CRIMINAL CAPITALI$M 

Teva, Units Held Liable for Fueling N.Y. Opioid Crisis

Jef Feeley
Thu, December 30, 2021


(Bloomberg) -- New York jurors concluded Teva Pharmaceutical Industries and some of its units helped create a public-health crisis through their marketing and distribution of opioid painkillers across the state, in the pharma industry’s latest loss in the sprawling litigation over the highly addictive drugs.

The Israel-based firm now faces potentially billions of dollars in compensation claims from the state and two Long Island counties accusing Teva executives of flooding their areas with more than a billion opioids pills over nearly a decade and using misleading tactics to sell them.

Teva’s American depository receipts fell as much as 5.3% in New York trading, the most intraday since Nov. 3.

“Teva Pharmaceuticals strongly disagrees with today’s outcome and will prepare for a swift appeal,” Kelley Dougherty, a U.S.-based spokeswoman for Teva, said in an emailed statement. The state and local governments “presented no evidence of medically unnecessary prescriptions, suspicious or diverted orders, no evidence of oversupply by the defendants” and also failed to show “any harm to the public in the state,” she said.

Judge Jerry Garguilo will decide later how much the state and counties should get to beef up treatment and social-service budgets depleted by the U.S. opioid crisis, which has killed more than 500,000 Americans over the last two decades. A hearing on the compensation issue hasn’t yet been set.

‘Death and Destruction’

Jurors found Teva itself was 30% liable for harm created by its opioid marketing in Suffolk and Nassau counties while it was 40% liable for the problems across the whole state. Its units’ percentages of fault made up the remainder of 100%, according to the verdict form.

“A jury has found an opioid manufacturer responsible for the death and destruction they inflicted on the American people,” New York Attorney General Letitia James said in an emailed statement. “Teva Pharmaceuticals USA and others misled the American people about the true dangers of opioids.”

Jayne Conroy, one of the counties’ lawyers, noted the jurors deliberated for more than a week before finding against Teva and its units. She said the panel properly found “manufacturer Teva and distributor Anda cannot break the law for profit and cause deadly harm to our communities.”

Lawyers for Teva and Anda on Thursday asked Garguilo to throw out the verdict, saying the state and counties didn’t prove the companies created a public nuisance. They also pointed to the inconsistency in the percentage of fault Teva faces in the verdicts on behalf of the counties and the state as warranting a new trial.

Second Verdict

Thursday’s jury verdict is the second in the burgeoning four-year opioid litigation. Municipalities accuse opioid makers, distributors and sellers of downplaying the painkillers’ addiction risks and sacrificing patient safety for billions in profits. They also blame them for contributing to the deaths of more than 500,000 Americans in the opioid epidemic over the last two decades.

The state-court jury found Teva and subsidiaries including Anda Inc. and Cephalon Inc. created a so-called “public nuisance” by marketing the opioid-based drugs in a misleading manner and not properly monitoring suspicious shipments of the highly addictive painkillers. The panel concluded the marketing “contributed to, or maintained a substantial and unreasonable interference with a public right that amounts to a public nuisance,” according to the verdict form.

The trial over the governments’ claims began in June with more than 30 companies as defendants. By the end, only Teva and its units, including Cephalon Inc., Actavis Pharma and Watson Laboratories Inc., were left to face the six-person jury. That’s because other opioid makers, including Johnson & Johnson and Endo International Plc, drug distributors such as McKesson Corp. and Cardinal Health Inc. drugstore chains like Rite Aid Inc. and Walgreens Boots Alliance Inc., settled to get out of the trial.

The six-month trial, held in Suffolk County on Long Island, featured internal sales-conference videos produced by Cephalon that the governments alleged showed the company pushed opioid sales to beef up bonuses and put profit over consumers’ safety.

Dr. Evil

The panel saw a 2006 video based on a scene from the 1992 film “A Few Good Men,” that the Teva subsidiary used at a sales conference to promote its opioid-based drug, Fentora.

Dressed in a Marine uniform, Roy Craig, a Cephalon sales manager, portrays Jack Nicholson’s character in the movie. “I have neither the time nor the inclination to explain ourselves to people who rise and sleep under the very blanket of revenue we provide and then question the manner in which we provide it,” Craig says on the video.

Lawyers for the governments also showed jurors a dubbed parody of the 1997 “Austin Powers, International Man of Mystery” movie in which the villain, Dr. Evil, portrays a Cephalon sales executive leading a Fentora marketing meeting.

Dr. Evil -- played by actor Michael Myers -- ejects subordinate Will Ferrell into a fiery pit over his unhappiness with the new painkiller’s packaging and comes up with several aggressive marketing ideas. The video was made for a 2007 annual sales conference.

The case is In Re Opioid Litigation, Index no. 40000/2017, Supreme Court of New York, Suffolk County.

ERs can boost efforts to stamp out opioid addiction, study suggests
By HealthDay News


Based on a trial program, researchers say that hospital emergency rooms could help improve efforts to treat people with opioid addiction issues. 

Photo courtesy of U.S. Department of Agriculture

A program meant to encourage the use of a drug that can help people overcome opioid addiction led to dramatic increases in its use in emergency rooms, researchers report.

Buprenorphine is a medication that stabilizes opioid withdrawal and soothes cravings. Using it can help people with opioid use disorder stay engaged with care, while reducing overdose deaths and other complications of drug use.

The program designed by researchers from the University of Pennsylvania worked both to give doctors incentives to train to treat opioid use disorder, as well as to develop and improve the connection between patients and peer recovery specialists.

Designed to increase initiation of the use of buprenorphine treatment for opioid use disorder in emergency rooms, the program was tested at three Penn Medicine hospitals and led to a sixfold increase in the treatment at these locations.

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"We used a behavioral design approach to make implementation of evidence-based treatment easy, attractive, social and timely," lead study author and assistant professor of medicine Dr. Margaret Lowenstein said in a university news release.

While we concentrated initially on prescribing itself, we realized we also needed to overcome other barriers, such as identifying and engaging patients in care," Lowenstein said.

This medication can be lifesaving for patients. To help make it easier for them to get it, researchers first needed to make it easier to prescribe by helping more clinicians become authorized prescribers.

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The physicians in the study needed something called an X-waiver that required training, but those restrictions were later loosened in 2021.

To prescribe the drug, physicians still need to register in advance on a government website.

The clinical team used a financial incentive system that rewarded doctors for the training, increasing their numbers from 6% to 90% in six weeks.

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The researchers also developed a system to identify patients through electronic health records and connect them immediately with peer recovery specialists while they were in the hospital and during early recovery.

For the study, data was collected from March 2017 until July 2020, 18 months before and after the start of the program.

It found that the rate of patients with opioid addiction who received buprenorphine in emergency departments climbed from 3% before the study to 23% by the end of the study period.


The patients sustained their use of the drug and increased it, even a year after the changes went into effect, though the study found that not all doctors prescribed it at the same rates.

Some doctors prescribed buprenorphine to 61% of their patients with opioid use disorders, while others never wrote a prescription, even if they were authorized.

"The fact that some physicians in our group were able to provide this evidence-based treatment to more than half of their patients while others had the ability to do so, but never did, showed there was much more work to be done to nudge clinicians and make offering this treatment a default process," said senior study author Dr. M. Kit Delgado, an assistant professor of emergency medicine and epidemiology.

This information led the team to conduct a focus group of 29 emergency department doctors or nurses. They learned that the automated process wasn't finding all eligible patients because the algorithm needed more specificity.

"Moving forward, we're going to test different ways to better ensure that patients we're discharging with buprenorphine prescriptions have a warm handoff and engagement with ongoing addiction treatment," Delgado said in the release.

"Starting this medication is the best first step, but there are many more on the long-term path to recovery once they leave the hospital," Delgado said.


The findings were published this month in the Annals of Emergency Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more on drug overdose.

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