SEATTLE (Legal Newsline) - It appeared on Thursday that defense attorneys for opioid drug distributor AmerisourceBergen were attempting to distance themselves from two other companies being sued by Washington State for allegedly causing an overdose epidemic.
“Were you able to draw any conclusions?” Joe Mahady, attorney for AmerisourceBergen, asked.
“There was very limited (opioid) distribution,” Ted Martens, a financial internal data expert (auditor) with the accounting firm of PWC, told the courtroom.
Martens referred to Washington State counties including Garfield, Clallam, Stevens and Ponderay receiving shipments of pills from AmerisourceBergen.
The trial is being streamed live courtesy of Courtroom View Network.
Prescription drug distributors McKesson, Cardinal Health and AmerisourceBergen Corp. are accused of irresponsibly over-promoting and distributing opioid drugs to pharmacies and doctors' offices that led to hundreds of overdose deaths in the state. The Washington State Department of Health estimated 1,200 in 2020.
Distributors take pills from the manufacturers and supply them to hospitals, doctor’s offices and pharmacies. The most commonly shipped opioid drugs include OxyContin, Hydrocodone, methadone and fentanyl.
Washington State Attorney General Bob Ferguson is asking for $32 billion in damages to enact anti-drug programs, but a state victory could result in a much higher award when surrendered profits and penalties are added in.
Martens, who said he has provided testimony 150 times and was called as a defense witness, studied (sales) transactions of AmerisourceBergen Corp. referred to as ABCD. He used ARCOS (Automated Reports and Consolidated Ordering System) data from the U.S. Drug Enforcement Administration (DEA) in studying profit margins and distribution trends of the company.
“Did you find the transaction data reliable?” Mahady asked.
“Yes,” Martens answered.
“Are you offering any opinions whether ABCD opioid distributions were appropriate?”
“No.”
Martens said ABCD took over opioid distribution from the Walgreens pharmacy chain in Washington State. Previously Walgreens had run its own in-house distribution program. Martens indicated that in the years after 2013 the trend in the scope of distribution was downward.
ABCD’s market share of distributed opioids in the years 2006 to 2014 was .9% in Pend Oreille County (Newport), none shipped in Garfield County (Pomeroy), 1.6% to zero (2006-2012) for Clallam County (Port Angeles), .59% in 2011-2014 for Stevens County (Colville).
“At any time did (ABCD) distribution in the state of Washington reach one percent?” Mahady asked.
“No,” Martens answered.
“Not even close?”
Martens agreed.
State attorney Annie Kouba questioned Martens about ABCD taking over the Walgreens distribution. Martens said ABCD's flow of drugs did not increase in the 2013 time period after the Walgreen's acquisition.
“If you track it, it went down,” Martens said. “The distribution of opioids did decline in 2014.”
Opioids were provided in addition to pharmacies, hospitals, Veterans Administration (VA) clinics and long-term care centers, Martens added.
“You’re not saying the distribution was not appropriate?” Kouba asked.
“That’s correct,” Martens said.
“You’re not offering anything on the reasonableness of these shipments?”
“That’s correct.”
“Did you do an analysis (ABCD) compared to other distributors?”
“I did not.”
A revenue chart displayed said ABCD had made $360 million from 2006-2018.
Later in the day, a 2021 deposition video showed questioning of Grant Chester, a pharmacy quality assurance investigator with the Pharmacy Quality Advisory Committee (PQAC). Chester said a lot of opioids were being sold illegally. He called attention to what he said were the limits of what could be checked.
“A wholesaler doesn’t have an opportunity to check a medical patient’s diagnosis or prescription,” he said.
Chester was asked if distributors could be responsible for the epidemic..
“I don’t know, I think they would be less (than others),” he responded.
In another deposition tape recorded in 2021, Gordon McDonald, a licensed pharmacist and investigation/inspection officer for the Washington Dept. of Health testified. He said he believed investigators were doing a good job preventing drug diversions.
“There is a license renewal period for distributors of 12 months,” McDonald said. "A license can be suspended or revoked, but involves a legal process. No action would be taken until PQAC made a determination.”
“Were there any (actions) against the three companies (defendants)?” McDonald was asked.
“I don’t recall them (PQAC) taking action,” he answered.
“Can pharmacies create more (opioid) demand?”
“I would say no, they don’t write prescriptions.”
McDonald was asked that if a doctor/patient relationship was legitimate, there was no reason for alarm. McDonald responded that there were exceptions.
“If the (drug) dose escalated,” he said. “If it’s for a legitimate purpose, the pharmacist should fill the prescription.”
“Do you believe the vast majority of pharmacists have acted in good faith, to prevent the diversion of opioids?”
“I do,” McDonald said. “In general, they (pharmacists) are very ethical.”