Infirmary Health, the Mobile-based hospital system that operates Mobile Infirmary Medical Center, has joined a group of hospitals in a sweeping lawsuit accusing major pharmaceutical companies of fueling the nation’s opioid crisis through deceptive marketing practices. The 134-page complaint, filed in Mississippi in late November, names Purdue Pharma, Endo Pharmaceuticals and several other drug manufacturers as defendants, along with distributor McKesson Corp.
Joining Infirmary Health in the suit are the Southwest Mississippi Regional Medical Center, the Monroe County Healthcare Authority and Monroe County Hospital, extending the legal action’s reach into rural south Alabama communities that have felt the strain of opioid addiction alongside the region’s larger hospital systems.
The complaint draws comparisons to the landmark lawsuits filed against tobacco companies in the 1980s, arguing that opioid manufacturers used “false, deceptive and unfair marketing” to convince doctors and patients that powerful painkillers carried little risk of addiction. According to the filing, the companies aggressively promoted opioids while “falsely representing that patients would rarely succumb to drug addiction,” language the hospitals say misled providers who prescribed the drugs in good faith.
“[They] turned patients into drug addicts for their own corporate profit,” the complaint states.
The lawsuit also targets distributors, accusing McKesson Corp. of failing to “monitor, detect, investigate, refuse and report suspicious orders of prescription opiates.” The hospitals contend that failure allowed large quantities of prescription opioids to be diverted into illicit markets, worsening the very crisis their emergency rooms and treatment programs have had to absorb.
The hospitals are represented by Mississippi attorney John W. “Don” Barrett, who previously played a role in the tobacco litigation of decades past, along with the Mobile-based law firm Taylor Martino.
“These hospitals and their leadership take very seriously their commitment to health care in their communities,” attorney Steve Martino said. “They try to keep health care efficient and safe, but the carnage of this epidemic falls on them, and many times they don’t get reimbursed.”
Martino said that burden shows up across nearly every department of a hospital, not just emergency rooms. Patients affected by opioid addiction frequently require psychiatric care, neonatal treatment for infants exposed to opioids in the womb, and detox services, much of it delivered to uninsured patients whose care goes unreimbursed.
The lawsuit arrives as opioid abuse continues to strain public health systems at every level. In October, President Donald Trump declared the opioid crisis a national “health emergency,” and in Alabama, Gov. Kay Ivey and Attorney General Steve Marshall have each formed committees to study the epidemic’s impact on the state and recommend responses.
The scale of the crisis is stark. The Centers for Disease Control and Prevention reported roughly 64,000 opioid-related deaths nationwide in 2016, a 22 percent jump from the year before. Economically, the White House estimated in November that opioid abuse and addiction cost the United States $504 billion in 2015 alone, factoring in health care spending, criminal justice costs and lost productivity.
Much of the hospitals’ complaint focuses on how opioid manufacturers marketed their products to doctors and patients. The suit alleges several companies spread misleading claims about how addictive opioids were and how effective they remained for long-term pain management, understating the likelihood that patients would develop a tolerance requiring ever-higher doses over time.
The complaint further alleges that some manufacturers spent millions of dollars quietly funding patient advocacy groups, medical publications and physicians who then echoed those same misleading claims, without disclosing the financial relationship behind them.
Some of the allegations echo conduct for which manufacturers have already paid steep penalties. Purdue Pharma, maker of OxyContin, paid $600 million in 2007 after admitting it misled regulators, doctors and patients about the drug’s addiction risks and potential for abuse.
Martino argued that drugmakers understood the consequences of their marketing long before the public reckoning arrived. “They knew there would be a health care fallout at some point, but it would be for somebody else to worry about,” he said, adding that hospitals and emergency rooms nationwide have shouldered that fallout for years.
“You’ve got the hospitals — nurses, doctors and administrators — on the ground dealing with this problem, and then you have these guys who just invented this market,” Martino said. “For years the medical standard was that these drugs were prescribed only for end-of-life treatment and cancer. Well, that’s not much of a market.”
None of the defendant companies has filed a formal legal response to the complaint. Purdue Pharma, in a written statement, said it is “deeply troubled by the opioid crisis” and “vigorously denied” the allegations. The company said its products account for about 2 percent of total opioid prescriptions and pointed to its distribution of CDC prescribing guidelines, its development of abuse-deterrent opioid formulations and its partnerships with law enforcement to expand access to naloxone, a medication that can reverse an opioid overdose.
Martino acknowledged that a civil lawsuit cannot force the companies to change how they do business, but said he is hopeful that a successful outcome could prompt voluntary changes. He emphasized that despite the substantial monetary damages being sought, the hospitals view the case as part of their broader obligation to provide safe, effective care to their communities.
“A lot of times, when the public hears about lawsuits like this, they think it’s just some big cash grab, but this is a real problem in emergency rooms,” Martino said. “It’s not just a money thing, either. If your kid falls out of a tree and breaks his arm, and you’re sitting in the ER waiting because they’re having to deal with someone looking for pills, that’s a problem.”