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EXCLUSIVE: This could be the first law to make big pharma pay for the opioid crisis

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WASHINGTON (CIRCA) - Trying to fight the opioid crisis in the United States has come at a hefty price tag, and one senator has a plan to make pharmaceutical companies to foot the bill. If passed, his law would be the first time Congress has forced big pharma to pay for the opioid epidemic it helped cause.

The U.S. opioid crisis has cost an estimated $1 trillion since 2001 and is expected to cost another $500 billion before 2020, according to an analysis by health research nonprofit Altarum.

Sen. Jeff Merkley, D-Ore., on Wednesday announced the Opioid Treatment Surge Act, which would legally put some of the financial burden for cleaning up the crisis on the drug companies he says are responsible.

"What the bill does is it says that the companies that have been pushing these pills going back to the big surge of 1999 have to take responsibility for providing a lot of the funds for treatment," Merkley said.

If the bill is passed, opioid manufacturers would be on the hook for $2 billion a year over the next decade to help fund the Substance Abuse Prevention and Treatment Block Grant, which is distributed by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Under Merkley's bill, he estimates each state would receive approximately 110 percent more from the block grant each year than currently received.

For example, California received over $254 million in 2018 from SAMHSA, but Merkley projects the Golden State's payout would top $537 million.

How much of the $2 billion a year must each manufacturer shell out? That will be determined by their portion of overall opioid sales since 1999, excluding sales of opioids used for medication-assisted treatment or for cancer or hospice patients.

So, whoever sold the most pays the most.

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The concept of getting money from these manufacturers to help pay for the crisis is not new. States, cities, tribes and even the federal government have filed lawsuits against pharmaceutical companies for their alleged role in the epidemic.

But according to one expert, never before has Congress successfully forced opioid manufacturers to pay up.

"If I were any one of these pharmaceutical companies and was told I am responsible for this share, I would say, 'Prove it,'" said Andrew Kessler, founder of consulting firm Slingshot Solutions. "And if I didn’t like what I was told, where would I end up? I would end up in court. And we are back to the court system."

Kessler has years of experience in substance abuse policy and questioned how the law could truly be enforced.

"I want to see the pharmaceutical companies held responsible, don’t mistake that, but how could you allocate, how could you discover, for example, which opioids from which company were abused the most? Or which opioids from which company ended up in pharmacies that had practices that allowed them to be abused?" he said.

Opioid crisis (states impacted) + Survey

Kessler said if Congress really wants to act and put more money toward the opioid epidemic, it has the power to do so.

“So, while the $2 billion that Sen. Merkley seeks would not only be a boon for treatment ... it’s not necessarily incumbent to think of gimmicks to increase the budget. They can increase the budget for SAMHSA, especially for the substance abuse prevention and treatment block grant, straight up," said Kessler.

Merkley says it is time for the the companies to be held accountable.

"If these companies... have to help finance the prevention and the treatment for people who have been so vastly affected by their pushing of these opioids, it will send a powerful accountability for them and a powerful message to others who mislead the public," Merkley said.

And he is not afraid to be the one to try and do it.

"Everyone says more resources are needed, but they often shy away from going after the drug companies that were the pushers, the drug pushers in this case, who lied to the American public about addiction, and they are afraid to go after the drug companies to hold them responsible, because they’re terrified of them. Because drug companies spend so much money in campaigns," Merkley said.

And Kessler's advice to Congress? Be patient.

"We can do all of this for opioids and for overprescribing, but addiction is still out there and it will continue to be," he said. "Congress needs to realize that the amount of time and effort it has put into the overprescribing issue is only a very, very small piece of a very, very large puzzle that we are going to be forced to address for decades to come."

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