Senators, Opioids, and EpiPens

Many things can be accomplished when you have a majority in Congress, Well. almost. For Democrats, Sinema is still growing up and trying to decide what she wants to be. Being a Democrat is boring. Sitting with Repubs is more exciting as Dems notice.  There is no excitement in going along with the crowd. Gotta mix it up and grab the attention by being a decision maker or a disruptor.

“I can’t deny the fact that you like me. Right now, you like me!” (Sally Fields)

Sorry Sinema, it’s not that we love you, we just need your vote. So we will make nice . . .

Then there is Joe Manchin III. He has never met a lump of coal he did not like. There is money in the almost black gold. Twenty years of supplying the Grant Town power plant in West Virgina with low-grade coal mixed with rock and clay known as “gob.” And stymieing any interest in less polluting energy. Joe the third made his retirement secure.

Never mind West Virginia ranks near the bottom of the states in economics and providing for its citizens. However, he did take to the floor to talk about one young pretty blond-haired woman, who came from a better than average family, a recovering drug addict.

Joe went on the Senate floor and discussed her lost battle brought on by 50 tabs of oxycodone prescribed to combat pain from surgery. The surgeon did not know she was still a recovering addict after 7 years. After running out of tabs, she bought from the street. She overdosed while sitting in her car. Apparently, the pills she obtained on the street were laced with Fentanyl.  It does not take much.

Democratic Sen. Joe Manchin also went to the Senate floor to crystallize his opposition to Dr. Robert Califf’s nomination to lead the Food and Drug Administration, but the nominee still advanced past a key procedural hurdle. He blamed him for the opioid epidemic because he signed off on a new drug.

What-aboutism” is still a valid reason for pointing to flaws in beliefs. What about the Williamson, West .Virginia. story of being the recipient of ~21 million hydrocodone and oxycodone pills at two small pharmacies. Williamson had a population of 3000 during this period from 2008 and 2015. 7200 pills for each citizen there. One a day for many years to come then.

In 2008, “Miami-Luken provided 5,624 pills for every man, woman, and child in Kermit,” according to the committee’s letter.

Can people, towns, and counties fight back in court against the distributors?

“A federal judge ruled in favor of three major U.S. drug distributors in a landmark lawsuit that accused them of causing a health crisis by distributing 81 million pills over eight years in one West Virginia County and the small city of Huntington ravaged by opioid addiction. There are no cities in West Virginia with over 100,000 people.

The verdict came nearly a year after closing arguments in a bench trial in the lawsuit filed by Cabell County and the city of Huntington against “AmerisourceBergen Drug Co., Cardinal Health Inc. and McKesson Corp.” These are the primary distributors of all pharmaceuticals. They help to set the pricing of all drugs to patients nationwide.

The citizens of Cabell County and the City of Huntington still could not get justice.

 Cabell County attorney Paul Farrell’s point being the distributors should be held responsible for sending a “tsunami” of prescription pain pills into the community. Stating the defendants’ conduct was unreasonable, reckless, and disregarded the public’s health and safety in an area ravaged by opioid addiction.

The companies deflected the arguments to an increase in prescriptions written by doctors along with poor communication and pill quotas set by federal agents.

I guess no one questions anybody even when it comes to narcotics. Joe Manchin was as quiet as a church mouse on the shipments of millions of opioid tablets to West Virginia. Did Senator Manchin do anything about another West Virgina manufacturer? There are reasons why he did not.

“This isn’t an EpiPen issue,” Heather Bresch, Mylan CEO, said. “This isn’t a Mylan issue. This is a healthcare issue.”

But what are Senator Manchin’s opinions on the controversy surrounding his daughter, Heather?

“Her heart is pure as can be and she’s the most generous person. She helps everyone she can. She’s very compassionate about all her fellow workers and she loves West Virginia. So I just tell her to be who she is. You know the facts will come out.”

The trade group representing PBMs, the Pharmaceutical Care Management Association, said in a statement to CNBC that:

“Mylan has spent the past year blaming Washington, the prescription drug supply chain, and competitors for its unusual pricing practices. It’s time for them to look in the mirror and take responsibility for their own actions.”

Mylan has been the motivating force behind the jaw-dropping 574 percent EpiPen price hike. One EpiPen consisting of ~$10.00 worth of components was priced at $90 list. Since then Mylan had increased the list price of the device 17 times.

It is no secret the pricing is negotiated from the point of manufacture to the drug store. Manufacturers do set their pricing. Mylan blamed the price increases on pharmacy benefit managers and also CVS CaremarkExpress  and Optum Rx.  

Where was Joe Manchin on this issue?

Some reference reading . . .

Drug Distributors Shipped 20.8 Million Painkillers To West Virginia Town Of 3,000: The Two-Way, NPR, Laurel Wamsley

Combating the Opioid Epidemic Examining Concerns about Distribution and Diversion,, Subcommittee.

Biden’s FDA commissioner nominee advances despite Manchin’s opposition, CNN Politics, Authors

A federal judge sides with 3 major drug distributors in a landmark opioid lawsuit, NPR, Associated Press.

Mylan hit with racketeering suit over big price hikes of EpiPen, (, Ryan Grim.