The health impact in Scott County with a population of 25,000 was catastrophic: 88% of the patients infected with HIV injected Opana ER or a generic with oxymorphone — a highly profitable opioid with a trail of misery formed over decades by the Malvern, Pa., drug firm Endo Pharmaceuticals Inc. Opana ER, the most sought Endo pill, was the “cornerstone” of the company’s pain-management business, the government says, the Philadelphia Inquirer reported. In 2017, two years after the Indiana crisis, the Food and Drug Administration requested that Endo remove the crush-resistant Opana ER pills from the market as drug users were shifting from snorting to injecting oxymorphone. Thousands of government and private organizations have sued Endo for its alleged part in the nation’s opioid epidemic, which government experts say has claimed more than 500,000 lives in America. Michael Carrier, a Rutgers Law professor who has studied pharmaceutical antitrust behavior for 15 years. But oxymorphone is still a big money-maker for Endo, whose patent for the drug makes it the medication’s “gatekeeper,” the government says. The FDA didn’t ban oxymorphone in 2017, and generic pills based on Endo’s original Opana ER formulation are still available for doctors to prescribe for cancer, lower back and other pain. Endo estimated in 2017 that a royalty stream from the oxymorphone ER generic pills over time was worth “close to $265 million” — non-crush-resistant pills that Endo once told the FDA should be taken off the market for safety. Endo controls a critical patent on the generic pills through 2029. Because of patents, Endo earns a percentage of the “monopoly” profits on the generic pills distributed by Impax Laboratories LLC, a 2021 Federal Trade Commission lawsuit says. The FTC, which enforces consumer protection laws, is asking the federal court to find that the agreement between Endo and Impax violates antitrust laws and seeks unspecified monetary damages.
