A federal judge in Cleveland has begun hearing demands that three of the largest pharmacy chains in the US pay billions of dollars in restitution after a jury found they helped drive America’s opioid epidemic.
The size of the award against CVS, Walgreens and Walmart for recklessly dispensing narcotic painkillers in two Ohio counties will help decide the total payout in thousands of federal cases across the country involving drug makers, distributors and pharmacies accused of enabling a drug epidemic that has claimed more than one million lives over two decades.
The hearing began after the criminal convictions of scores of doctors who were the leading prescribers for the US’s largest manufacturer of opioids, Mallinckrodt Pharmaceuticals. The Washington Post reported that 65 of the company’s 239 top pain pill prescribers in 2013, at the peak of the prescription opioid epidemic, have been imprisoned, fined or lost their medical licenses.
Mallinckrodt at one point accounted for the single largest share of the high potency opioid pill market, taking over from Purdue Pharma, which manufactured OxyContin, the drug that kickstarted the epidemic after its release in 1997.
According to documents and depositions made public as part of a legal settlement, Mallinckrodt joined other opioid manufacturers in pushing doctors who were already prescribing large amounts of narcotics to give patients even more drugs and at higher doses while severely underplaying the risks of addiction.
Several of those doctors were arrested for running “pill mill” pain clinics that dispensed opioids without following proper medical procedure, fraud and other crimes. Among them was Fathalla Mashali, who ran four clinics in Massachusetts and Rhode Island where his employees had already complained to the authorities about his “unprofessional, unethical, and unlawful behaviour”. Mashali was arrested while attempting to leave the country and in 2018 was sentenced to eight years in federal prison.
Another was George Griffin, a doctor who Mallinckrodt’s sales force valued for his prolific opioid prescribing and who was sent to prison last year for illegally distributing narcotics.
The decision by the court in Cleveland centers on two Ohio counties, Lake and Trumbull, that are part of a bellwether federal case deciding the degree of culpability and amount of payouts for thousands of opioid lawsuits filed by municipalities, counties and Indigenous tribes across the country.
Lawyers for the Ohio counties have said that each needs at least $1bn to deal with the fallout of opioid addiction and deaths. Those attorneys contend that about 400 pain pills were dispensed for every resident of Trumbull county when mass prescribing of opioids was at its worst.
The parties in another bellwether trial involving distributors accused of illegally flooding West Virginia with opioids – driving the nation’s highest overdose rate – are awaiting a verdict. According to evidence presented during the trial, pharmaceutical executives circulated emails mocking “pillbillies” who became addicted to painkillers.
Another prominent case set to be heard stems from a lawsuit by the Cherokee Nation against the drug distributor McKesson.
But shocking revelations about the greed and cynicism of opioid makers such as Mallinckrodt, Purdue Pharma and Johnson & Johnson during the lawsuits’ discovery phases have increasingly pushed drug manufacturers, distributors and pharmacy chains to settle without going to trial.
Collectively, so far, they have agreed to more than $40bn in payments, albeit without admitting wrongdoing.
Earlier this month, CVS and Walgreens agreed to pay Florida hundreds of millions to settle claims over opioid dispensing. Last year, Johnson & Johnson announced it would stop manufacturing opioid painkillers after litigation uncovered disdain for patients among its sales force.
In one company memo, a sales representative said she dismissed a doctor’s fears that patients might become addicted to opioids by telling him those who didn’t die probably wouldn’t get hooked.
