Walmart offers to pay $3.1 billion to settle opioid lawsuits

[BumRushDaShow]

Source: AP

Retail giant Walmart on Tuesday become the latest major player in the drug industry to announce a plan to settle lawsuits filed by state and local governments over the toll of powerful prescription opioids sold at its pharmacies with state and local governments across the U.S.

The $3.1 billion proposal follows similar announcements Nov. 2 from the two largest U.S. pharmacy chains, CVS Health and Walgreen Co., which each said they would pay about $5 billion.

The deals are the product of negotiations with a group of state attorneys general, but they are not final. The CVS and Walgreens deals would have to be accepted first by a critical mass of state and local governments before they are completed. Walmart’s plan would have to be approved by 43 states. The formal process has not yet begun.

The national pharmacies join some of the biggest drugmakers and drug distributors in settling complex lawsuits over their alleged roles in an opioid overdose epidemic that has been linked to more than 500,000 deaths in the U.S. over the past two decades. The tally of proposed and finalized settlements in recent years is more than $50 billion, with most of that to be used by governments to combat the crisis.

Read more: https://apnews.com/article/health-business-lawsuits-opioids-e49116084650b884756427cdc19c7352

[mucifer]

1. No one goes to prison for this. It's horrific!

[BumRushDaShow]

2. "No one goes to prison for this. It's horrific!"

https://www.justice.gov/opa/pr/16-defendants-including-12-physicians-sentenced-prison-distributing-66-million-opioid-pills

Department of Justice

Office of Public Affairs

FOR IMMEDIATE RELEASE Wednesday, March 9, 2022

16 Defendants, Including 12 Physicians, Sentenced to Prison for Distributing 6.6 Million Opioid Pills and Submitting $250 Million in False Billings

Sixteen Michigan and Ohio-area defendants, including 12 physicians, have been sentenced to prison for a $250 million health care fraud scheme that included the exploitation of patients suffering from addiction and the illegal distribution of over 6.6 million doses of medically unnecessary opioids. Five physicians were convicted in two separate trials, while 18 other defendants pleaded guilty. Seven defendants await sentencing.

“It is unconscionable that doctors and health care professionals would violate their oath to do no harm and exploit vulnerable patients struggling with addiction,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “These are not just crimes of greed, these are crimes that make this country’s opioid crisis even worse – and that is why the department will continue to relentlessly pursue these cases.”

“Patients look to physicians and medical professionals for their expertise and knowledge, trusting that they will do what is best to take care of them,” said Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division. “In this circumstance, these medical professionals provided prescription drugs to those with no medical need. It is unacceptable that in this nation’s current opioid crisis, physicians and medical professionals are exploiting the well-being of their patients for profit. Thanks to the diligent work of the FBI and our law enforcement partners, we are able to navigate the important sphere of healthcare fraud and to continue our mission of bringing those who operate these criminal schemes to justice.”

“Health care professionals who exploit opioid addiction for financial gain do so at the risk of endangering their patients and undermining critical public health efforts to address the opioid epidemic,” said Special Agent in Charge Mario Pinto of the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG). “We will continue working with our law enforcement partners to ensure that bad actors are held accountable for such egregious disregard for patient safety and well-being.”

“IRS-CI is committed to working with its law enforcement partners to help fight the opioid crisis and to prevent unscrupulous heath care professionals from using taxpayer funded programs as their own piggybanks,” said Special Agent in Charge Sarah Kull of the IRS Criminal Investigation (IRS-CI), Detroit Field Office.

According to court documents and evidence presented at trial, the scheme involved doctors refusing to provide patients with opioids unless they agreed to unnecessary back injections. Perpetrated through a multi-state network of pain clinics from 2007 to 2018, the evidence established that the clinics were pill mills frequented by patients suffering from addiction, as well as drug dealers, who sought to obtain high-dosage prescription drugs like oxycodone. The doctors working at the clinics agreed to work only a few hours a week to “stay under the radar” of the Drug Enforcement Administration (DEA), yet were among the highest prescribers of oxycodone in the State of Michigan.

To obtain prescriptions, the evidence showed that the patients had to submit to expensive, unnecessary and sometimes painful back injections, known as facet joint injections. The injections were selected because they were among the highest reimbursing procedures, rather than based on medical need. Trial testimony established that, in some instances, patients experienced more pain from the shots than from the pain they had purportedly come to have treated, and that some patients developed adverse conditions, including open holes in their backs. Patients largely acquiesced to these unnecessary procedures because of their addiction or desire to obtain pills to be resold on the street by drug dealers. Evidence further established that the defendant physicians repeatedly performed these unnecessary injections on patients over several years and were paid more for facet joint injections than any other medical clinic in the United States.

The evidence further established that the proceeds of the fraud were used to fuel lavish lifestyles. Francisco Patino, a doctor and part-owner of the clinics, bought jewelry, cars and vacations, as well as paid Ultimate Fighting Championship and other mixed martial arts fighters to promote his specialized diet program. Mashiyat Rashid, Patino’s business partner and part-owner of the clinics, purchased private jet flights, courtside tickets to the NBA Finals and expensive real estate. Other physicians involved in the scheme purchased luxury cars, gold bars, and indoor basketball courts and swimming pools. Over $16 million in fraud proceeds was forfeited by the United States from the defendants.

The physicians sentenced by the court include:

(snip)

[Major Nikon]

3. I'm trying to figure out why the pharmacies have liability here

According to the article, people were turning to illicit drugs when the government made it harder to get prescription opioids. So how exactly are pharmacies to blame for the US failed drug policy?

[BumRushDaShow]

5. I expect that there were a handful of small pharmacies

(including in-store ones) working in tandem with physicians who were acting as "pill mills" to fill an unusual number of scripts for the product.

In situations like this, it often ends up to be a tiny number of retailers who are found to have been churning out the pills.

I know there have been cases here in the Philly area where you had caretakers/caretaker organizations who took care of older vets residing in assisted living or similar medical facilities or small group homes, and would obtain scripts "on their patients' behalf" written by a physician in the ring. It would end up that the vets were never taking the medication and the caretaker was actually reselling the pills, and everyone in the chain of prescribing, fulfilling, and repackaging for sale, was getting a kickback.

[Major Nikon]

6. With any large chain pharmacy, this is bound to happen

However, I just can't imagine how you can come up with $8 billion worth of liability for three pharmacy chains. This is a staggering figure.

All of this is a direct result of a failed drug policy. When the government starts cracking down on legal avenues for prescription drugs, it's guaranteed this is going to result in increasing the illegal avenues for the same classes of drugs. I know several people who suffer with chronic pain who have been forced to undergo increasingly invasive procedures that don't work at a massive cost to them and insurance companies who pass down the cost to everyone else. Certainly those who profiteer illegally from all of this are scum of the earth, but the government itself deserves most of the blame.

[BumRushDaShow]

10. Look

I have a sister who has had progressively worsening R.A. for the past 25 years and has already had a hip and knee replacement and needs a shoulder replacement. She has pain management docs along with her rheumatologist and has rotated through a laundry list of biologic-derived infusions over that time, but is also on opioids and prednisone daily. She is prepping for once again having an ablation procedure (for the 2nd time in the past few years) to kill misfiring nerves that are causing her back pain.

The hoops she has had to jump through have been ridiculous, so I get it.

However as long as you have the U.S, medical community all over the place with opinions, like we have seen with how COVID-19 manifests, what it can do, and how to treat it, then that is going to present problems. So for example, one group tells people to "mask up with what you have" and another group yells "masks are useless unless they are N95 and fitted", and you will see the same is going to apply to "opinions" about pain management.

In other words, the different opinions spill over into public policy, clashing enough to result in a status quo. "The government" is not a medical institution and has to rely on medical professionals for policy-making decisions and a subset of medical professionals become advisors for the government when it comes to drafting policy.

You give 10 scientists (and I am one) the same set of "facts" and you will end up with 10 different opinions about what those facts "mean". Some opinions might cluster together as being similar to each other, but other opinions may be completely contrary to the prevailing opinion, and those holding those views are often very strongly defending their positions.

So it is difficult to come up with a good solution, but it's not all "the government's fault". If anything, it's "the medical community's fault".

[Major Nikon]

12. Here is what is the government's fault

They make this class of drug almost impossible to get for everyone, and not just the very small percentage of abusive addicts, but the much larger percentage of people who genuinely need them. The hardest hit are those in the greatest need.

The other easily identifiable problem is when you try to address the problem at the supply level, all you are ever going to do is push that supply underground where it becomes far more dangerous.

Drug policy in the US is virtually unchanged for the last 100 years and if the empirical data isn't enough to show people this approach doesn't work, the results should speak for themselves. Meanwhile there's no shortage of examples where other countries have taken a results oriented approach and achieved outstanding success. So yes, it is the government's fault and it just isn't that hard to demonstrate.

[BumRushDaShow]

13. You are preaching to the choir about there being a problem

but again, like you see the turmoil going on right now with CDC, it's not "the government" as some solitary entity, but the people who have been chosen to advise it, and the laws that have been passed that determine their mission and scope.

"Other countries" don't have "free market economies" like here and severely regulate their industries including the medical one, which in most countries outside of the U.S. IS run by the government, save for a few carve-out exceptions that those countries put in place. The closest that the U.S. has to "government-run medical institutions" are the VA hospitals, but otherwise, it's all private industry.

There have been many many studies where they have shown that those who are members of the black and brown communities are less likely to be given pain meds than the white community. THAT is not "government policy". But it is the same sort of nebulous thing that goes on within the medical community that flows into government policy through advisors.

Couple that with big pharma and their congressional lobbyists, and you end up with legislation that ultimately restricts or directs what the government can and cannot do.

It's no different from the NRA and gun manufacturers influencing the U.S.'s gun policies or big oil influencing the U.S.'s energy policies.

[Major Nikon]

16. The countries in which you are referring didn't address the problem at the supply chain level

So I don't see how implying more regulation on the supply chain is the answer. It's actually more of the exact same wrong answer we've been trying for the past 100 years.

Those countries addressed the problem by reducing regulation on the medical community and treatment community allowing them to do their jobs and funded solutions that are known to work.

I don't know if you've noticed, but the current trend in regulation is to make these drugs far more difficult to get legally for everyone. I have a hard time believing that's the fault of big pharma.

[BumRushDaShow]

18. I never said anything about "supply chain" issues or "adding 'more' regulation"

I said that the U.S. has adopted what they call "a free market economy" and as part of that, "private industry" is given preference over all else. Our laws are based on a little bit of "we the people" and the rest is what the "free market economy wants".

DU has a sadly breathtaking lack of Civics knowledge and how the U.S. government works.

This country was set up with a Legislative branch that defines what will and will not "be" and it is the job of the Executive to just "do it". "Regulations" are the further explicit detailed codification of the laws that CONGRESS passes and the President signs.

And when the Executive, as it begins carrying out those laws, does something that results in someone believing they have over-stepped their bounds, then their grievances are taken to the courts to decide.

What "restrictions" or changes that are made to drug product policies, are governed by what was dubbed -

The Comprehensive Drug Abuse Prevention and Control Act of 1970

The fact that you had stuff like Codeine that used to be OTC many years ago before being restricted or on the distaff side, having products like Plan-B that was prescription-only and dragged kicking and screaming into being OTC (after a myriad of court cases), shows how wedded to the law our medicine is.

If you don't like "the policies" that are based on "the law", you elect a Congress to change it.

[Major Nikon]

19. What DU has an abundance of is condescension

Since you've clearly decided to go down that road I have little interest in anything you just wrote.

[BumRushDaShow]

20. It is unfortunate

that I have to explain, after being a retired federal employee who worked for one of these health agencies for over 30 years before retiring, how it all "works", and still get push back.

I get what you are saying and I agree with it whole-heartedly. How we handle medicine in the U.S. is horrid and you can see that through the outcomes of many medical conditions vs other countries. But I think where we disagree is the root cause and I am attempting to explain what that is, as bad as it is, and what it will take to change course.

[Major Nikon]

21. It's unfortunate you have to use condescension to make a point

If you can't own up to that, so be it. That too doesn't do your argument any favors regardless of what knowledge or experience you anonymously claim.

[BumRushDaShow]

22. I then offer that you do your own research

I offered my perspectives and reasons (and even included some links to check out). Not much more I can do.

[GusBob]

7. Reply

Purdu Pharma, the manufacturer of Oxy, crooked Drs and the pharmacy chains made billions by creating millions of addicts and killing thousands. Some pharmacists knew it was wrong and refused the scripts, making the ones who kept filling more and more culpable.



I suggest you read the books by Sam Quinones: " Dreamland" and "The Least of Us"

[hatrack]

8. Also, "American Pain", about a legendary (not in a good sense) pill mill in FL

.

[GusBob]

9. Yes I will

It seems apparent to me that the source of the problem was created by greedy folks in the private sector, not failed government drug policies. The illicit drugs are manufactured outside of the US by more greedy criminal types.

It seems apparent also that these funds are being collected by the government for treatment of addiction to keep folks alive and out of prison

And as the books I recommended above go into detail about, there are success stories in that regard

[Major Nikon]

11. Some also refuse scripts for BC

I don't need a pharmacist injecting their idea of morality on decisions that are between my doctor and me and I have no respect, much less expectation of any doing that.

I can certainly see some level of culpability on behalf of doctors conspiring with drug manufacturers. I don't see how that translates to pharmacies and I can see all sorts of problems that almost certainly will result with imposing morality liability on pharmacies.

[GusBob]

14. apples and oranges

This is not an issue of morality. Medical ethics perhaps. Pharmacists do take oaths. They knew the same crooked Drs were over Rx-ing to the same addicts. Same folks coming in for months and years getting stronger doses of Oxy all gacked out. They understood the addictive and deadly nature of opioids or should have. Everyone does now

This is an issue of liability, malpractice and legality...these issues are being settled in the courts after all.

The manufacturer made the poisons and lied about their safety, the Drs Rx'd them, the pharmacies handed them out. Folks got addicted and died.

You seem to want to blame government drug policies. The problem was caused by the private sector and the governments are cracking the whip now. Millions of victims of corporate wrongdoing are still addicted, and these funds can be used to keep them alive and out of jail.

I wonder if gun manufacturers are looking at these settlements

[Major Nikon]

15. So cite the medical ethics in which you're referring that's somehow being violated

I get it, big pharm is bad. But if that's all you have to offer as an argument, I can't say I'm convinced your apples and oranges claim holds much water.

[GusBob]

23. Easy-peasy

First rule of medicine: DO NO HARM

Obama adopted that as his mantra: 'dont make a bad situation worse'

Let's look at it this way: Your adult son gets addicted to Oxy, OD's and dies
Who do you blame?
Him?
You?
The government?
the cops? the courts?
The Dr who Rx'd the pills?
The maker of the pills?
The dispenser of the pills?
God?

It's not 'my argument'. There's a reason these cases are being settled by lawyers. Parents of victims stood up and started pointing fingers. First Purdu, now the pharmacies. If you read the books I suggested, which are well written and well researched, you will learn that the author accurately diagnosed the problem and predicted these settlements. They are slam dunk cases

The law is deciding man, not me or you

[SheltieLover]

4. Kicking for visibility

[republianmushroom]

17. How much did they make selling it

Nobody goes to jail, why not?

[BumRushDaShow]

24. "Nobody goes to jail, why not?"

See this upthread - https://www.democraticunderground.com/?com=view_post&forum=1014&pid=2994908

That is just one case set of cases that covered MI and OH.

DOJ has a whole part of their website devoted to opioids and their enforcement actions - https://www.justice.gov/civil/consumer-protection-branch/opioid