The Phelps County Commissioners voted unanimously to join the multidistrict litigation against the opioid distributors and manufacturers on July 19, 2018.

The multidistrict litigation is a unification of Missouri counties as the plaintiffs, and if a settlement is reached the money would go back to the counties, and the law firm of lawyer John Eccher, who originally proposed the idea to the county, would be compensated with a contingency fee -- county participation is on a contingency basis.

If successful, proceeds from a settlement would be able to be earmarked for prevention programs and other services to help offset the costs being incurred by government agencies responding to the opioid crisis.

Yet a concern raised at the county commission meeting Tuesday, June 19 contemplated how going after the big money players – opioid distributors and manufacturers—will solve the multifaceted problem the county is facing with heroin and opioid addiction and overdoses, since the litigation has elected to not go after the physicians prescribing the opioids.

District 1 Commissioner Larry Stratman stated, “It is a huge problem and it is kind of like the tobacco industry, where we are going after the people that have money, so does that attack the problem?

“Is that really going to help anybody, or does it just hurt big pharma, and big pharma turns around and says now we’ll raise all the rest of our drugs 5 percent to make our money back and we really haven’t solved any of the problems anyway.”

In response, according to Fox, the lawsuit won’t solve the problem, but the tide has been turning in the country for the last few years where the issue is discussed more. Thereby, the litigation is going to help bring about the changes the community would like to see through added awareness to the problem no matter the outcome in the massive civil case.

“You know if they go up and they lose we don’t lose anything. If they go up and they win we might get something, I don’t know. It depends how much the settlement is,” said Fox.

The Distributor’s Response

Senior vice president, John Parker, of Healthcare Distribution Alliance, the national trade association representing distributors including AmericansourceBergen, Cardinal Health and McKesson said:

·         “The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders.”

·         “Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated.”

·         “Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

·         Distributors are logistics experts, tasked with the primary responsibility of delivering all medicines to licensed pharmacies and healthcare providers.

·         Distributors do not manufacture, prescribe, dispense or in any way, drive demand. Further, distributors cannot make medical determinations about patient care or provider prescribing.

·         The Drug Enforcement Administration (DEA) is responsible for setting the annual production of controlled substances in the market, approving and regulating the entities allowed to prescribe and handle opioids, and sharing data with entities in the supply chain regarding potential cases of diversion.

·         Distributors report every single opioid order to the DEA – whether it is suspicious or not. Greater communication and coordination with the DEA will help support real-time response against abuse and diversion where it occurs.