Key findings of investigation into harder-to-abuse opioids

This story was co-published with The Associated Press.

The Associated Press and the Center for Public Integrity investigated how pharmaceutical companies are using their political clout to push a new form of opioids as their answer to the epidemic of prescription painkiller abuse. The pills are marketed as abuse-deterrents because they usually are difficult to crush and dissolve, but they also are lucrative for the industry. Some key findings:

About this project

This is another installment in an investigation by The Associated Press and the Center for Public Integrity examining the politics behind the nation’s opioid epidemic.

The story examines how drug companies are working to convince lawmakers and regulators that abuse-deterrent formulas — new, higher-priced forms of their painkillers — are a key solution to America’s opioid crisis. They are making the push even though there is little evidence that the reformulated opioids reduce overdoses or deaths.

AP reporters Geoff Mulvihill and Matthew Perrone and Center for Public Integrity reporters Liz Essley Whyte and Ben Wieder collaborated on the project for 10 months. They pored over hundreds of documents, collected and analyzed campaign finance and lobbying data from 2006 through 2016, and interviewed more than 200 people to gain insights into how the political process influenced the response to the opioid epidemic.

The initial stories, published in September, examined how opioid makers rely on a 50-state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at stemming the tide of prescription opioids. They also uncovered how a loose coalition of drugmakers and industry-backed nonprofits called the Pain Care Forum shaped the federal response to the opioid crisis.

Taken together, this information provides a unique national look at how drugmakers and their allies often have sought to delay steps intended to combat opioid abuse while pushing their own priorities with state legislatures, Congress and regulators.

Lawmakers in 35 states introduced more than 100 bills over the last two years dealing with the harder-to-abuse opioids. Roughly half included nearly identical language requiring insurers to cover the new formulations, and several of the sponsors said they received the wording from pharmaceutical lobbyists.

At least 21 bills related to abuse-deterrent drugs have become state law in the last five years, including five that require insurers to pay for the more expensive drugs.

Manufacturers of abuse-deterrent opioids have spent more than $20 million on federal lobbying efforts that included legislation promoting those drugs between 2012 and 2015.

Drugmakers also have tried to influence state attorneys general. Two of the biggest, Purdue Pharma and Pfizer, gave a total of $950,000 to the Republican and Democratic attorneys general associations in 2015 and 2016, more than in the previous four years combined.

Abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year but generated more than $2.4 billion in sales _ roughly a quarter of the entire U.S. market for the drugs.

Converting the U.S. Department of Veterans Affairs medical system exclusively to the new formulations, according to one recent VA estimate, would increase its spending on prescription painkillers more than tenfold, to over $1.6 billion annually.

A federal bill passed this summer that includes a provision promoting abuse-deterrent opioids is expected to cost the federal government $75 million in lost Medicaid payments over 10 years. Makers of such harder-to-abuse drugs spent more than $1.7 million on lobbying efforts in 2016 that included that bill.

Politics of Pain

Key findings of investigation into harder-to-abuse opioids

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