Winchester, TN Big Pharma: Profits Over Health & Safety

Part I- The American Opioid Epidemic

Recently the pharmaceutical industries have been on the forefront of investigations launched by not only federal agencies, but by the national media. The Washington Post recently spotlighted, in a 3-installment investigative series, the opioid epidemic and the DEA data that they prevailed upon the courts to release.  The data released shockingly revealed that between 2006 – 2012 the pharmaceutical industry pumped out more than 76 billion pain pills into the stream of America’s Pharmacies for distribution.

At the same time, the pharmaceutical industries are being taken to task for their hand in the opioid crisis that America is currently experiencing. Trials in the past 60 days of note have been that of Purdue Pharmaceutical and Johnson & Johnson. Newly unsealed exhibits in the opioid cases have revealed the innerworkings of the drug industry. The release of the exhibits included sworn depositions of executives, internal corporate emails, and expert reports that reveal that the corporate drug giants ignored concerns of employees about its huge volume of pain pills streaming across the nation.

In one exhibit, a Purdue Pharma email shows an executive signing off on a distributor ordering 115,200 Oxycodone pills, nearly twice as large as the distributor’s average order over the previous 3 months, and the order being approved within minutes. Another email showed a pharmaceutical compliance officer noting that customer service reps all state that a national account manager will tell them anything they want to hear just so he can get the sale. These corporate documents were unsealed by US District Judge Dan Polster in a massive lawsuit unfolding in the Cleveland, Ohio, courthouse that involves the biggest names in the drug industry.

The Drug Enforcement Agency Database was also made public through the litigation on July 15^th that showed more than 76 billion Oxycodone and Hydrocodone pills from 2006-2012 where pumped into the nation’s pharmacies for distribution and consumer consumption. The plaintiffs contend in the opioid lawsuit that the failure of Big Pharma to identify suspicious orders was their business model. Drug Companies have issued multiple defenses by stating that the pill mills and addicts are to blame and over-prescribing physicians; however, it should not be forgotten that Big Pharma profited off this business model for years.

A recently released database also revealed that of the 100 top-prescribing opioid pharmacies, the majority of those establishments were located in Appalachia and the Tennessee Valley. Shockingly, one pharmacy making America’s top 30 list, is a small rural pharmacy within a 30-minute drive of my office. The title of the Washington Post article giving the statistics of the top 100 pain pill pharmacies in the nation was released in an article dated August 15, 2019, entitled “How many pain pills went to your pharmacy?” Despite only listing only 100 pharmacies in the Washington Post investigative report, there are nearly 83,000 pharmacies that are on the frontlines of the opioid crisis in America. More alarming is the fact that among the top prescribing pharmacies there were millions of opioid pills dispensed between 2006-2012 by a majority of the individual pharmacies listed.  This statistic creates an unbelievable pill count per resident in the counties affected. Let me say that again. Many of the pharmacies listed were generating multimillion total pill counts, some as high as 6 million pills, in a 6-year period which equates to a million pills per year, per pharmacy. Not only were the pharmaceutical companies profiting off this business model, but the opioid death rates soared in the communities that were flooded with pain pills.

The national death rate from opioids were 4.6 deaths per 100,000 residents, but the counties that had the most pills distributed per person in Appalachia of West Virginia, Kentucky, and Southwest Virginia experienced more than 3 times that rate on average. Internal documents  released from the litigation have revealed that drug companies faced numerous red flags during the height of the epidemic, but failed to take corrective action. While drug maker Purdue Pharma has borne the brunt of the public criticism for inventing and deceptively marketing Oxycontin, records show a handful of obscure generic drug manufacturers were selling the bulk of the opioid pills flooding the country.

On August 23^, 2019 a Judge in Norman, Oklahoma, ordered Johnson & Johnson to pay $572 million to remedy the devastation wrought by the epidemic on the state and its residents. Cleveland County District Judge Thad Balkman’s landmark decision is the first to hold a drug maker responsible for the fallout created by years of liberal opioid dispensing that began in the late 1990’s culminating in a nationwide epidemic of overdose deaths and addiction. Reportedly more than 400,000 people have died of overdose from pain killers, heroine, and illegal fentanyl since 1999. Many have argued that Johnson & Johnson’s marketing scheme was driven by a desire to make billions for their pain franchise. To do this, they developed and carried out a plan directly to influence and convince doctors to prescribe more and more opioids despite the fact that Big Pharma knew increasing the supply of opioids would lead to abuse, addiction, misuse, death and crime. Some have even gone as far as to allege that Johnson & Johnson took part in the industry’s effort to change doctors’ reluctance to prescribe opioids by mounting an aggressive misinformation campaign that targeted the least knowledgeable physicians. Company lawyers in both the Norman, Oklahoma, case and the Cleveland, Ohio, case, have pushed back against these accusations by attributing actions to third parties and contending that sales calls to doctors did not lead to overprescribing or the drug crisis.

Not only is the opioid crisis and Big Pharma’s alleged corporate malfeasance in creating such alarming to Americans, but it is also unsettling due to the fact that the opioid crisis has affected society’s most vulnerable, being the injured, disabled, and those without access to proper healthcare. Many without insurance have to rely on so called pill mills and unscrupulous doctors who take cash only payments and are not set up within an insurance model. While the opioids were prescribed for people with chronic pain and disabilities, the medications only masked the underlying problem and never provided a long-term real solution, and a lot of times created addiction and devastated families and communities. While many in the drug industry are stating that they should not be taken to task for the opioid crisis, Big Pharma’s track record is somewhat questionable when it comes to the supply chain and profits within American healthcare.

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