The world's biggest drug companies largely deny any wrongdoing regarding their role in fueling the opioid epidemic—multimillion-dollar settlements or not.
Drugmakers Johnson & Johnson and Purdue Pharma, along with distributors McKesson, AmerisourceBergen and Cardinal Health, have all agreed to reimburse states, counties and the federal government for dishonest marketing and failure to regulate the deadly painkillers, which have taken hundreds of thousands of U.S. lives.
Reimbursement is one thing, but admission of guilt is another. In nearly a dozen cases reviewed by Newsweek, all the drug companies have clauses in their opioid-related settlements over the years that allow them to avoid saying they did anything wrong.
Earlier this week, drug distributors agreed to pay Ohio counties $260 million, minus a contribution from drugmaker Teva Pharmaceuticals. Cuyahoga and Summit counties have been ravaged by the opioid crisis, losing tens of thousands of lives and many millions of dollars in opioid-related costs, according to local officials.
Despite the agreement, the distributors "strongly dispute the allegations," which mostly involve dodging their regulatory responsibilities.
"While the companies strongly dispute the allegations made by the two counties, they believe settling the bellwether trial is an important stepping stone to achieving a global resolution and delivering meaningful relief," said McKesson, AmerisourceBergen and Cardinal Health in a joint statement.
"The distributors remain deeply concerned about the impact the opioid epidemic is having on families and communities across the nation—and are committed to being part of the solution," the companies added.
Earlier this year, McKesson paid $37 million to West Virginia without admitting fault. Two years ago, the company paid the federal government $150 million in civil penalties for alleged violations of the Controlled Substances Act, agreeing to suspend sales and ramp up compliance measures.
In a press release at the time, McKesson said it settled "in the interest of moving beyond disagreements about whether McKesson was complying with the controlled substance regulations...and to instead focus on the company's partnership with regulators and others to help stem the opioid epidemic in this country."
In 2017, AmerisourceBergen and Cardinal Health agreed to pay $16 million and $20 million, respectively, to West Virginia after accusations that they didn't properly monitor the supply of opioids coming into the state. Both companies denied the allegations.
In 2016, Cardinal Health admitted it failed to report suspicious orders to the Drug Enforcement Administration from January 1, 2009, to May 14, 2012, and paid $44 million to the federal government. In a statement, Chief Legal and Compliance Officer Craig Morford drew attention to other players in the opioid pipeline.
"To combat the scourge of opioid abuse successfully, this must be a collaborative effort that includes all parties—the regulators, who set and license supply; the manufacturers, who produce medications; the physicians, who treat patients and prescribe medications; and the pharmacists, who fill those prescriptions," Morford said.
Earlier this year, Johnson & Johnson settled with the two Ohio counties for $20.4 million, including reimbursement for legal fees and charitable contributions to opioid-related nonprofit programs. Amid the crisis, Johnson & Johnson made a fentanyl patch and opioid tablets, but it also produced a lot of the raw opium used by other drug companies.
In a statement at the time, the company said the agreement came with "no admission of liability."
"As previously stated, the company is open to identifying an appropriate, comprehensive resolution of the overall opioid litigation. At the same time, the company remains prepared to defend its actions," a spokesperson said, adding that some of Johnson & Johnson's products accounted for less than 1 percent of total opioid prescriptions in the U.S.
A judge ordered Johnson & Johnson to pay $572 million to Oklahoma earlier this year. The company appealed the verdict, and Cleveland County District Judge Thad Balkman later said the figure was about $100 million too high because of a miscalculation, according to CBS News.
Purdue Pharma, which makes OxyContin, filed for bankruptcy in September to resolve suits with a dozen states and thousands of counties. The company's owners, members of the Sackler family, agreed to pay $3 billion over seven years to the plaintiffs and to sell Mundipharma, its British pharmaceutical firm. Included in the terms of the agreement was no admission of wrongdoing from the Sacklers.
The companies did not immediately respond to request for comment.
The opioid epidemic cost the U.S. economy at least $631 billion over four years, according to the Society of Actuaries. A study published earlier this year by Massachusetts General Hospital estimated that 700,000 people in the U.S. will die from opioid overdoses between 2016 and 2025.
According to another recent report, most people who died from overdoses in a Massachusetts sample used heroin or illicitly fentanyl, suggesting the U.S. could be heading toward another public health crisis. As prescription painkillers become harder to find, those dependent on opioids are turning to deadlier alternatives.