A federal judge has ruled that the country’s three largest drug distributors cannot be held responsible for the opioid epidemic in one of the country’s most plagued provinces – a place where 81 million prescription painkillers over eight years after a population of less than 100,000 were sent. .
Judge David A. Faber of the U.S. District Court for the Southern District of West Virginia released the opinion on the 4th of July holiday, almost a year after the end of a trial pursued by the City of Huntington and Cabell County, which is the focus of an Oscar-nominated documentary called “Heroin (s)” on the effects of prescription painkillers.
The fatal overdose rate in Cabell County increased to 213.9 from 16.6 per 100,000 people, from 2001 to 2017, according to the ruling.
In the release of the drug distribution companies – AmerisourceBergen, McKesson and Cardinal Health – Judge Faber acknowledged the terrible costs for the country and the city, but added that “while there is a natural tendency to blame in such cases, it must be decided that it is not based on sympathy, but on the facts and the law. “
His decision points to the difficulty of determining responsibility for a decade-long disaster in which many entities played a role, including drug manufacturers, pharmacy chains, doctors and federal oversight agencies, as well as the drug distributors.
Drug distributors usually fulfill pharmacy orders by transporting medications from the manufacturers to hospitals, clinics and stores, and are responsible for managing their inventory. Like other companies in the drug supply chain, distributors are supposed to comply with federal limits set for controlled substances such as prescription opioids, and have an internal monitoring system to detect problematic orders. Lawyers for the city and province argued that the distributors should have investigated orders through pharmacies requesting addictive pills in quantities that were wildly disproportionate to the population in these small communities.
But Judge Faber ruled: “At best, distributors can detect increases in dispensers’ orders that can be traced to physicians who may have intentionally or unintentionally violated medical standards. Distributors are also not pharmacists with expertise in assessing red flags that may appear in a prescription. ”
The judge also argued that the distributors had caused a “public nuisance”, a claim widely used in national opioid litigation and which had so far had mixed results in a handful of state and federal test cases. grounds denied.
The three distributors reached an agreement earlier this year to settle thousands of lawsuits filed by states and thousands of local governments, in which they agreed to pay $ 21 billion over 18 years for addiction treatment and prevention services. But Cabell County and the city of Huntington, often described as ground zero for the crisis in the United States, refused to report because they believe they can get more money by going on trial. They sought more than $ 2 billion from the companies.
“Trial is always a gamble, and this one has not borne fruit,” said Elizabeth Burch, a professor at the University of Georgia School of Law who closely followed the national opioid litigation.
During the trial, attorneys for the district and city AmerisourceBergen released emails mocking West Virginiaers as “pillbillies” and referring to the region as “Oxycontinville.” A manager of the company said the samples were cherries selected and only examples of employees expressing work fatigue.
Cardinal Health said in a statement that applauded the ruling, saying it had a strict screening system. Distributors “do not manufacture, market or prescribe prescription drugs, but rather provide only a safe channel to deliver drugs of all kinds to our thousands of hospital and pharmacy customers who dispense them to their patients based on prescriptions issued by the physician. has been ordered. “
Amerisource Bergen noted that pharmaceutical distributors “were asked to walk a legal and ethical cord between providing access to the necessary medication and taking action to prevent the diversion of controlled substances.”
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McKesson added in his statement: “We only distribute controlled substances, including opioids, to DEA-registered and state-licensed pharmacies” and argued that drug prevention and abuse is an issue that needs to be addressed through a comprehensive approach to private industry , involving the government. , providers and patients.
Steve Williams, the mayor of Huntington, who took office in 2012 because opioids were destroying ingredients, said his disappointment in the ruling could not be measured, calling it “a blow to our city and community,” but we remain resilient even in the face of adversity. ”
Citizens, he said, “should not bear the main responsibility for ensuring that an epidemic of this magnitude never occurs again.”
Attorneys for Cabell County and Huntington, and a national opioid plaintiffs’ executive committee, have released a joint statement expressing their deep disappointment.
“We felt the evidence that emerged from witness statements, company documents and extensive data sets showed that these defendants were responsible for creating and overseeing the infrastructure that flooded West Virginia with opioids,” they said. “Apart from the outcome, our appreciation goes out to the first responders, public officials, treatment staff, researchers and many others who gave their testimony to bring the truth to light. ”
The province and the city are considering whether to appeal.
Although the daring to press the case was risky, some other governments succeeded in the trial. The state of Washington also refused to sign up to the national settlement, sued the distributors and in May settled for $ 46 million more than it would have received in the national settlement. In June, Oklahoma also settled with the distributors for more money than the national settlement would have offered.
The state of West Virginia had previously settled its cases against the distributors for a total of $ 73 million, but local governments were free to pursue their own lawsuits. The outcome of this case, Ms. Burch, he said, is “very much a warning story about withdrawing the irrefutable money that a settlement offers.”
A new West Virginia trial against the same three distributors would have opened in state court on Tuesday, brought by another group of West Virginia counties and cities, represented by the same attorneys who followed the case decided Monday. However, in court on Tuesday, the start date was postponed.