Have you noticed that Big Opioid Pharma (BOP), manufacturers and distributors of prescription opioids, are under attack? I have.
In fact, I've written about it for a while. Read "Suing Big Opioid Pharma — the Next Big Thing?", "780,069,272 Pain Pills," "Suing Big Opioid Pharma" on and "'Patients' Sue 'Physicians' and 'Pharmacists.'"
As I've followed the strategic initiative, it reminds me of Big Tobacco. As a refresher, Big Tobacco was accused (informally at first and then collectively over time) of knowing that tobacco was dangerous and addictive but kept it a "secret." In November 1998, attorneys general from 46 states entered into the Tobacco Master Settlement Agreement (MSA) with the four "major" tobacco companies:
The states settled their Medicaid lawsuits against the tobacco industry for recovery of their tobacco-related health-care costs, and also exempted the companies from private tort liability regarding harm caused by tobacco use. In exchange, the companies agreed to curtail or cease certain tobacco marketing practices, as well as to pay, in perpetuity, various annual payments to the states to compensate them for some of the medical costs of caring for persons with smoking-related illnesses. In the MSA, the original participating manufacturers (OPM) agreed to pay a minimum of $206 billion over the first 25 years of the agreement.
Throughout 2017 I have saved every article I read on the subject. You are more than welcome to read the entire article but I think the date (constant throughout the year), source (wide variety of publications) and headline (provocative and descriptive) provides a sweeping perspective on the scope of this activity:
The full scope includes an investigation by Congress, lawsuits by individual states, counties and cities around the country (and in Canada), collaboration among attorneys general, and class action lawsuits (and maybe others). The initiation of most of this action is not academic but personal.
Take for example Mike Moore, the former Mississippi attorney general who was the first to sue Big Tobacco using a then-unproven legal strategy. His nephew started with Percocet as prescribed by a doctor in 2006. By 2010, the nephew was using street fentanyl. He saved his nephew from an overdose by taking him directly to the hospital.
As he’s watched the tobacco victory pay off in declining smoking rates, he’s also seen easy access to powerful pain medication spark a new deadly crisis. He’s convinced this is the moment to work the same mechanisms on the drug companies that forced the tobacco industry to heel — and he’s committed himself to making that happen. “It’s clear they’re not going to be part of the solution unless we drag them to the table.”
The primary argument against BOP is the same as Big Tobacco. They knew the dangers of their products but misled consumers (in this case, prescribers) by purposefully obfuscating the truth.
If you look at the evidence (anecdotal and factual), it appears as though there was a strategic effort to hide the truth. Of course, all of this in large part is still alleged — not proven in a court of law — and BOP will have an opportunity to make its arguments.
Except Purdue Pharma, which settled a class action lawsuit in Canada for $20 million in May. Of course, settlements always include the language "no admission of guilt." As I stated in a post of that article:
$20M (or 0.064% of OxyContin revenue) to settle? This is a rounding error for Purdue Pharma. But not to those who became dependent/addicted and lost anything from an active lifestyle to life itself. Fair and equitable? That was a rhetorical question — I don't believe it is either fair or equitable. Not so much the dollar amount, but the fact that it will not hurt Purdue at all in the pocketbook. If the goal of a lawsuit is to change behavior because it's too painful not to, then this probably didn't hit the mark.
Whether you believe the opioid epidemic is real or not (I do) or whether at least some of the deaths from illicit street heroin and fentanyl are a consequence of over-prescribing prescription opioids (I do), I think we can all agree it's wrong for a company to tell its customers there is no danger when there really is (and knows it). In this case, deadly danger. Is that what happened? Only time will tell.
So if BOP wants to know where this is heading, it just needs to refresh its memories on Big Tobacco. What happened then is about to happen again.
Mark Pew is a national speaker and author on chronic pain and appropriate treatment, as well as senior vice president of Prium, a medical managed care provider for the workers' compensation industry. This post is republished with permission from his Rx Professor blog.
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