The headline "WV settles Opioid Lawsuit for 37M" struck me like a needle in my forearm.
Yes it was "only" a distributor (McKesson). Yes it was millions. Yes, it was a start. Yes, there will be more to follow. But was it just? Was it a settlement or was it simply, as we have seen so often here, "hush money"?
Overdose deaths in West Virginia lead the entire nation by a very large margin. Today many of these deaths are attributed to synthetic opioids, like fentanyl (notably overdoses from methadone and other substitutes are not included; but more on that later). Yet the addiction crisis began with the incredible greed of the pharmaceutical industry in abetting the utilization of opioid painkillers, later blossoming into a return of the old enemy, heroin. After that the deluge. The even more lethal synthetics (fentanyl).
At the same time, the market force (aka "greed") that started the whole thing is still very much at work in an even more disastrous way. Street drugs (now stronger and more lethal than ever before) are going down in price while their antidotes and "safer" substitutes are rising dramatically in cost.
As an example: Five years ago a pre-filled Naloxone injection (the antidote for opiate overdose) had a list price of $288. Today that same auto-injector is listed at $2,000! The justification the manufacturer gave for this increase was noteworthy: "No customers actually pay that much because of all the discounts and rebates the company offers."
Really? Then who does pay the $1,700-plus difference? Perhaps someone should ask the IRS.
Therapeutic substitutes (like buprenorphine) can cost up to $720 per month. Methadone, the oldest chemical treatment, runs around $500 to $600 dollars per month (cash only). Both of these modalities yield profits to drug manufacturers. Neither have shown much success in creating final abstinence, so their coffers continue to grow.
My point is this: As states seek redress from Big Pharma, the monies won should both be enough to change its behavior and directed to prevention and recovery. West Virginia officials should be required through legislation to contribute a significant portion (if not all) of any "settlement" to the things that may actually resolve Pharma's debt to our state and society as a whole.
Otherwise the "deluge" will most assuredly continue.
Don Perdue is a pharmacist and a former member of the House of Delegates from Wayne County.