Attorneys general from 39 states, including Connecticut, have broadened an investigation into whether pharmaceutical manufacturers and distributors have played a role in the opioid epidemic, Connecticut Attorney General George Jepsen said Tuesday.
Calling it a “dramatic expansion and coordination of the investigations,” Jepsen said the coalition of attorneys general has sent investigative subpoenas to five manufacturers, including Stamford-based Purdue Pharma, the maker of the pain-killer OxyContin. The group also sent letters to three distributors requesting information.
“This is a major public health crisis nationally and in Connecticut,” Jepsen said. “For every person who dies, there’s dozens of lives that are ripped apart by this … This is an issue that certainly merits a commitment of resources from my staff and a lot of my time.”
Connecticut joined the multi-state investigation this summer, but didn’t disclose then what companies the group was looking at. Since then, the coalition has broadened its scope. Connecticut, unlike some other states, has not sued any drug companies over potential involvement in the opioid epidemic.
Jepsen said Tuesday the group is investigating whether manufacturers changed their marketing practices to doctors to encourage the use of opioids not just for acute pain, but also for chronic pain, and, “if doing so, did they overstate the benefits and understate the risks of addiction?”
He said drug distributors are mandated under federal law to monitor who they sell their products to and to report any anomalies they come across. He said distributors have showed signs of improvement in their monitoring, but “there’s a question to whether they were asleep at the wheel” in previous years and whether “they are doing enough today.”
In Connecticut, the chief medical examiner has projected more than a thousand people will die from drug overdoses this year. That number has tripled since 2012, when 357 people died from overdoses.
“We share the attorneys’ general concern about the opioid crisis, and we are cooperating with their request,” said a Purdue spokesman in an email. “This is a multifaceted public health challenge, and we look forward to working collaboratively with government entities to be part of the solution.”
The other manufacturers sent investigative subpoenas were Endo International plc; Janssen Pharmaceuticals; Teva Pharmaceutical Industries Ltd./Cephalon Inc.; and Allergan Inc., according to Jepsen’s office.
Janssen spokesman William Foster said in a statement that the company had received and planned to address the request from the attorneys general.
“Janssen has acted responsibly and in the best interests of patients and physicians with regard to these medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label,” Foster said.
Endo spokeswoman Heather Zoumas Lubeski said in an email that the company doesn’t comment on current litigation or investigations.
But she added that Endo shared “the FDA’s goal of appropriately supporting the needs of patients with chronic pain while preventing misuse and diversion of opioid products.”
The three distributors sent letters requesting information were AmerisourceBergen, Cardinal Health and McKesson. The three companies manage about 90 percent of the United States’s opioid distribution, Jepsen’s office said.
After Tuesday’s announcement, John M. Gray, president and CEO of the HealthCare Distribution Alliance, said in a statement that, “Distributors have no ability to influence what prescriptions are written. The fact is that distributors don’t make medicines, market medicines, prescribe medicines or dispense them to consumers. Our role is to deliver medicines safely, securely and efficiently from manufacturers to pharmacies, hospitals and other healthcare institutions based on prescriptions written by licensed prescribers.”
Gabe Weissman, AmerisourceBergen spokesman, said in an email that the company had “taken extensive action to help ensure the safe and secure delivery of these drugs, including reporting suspicious orders to the Drug Enforcement Agency and stopping tens of thousands of suspicious orders from being shipped.”
A spokeswoman from McKesson said the company is “committed to maintaining—and continuously improving—strong programs designed to detect and prevent opioid diversion within the pharmaceutical supply chain.”
A number of states, counties and cities nationwide have sued various drug companies, alleging they are partially to blame for the epidemic.
Waterbury has filed a suit and 12 municipalities have signed retainers to join the suit — New Milford, Roxbury, Bristol, Naugatuck, Wolcott, Bridgeport, Oxford, Southington, Prospect, Woodbury, East Hartford and Southbury — according to the Waterbury’s mayor’s office.