Opioids: Big Pharma, Big Problems

Oklahoma might not be known for much: a musical from the 1940s, tornados, Native American history, oil rigs, corn, and beautiful landscapes. 

Of course, between 2010 and 2016 Oklahoma was also known as one of the hardest-hit states in the opioid crisis. They outpaced the national average of deaths per 100,000 people. But this does make sense: there were 88 opioid prescriptions per every 100 people in 2017, down from 127 prescriptions per every 100 people in 2012. With some of the highest prescription numbers in the entire country, it is no wonder that they were hit so hard. So Oklahoma did one of the few things it could do.

The Lawsuit: Oklahoma Vs. Johnson & Johnson

The premise of the lawsuit is simple: Johnson and Johnson deceived doctors into thinking opioids were safer than they actually are, and supplied billions (with a ‘b’) of pills to the state. They underplayed the risks and over-exaggerated the benefits of their drugs. The state claims that the aggressive, false claims lead to their public health crisis, and want Johnson and Johnson to pay the state big time so the state can start massive rehabilitation programs. 

Throughout the case, Oklahoma (Attorney General Mike Hunter) referred to Johnson and Johnson as a “kingpin” and a “cartel”, pointing to across-the-board domination by J&J. J&J purchased huge tracts of land in Australia to grow opium for their drugs, manufacture the drugs, convinced doctors the drugs were safer than they actually were, and made millions of dollars while people overdosed and died. Oklahoma is claiming that J&J created a “public nuisance” and sued for damages, an amount of $17 billion.

A Brief History: Lawsuits Against Opioids & Big Pharma

Oklahoma’s lawsuit is not the first lawsuit from the state against pharma companies, nor is it the first suit in general. Purdue Pharma, the company responsible for OxyContin, has been sued by 48 states and the District of Columbia. The premise of these suits may sound familiar: a big pharmaceutical company deceives doctors into believing that their pills are safe and non habit-forming, and that the company’s aggressive marketing practices helped doctors write more opioid prescriptions, killing thousands upon thousands of people. While these suits are far from over, Purdue’s strategy is to try to settle for a few million dollars and continue on, business as usual. In Oklahoma, a suit for $20 billion dollars turned into a settlement of $270 million dollars, to help fund addiction programs and pay for legal fees. 

While Purdue is fighting these lawsuits with tooth and nail, there are a lot of suits to go through. If the lawsuits do not go away soon, there is a very real chance that Purdue Pharmaceuticals will file for bankruptcy. After all, Insys Therapeutics sold a highly addictive drug that included fentanyl. Despite its massive popularity (and sales), they got buried under federal fraud charges for unlawful marketing and filed for bankruptcy.

Teva Pharmaceuticals manufactures generic painkillers, as well as two of their own opioids. Days before a trial in Oklahoma, Teva agreed to an $85 million settlement. Whereas the Purdue settlement went to fund a research clinic at Oklahoma State University, the $85mil from Teva is going to be spent more directly helping addicts. This process will be lengthy, as are all political processes, but nevertheless, Oklahoma continues to fight for financial help combating the drug crisis fueled by the pharmaceutical companies.

Purdue Pharma’s settlement with Oklahoma represents just one lawsuit, and they had to pay millions of dollars. Teva Pharmaceuticals settled out of just one lawsuit, for millions of dollars. If the rest of these lawsuits proceed and end similarly, with a hefty settlement, Purdue will also go bankrupt.

All the drug companies are claiming innocence, but hopefully soon a state judge in Oklahoma is going to determine whether or not Johnson and Johnson created a public nuisance, and if they are going to pay the $17 billion asked for by the state of Oklahoma. One thing is for sure though: the verdict of the case in Oklahoma is going to determine the future of the other lawsuits against them. 

One lawsuit down, 1,599 lawsuits to go.

Why It Matters

Taking on big pharmaceutical companies is a daunting prospect. Big pharmaceutical companies have lots and lots of money, and lots and lots of lawyers. Taking on a pharmaceutical company is time-consuming, and while all the companies deny wrongdoing, a judge has to determine whether or not the approach of these drug companies lead to a public nuisance, the argument of Oklahoma.

It is also a good time to mention precedent, as much of the American judicial system is built on this concept. Basically, precedent is the idea that when a verdict is issued in a case, similar cases should be treated the same. When companies settle, it is usually out of fear of losing a case, because then judges in other cases against them would view the Oklahoma case as precedent. A settlement saves money, a settlement saves face, and a settlement saves a company for any actual responsibility. If J&J is found to have created a nuisance and have to pay, it can quite possibly become a death spiral for the company. Thousands of lawsuits, each lawsuit for millions or billions of dollars, each one going in favor of the states or against J&J.

Conversely, if J&J does not have to pay Oklahoma, it is a sign that the other lawsuits might not bear any fruit, or would be relatively low payout compared to the $17 billion asked for by Oklahoma.

A Bigger Issue

Perhaps the biggest issue, not yet discussed, are the other problems from drug abuse. A lawsuit against big pharma for fueling the opioid crisis is not going to do justice to someone who started off on opioids and is now using heroin. And a lawsuit isn’t going to do anything for someone who has died. 

In 2017, Ohio launched a major lawsuit against 5 pharmaceutical companies who manufactured opioids, among them Johnson and Johnson, Teva, and Purdue Pharma. One of the statistics given to a judge was the number of people treated in Cuyahoga County hospitals for drug-related health problems: 9191 cases, up from previous years by 21%. Cuyahoga County is one of the hardest-hit counties in Ohio, and in 2016 2 people were dying every day from drug overdoses.

The hardest part of the opioid epidemic is figuring out the actual cost estimate. Conservative costs of the epidemic start around $70 billion and go upwards from there. Everyone has been affected, from small towns to large cities. The cost in lives might be incalculable; after all, what is the value of a life? In the case of the opioid crisis, what is the value of 70,000 lives? 100,000 lives? If a heroin addict goes to a hospital, and the heroin addict is a heroin addict because of an addiction nurtured by OxyContin or Percocet, should big pharma pay? And what is the cost?

Pharmaceutical companies are fighting these lawsuits tooth and nail, and because of settlements, big pharmaceutical companies have yet to be held culpable for their role in pushing billions of pain pills throughout the United States that resulted in the deaths of hundreds of thousands of people. THAT is why the Johnson and Johnson lawsuit is so important: if J&J is found guilty, then all the lawsuits against them, and the lawsuits against the other pharma companies, will continue and the companies will have to start undoing all the damage they have caused.

-- Jacob Greenberg