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Purdue Pharma files for bankruptcy with $10B plan to settle claims
- simplecomplex 7y agoGreat now all the opioid production and prescriptions and thus addiction will stop! Oh wait...
- tibbydudeza 7y agoToo late ... Fentanyl is shipped via mail. Buy stock in the folks who make Narcan.
- jjeaff 7y agoUnfortunately, it's the same companies.
- jmcguckin 7y agoMost opiod deaths are from fentanyl. Most fentanyl comes from China, not perscription medication.
- loeg 7y agoNot sure why you're downvoted. Fentanyl is involved in almost 2/3 of opioid-involved overdoses. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/related-topics/trends-statistics/o... Fig 3-5 & descriptions.
- Scoundreller 7y agoHow many of those people started on prescription opiates?
- loeg 7y agoTl;dr: About 80% of heroin users started on prescription opioids. This sounds bad, but actually the conversion rate from opioid on-label use to abuse is pretty low and the conversion from pill abuse to heroin is even lower. * Rate of conversion from on-label opioid prescription to addiction ("opioid use disorder") is lowish; this metastudy[1] claims 8-12% on average, but the 95% CI is anywhere from 3-17% and I'm not sure what they're measuring the percentage of (i.e., long-term prescriptions might both be more represented in the data and have higher conversion rates) — I doubt 8-12% of people who get 3 days of vicodin for their wisdom teeth extraction develop an opiate use disorder. They also point out that some studies showed misuse rates below 1% and "significant variability remains in this literature." We should expect these rates to fall as tighter prescription quantities from the last several years impact "leftover" pill rates. * The rate of conversion from prescription opioid addiction to heroin is low; 4-6% per the government.[2] * Overall opioid-involved overdose annual deaths in the US rose from 8000 in 1999 to 47600 in 2017; of those, the prescription-involved number rose by 13600 deaths (+300%), from 3400. Conversely, the non-prescription-involved deaths rose from by 26000 deaths (+465%), from 4600.[3](Figs 3-4) 26000/39600 = ~66%. (The population has also grown about 17% over that period, but that doesn't change the calculus too much.) * Therefore: the overall growth pattern in opioid deaths in the last two decades is largely accounted for by heroin and other non-Rx use, which are a tiny population with a very high (and rising) death rate. The rising death rate is mostly due to the surge in black market sale of fentanyl as "heroin."[3] (esp. figures 4-5 and associated text) (Perhaps as a result of DEA and other restriction on the supply of the relatively safer, but less dense, heroin, and restriction on supply of the vastly safer prescription opioids.) * Notably, the number of non-fentanyl-involved prescription opioid-involved deaths has actually been in decline since 2011![3] (fig. 4.), despite a rising population. Let me echo that since it's really important: prescription opioid-involved overdose, ex fentanyl, both in number and per capita rate, HAS BEEN IN DECLINE SINCE 2011! Why doesn't any news story on opioids in the US headline with that? The primary reason the overall prescription opiate-involved death rate hasn't tracked that decline is rising co-(ab)use with illicit fentanyl, and its relatively higher death rate. If we could wave a magic wand and wipe (illicit) fentanyl off the earth, our annual opioid death rate would fall by something like half. [1]: https://www.ncbi.nlm.nih.gov/pubmed/25785523 https://www.ncbi.nlm.nih.gov/pubmed/25785523 [2]: https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdos... [3]: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/related-topics/trends-statistics/o...
- trimbo 7y ago75% of opioid/opiate addicts started with pills. Source: https://www.ncbi.nlm.nih.gov/pubmed/24871348 https://www.ncbi.nlm.nih.gov/pubmed/24871348
- loeg 7y agoTrue, but I added a little more nuance here: https://news.ycombinator.com/item?id=20981382 https://news.ycombinator.com/item?id=20981382
- youeseh 7y agoThose conversion rates are not low.
- loeg 7y agoThey're not zero, but single digit percent times single digit percent is generally considered a small percent. The math works out to 0.32-0.72% total, taking either the low end of both ranges or the high end of both. I think anyone should agree that in an absolute mathematical sense, 0.3-0.7% is a "low percent." In this specific context? Sure, it's subjective and reasonable people can disagree.
- refurb 7y agoNote, most were not actually prescribed those pills.
- deleted 7y ago[deleted]
- mnm1 7y agoAnd if they had continued access to those pills they wouldn't be hitting the black market, getting fentanyl, and dying. Eventually, with support and help, they could start to wean off directly or with methadone or suboxone. But no, we can't have that. Instead our government and society prefers to let people die and then pretends like dismantling one company and taking their money is going to help. It's not going to help a single addict.
- artpop 7y agoHow can this be legal?
- tibbydudeza 7y ago"The New York attorney general’s office said on Friday that it had tracked about $1 billion in wire transfers by the Sackler family, including through Swiss bank accounts, suggesting that the family tried to shield wealth as it faced a raft of litigation over its role in the opioid crisis." Capitalism as it's finest.
- toomuchtodo 7y agoLuckily, this means the family will be pursued criminally. Bankruptcy doesn’t shed that.
- adrr 7y agoPurdue is already convicted of a felony. You shouldn't be able to declare bankruptcy to dissolve damages from a felony and felony conviction of company should hold directors accountable for damages.
- toomuchtodo 7y agoWhile it’s unfortunate bankruptcy code wasn’t designed for these edge cases, I’m optimistic about how a court will handle this. Even more so about criminal charges that will likely include a prison sentence due to the amounts involved and clear intent.
- fucking_tragedy 7y agoBankruptcy exists as a safety net for failed capitalists.
- ChuckMcM 7y agoYeah this. I really wish there was some way to sentence these billionaires to the middle class for the rest of their lives. Some sort of "external" prison where their net worth is held to that of the median net worth of the OMB's "middle class" range.
- gibolt 7y agoLooks like they got a golden escape hatch. Sounds like this arm of the company will end up controlled by a government trust. The best outcome would probably be the government running the operation at break even, lowering costs, and heavily regulating how much product it could give to hospitals.
- deleted 7y ago[deleted]
- simplecomplex 7y agoThe best outcome would be directing resources at preventing and treating opioid addiction, not at punishing the drug manufacturer.
- MegaButts 7y agoThat just sends the message that the rich can get rich by ruining the lives of however many thousands of people and will just seek new ways to get rich by ruining the lives of however many thousands of people.
- jrochkind1 7y agoI agree with you both.
- jrochkind1 7y agothat is, the important thing is directing resources at preventing and treating opioid addictions and ODs, and if there's any justice the entire Sackler family fortune would be used to do so. Fortunately, these two goals are not in conflict, the Sackler's have a net worth upwards of $13 billion, which would be quite helpful resources to direct at preventing and treating opioid addiction and health effects.
- bilbo0s 7y ago
- deleted 7y ago[deleted]
- dantheman 7y agoAre the other manufacturers of oxycontin being sued too? I know that Purdue tried to underplay their role, but from the best #s I've seen they've only sold 20% of the market. https://www.statnews.com/2019/09/09/purdue-pharma-data-downplay-its-role-in-opioid-epidemic/ https://www.statnews.com/2019/09/09/purdue-pharma-data-downp...
- Scoundreller 7y agoThat's 20% of the whole opioid pill market, not just oxycontin. As far as I know, generic manufacturers of off-patent drugs usually aren't sued. On the one side, they don't actively promote/market their products to prescribers or patients, but I'd still think they share some blame by manufacturing it.
- slimed 7y agoAre you of the opinion that opioids have no legitimate medical use? How else could suing generic manufacturers be justified? The issue with Purdue is that they lied about the risks of the drug. Presumably, they lied to the generic manufacturers as well.
- peteretep 7y ago> but I'd still think they share some blame by manufacturing it Nah. Opioids are an essential medication. The problem is not that OxyContin exists, it's the creation of irregular demand for it through the actions that Purdue Pharma are having to settle for.
- Scoundreller 7y agoIt’s a question of what extent, if any, vendor liability exists.
- pkaye 7y ago> In March, Purdue settled claims brought by the state of Oklahoma for $270 million, and another defendant, Teva Pharmaceutical Industries Ltd., also reached a, $85 million deal to avoid trial. J&J, which refused to settle, was ordered to pay $572 million for creating a public nuisance in the state with its over-promotion of its opioid pain medicines.
- Scoundreller 7y agoSO what does this mean for non-US litigants, or future non-US litigants?
- rosybox 7y agoWell according to the WSJ, what's left of Purdue after the bankruptcy will be owned by a trust who's only purpose is to repay the litigants. So I imagine they'll just be part of that. Also not all US based litigants are part of the settlement that is being worked out. There are also individuals who are being personally sued that aren't part of this as well.
- jmcguckin 7y agoI guess they’ll have to flog even more pills in order to pay the litigants...
- joshmn 7y agoWith the Sackler family funneling out money prior to this, is there any chance a judge would refuse the bankruptcy?
- Aloha 7y agoLast I heard the transfers were several years ago
- mcbain 7y agoRecently in the news: https://www.nytimes.com/2019/09/13/health/sacklers-purdue-opioids.html https://www.nytimes.com/2019/09/13/health/sacklers-purdue-op...
- Aloha 7y agoYes, the article points out that the transfers were several years ago
- loeg 7y agoPeople keep misreading this, or maybe just looking at the headline and getting the wrong impression. The news in that piece is that NY discovered the transfers at all. The transfers themselves are a decade old. The payments to the Sacklers from Purdue are from 2008-2016 but the lawsuits only date to 2018. All of this is in the article if you read it. I.e., no self-payments after lawsuits became material threat.
- casefields 7y ago"Sackler was involved in 137 wire transfers totaling nearly $20 million, and some of those transfers occurred as recently as 2018, the filing indicates." Who's misreading what now?
- loeg 7y agomcbain's comment that I am replying to, https://news.ycombinator.com/item?id=20981242 https://news.ycombinator.com/item?id=20981242 , is referring to the NYTimes story on $1B in transfers. Those substantial transfers ($1B) were a decade ago. The sentence you quote does not appear in the NYTimes piece and is, in comparison, peanuts. I do not have access to the Bloomberg piece for full context, but the sentence you quote does not say the movements were self-payments from Purdue rather than just personal transfers between personal accounts. It also does not say all $20M was in 2018; there could be a $1k wire in 2018 for all we know from the single sentence.
- Havoc 7y agoSeems like an abuse of the limited liability. Does the US have a way to set that aside? I know other countries do
- deleted 7y ago[deleted]
- bencollier49 7y agoI think in the UK,a judge can rule that two companies constitute a 'group'. Prevents misuse of multiple companies for tax, etc.
- YokoZar 7y agoThe US indeed has this concept, known as "piercing the corporate veil". Excess payments to ownership (especially if you think the company is about to face a huge liability) is a classic example of one of the justifications for a judge to do just that: make the owners personally liable rather than just the company.
- Scoundreller 7y agoThe smart way is to pay yourself 10% dividends every year into your own holding companies from the start. Sounds like that’s what they did. Don’t store your gold next to a nuclear reactor and all.
- scardine 7y agoIn Brazil there is a concept called Business Entity Disregarding (Desconsideração da Personalidade Jurídica) that can get both ways: make partners liable for company debts or companies liable for partner debts. It can be triggered when the plaintiff engaged in some kind of asset hiding fraud or there are substantial confusion regarding company/personal assets.
- bgorman 7y agoOne naive question - why are doctors who overperscribed opiates still allowed to practice medicine?
- wil421 7y agoA quick google search brings up multiple articles about doctors going to jail. Here’s one where the doc got 13 years for prescribing over 1 million units[1]. [1] https://www.dea.gov/press-releases/2019/05/13/pill-mill-doctor-sentenced-13-years-conspiracy-distribute-narcotics https://www.dea.gov/press-releases/2019/05/13/pill-mill-doct...
- fucking_tragedy 7y agoWe spent the better part of decade catching and locking up doctors who prescribed opioids out of guidelines, so much so that doctors are now terrified of prescribing them to people who legitimately need them. The problem is that the prescribing guidelines, which were written by the pharmaceutical companies themselves, described a regimen that would get pretty much anyone physically addicted to their product. So you had doctors acting in good faith, prescribing medications only when indicated and following their manufacturer's prescribing guidelines, inadvertently creating new addicts where the manufacturer's literature said there would be none. Not only that, but we spent several decades treating chronic pain patients with opioids, such that they are completely dependent on that class of drugs to manage their condition. Only very recently have prescribing guidelines adjusted to reflect the reality that opioids are not a good treatment for chronic pain. When those pain patients are driven off of their opioid prescriptions, even if their doctor is well-meaning, some of them turn to heroin/fentanyl to manage their pain.
- evandijk70 7y agoShouldn't the FDA be checking whether the guidelines written by the pharmaceutical companies are safe?
- dsfyu404ed 7y agoThe guidelines are almost always on the conservative side of safe because people who died as a result of taking the medication the manufacturer recommended way turn into slam dunk lawsuits. Part of the reason the opioid problem flew under the radar is because people got hooked and weren't dying until they OD'd so it never came back to bite the manufacturer. What are the odds of another opioid type situation? What else could the FDA do with those resources?
- formatkaka 7y agoIf anyone doesn't know what's going on here exactly. The Sackler Family – A Secretive Billion Dollar Opioid Empire - https://www.youtube.com/watch?v=zGcKURD_osM https://www.youtube.com/watch?v=zGcKURD_osM
- lysp 7y agoIt's ok, they've already moved all their billions away. Their fortune is safe.
- paulie_a 7y agoThe amazing thing is when I was in legitimate pain in the hospital I couldn't get more than Tylenol. After I was released I drove by a pain clinic and I guarantee I could have scored some oxy that day. I didn't but it's nuts when people that need medication can't get a few pills. Dont get me started on testorone or ADHD medication hypocrisy.
- cies 7y agoJust accept that the system is broken and get 'm on the most free market we currently have: the market of stuff that is merely illegal.
- bythckr 7y agoI am legal expert but I have a logical question. Shouldn't they look at the fund the company had on the "day that the lawsuit started". Where ever they funneled the money, I am sure they are just look at the bank statement.
- BLanen 7y agoWithout criminal charges, there's no justice.
- ykm 7y agoRecommended read: Dopesick from Beth Macy. For a non-American, it reads like a horror script.
- tjpnz 7y agoAre any of the Sackler family going to face real consequences for this?
- xysut 7y agoThey are jews so I doubt it.
- DickingAround 7y agoI have a high level question; a lot of want to legalize drugs. Ending the war on drugs and all that. This is a drug that was legal and a lot of people got on it and now we're angry. Why? I don't like that people got hurt. I also recognize that bad drugs are bad. But I can't find a way out of "tell people drugs are bad and they have to make their own choices." Is the problem here the doctors told them the bad drugs were good drugs?
- notfromhere 7y agoProblem here is that doctors pushed highly addictive painkillers on anyone and anything, while Purdue did everything they could to increase sales and disguise the risks associated with opioids.
- calphalon 7y agoYes, and in some cases actively pushed them, as did the manufacturers.
- brogrammernot 7y agoOxyContin isn’t a bad drug, it’s a highly addictive drug and the company knew it was highly addictive & not only didn’t do enough due diligence to make sure prescribers didn’t over prescribe it but also intentionally encourage that behavior which has led to an epidemic. However, food for thought on that same subject is the over prescribing of amoxicillin and other similar class of drugs for viruses. The doctor is operating a business and his/her clients want a solution to their problem, so they write a script as they want to keep their customer happy and it “can’t be too bad”. There’s a case to be made that a certain amount of immediate gratification expected on the part of the consumer is a large contributing factor to overprescribing in general. However, in this case, Purdue was very much in the wrong and should not have been encouraging over prescription of a highly addictive drug.
- projektfu 7y agoYeah. I think the underlying story is that doctors used to be more apprehensive about prescribing opioid painkillers, and when they did they prescribed lortabs or something like that for acute cases and they wouldn't put refills on or rewrite the scripts when asked. Then, along comes Purdue with a claim that OxyContin, because of its unique formulation, is a big addiction concern and is safe to prescribe for chronic pain. Then they (and a couple other manufacturers) basically conducted a successful campaign to convince doctors that undertreatment of chronic pain was widespread and they were basically letting their patients suffer, strongly suggesting that this may be considered malpractice in the future if they do not start prescribing more opioids. This campaign was very smart and even reached the doctors who refuse to take incentives from drug manufacturers. Essentially, in the way that Pfizer created a new category of concern in the mind of patients with Viagra, Purdue did the same in the mind of doctors with OxyContin. Lo and behold, people are addicted to OxyContin, some start looking for more immediate-relase formulations of opioids because they don't feel right even on 80mg Oxy tablets, and hundreds of thousands who otherwise would have been alive with chronic pain are now dead of overdose. Meanwhile, research is showing that opioids are not very good for chronic pain and other approaches, usually multimodal approaches, are better, including NSAIDs, gaba-ergic drugs like gabapentin and pregabalin, ketamine, physical therapy, psychological retraining, meditation, acupuncture, etc.
- 1024core 7y agoThe Sacklers are running around free, enjoying their wealth, while El Chapo is in jail.
- jbottoms 7y agoGo To Jail, Go Directly To Jail, Do Not Pass Go. Do Not Collect $200B.