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41 state attorneys general subpoena opioid manufacturers and distributors

By Nadia Kounang, CNN

(CNN) -- A coalition of 41 states' attorneys general have served five major opioid manufacturers and three drug distributors with subpoenas seeking information about how these companies marketed and distributed prescription opioids.

The development was announced at a news conference by New York Attorney General Eric Schneiderman, the first public announcement of subpoenas in this multistate effort.

The coalition was announced in June, with the aim of investigating what role these companies may have had in contributing to the United States' opioid epidemic.

Major opioid manufacturers and distributors investigated

The investigative subpoenas and document requests were served Monday to pharmaceutical manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd./Cephalon Inc. and Allergan. The group also served a supplemental investigative subpoena to Purdue Pharma.

Documents were also requested of three major pharmaceutical distributors: AmerisourceBergen, Cardinal Health and McKesson. According to the Drug Channels Institute, a group that tracks the pharmaceutical industry, these three companies had more than $400 billion in revenue last year and manage about 90% of the country's national drug distribution.

The attorneys general are hoping to learn whether these companies may have marketed or distributed their products illegally.

'Prescription opioids are the on-ramp to addiction'

"Too often, prescription opioids are the on-ramp to addiction for millions of Americans," Schneiderman said. He pointed out that according to the National Institutes of Health, about 80% of all new heroin users begin with using prescription opioids.

The US Centers for Disease Control and Prevention says the number of fatal drug overdoses in 2016 was expected to top more than 64,000, more than the number of American troops lost in the Vietnam War. Many of those deaths involve an opioid, either a legally prescribed narcotic or an illicit drug like heroin or fentanyl. Drug overdoses are the leading cause of accidental death in the US, killing more people than guns or car accidents.

"The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency," President Trump said in August. "It's a national emergency."

However, five weeks later, the administration has yet to make an official declaration about a national emergency on the opioid epidemic.

A number of states have filed their own lawsuits against pharmaceutical manufacturers and distributors: Oklahoma, Missouri, Ohio, Mississippi, New Hampshire, New Mexico and South Carolina. None of these states is involved in the broader multistate investigation.

In addition,New York and Kentucky filed suits that have since been settled.

Companies respond

Allergan said Tuesday that "While we work proactively with (state attorneys general) offices to provide information, it is important to put into perspective Allergan's role regarding opioids. Allergan's two branded opioid products -- Norco and Kadian -- account for less than 0.08% of all opioid products prescribed in 2016 in the U.S. These products came to Allergan through legacy acquisitions and have not been promoted since 2012, in the case of Kadian, and since 2003, in the case of Norco."

Amerisource Bergen said that it "has taken extensive action to help ensure the safe and secure delivery of these drugs, including reporting suspicious orders to the Drug Enforcement Agency and stopping tens of thousands of suspicious orders from being shipped."

Cardinal Health said, "As a pharmaceutical distributor, we operate as part of a multi-faceted and highly regulated healthcare system. We do not manufacture, promote or prescribe prescription medications to members of the public -- and believe everyone in that chain, including us, must do their part to address the current crisis."

Endo International said its policy is "not to comment on current litigation or investigations."

Janssen Pharmaceuticals said, "We have received and plan to address the request from the coalition of State Attorney Generals, and will continue to work with stakeholders to support solutions."

McKesson said it "agrees that the opioid epidemic is a national public health crisis and plans to cooperate fully with the investigation."

Purdue Pharma said, "We share the attorneys' general concern about the opioid crisis and we are cooperating with their request. This is a multifaceted public health challenge, and we look forward to working collaboratively with government entities to be part of the solution."

Teva Pharmaceuticals said, "We are committed to working with the healthcare community, regulators and public officials to collaboratively find solutions."

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