NORMAN, Okla. (Legal Newsline) – The attorney for Johnson & Johnson and its drug subsidiary Janssen Pharmaceuticals on Monday attempted to convince an Oklahoma judge that making the companies pay for a drug crisis, including addicts who never used their products or who used illegal drugs, is unfair.
Steve Brody, the attorney for Johnson & Johnson, said one part of the state's opioid abatement plan would provide pain services for 32,178 pain patients currently on Medicaid.
“Whether or not any of these people ever received a prescription for a Janssen opioid, correct?" Brody asked.
“That's correct," said Jessica Hawkins, senior director of prevention services for the Oklahoma Dept. of Mental Health and Substance Abuse Services. “We will never stop working to help the people of Oklahoma.”
Hawkins added that Johnson & Johnson and Janssen should be held responsible to abate the opioid crisis, not taxpayers.
The cost to abate the drug crisis officials called the worst health emergency in the state’s history could cost $17.5 billion, a yearly average of $767 million.
Hawkins, who developed an abatement plan with Oklahoma Mental Health and Substance Abuse Commissioner Terri L. White, appeared for a second day of testimony after describing each proposed program in the state's abatement program and its cost last week.
The trial in the Cleveland County District Court is being streamed live courtesy of Courtroom View Network.
Oklahoma Attorney General Mike 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 case 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.
During Monday’s hearing, Brody challenged the state’s plan to stick Johnson & Johnson and Janssen with the abatement plan bill. He indicated that federal money for the state’s Medicaid programs called “SoonerCare” already in place and earmarked for drug treatments had not been factored into the abatement plan figuring.
In one example. a university (drug) screening program estimated to cost $1.3 billion over 30 years in the abatement plan Brody said the state already receives $810 million in federal Medicaid money for such purposes.
“Is Oklahoma going to refuse the $810 million from the federal government?” Brody asked. “Johnson & Johnson and Janssen would pay the $1.3 billion?”
“That would be up to the court how that would be handled,” Hawkins said. “It ($810 million) is not discounted. My role was to identify intervention that would abate the opioid crisis, to present the costs.”
A prenatal screening program costing $171 million over 30 years also a part of the state’s abatement plan Brody asked again if Johnson & Johnson and Janssen would pay for.
“SoonerCare (Medicaid) pays, but we are going to shift costs to Johnson & Johnson and Janssen?”
“Yes.” Hawkins agreed.
Portions of the plan include an adult treatment services program (recovery housing for addicts) at a projected 30-year cost of $767 million, an addiction mental helpline at $96.5 million over 30 years, a medical drug disposal system at an estimated $3.3 million over 30 years, and technical assistance to provide training for support services at 22.3 million over 30 years.
Expanded family drug courts will cost an estimated $374.2 million over 30 years and a K-12 school education program aimed at six and seven-year-olds $424 million over 30 years.
A Naloxne (anti-opioid drug) distribution and education program would cost $42 million over 30 years, a program for removing dirty syringes and providing clean ones, plus related services at $693 million, transportation services to help people get to appointments for drug treatments, a pharmacy disposal program at $219 million over 30 years, and a pain prevention services program (non-drug treatments) projected at $2.4 billion over 30 years.
Other services include prenatal screening of pregnant and postpartum women at 150 birthing hospitals and obstetrics and gynecology (OB-GYN) offices, an opiate overdose review board budgeted at $3.8 million, a prescription monitoring system costing $38.8 million and a program management and monitoring/evaluation arm with a price tag of $55 million over 30 years.
Brody questioned Hawkins about grant money available to Oklahoma and whether she had taken such money into account in figuring the abatement plan costs.
Hawkins said grants had limitations.
“Grants are time-limited,” she said. “They have an end. Also, they are competitive. You’re never sure of (receiving) those resources. To abate (drug crises) you have to have a sustained effort.”
As he did last week Brody again asked Hawkins what would happen after 30 years, the projected life of the abatement plan, if the payments would continue.
“It’s my opinion the crisis could be abated in 30 years,” Hawkins said. “If more needs to be done the state would have to make that determination.”
“Is it realistic to assume that no high school student will misuse drugs (because of abatement)?” Brody asked. “What’s the level of abuse that’s on target for abatement?”
Hawkins said it would take at the least 20 years to reduce the misuse of opioids to pre-1996 levels.
“How do we know how long it will take?” Brody asked.
“Prevention in schools and families is one way we can reduce,” Hawkins said. “We know the prevalence of use disorder.”
Hawkins indicated the plan would be monitored for success as it progresses.