THE PROGNOSIS

If there was a “most wanted” when it comes to the country’s opioid addiction crisis, it might be the Sackler family and its company Purdue Pharma. The maker of OxyContin, now at the brink of bankruptcy, is increasingly viewed as a top culprit for its alleged central role in getting hundreds of thousands of Americans hooked on opioids.

California, Maine, Hawaii and the District of Columbia announced lawsuits yesterday against Purdue for how it marketed, distributed and sold its popular prescription painkiller. They’re just the latest group of states to go after the company, which is also facing a crush of lawsuits from New Jersey, West Virginia, Maryland, Kansas, Iowa and Wisconsin.

“The truth is, the start of this crisis can be traced back to Purdue Pharma and the Sackler family and their pursuit of profits,” California Attorney General Xavier Becerra said at a news conference announcing the lawsuit.

Like other states, California alleges Purdue and its former chairman and president Richard Sackler acted illegally by encouraging the widespread use and sale of OxyContin. Becerra said the company knew as early as the 1990s that the drug was one of the most-abused opioids in the country yet went on to double its sales force in subsequent years.

“Their sales representatives falsely marketed OxyContin, saying that it was neither addictive nor subject to withdrawal symptoms,” Becerra said.

Of course, Purdue is far from the only drugmaker blamed for the spike in prescription opioid overdoses, which have claimed the lives of more than 200,000 Americans since 1999.

In October, a federal court in Cleveland will consider a massive lawsuit with claims filed by some 1,600 cities, counties, Native American tribes and others. Nearly every state has sued manufacturers or distributors. Among those states is Oklahoma, whose lawyers argued in a trial last week that Johnson & Johnson and its subsidiaries flooded the market with prescription painkillers and deceptively promoted them.

As my Washington Post colleague Lenny Bernstein reports, the trial “has emerged as an early test of whether the pharmaceutical industry will be forced to pay billions of dollars” to cover local governments' costs of coping with the crisis.

But much of the spotlight is on Purdue, partly because of who owns it and how the company allegedly behaved. The Sacklers appeared to have profited handsomely from sales of OxyContin, with evidence that members of the family transferred at least $4 billion out of the company and into their own personal accounts over about half a decade. Some attorneys general have alleged that Richard Sackler, the company’s former chairman and president, was behind tactics of pushing high doses to maximize sales.

There’s also evidence that Purdue exerted undue influence over the World Health Organization’s guidelines on treating pain. An investigation released last month by Reps. Katherine Clark (D-Mass.) and Hal Rogers (R-Ky.) says WHO guidelines for treating severe pain draw directly from Purdue’s strategies on how to market opioids.

Now the Sacklers are being shunned all over the place. David and Joss Sackler are reportedly selling their Upper East Side apartment and moving to Palm Beach, Fla. The Sacklers’s philanthropic trust announced in March it would stop making donations, after three major art museums — London’s National Portrait Gallery and Tate galleries and New York City’s Guggenheim Museum — said they would no longer accept the money.

Jillian Sackler, widow of the foundation’s founder, Arthur Sackler, defended her husband in a Post op-ed in April. Noting that Arthur died nearly 32 years ago — long before OxyContin was invented — she wrote that his philanthropic endeavors shouldn’t be devalued simply because of the family’s association with Purdue.

“Blaming him for OxyContin’s marketing, or for any other wrongdoing by the pharmaceutical industry, is as ludicrous as blaming the investor of the mimeograph for email spam,” Jillian Sackler wrote.

Even JPMorgan Chase has severed its relationship with Purdue, telling the company in March it had six months to find another bank.

This much is clear: Purdue is paying the piper. The company agreed in March to a $270 million settlement with Oklahoma, with members of the family paying $75 million of the total out of their personal funds. The money will help provide treatment drugs, fund a new foundation for addiction treatment and research, and pay for costs to cities and towns with many residents struggling with addiction.

Around that time, Purdue chief executive Craig Landau told my colleague Katie Zezima that the company is considering bankruptcy. He said it’s on the table as the company confronts more potential legal settlements or jury verdicts that could cost tens of billions of dollars.

“It is an option,” Landau told Katie. “We are considering it, but we’ve really made no decisions on what course of actions to pursue. A lot depends on what unfolds in the weeks and months ahead.”

Rep. Hal Rogers (R-Ky.):

AHH, OOF and OUCH

AHH: A federal judge decided for the Food and Drug Administration in a lawsuit against a Florida-based stem cell company whose treatments have blinded at least four patients, as our Post colleagues William Wan and Laurie McGinley report, ruling the agency can regulate procedures that use fat to create a stem-cell treatment.

Judge Ursula Ungaro ruled the FDA can call for an injunction to stop U.S. Stem Cell from performing the procedure, writing that unless it is ordered to stop, “there is a reasonable likelihood that Defendants will continue to violate” regulations by providing unapproved treatments.

“Scientists, medical associations and health officials have criticized stem cell clinics for selling treatments unproven by science and unapproved by the government for a wide spectrum of unrelated ailments, such as Parkinson’s disease, multiple sclerosis, joint pain and erectile dysfunction,” Laurie and William write. “Beginning in 2015, at least four patients were blinded after U.S. Stem Cell and clinics associated with the company injected stem cell treatments into their eyes. The FDA’s slow initial response to patient injuries permitted U.S. Stem Cell to continue operating four years after those first reports of blindness.”

“This case is an important victory in the FDA’s work to protect the public health,” the FDA said in a statement. “We’ve been taking action, like this case, against clinics that abuse the trust of patients and endanger their health. We will continue to promote the sound and scientific development of regenerative medicine products, but we will not tolerate those in this field who try to skirt the law and put patients in harm’s way.”

OOF: The medical testing company Quest Diagnostics disclosed that it experienced a data breach affecting 11.9 million patients.

An “unauthorized user” gained access to Social Security numbers as well as medical and financial information, our Post colleague Christopher Rowland reports. But the breach did not include lab test results.

“A collections agency called American Medical Collection Agency notified Quest about a potential intrusion on May 14 and then reported on the scope of the breach on Friday,” Christopher writes. “AMCA provides services to Optum360, a Quest billing contractor. Quest said it does not have details about which patients were affected and what data was stolen.”

But in a statement on its website, Quest said it “has not been able to verify the accuracy of the information received from AMCA.”

OUCH: Here’s an interesting tidbit from an interview Roll Call did with Keith Hall, outgoing director of the Congressional Budget Office. Hall, a Republican, said Republicans themselves are to blame for the failure of their whole 2017 Obamacare repeal-and-replace effort.

Hall told Roll Call’s Paul M. Krawzak that as part of the CBO, he saw himself as a “referee.” “If I go back to that referee analogy, it’s a coach screaming at the referees, ‘You blew the game for me,’” Hall said of those who criticized the CBO’s analysis of the impact of repealing the ACA. “In fact, if you want to blame somebody — I’m on the way out so I can say this — if Congress really wanted to change Obamacare, they’re the ones that blew it with their process, not CBO. We just called it like we saw it.”

“Hall said it should have been apparent, even without a CBO score, that scaling back subsidies that helped low-income people pay for health insurance would result in fewer people being covered," Paul writes. “Hall said Republicans revealed little about their plan to repeal the health care law until they introduced the legislation.”

AGENCY ALERT

— The Food and Drug Administration plans to make it easier for doctors to get unapproved drugs for cancer patients who have run out of other treatment options.

The pilot program will help faciliate the process for what’s sometimes referred to as “compassionate use.” The program “is designed to help patients with immediate life-threatening or serious illnesses who don’t qualify for clinical trials and have no other treatment options,” our Post colleague Laurie reports. “Typically, a doctor first asks a drug company to provide the experimental treatment. If the firm agrees, the physician submits a protocol to an institutional review board (IRB) — which makes sure the patient is properly informed about the treatment. The FDA then decides whether to approve the request — and almost always does.”

Now, there will be a call center run by the FDA’s oncology staff that’s meant to eliminate hurdles for doctors in this situation by giving them a direct contact for the requests. The staffers under the new program will help doctors from the initial request to fill out paperwork and aid them in finding an IRB as well as the appropriate contacts at the drug company.

The Department of Health and Human Services announced that Secretary Alex Azar’s chief of staff Peter Urbanowicz is leaving the agency this month. “Earlier this year, Peter advised me of his intention to return to his home in Texas this summer. Peter has been a key leader in HHS’s success over the past year and a half, and has played a vital role in our work to lower prescription drug prices, advance value-based care, and improve rural healthcare access,” Azar said in a statement. Brian Harrison, the current deputy chief of staff, will fill the chief of staff post.

HEALTH ON THE HILL

—Nikki Haley, former South Carolina governor and U.S. Ambassador to the United Nations, said advocating for abortion rights isn't "real feminism," speaking last night at the annual gala hosted by the antiabortion group Susan B. Anthony List. President Trump headlined the event last year.

"Unfortunately, many on the left use the abortion debate to divide women and demand conformity," said Haley, who resigned from her ambassador post late last year. "They do this in the name of feminism. But that is not real feminism. The idea that women must adhere to a particular set of values is one of the most anti-women ideas in today’s culture."

"As a pro-life, female governor, I was blessed with a unique platform, and I made every effort to use it appropriately. Not to lob attacks at people who disagreed with me, not to diminish the other side, but to reframe the debate. To explain that being pro-life is not about being for or against women. It is about being for a baby’s right to live – the most basic right there is."

Rep. Eric Swalwell (Calif.), a Democratic presidential candidate, suggested CNN should consider moving its Atlanta-based headquarters if a new highly restrictive abortion law takes effect in Georgia.

During a CNN town hall on Sunday night, as our colleagues Hamza Shaban and Rachel Siegel report, the network's Jim Sciutto asked the California Democrat if he supports the boycott from some businesses and industries — such as major film and TV studios — that have warned they would pull out of Georgia because of the so-called “heartbeat bill," which bans abortions once a fetal heartbeat can be detected. 

“If that law goes into effect, I absolutely do. And CNN may have to move — there’s a lot of young women who work for CNN who could be affected,” Swalwell said, receiving applause from the town hall’s audience.

— At another town hall on Sunday night, presidential contender Sen. Kirsten Gillibrand (N.Y.), took the opportunity while appearing on Fox News to criticize the network for terminology it has used while covering the issue of abortions late in pregnancy.

I want to talk about the role Fox News plays in this, because it’s a problem,” Gillibrand said. She specifically referenced the use of the term “infanticide” by hosts and guests on Fox News.

“Infanticide, it doesn’t exist,” Gillibrand said, as our Post colleague John Wagner writes.

Fox News anchor Chris Wallace interrupted Gillibrand to suggest the New York Democrat wanted to attack the network to “make your credentials with the Democrats who are not appearing on Fox News.”

But Gillibrand, insisting her point would be “polite,” once again noted the use of “infanticide”: “It doesn’t happen. It’s illegal. It’s not a fact. And I believe all of us have a responsibility to talk about the facts.”

— John Delaney, a former Maryland congressman and another member of the growing Democratic presidential field, was booed over the weekend during his remarks about Medicare-for-all at California Democratic Party convention. And his comments also sparked a Twitter feud with Rep. Alexandria Ocasio-Cortez (D-N.Y.).

Audience members were displeased when Delaney said, “Medicare-for-all may sound good, but it’s actually not good policy, nor is it good politics.”

Ocasio-Cortez suggested his remarks, which she called “awful” and “untrue,” were reason for Delaney to bow out of the presidential race:

In response, Delaney called for the New York Democrat to debate him on health care, saying he and Ocasio-Cortez have similar goals:

He followed up Monday morning with a tweet criticizing “intolerance” of different views within the party. And in a statement, Michael Starr Hopkins, Delaney’s national press secretary, took a jab at the freshman Democrat, as our Post colleague John Wagner reports, saying the “only person Congresswoman Ocasio-Cortez helped with her tweet about Congressman Delaney was Donald Trump.” He added: “2016 should have taught us that if we allow this primary to become a popularity contest on Twitter rather than a debate of ideas in the public square, the country will lose.”

STATE SCAN

— D.C. Mayor Muriel Bowser (D) announced plans to create a commission to recommend changes to the District’s health-care system, which has been dealing with the aftermath of two incidents: the closure of the city’s oldest hospital and the closure of the obstetrics ward at United Medical Center. The commission is set to make its recommendations to Bowser by December.

“The 26-member commission will include representatives from hospitals, insurers, health advocacy groups and D.C. government agencies,” our Post colleague Fenit Nirappil reports. “It will be co-chaired by former Council member David Catania, who now runs a lobbying firm, and Sister Carol Keehan, who recently retired as chief executive of the Catholic Health Association of the United States.”

The group is also meant to recommend a solution to the lack of an urgent care center in Southeast Washington. It will also recommend solutions for improving maternal and behavioral health care in the city.

— And here are a few more good reads: 

With two large outbreaks pushing the country’s measles count to a quarter-century high, officials are starting to grapple with an unpleasant prospect.
Stat
MEDICAL MISSIVES
Virginia Politics
The event would be the first time Gov. Ralph Northam, Lt. Gov. Justin Fairfax and Attorney General Mark Herring have gathered in public since their scandals.
Gregory S. Schneider
The tweet comes after the presidential hopeful's remarks on the NRA at a Sunday Fox News town hall.
Politico
INDUSTRY RX
The cheers for the health tools were a bit subdued compared to the applause when Apple executives touted new photo-editing capabilities for the iPhone.
Stat
REPRODUCTIVE WARS
The president of the nation’s largest anti-abortion advocacy group said Monday night it would spend $41 million in the 2020 cycle to re-elect President Trump and “pro-life” members of Congress while advocating for more abortion restricti
The Hill
DAYBOOK

Today

  • The Senate Judiciary Subcommittee on Intellectual Property holds a hearing on patent eligibility.
  • House Energy and Commerce Subcommittee on Health holds a hearing on “Investing in America’s Health Care."
  • The House Veterans Affairs Subcommittee on Economic Opportunity holds a hearing on “Evaluating the Effectiveness of VA Vocational Rehabilitation and Employment programs."

Coming Up

  • The Senate Judiciary Subcommittee on Intellectual Property holds a hearing on patent eligibility on Wednesday.
  • The Senate Veterans Affairs Committee is scheduled to hold a meeting on pending nominations on Wednesday.
  • Axios hosts an event on health care and drug pricing with Sens. Chuck Grassley (R-Iowa) and Debbie Stabenow (D-Mich.) and former FDA commissioner Scott Gottlieb on Wednesday.
SUGAR RUSH

A look at James Holzhauer’s hot streak on Jeopardy!: