Maryland Expects $238M From Opioid Makers and Pharmacies

Maryland Attorney General Anthony G. Brown reported that his Opioids Enforcement Unit has finalized settlements with Teva, Allergan, Walmart, and Walgreens, after multi-year investigations of these opioids-makers’ or chain pharmacies’ involvement in the opioid crisis in the state.

The settlements are expected to provide a total of $238 million to the state. The amounts per company are Teva, $70 million; Allergan, $38 million; Walmart, $55 million and Walgreens, $75 million.

The settlements also force these companies to stop engaging in practices that gave rise to the opioid crisis and take steps to prevent further illegal conduct.

All revenue received by the state will be placed in the Maryland Opioid Restitution Fund. Attorney General Brown said the money will “help support recovery efforts in Maryland and prevent future loss where we need it most.”

According to court documents filed in the Circuit Court for Frederick County, Teva marketed and sold extremely dangerous and addictive rapid-onset fentanyl products, including Actiq, a fentanyl lozenge that resembles a lollipop, and Fentora, a fentanyl tablet. Actiq and Fentora were appropriate and approved by the U.S. Food and Drug Administration only for extreme cancer pain. But Teva falsely claimed that the drugs were safe and appropriate for non-cancer conditions and funneled hundreds of thousands of dollars to at least 16 Maryland prescribers through a bogus speaker bureau, according to the complaint. The complaint alleges that these kickbacks encouraged these prescribers to prescribe Actiq and Fentora to consumers, most of whom did not have cancer and should not have taken Actiq or Fentora.

A former sales representative who provided sworn testimony stated that Teva’s sales employees understood that these prescribers would prescribe fentanyl inappropriately if paid to do so. Another representative testified that Teva paid thousands of dollars in speaker fees, meals, and drinks to three prescribers who generally did not treat cancer patients; they treated chronic non-cancer pain. According to the complaint, at Teva’s direction, sales representatives also helped provide deceptive information to prescription plans to secure inappropriate coverage of the problematic prescriptions.

The complaint against Allergan charges that Allergan misled prescribers and patients about the relative safety of its extended-release morphine product, Kadian. Allergan sold Kadian by deceptively representing that Kadian was safer than other opioids. It also misled prescribers about the nature of addiction, claiming that addicted patients who were exhibiting signs of addiction were not really addicted but simply required more medicine to relieve their pain.

The complaints against Walmart and Walgreens allege they put inappropriate pressures on pharmacists and other pharmacy employees to fill prescriptions despite “red flags” that showed the prescriptions might be unsafe. According to the complaints, this led to Walmart’s 62 and Walgreens’ 186 stores in Maryland filling opioid prescriptions that were inappropriate and unsafe, creating or contributing to the addiction and ultimate death of many Marylanders.

Maryland’s settlements are part of a broader collaborative effort with other states in which it and many Maryland subdivisions took part.