By LEAH WILLINGHAM, Associated Press
CHARLESTON, W.Va. (AP) — Lawyers for the state of West Virginia wrapped up the first week of a lawsuit against three major opioid makers on Friday by outlining how drug companies renamed the highly addictive drugs it there are decades to expand their base of prescribers while minimizing risk.
The trial began Monday in the state’s case against Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc., Teva Pharmaceuticals Inc., AbbVie Inc.’s Allergan and their family of companies.
On Friday, state attorneys spent hours questioning Matthew Perri, a pharmaceutical marketing expert who said he “carefully” reviewed thousands of pages of companies’ marketing materials.
Much of Friday’s early testimony related to materials produced by Cephalon Inc., a company acquired by Teva, to sell fentanyl drugs Actiq and Fentora.
Perri described a “paradigm shift” in the late 1990s to early 2000s in which companies shifted from marketing opioids as drugs designed for terminal cancer patients to drugs designed to treat long-term pain.
Documents used by sales reps to market the drugs downplayed or failed to mention the addictive risks associated with opioid use, Perri said. Instead, the marketing described the drugs as “safe and highly effective” in controlling pain and “improving functionality and quality of life” for patients.
“It broke down the barriers that existed and effectively lowered the bar” for prescribing opioid drugs, he said. “Opioids could be prescribed earlier in the treatment process, with less worry.”
A 2010 training manual used by salespeople marketing the morphine drug Kadian repeatedly downplayed the risk of addiction among users. Allergan owns the rights to Kadian.
“Despite the persistent unscientific beliefs of some clinicians, there is no evidence that simply taking opioids for a period of time will lead to addiction or dependence,” the document states.
The report says that “it seems likely” that most patients who abuse opioids as part of pain management practices have had an “abuse problem” beforehand.
“This topic is so important and there is so much misinformation out there,” it read.
The test bed should last up to two months.
Earlier in the week, the judge heard a video deposition from the new White House drug czar, Dr Rahul Gupta, who said the opioid epidemic had gotten so bad in ravaged West Virginia by drugs that the state had difficulty finding adoptive parents. children.
Gupta previously served as West Virginia’s health director from 2015 to 2018 and executive director of the Kanawha-Charleston Health Department. He was confirmed last fall by the US Senate as director of the White House Office of National Drug Control Policy.
His testimony was recorded before he was appointed to his position in the White House.
West Virginia has long led the nation in drug overdose death rates. Gupta said the opioid crisis has also led to an increase in public health issues such as cases of hepatitis B and HIV and neonatal abstinence syndrome, withdrawal in newborns caused by exposure to drugs in the womb.
The lawsuit filed by Attorney General Patrick Morrisey accuses the companies of creating a public nuisance and violating the state’s credit and consumer protection law.
Lawyers for the companies said in their opening arguments Monday that their individual products in question had considerably less than 1% of the market share in West Virginia, were medically necessary prescriptions and could not have contributed to the health problems. state opioids.
In November, a California judge ruled in favor of Johnson & Johnson, Allergan, Endo International, Teva and others, saying local governments failed to prove in a lawsuit that drug companies used deceptive marketing to increase unnecessary opioid prescriptions and creating a public nuisance.
Nationwide settlements were finalized in February by Johnson & Johnson and distributors AmerisourceBergen, Cardinal Health and McKesson regarding their role in the opioid addiction crisis. This paved the way for $26 billion to go to almost every state and local government in the United States. West Virginia previously reached settlements in separate lawsuits, including $37 million with distributor McKesson in 2019, $20 million with Cardinal Health and $16 million with AmerisourceBergen in 2017.
In Charleston, a separate lawsuit ended last summer in federal court in a lawsuit accusing AmerisourceBergen, Cardinal Health and McKesson of fueling the opioid crisis in Cabell County and the city of Huntington. This judge did not indicate when he will rule.
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