MORGANTOWN — Attorney General Patrick Morrisey announced two new lawsuits against opioid manufacturers Friday morning.
Both were field in Boone County Circuit Court. One involves Teva Pharmaceuticals USA and Cephalon, both subsidiaries of Israel-based Teva. Teva makes Actiq and Fentora, both for breakthrough cancer pain, along with generic oxymorphone and hydrocodone, the suit says.
The other involves Johnson & Johnson and its subsidiary Janssen Pharmaceuticals. Janssen makes the fentanyl patch Duragesic and the oral opioid tapentadol immediate release. It previously made Nucynta and Nucytna ER, also versions of tapentadol, the latter for round-the-clock pain.
Morrisey elected to file these suits in state court rather than join the National Prescription Opiate Litigation in Ohio federal court (the town is Granville is among the 30 West Virginia towns, cities and counties joining thousands of other around the country in that litigation) and the suits include language aimed at keeping them out of federal court.
He first announced the suits on Hoppy Kercheval’s Talkline on MetroNews and told Kercheval that they raise issues that uniquely impact West Virginia.
The suits –crafted after more than 18 months of work, he told Kercheval – aren’t identical but largely overlap. Morrisey opens with the statement, “Opioid addiction has destroyed the lives of tens of thousands of West Virginian and has caused immense pain and suffering for families throughout West Virginia.”
Among the impacts, West Virginia has the highest drug overdose rate I the country. The state’s Neonatal Abstinence Syndrome rate is five times the national average and results in thousands of children being placed in foster care. About 70% of Child Protective Services referrals in 2017 had a substance abuse component.
The cost of treating a NAS baby is $36,000, compared to $3,600 for a healthy baby. In 2017, 1,000 state residents died of drug overdoses, and 86% of them involved opioids.
The drug makers tactics alleged in the suits reflect those alleged in the federal suits.
Among them: Teva directed its sales reps to encourage physicians to prescribe Actiq and Fentora for off-label use for chronic pain, instead of cancer pain, and tied the reps sales quotas to off-label sales. The reps spent most of their time marketing to non-oncologists.
All defendants underplayed the addictive qualities of opioids and encouraged increasing dosages, and consequent dependence, saying there was no ceiling dose. Although there were no studies exceeding 12 weeks, the defendants promoted the benefits of opioids for long-term pain treatment.
The defendants promoted opioids as improving quality of life, although federal agencies warned that opioids in fact increased prevalence of depression, anxiety, PTSD and substance abuse and led to hyperalgesia, which is increased pain sensitivity.
The defendants financially backed physicians, termed Key Opinion Leaders, and two front organizations – the American Academy of Pain Medicine and the American pain Foundation, both led by KOLs – to promote opioid use via books, medical articles and continuing education materials.
Opioid users, the suits allege, often turn to cheaper and more readily available heroin when they run out of opioids. Opioid use and abuse leads to thousands of hospitalizations and emergency room visits, with the state bearing the costs.
The Janssen suit quotes the Centers for Disease Control from 2016: “For the vast majority of patients, the known, serious, and too-often fatal risks far outweigh the transient and unproven benefits” of opioids for chronic pain. “We know of no other medication routinely used for a nonfatal condition that kills patients so frequently.”
Each suit alleges two counts, the first being that the drug makers violated the state Consumer Credit and Protection Act through their deceptive practices.
In May, as MetroNews reported, Morrisey announced a $37 million settlement with opioid maker McKesson. The pharmaceutical giant agreed to pay that money to West Virginia to resolve a lawsuit that alleged the company did not properly monitor the pills it shipped to the state. Morrisey’s office said the settlement is the largest settlement with a drug company in the state’s history, though critics said it was a lowball settlement.
Two years ago, MetroNews reported, the state settled a lawsuit against Cardinal Health Inc. for $20 million and settled a lawsuit against AmerisourceBergen Corp. for $16 million.
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