WASHINGTON — The CEO of Cardinal Health told House members he was “deeply sorry” for the company’s poor oversight of some opioid orders. The chairman of Miami-Luken’s board broke ranks with four peers by directly acknowledging his company had contributed to the opioid crisis. And McKesson’s CEO, after minutes of being pressed, said his company had fired employees in light of its previous oversight practices.
But for hours on Tuesday, executives from five drug distributor companies largely parried questions from House members and attempted to shift blame to anyone but them — to the Drug Enforcement Administration, physicians, and pharmacies, among others.
“I just want you to feel shame,” Rep. David McKinley (R-W.Va.) told the executives at one point, suggesting that financial penalties were insufficient and alluding to jail time. “So what’s the proper accountability? What’s the punishment? It’s just a slap on the wrist? Maybe a hundredth of one percent of the revenue? What’s the punishment that fits this crime?”
McKesson and Cardinal Health, in the past two years, agreed to pay the federal government $150 million and $44 million, respectively. AmerisourceBergen, Miami-Luken, and H.D. Smith have agreed to pay $16 million, $2.5 million, and $3.5 million, respectively, to West Virginia’s government, among other penalties and settlement agreements.
“Congressman, I don’t know how you could look at this crisis and not feel terrible about what’s going on in this country,” John Hammergren, the CEO of McKesson, at one point told McKinley.
At the beginning of the hearing, Rep. Gregg Harper (R-Miss.), the chairman of the House Energy and Commerce subcommittee on investigations, walked the executives through a series of yes-or-no questions: whether their companies had contributed to the crisis and whether they had failed to maintain effective controls in the past.
Only Joseph Mastandrea, the chairman of the board at Miami-Luken, answered “yes” to either question.
But the executives were uniform in acknowledging that their systems had changed since the height of opioids shipments roughly a decade ago, and that they now conducted their day-to-day business differently.
Steven Collis, the CEO of AmerisourceBergen, said his company had stopped shipments to as many as 800 pharmacies because of suspected diversion. Hammergen acknowledged his company had fired employees after being questioned repeatedly by Rep. Morgan Griffith (R-Va.), leading to a follow-up query from Harper.
“I think what you’re hearing from us today is: enough is enough,” Rep. Marsha Blackburn (R-Tenn.), told the five witnesses. “We expect you all to do more.”
Scarcely mentioned, however, were drug manufacturers, many of which have become increasingly infamous for their role in shifting pain treatment practices in the U.S. and marketing their drugs in a manner dismissive of their addictive properties.
At no point, either, did any member bring up the 2016 law that raised the threshold the DEA must meet in order to conduct enforcement actions against wayward drug distributors and pharmacies.
The sharp questions, however, came from both sides of the aisle. Earlier in the hearing. Rep. Kathy Castor (D-Fla.) introduced a record of Hammergren’s personal compensation over a decade-long period, which totaled more than $600 million.
Members also were quick to whip out statistics from an ongoing House investigation into the distributors, which produced numerous anecdotes of gross oversupply allegedly aided by distributors unwilling to police wayward pharmacies.
In a recent 10-year period, distributors shipped over 20 million opioid tablets to Kermit, W.Va., a town of roughly 2,000.
Rep. Diana DeGette (D-Colo.), the subcommittee ranking member, also aggressively questioned the distributors.
At one point, she waved a thin pile of order procurement records to question whether Miami-Luken had sufficiently overseen suspicious orders, asking Mastandrea: “Do you think this is a sufficient due diligence file for the number of opioids that you were sending to this one Sav-Rite pharmacy in Kermit, W.Va.?”
Mastandrea answered in a word: “No.”
Legal proceedings involving all five of the distributors are ongoing in an Ohio federal court, a consolidated case many expect to yield an unprecedented settlement from manufacturers and distributors alike. Sen. Claire McCaskill (D-Mo.) also requested information from the “Big Three” distributors — McKesson, AmerisourceBergen, and Cardinal Health — in a separate, ongoing investigation.