Worcester Business Journal

wbjournal.com | April 2, 2018 | Worcester Business Journal 13 Drug companies are culpable in opioid epidemic Dozens of Massachusetts cities and towns like Worcester and Charlton have said they will sue opioid manufacturers for their role in the opioid epidemic ravaging Central Massachusetts, the state, New England and much of the country. The costs of combating the epidemic – including overdose-reversing Narcan and recovery programs – have been burdensome, the municipalities say. When polled online, four out of every five WBJ readers said drugmakers are at least partially at fault. F L A S H P O L L How culpable is the pharmaceutical industry in the opioid epidemic? Significantly. They aren't adequately informing patients and doctors of the drugs' addictive nature. 38% "I used OxyContin when I fractured my spine and can tell you that it saved me. I took it for three weeks, which got me through the worst of the pain. It has a lot of side effects, which were no longer worth it. I hope they don't stop making it because it helps many people." Partially. They bear some blame, but doctors and patients are the ones prescribing and using opioids. 26% 17% Totally. Drugmakers are the main responsible party since they're manufacturing the painkillers. H E A L T H C A R E F O C U S people passed out on the road in the middle of the night, ostensibly under the influence of opioids – often heroin, which people end up using when they lose access to prescription opioids. Craver said she brought the lawsuit forward after being contacted by a MOLA attorney, suggesting Charlton pursue litigation. At least 10 other towns have engaged with MOLA about filing a lawsuit, including Auburn, Dudley, Douglas, Hopedale, Leicester, Leominster, Northbridge, Southbridge, Spencer and Winchendon. For small towns, the costs of a drug crisis add up, Craver said, with police responding to increased breaking-and- entering calls, and encountering dan- gerous and more time-consuming situ- ations on the job. "The taxpayers have been subsidizing the fallout from the opioid epidemic … and it's time stand up and say, 'No more,'" Craver said. Quantifying the cost Worcester didn't quantified the cost of responding to and trying to stem the opioid crisis in its lawsuit. Details about the costs will be determined during the discovery phase of the case, though it's unlikely a dollar figure will be provid- ed, said Worcester City Solicitor David Moore. Damages will be determined by the court. "We have a duty to file the suit and return as much funding as we can," Moore said. While the city doesn't have an accounting of expenditures, the opioid crisis has been costly. Moore said the city has spent money on emergency response within the police and fire departments; training employees to use Narcan, a drug that blocks the danger- ous effects of opioids in emergency sit- uations; recovery programs; and health insurance claims for city employees and their dependent family members who have struggled with addiction. In addition to getting money to recoup spending on these items, Moore said the city is looking for the court to impose measures to prevent similar problems in the future. "We want to see some injunctive measures for these companies going forward in hopes of containing this epi- demic," Moore said. Worcester's strategy is a departure from other cities and towns filing law- suits like Charlton. The MOLA consor- tium is leading litigation for four other communities with filed lawsuits in fed- eral court in Massachusetts, including Greenfield, Revere, Methuen and Woburn. The lawsuits are separate but communities can leverage work done by MOLA by filing with the consortium. The same group is expected to file dozens more on behalf of about 40 cit- ies and towns voting to move forward to lawsuits, said Tucker Merrigan, one of the MOLA attorneys. Worcester officials were advised by the Connecticut law firm they've hired to lead the litigation, Scott & Scott, Attorneys at Law LLP, to pursue litiga- tion in Superior Court, said Moore. Most other Massachusetts cities and towns will file under the direction of MOLA in federal court, and those law- suits are being handled by a federal judge in Ohio, who is managing law- suits for municipalities all over the U.S. If they go to trial, they will end up back in a Mass. federal court, Merrigan said, but the discovery phase will be streamlined in the Ohio federal court. "There's a better chance for a better result for the city to be one of a small number [of cases] in state court than being one of a large number in federal court," Moore said. Litigation won't cost Worcester any money up front, as attorneys are work- ing on a contingency basis and won't get paid unless damages are awarded. Moore said he is confident about Worcester's chances of receiving damag- es, but any city or town taking on the pharmaceutical industry faces a formi- dable opponent. Big pharma companies making opioids like Connecticut-based Purdue Pharma and Israel-based Teva Pharmaceutical Industries rake in tens of billions of dollars and have ample resources to defend themselves. Misguided lawsuits? Interestingly, Worcester did not name any drug manufacturers specifically when it announced it would file suit, but did call out major drug distributors, including Pennsylvania-based AmeriSourceBergen Drug Corp., Ohio- based Cardinal Health Inc. and Ludlow-based McKesson Corp., when it announced plans for a lawsuit. John Parker, senior vice president of the Healthcare Distribution Alliance, the national trade association repre- senting drug distributors, responded to the Worcester lawsuit and others, saying distributors don't drive demand for opioids. "Tying those pieces together … seems to be misguided and misin- formed in terms of the way the system works," Parker said. But Merrigan, the MOLA attorney, said drug distributors are bound by the federal Controlled Substances Act of Drug distributors are bound by the federal Controlled Substances Act of 1970, which, among other things, requires distributors to report prescription drug orders unusual in terms of size, frequency and location. Tucker Merrigan, Massachusetts Opiod Litagation Attorneys 1970, which, among other things, requires distributors to report prescrip- tion drug orders unusual in terms of size, frequency and location. Perhaps the most notable example of distributors failing to adhere to the law was a report about drug companies shipping 21 million opioid prescriptions to just two pharmacies in a small West Virginia town between 2006 and 2016. But Parker said the federal Drug Enforcement Administration hasn't pro- vided clear-cut guidelines for what con- stitutes reportable activity. "We've been asking the DEA for great- er clarity of the roles and responsibilities as it relates to reporting," Parker said. Merrigan said plaintiffs filing law- suits through MOLA are hoping to get access to the Congressional data used to inform the West Virginia report during the discovery phase. So far, examples of blatant overprescription haven't been pinpointed. Not at all. They make products for legitimate purposes, and it's not their fault the drugs are abused. 19% COMMENTS: "Doctors who are prescribing significant amounts and getting rewarded by the pharmaceutical companies are equally or more at fault." "Are the drug companies not adequately informing, or are they intentionally misleading?" W

• Cover