation of the Controlled Substances Act.

Shirking Responsibilities?

Under federal law and DEA policy, pharmaceutical companies are required to “know their customers,” monitoring amounts, frequencies, and patterns of drug orders, immediately notifying the DEA of suspicious activity – or risk losing their license to manufacture and sell controlled substances, as well as civil and criminal penalties. Though Mallinckrodt maintained publicly the company has worked hard to fight drug diversion, internal case summaries prepared by federal prosecutors indicated Mallinckrodt’s response was that ­‘everyone knew what was going on in Florida but they had no duty to report it.’ Sources familiar with settlement talks indicated Mallinckrodt acknowledged its responsibility to report suspiciously large orders, but contended the DEA did not require manufacturers to know about (or be responsible for) ‘their customers’ customers,’ further pointing to conflicting DEA advice as to legal responsibilities. Prosecutors considered a whopping 43,991 unreported orders from distributors and retailers suspicious.

Uncharted Waters

Appalled by the rising opioid death toll, the DEA’s push to hold drug manufacturers accountable was hoped to be a wake-up call, putting the industry on notice for its responsibilities in the diversion of drugs to the black market. Instead, after years of industry investigations spanning five states to build the massive case, the results mirrored the DEAs previous attempt to hold wholesale distributors accountable. The case stalled. Fierce company resistance and intense lobbying efforts may have played a role in the lack of legal action pursued. The case settled for $35 million in fines and no admission of wrongdoing.

Small Potatoes

The proposed settlement, a mere fraction of the 44,000 federal violations pointed to in the investigation which could have cost the company $2.3 billion in fines, amounts to small potatoes for a company that posted $3.4 billion in revenue and $489 million in profit in 2016. In a later February 2017 SEC filing, Mallinckrodt even noted the investigation “will not have a material adverse effect on its financial condition” because it had set aside the funds.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

SOURCES:
https://www.washingtonpost.com/graphics/investigations/dea-mallinckrodt/?_hsenc=p2ANqtz-9DxkF3wbuslmavvDf3o8CSw_0KLDObRAx7Ah4JgQ2Vi7_84yvAVhoUcmcpQyMQ-LDuL7935zGFyhc7J8njQ-cALSVCEg&_hsmi=51277531&utm_campaign=Rx%20Summit&utm_content=51277531&utm_medium=&utm_source=hs_email&utm_term=.ebaec91ff136
http://www.reuters.com/article/us-mallinckrodt-settlement-idUSKBN1751JM
https://www.opensecrets.org/lobby/clientsum.php?id=D000022900

Original content posted on http://ans-solutions.com/government-struggles-to-hold-opioid-manufacturers-accountable/ 


Monday, July 10, 2017

Can States Surpass Federal & Address Big Pharma?


With some states and areas across the country on the receiving end of opioid painkiller prescription shipments that outnumber the people housed therein, state officials are beginning to address the link between the opioid crisis, Big Pharma, and the heavy burden weighing on their municipalities. In an attempt to hold Big Pharma accountable, they’re taking a page out of past lawsuits against tobacco companies – and suing them.

Key Players

Until now, these multibillion dollar companies have been sidelined in the fight against the opioid epidemic. Now they’re being looked at as star players by city, county, state, and federal officials – even the DEA has taken notice, responding in-kind. This year, in a push to hold opioid manufacturers and distributors responsible, multiple lawsuits have been launched…

States Join Forces in the Fight Against Opioids

Taking the lives of 40 Americans each day, the total economic burden of prescription opioid overdose is costing the country $78.5 billion per year – and these states are taking action…
  • Missouri
    Most recently, Missouri’s filed suit against 3 opioid manufacturers, alleging a deliberate campaign of fraud to convince doctors and the public against the highly-addictive, life-threatening potential of the drugs.
  • Mississippi
    Suing Purdue Pharma and 7 others, Mississippi lawsuits are borrowing tactics used in their successful fight against tobacco companies in 1998, alleging companies misrepresented the dangers of opioids to doctors and patients, marketing the drug as rarely addictive, and a safe substitute for non-addictive pain medications like ibuprofen or naproxen. But pharmacy companies don’t want the suit to go through – not until FDA-ordered studies on long-term risks/benefits are completed, which could take several years.
  • Ohio
    Ohio filed suit against multiple manufacturers for false advertising, Medicare fraud, and violation of the Ohio Corrupt Practices Act, claiming the companies knew (or should have known) their drugs weren’t safe or effective.
  • Illinois
    Illinois is taking part in multi-state investigations into manufacturers, with 2 lawsuits in-play. One against Insys, for the deceptive marketing of highly-addictive Subsys for the off-label treatment of back and neck pain in efforts to gain huge profits. Another, an anti-trust suit against the makers of Suboxone, used to treat opioid addiction, alleging a scheme to block generics to artificially inflate prices.
  • East Tennessee
    Prosecutors representing 9 counties are taking aim at Big Pharma using the Tennessee Drug Dealer Liability Act, or ‘crack tax’ law. Designed to hold dealers criminally and financially responsible for the effects of the drugs they distribute, the suit labels drug makers as dealers, further accusing them of lying about the addictive properties of opioids, aggressively pushing them as miracle cures for all types of pain. The state AG is investigating its options in pursuing its own legal action.
  • New York
    8 NY counties have joined in seeking compensation for expenses caused by the state’s growing drug problem, alleging marketing omitted critical information about the addictive nature of the drugs and risks associated with long-term use.
  • Everett, Washington
    They city of Everett filed suit against Purdue Pharma, makers of OxyContin, alleging the company was intimately aware its drug was being funneled into the black market, yet did nothing.

Distributors Sinking, Similar Challenges Against Manufacturers Possible 

CVS, Walgreens, Walmart, McKesson, Cardinal Health, KeySource, Sunrise Wholesale and more are facing charges and paying fines – sometimes multiple times. Some suits have settled. Others have resulted in criminal convictions. Could Big Pharma be next? Though manufacturers vigorously reject the argument they’ve fueled the current opioid crisis, it’s hard to ignore the overdose deaths – more than 300,000 since 1999. But opioids (opium, morphine, heroin) have been around, literally, for centuries, and their highly-addictive properties well-known.

More Lawsuits On the Way

Lawyers currently working these cases note a growing number of jurisdictions showing interest. States are joining forces in the current investigation, with dozens more lawsuits expected. The ultimate hope? That if enough attorneys general are able to join forces in bringing suits, they can accomplish what the federal government has been unable to… And snowball the lawsuits into a massive settlement that might finally put an end to practices that have fueled the deadliest drug overdose crisis in U.S. history.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ compensation insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

Sources:
https://www.vox.com/policy-and-politics/2017/6/7/15724054/opioid-companies-epidemic-lawsuits
https://www.theatlantic.com/business/archive/2017/06/lawsuit-pharmaceutical-companies-opioids/529020/
https://www.levinlaw.com/government-opioid-lawsuit
https://www.washingtonpost.com/national/the-drug-industrys-answer-to-opioid-addiction-more-pills/2016/10/15/181a529c-8ae4-11e6-bff0-d53f592f176e_story.html?utm_term=.a364db6d5fe7

Original content posted on http://ans-solutions.com/can-states-surpass-federal-address-big-pharma/