Our Opinion: Big Pharma must contribute to opioid crisis fight

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Massachusetts provides $266 million in funding for substance abuse treatment, and as that figure is not likely to decline soon, Gov. Baker and the state Legislature want drug companies to help pick up the tab. A legislative effort to do that is in the works, but it may be difficult if not impossible to prevent Big Pharma from undermining that effort.

A total of 1,974 people died of confirmed or suspected opioid overdoses in 2018 according to the state Department of Public Health. That represents a modest decline from 2017 but despite concerted efforts by the state and a variety of health organizations the addiction problem continues to defy solution. Health officials assert that the over-prescribing of highly addictive painkillers is a major cause of the epidemic, and while the medical community has cut back on such prescriptions, the drug companies continue to resist pressure to reform and insist on marketing campaigns to promote their products.

Gov. Baker, in his fiscal 2020 budget, has proposed a 15 percent tax on drug manufacturers' gross receipts from the sale of opioid products. The tax, which the governor projects will generate $14 million in the next fiscal year, will be targeted specifically for the cost of providing treatment and services for substance misuse. Rep. James O'Day, a West Boylston Democrat, has proposed legislation requiring drug manufacturers to cover the state's expenses for addiction treatment and recovery services up to $75 million per year. He told the State House News Service that the bill represents "an important opportunity to hold opioid manufacturers accountable for the devastating effects of their reckless and deceitful marketing prices."

Proceeding on a separate track, Attorney General Maura Healey has brought a lawsuit against Connecticut-based Purdue Pharma, manufacturer of the highly addictive painkiller Oxycontin, based in large part on emails by corporation executives describing efforts to heavily market the potentially dangerous drug. Purdue Pharma argues that the email comments were taken out of context and says it will "vigorously" fight the lawsuit.

New York State last year passed a first-of-its-kind assessment on opioid manufacturers only to have two pharmaceutical companies successfully sue to prevent its enactment. A U.S. District Court judge praised the state for its effort but found that the law violated the Commerce Clause section of the U.S. Constitution by prohibiting drug manufacturers from passing along the cost of the tax to consumers. Gov. Baker's bill does not contain this provision and Rep. O'Day's legislation requires the state Health Policy Commission to work with manufacturers "to prevent this assessment from being translated into increased costs for consumers." It is unclear how, in the wake of the District Court judge's ruling, how the commission can be expected to do this.

There are other complexities posed by the necessary effort to cut back on opioid addiction. While the Massachusetts Medical Society acknowledged the over-prescribing of painkillers in 2015 it warned that people in real need of painkillers risk being prevented from getting them. There has been anecdotal evidence since of people being denied prescription painkillers they have long used and of being dropped by their doctors. The Healey lawsuit revealed that studies and educational programs at Massachusetts General Hospital and Tufts University have been funded by Purdue Pharma, giving the company influence at both major institutions.

While it would be naive to expect the pharmaceutical companies to do the right thing and pay for a share of the cost of dealing with the opioid crisis they helped create, the effort must still be made. The obstacles ahead aside, the governor and the Legislature should continue to push for legislation, as legally airtight as possible, to make the companies do the right thing, and we encourage Attorney General Healey to push aggressively for financial compensation in court.

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