Distributor executive apologizes for large opioid shipments

An executive of a pharmaceutical distributor on Tuesday apologized for the company’s role in shipping a high volume of opioids to two West Virginia pharmacies.

George Barrett — Cardinal Health’s executive chairman — said he wished the company had made different decisions in regard to two pharmacies in West Virginia situated in areas with small populations.  

“We reached decisions at the time based in part on the demographics of the surrounding area, the characteristics of the individual pharmacy, and the views of our internal staff,” Barrett said Tuesday before the House Energy and Commerce Subcommittee on Oversight and Investigations.

“Those decisions allowed the two pharmacies to continue to receive certain volumes of hydrocodone and oxycodone from Cardinal Health for longer than I think they should have, based on what I have since learned about the circumstances surrounding those pharmacies.”

He apologized, saying, “with the benefit of hindsight, I wish we had moved faster and asked a different set of questions. I am deeply sorry we did not.”

A year ago, the subcommittee launched an investigation into the distribution of prescription opioids, and particularly homed in on areas of West Virginia where millions of pills were sent to areas with small populations.

From 2007 to 2012, distributors sent more than 780 million hydrocodone and oxycodone pills to West Virginia, about half of which came from AmerisourceBergen, Cardinal Health and McKesson, according to a memo from the Energy and Commerce Committee’s majority staff.

“We have learned much from the investigation but still have many questions,” the subcommittee chairman, Rep. Gregg Harper (R-Miss.), said in his opening statement.

“For example, why did the distributors repeatedly fail to report suspicious orders of opioids or exercise effective controls against diversion?”

The other four distributors testifying before the subcommittee stopped short of a formal apology. Some said they would have done things differently in hindsight and highlighted recent measures they’ve taken to address the opioid epidemic.

After witness testimony, Harper asked a pointed question: “Do you believe that the actions you or your company took contributed to the opioid epidemic?”

One company executive — Joseph Mastandrea, the chairman of the board of Miami-Luken — responded “yes.” The others said they believed their company had not contributed.

As the hearing drew to a close, Rep. David McKinley took the microphone, his voice full of frustration and anger.

“I’m from West Virginia,” the Republican said.

“The fury inside me right now is bubbling over with how we’re going to address this problem, and for several of you to say you had no role whatsoever in this, I find particularly offensive.”

Some opioid distributors — particularly the three largest, Cardinal Health, McKesson and AmerisourceBergen — have been named in opioid lawsuits by cities, counties, tribes and other stakeholders. The litigation alleges that pharmaceutical manufacturers and distributors shipped large quantities of painkillers without alerting authorities.

In a statement sent during the hearing, the trade association for the industry defended the distributors and said they’ve invested in more sophisticated monitoring tools and also supported policies to decrease overprescribing of painkillers. 

“Distributors understand the tragic impact the prescription opioid abuse epidemic has had on our country,” John M. Gray, president and CEO of the Healthcare Distribution Alliance, said in a statement.

“But we need to be realistic and acknowledge that this epidemic was not caused by distributors who neither prescribe, manufacture, nor dispense medicines. This crisis was caused by decades of belief that opioids could be prescribed with little risk. From the federal government to the medical community — that belief was pervasive.”

The opioid epidemic is contributing to an estimated 115 American deaths per day, and has shown no signs of stopping. Lawmakers and the administration are grappling with how to stem the tide.

On Capitol Hill, the Senate Health Committee recently sent bipartisan legislation to the chamber’s floor. The House Energy and Commerce Committee is in the throes of hammering out bills to be included in an opioid legislative package, which Chairman Greg Walden (R-Ore.) hopes to put on the House floor by Memorial Day weekend.

– Updated at 1:02 p.m.