NORMAN, Okla. (Legal Newsline) – Attorneys defending Johnson & Johnson on Monday fended off accusations their client caused an addiction crisis and shifted attention onto Purdue Pharma, while also noting a plaintiffs expert is being paid upward of $500,000 for his testimony.
This came during the beginning of the fourth week of trial in Oklahoma Attorney General Mike Hunter's lawsuit against makers and distributors of opioids. Michael Yoder, the attorney for Johnson & Johnson, asked Dr. Andrew Kolodny if he thought the J&J opioid pill Nucynta helped cause the opioid crisis. The drug was first marketed in 2009.
“I would agree it couldn’t happen prior to that time (2009),” said Kolodny, co-director of Opioid Policy Research for the Brandeis University Heller School for Social Policy and Management in Massachusetts.
According to charts exhibited in the trial, the rate of overdose deaths from opioids peaked between the years 2008 to 2014. Attorneys hired on a contingency fee by the State of Oklahoma are calling it the worst health crisis in the state’s history.
The trial in the Cleveland Country District Court is being streamed live courtesy of Courtroom View Network.
Kolodny, considered a leading advocate for reform in the prescribing of opioid drugs, testified last week before attorneys for both sides and again on Monday.
Hunter alleges that J&J and its prescription drug subsidiary Janssen Pharmaceuticals carried out a fraudulent advertising campaign to over-supply opiates in Oklahoma for profits leading to an epidemic Hunter called the worst in the state's history. J&J's opioid brands are Duragesic, which dispenses opioids by the use of a timed-release patch, and a pill called Nucynta.
Thousands of cases are still pending around the country and the Oklahoma trial is being followed nationwide. It's also the first opioid trial under the "public nuisance" legal theory, attempting to hold pharmaceutical companies, distributors and pharmacies liable for the nation's addiction crisis. Critics of the nuisance claim say the state’s case is in reality a products liability case.
Two other co-defendant pharmaceutical companies, Purdue Pharma of Connecticut and Teva Pharmaceutical based in Israel, earlier settled with Oklahoma - $270 million from Purdue and $85 million from Teva. That left J&J (and Janssen) as sole defendants in the case.
In the Purdue Pharma settlement, private attorneys took in $60 million, while about $200 million went to a research project at Oklahoma State University, which is Hunter's alma mater.
Purdue officials pleaded guilty in 2007 of misleading the public about the risk of addiction from their opioid pain killer OxyContin and agreed to pay $600 million, at the time one of the largest pharmaceutical settlements in U.S. history.
Yoder asked Kolodny about his writings in 2015 in an article about the sharp rise in the prescription opioid crisis, in which he said the crisis was brought about by a "multi-faceted" adversting campaign. Yoder said no mention was made in the article about Johnson & Johnson’s opioid timed-release fentanyl patch Duragesic.
“You said nothing about Janssen’s marketing and sale of Duragesic and the fentanyl patch,” Yoder said.
Yoder added that at a panel discussion sponsored by the Washington Post in 2017, Kolodny had said the epidemic would not have gotten as bad as it did if the Food and Drug Administration (FDA) had acted more quickly against Purdue. Again Yoder noted, no mention was made at the panel discussion of Janssen's Duragesic product.
Kolodny agreed he had not mentioned Duragesic at the time but referred to Purdue's OxyContin, marketed to doctors beginning in 1996. Kolodny said at the time he had not yet learned the full extent of Johnson & Johnson's involvement in the opioid crisis.
“I was not aware (yet) of Johnson & Johnson’s wrongdoing,” he said.
Kolodny agreed that had the FDA acted to limit Purdue's promotion of OxyContin, the epidemic would not have gotten as bad as it did.
He said what helped fuel the drug crisis in Oklahoma was an “unbranded” advertising campaign (no specific brand mentioned) to pave the way for greater sales and prescriptions of opioids.
“Prior to 2008 Johnson & Johnson was involved in an unbranded campaign to increase the sale of opioids,” Kolodny said. “J&J wanted to lay the groundwork to increase the sales of Nucynta.”
Kolodny said advertising materials from the company were designed to downplay the addiction risk of the drugs. One brochure showed an older man playing golf under the title “Pain Management for Older Adults.”
“It’s making opioids sound completely benign,” Kolodny said.
Yoder exhibited payments from Janssen for key opinion leaders (KOL’s) including doctors to serve as speakers and advisors on drugs like Nucynta at the time the drug was launched. Some of the payments ranged from approximately $2,000 to $35,000 for a year.
Yoder compared it to what he said was Kolodny’s high rate of pay as an expert for the state.
“The state (Oklahoma) paid you over $500,000?” he asked.
“My established range was $300,000 to $500,000,” Kolodny said. “It’s correct that it’s more than these individuals (KOL’s).”
Tasmanian Alkaloids, a poppy-processing subsidiary of Johnson & Johnson from 1982 to 2016, produced about 40 percent of the world’s legal opiate crop. The firm based in Tasmania developed a new strain of poppy that officials called Norman, the crop used to create a substance called thebaine that was used in the production of OxyContin and other opioids.
Kolodny said Johnson & Johnson pursued an unbranded promotional campaign to sell opioids despite those from Tasmania flooding the country. He added that J&J supplied the opioid ingredients to other drug manufacturers.
“If Johnson & Johnson had been adhering to their code of conduct, it would have stopped doing business with Purdue Pharma,” Kolodny said.
Yoder took issue with Kolodny’s reference to Johnson & Johnson as a drug “kingpin,” saying he had used the term in a tweet. Kolodny said state attorneys had first used the term.
“Do you believe that it's (J&J) a kingpin of illicit drugs, is that your testimony?” Yoder asked.
“That’s what I believe a kingpin is,” Kolodny answered.
Brad Beckworth, of Nix Patterson and representing Oklahoma, asked if doctors in the past had been more reluctant to proscribe OxyContin because of long-term concerns about addiction.
“Yes,” Kolodny said.
Kolodny told Beckworth the drug crisis began to accelerate in 1996. He said studies minimizing addiction risk had been used to overcome “opia-phobia,” fear of addiction from opioids.
A document exhibited by Beckworth stated that addiction was rare and completley distinct from physical dependance.
"Did Janssen do this (document)?” Beckworth asked.
“Yes,” Kolodny said. “Janssen was promoting deceptive information about opioids.”