June 10, 2019

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Business June 10, 2019

Opioid Crackdown Could Lead To More Drug Company Bankruptcies

Two years ago, the drug company Insys Therapeutics posted a quarter-billion dollars in annual sales. But the Arizona-based firm’s fortunes plummeted so far that on Monday its leaders declared bankruptcy. It was the latest fall-out from the nation’s prescription opioid epidemic, which has killed more than 200,000 Americans and triggered hundreds of lawsuits against Big Pharma.

Insys marketed an opioid pain medication called Subsys that included fentanyl. It generated tens of millions of dollar in annual sales. But like other prescription opioids marketed aggressively by the drug industry, it turned out to be highly addictive.

Many of the drug industry’s biggest companies are tangled up in a wave of opioid litigation, including name brand companies Johnson & Johnson and CVS. It’s unlikely large firms will follow Insys’ lead and seek Chapter 11 protection, but smaller firms including Purdue Pharma, the maker of OxyContin, have already floated the possibility.

Attorneys representing hundreds of communities that hoped to win compensation from Insys issued a statement Monday saying they’ll work to determine whether the company is actually insolvent. “We will actively pursue full financial disclosure for Insys and any other defendant that files for bankruptcy,” the plaintiff group said.

They added that their goal in targeting 21 other drug firms isn’t to put them out of business but to “abate the current opioid epidemic and seek long-term, sustainable solutions.” State and local officials hope to recoup some of the billions of dollars they’ve spent responding to the opioid crisis.

One major state opioid trial is underway now in Oklahoma against Johnson & Johnson, with a second consolidated trial against other firms set to begin in October in Ohio. Judge Dan Polster, who’s presiding over that federal case, has urged the parties to reach a settlement so communities receive some compensation without disrupting the pharmaceutical industry.

Sources tell NPR negotiations are underway but no deal has been reached.

In all, more than 1,800 state and local governments have filed opioid-related lawsuits. Penalties and settlements could run into the tens of billions of dollars, rivaling big tobacco payouts of the 1990s. The move by Insys came a week after the firm pleaded guilty to felony charges that it bribed doctors to prescribe its Subys fentanyl medication to patients who shouldn’t have been using it.

The company agreed to pay the federal government $225 million in penalties. Last month, company founder John Kapoor, once a towering figure in the drug-tech industry, was found guilty on federal racketeering charges along with four other Insys executives. The company still faced numerous other opioid-related lawsuits.

In his statement, Insys CEO Andrew Long, said in a statement those “legacy legal challenges” contributed to the firm’s decision to enter bankruptcy proceedings.

He said bankruptcy proceedings would allow the company to negotiate with creditors.

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Health June 10, 2019

Oregon’s Criminal Justice System To Be Examined Over Treatment Of Mentally Ill People

Some Oregon inmates with mental illness are in jail rather than a state mental health hospital. A federal judge will hear arguments Tuesday that Oregon is not providing timely, appropriate care.



AUDIE CORNISH, HOST:

Oregon’s criminal justice system will be examined in a Portland courtroom tomorrow. At issue is how the state treats defendants with mental illnesses. The lawsuit accuses Oregon of letting mentally ill people languish in jail rather than provide the health care they need at the state psychiatric hospital. Oregon Public Broadcasting’s Conrad Wilson reports.

CONRAD WILSON, BYLINE: In December, Carlos Zamora-Skaar was arrested on a felony burglary charge. Court documents show he was undergoing a severe mental health crisis at the time. A few weeks after his arrest, a judge ordered a psychological evaluation at the Oregon State Hospital.

Amanda Thibeault is Zamora-Skaar’s criminal defense attorney.

AMANDA THIBEAULT: January came and went. February came and went. And he was just languishing in jail, where a mentally ill person shouldn’t be.

WILSON: In court, he made delirious statements during hearings, so much so that after months in jail, a judge found him unable to aid in his own defense and ordered him this time to receive treatment at the Oregon State Hospital. But for weeks, that didn’t happen.

It wasn’t until late last month that Zamora-Skaar was finally admitted to the state hospital. The idea is to treat his mental illness until he’s able to aid in his defense. And only then, Thibeault says, can his criminal case move forward.

THIBEAULT: This is happening statewide.

WILSON: Attorneys and mental health experts say, right now, there are about 40 people like Zamora-Skaar with mental health issues who are waiting in Oregon jails to get transferred to the state hospital for treatment.

Emily Cooper is the legal director for Disability Rights Oregon, a nonprofit that sued the state nearly 20 years ago over the same issue and won.

EMILY COOPER: People with mental illness don’t belong in places that are intended to punish. They should be in places that are designed to treat.

WILSON: In 2002, a federal judge found the state can’t keep people in county jails for more than seven days when a state court judge has found they need to be at the state psychiatric hospital.

COOPER: It’s not happening.

WILSON: For years, it was. But in the last year or so, Cooper says the state has a backlog because it’s lost control of the situation.

COOPER: The problem is, nationally and here in Oregon, we haven’t appropriately funded a community behavioral health system to meet the needs of those individuals. And so what’s happened – again, here in Oregon and nationally – is jails have become the de facto mental health provider.

LEE EBY: And that’s to a large extent very true.

WILSON: Captain Lee Eby is the jail commander in Clackamas County, Ore. He says he regularly has people in his jail who are waiting past the seven-day window to be sent to the state hospital for treatment. He says jails have become the new mental hospitals.

EBY: And that’s not the way it should be. And if there’s one thing I would change, it would be that – is to get away from that notion of criminalizing some of the behavior, not having the resources to deal with it.

WILSON: The state’s psychiatric hospital is run by the Oregon Health Authority. Patrick Allen is the agency’s director. He acknowledges it’s taking longer than seven days to admit people from jails.

PATRICK ALLEN: The challenge is that this rate of sending people to us continues to accelerate.

WILSON: He says he’s working to reduce the amount of time people are waiting and to speed up the discharge process for those who no longer need hospital-level care. But Allen says the hospital is also dealing with things that are outside his control.

ALLEN: Sixty percent of people referred to us on an aid and assist order were homeless at the time of their arrest. To me, that speaks volumes in terms of the nature of the kind of problem that we’re struggling with.

WILSON: And while Allen says he’s doing everything he can, that’s of little comfort to those in a jail cell rather than a hospital bed.

For NPR News, I’m Conrad Wilson in Portland.

(SOUNDBITE OF 36’S “APARTMENT 451”)

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Sports June 10, 2019

Santa Anita Park Resists Call To Suspend Racing After 2 More Horses Die

Santa Anita Park in Southern California is resisting calls to suspend its season, saying recent changes have reduced catastrophic injuries “by 50 percent in racing and by more than 84 percent in training.”

Jae C. Hong/AP


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Jae C. Hong/AP

Los Angeles County’s Santa Anita Park is standing firm against calls to cancel the rest of its racing season after the deaths of two more horses over the weekend, bringing the number of horses that have died at the track since December to 29.

In a highly unusual move Saturday, the California Horse Racing Board asked the park to scuttle competition for the seven remaining race days to “provide the industry more time to fully implement announced safety initiatives and perhaps additional ones.”

But park owner The Stronach Group along with the Thoroughbred Owners of California and California Thoroughbred Trainers released a joint statement Sunday saying the racetrack will remain open until the season ends on June 23.

“Since wide-sweeping reforms have been instituted at Santa Anita, catastrophic injuries have dropped considerably compared to earlier this meet,” the statement read, adding: “To be clear, there are no acceptable losses, and every day we work toward ending all serious injuries. But the reality is that our improvements and changes have been effective.”

Santa Anita suspended racing for much of March, when the toll of horse deaths neared two dozen — twice the rate of the previous year — and as it worked to figure out why so many horses were dying.

Before reopening on March 29, the park announced a series of changes it planned to implement, including limiting the use of pain or anti-inflammatory medications and treatment for horses and improving early detection of preexisting health conditions. Santa Anita had already pledged to bring in outside experts on a regular basis to review its dirt, turf and synthetic course surfaces.

The park says those moves have already reduced catastrophic injuries “by 50 percent in racing and by more than 84 percent in training.”

Since the park reopened, seven more horses have died there.

On Saturday, a horse named Formal Dude was euthanized after “taking a bad step” in a mile race, according to the official race chart. An examination revealed a fractured pelvis, reports The Daily Racing Form.

In response to the death of the 4-year-old gelding, the state Horse Racing Board issued a recommendation Saturday that Santa Anita “suspend racing for the seven remaining race days but that they allow horses to continue to train during that period.”

Santa Anita issued its refusal on Sunday. That same day saw another horse fatality: Truffalino pulled up during the third race of the day, and the jockey dismounted just before the 3-year-old filly collapsed. The horse died of a suspected heart attack.

In an emailed statement, the California Horse Racing Board said it “does not have the authority to suspend a race meet or remove race dates from a current race meet without the approval of the race track operator or without holding a public meeting with ten days public notice.”

At the time Santa Anita suspended races in March, questions swirled about whether heavy Southern California rains and poor track conditions were causing the horse injuries and deaths. But other experts weren’t so sure.

“There’s no obvious answer. So every question is being asked: Is it the surface? Is it the horses that are running on the surface?” Rick Baedeker, executive director of the California Horse Racing Board, told NPR’s All Things Considered in March.

“Racing has become more competitive over a period of time,” Rick Arthur, equine medical director at the School of Veterinary Medicine at the University of California, Davis, told NPR’s Tom Goldman. “Horses are worked faster and there are fewer horses to fit the slots that are available. So there’s more pressure on the horses to race more frequently.”

People for the Ethical Treatment of Animals says that horses, with their massive frames supported by spindly legs, simply aren’t built to withstand the rigors of training and racing. The organization notes that injuries such as strained tendons or hairline fractures can be difficult to diagnose before a horse is run again.

PETA has called for a nationwide suspension of racing until greater safety measures are put in place. “Trainers, owners, and veterinarians have recklessly controlled racing and imperiled horses for too long, and those days must come to an end,” Senior Vice President Kathy Guillermo said in a statement.

And while just a handful of race days remain this season, Santa Anita is set to host the prestigious Breeders’ Cup in November. Amid the spate of horse deaths, according to the LA Times, the Breeders’ Cup committee is considering moving the event to Churchill Downs in Kentucky.

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