GUEST VOICES: Time for Opioid Makers to Pay Their Share

by Ramon Castellblanch, Ph.D., President, Quality Healthcare Concepts, Inc.

With AB 1468 (McCarty), opioid manufacturers and distributors will begin to pay California to help stop the deaths and misery caused by the opioid epidemic, off of which these businesses have so highly profited. For two decades, opioid manufacturers and distributors have irresponsibly promoted opioids. Opioid-makers like the Sackler family-owned Purdue Pharma have pleaded guilty to misleading regulators, doctors and patients about their opioid Oxycontin’s risk of addiction and its potential to be abused. Opioid distributors like Cardinal Health and AmerisourceBergen have settled lawsuits that they were shipping opioids to “pill mill” pharmacies that dispense excessive numbers of painkillers.

Over the past two decades, opioid overdoses have killed more than 200,000 Americans. In 2017, 68% of the more than 70,200 drug overdose deaths involved an opioid. The death toll is so high that it’s now a major factor in lowering U.S. life expectancy. For 2015, the Centers for Disease Control estimates that there were 316,900 hospitalizations for nonfatal drug poisonings and an estimated 547,543 emergency department visits for drug-related poisonings in the U.S.

In California, there were 2,196 reported opioid OD deaths in 2017 and our state is one of the three where the opioid OD death rate is still rising. The age group with the highest number of opioid OD deaths in California are those 55 and older. The industries with the highest OD death rates are construction and healthcare. As of 2016, there were an estimated 348,193 Californians with opioid use disorder (OUD), people self-reporting heroin use or meeting the American Psychiatric Association’s criteria for opioid abuse or dependence. Most people who die of an opioid OD had either OUD or another substance use disorder.

As of 2016, our state didn’t have enough capacity to provide needed medicines for most Californians with OUD. The gold standard for beginning treatment of OUD, chronic opioid agonist treatments like buprenorphine, was not available to between 165,977 and 245,093 Californians. Just to provide this population with opioid agonist treatments, let alone behavioral healthcare usually needed to recover from OUD, would cost over $1 billion/ year.

Manufacturers and distributors who are profiting from opioids can afford to help California with our tremendous costs of treating OUD. They have plenty. We know that the privately-held Purdue Pharma’s annual revenues were about $3 billion in 2015, mostly from OxyContin. The Sackler family by then was in the top 20 of Forbes list of richest families, beating families like the Mellons and the Rockefellers. Publicly-held opioid distributor McKesson’s 2018 adjusted operating profit was $4.1 billion, up 8% from the prior year. AmerisourceBergen’s 2018 gross profit was $4.6 billion.

AB 1468 (McCarty & Gallagher) would require opioid manufacturers and distributors to give back $50 million/ year of their opioid profits to help stem the death toll of the epidemic they helped create. Opioid maker & distributors could easily afford it and they, more than anyone, should help Californians with desperate needs for OUD treatment. We either get these opioid profiteers to share in the cost of fighting the epidemic they helped create or watch hundreds more Californians with OUD die each year who would have been saved, if they’d been able to get treatment or prevented from suffering OUD altogether.