Reports One and Two of “Fueling an Epidemic,” issued earlier in 2018, had documented that McKesson, Amerisource Bergen, and Cardinal Health had shipped 1.6 billion doses of opioids to Missouri alone from 2012 to 2017; at the peak, they sent 52 doses for every man, woman, child, and baby in the state in 2015. Report Three, in September 2018, said Insys employees used a variety of practices to deceive and game the Medicare prior authorization system for fentanyl.
- The Food and Drug Administration (FDA) is trying to fix the obviously broken system for preventing massive diversion of opioids. On February 7, (FDA announced a pilot program to “inform the development of the enhanced electronic, interoperable track-and-trace system for industry set to go into effect in 2023 as part of the Drug Supply Chain Security Act.” This action underscores what the McCaskill report and many news stories have documented, that to date, the tracking system under this 2013 law has been massively outmaneuvered. By the 2023 deadline, opioids and other drugs are to be tracked down to the unit level, and FDA is considering the use of blockchain technologies to make it all work.
The common themes in items 1-5: that the states are clearly turning their attention toward seeking massive judgments or a national settlement against drug companies along the lines of the historic Tobacco Master Settlement Agreement to pay for their own costs in treating opioid abuse, and possibly also to compensate victims individually, and that the federal government—at least the FDA—is acknowledging that the worst problem has been diversion from distribution, not legitimate prescriptions.
