Missourians are drowning in opioids but can’t afford prescriptions. Rein in Big Pharma | Opinion

All too often, people with a drug problem blame themselves. This is dangerous because they may feel too embarrassed to ask for help. By withdrawing into themselves, they often pull away from friends and family who could help them, and instead suffer alone. Too often, this suffering ends in death.

But they are not solely at fault.

Nobody can doubt that drugs are a major problem. Drug overdoses are the leading cause of death among those age 18 to 44 in Missouri. These people, in the prime of life, are often just one mistake away from death. In 2021, more than 1,500 Missourians died from an opioid overdose, meaning 1 of every 47 deaths in the state was caused by an overdose.

But these deaths don’t “just happen.” People must be able to get opioids before they can use or misuse them. The drugs people are overdosing on include heroin, fentanyl, methadone, morphine and oxycodone, among other prescription and non-prescription pain relievers.

The long chain of prescription drug abuse begins when a company makes the drugs. Then another company distributes the drugs. Only then can the person at the end of the chain take the drugs and become addicted or overdose.

One place to break this chain is by forcing Big Pharma — in particular the drug wholesalers, the companies that buy drugs from manufacturers then turn around and sell them to pharmacies — to take responsibility for their irresponsible actions.

Three companies — AmerisourceBergen, Cardinal Health and McKesson — control more than 90% of the wholesale prescription drug market. A pre-pandemic report found that these companies brought some 1.6 billion doses of opioids into Missouri from 2012 through 2017. That would be enough to give each of us 260 pills.

The cascade of these drugs is causing problems throughout the economy. An in-depth report from the University of Missouri Extension shows shows that between 2000 and 2015, opioid abuse reduced the Missouri labor force by 2.7% among men 25 to 54, and 3.4% among women 25 to 34. The study shows that our state lost “an estimated 14,744 total jobs (5,518 direct, 4,801 indirect, and 4,425 induced) due to opioid-related workforce losses in the state’s manufacturing workforce.” This has cost our state more than $4 billion in economic output.

As bad as the opioid problem is, just think how much worse it could be with that many pills available. Simple math should have alerted these companies to the problem and caused them to work together to reduce the flood of pills flowing into our state (and other states as well). To have simply kept the pipeline flowing seems like criminal negligence.

The attorneys general of several states agree. They pointed a finger at the wholesalers, and said the wholesalers should have alerted authorities that manufacturers were churning out a suspicious number of opioids, instead of simply moving those pills through the pipeline.

The companies have agreed to pay billions to settle lawsuits from across the country. McKesson will pay up to $7.9 billion, while AmerisourceBergen and Cardinal each agreed to provide up to $6.4 billion over the next 18 years. That is a start. But it will not solve all the problems these companies are causing.

That is because at the same time they were importing opioids into Missouri, these three companies were also working together to jack up the price of the other prescription drugs they handle. That is having an impact. More than half the people in our state are concerned about the cost of their prescriptions. At least one-third say they have cut pills in half or simply skipped filling a prescription.

For the average patient, skipping pills they need to take can be just as unhealthy as an overdose. People are suffering and dying so that wholesalers can improve their own bottom line.

Individual Americans are paying a heavy price for the misuse of drugs, especially opioids, in recent years. But they are not entirely to blame. Drug wholesalers provided too many drugs, even as these same companies — three of the 20 wealthiest businesses in America — worked together to make many other drugs too expensive. The way to begin unwinding our state’s drug problems is to start cracking down on these wholesalers.