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Endo International PLC has tapped a financial restructuring adviser to help the drugmaker evaluate its options for dealing with thousands of lawsuits alleging it contributed to the opioid crisis, WSJ Pro Bankruptcy reported. Endo has engaged consulting firm Alvarez & Marsal Holdings LLC to advise on options that could include a balance-sheet restructuring that would address the company’s liability from litigation around its opioid drugs, as well as its more than $8 billion in debt. As of July, there were nearly 3,000 legal cases pending against Endo from states, counties, cities and Native American tribes over opioids, as well as more than 300 lawsuits from hospitals, health systems, unions, and health or welfare funds. Opioid producers Mallinckrodt PLC, Purdue Pharma LP and Insys Therapeutics Inc. all have turned to chapter 11 since 2019 to drive settlements with state and local authorities alleging the companies contributed to widespread addiction. Endo, which has operations in Malvern, Pa., but is domiciled in Ireland following a 2014 corporate tax inversion, has said that by 2017, it ceased promoting opioid products to healthcare professionals and eliminated the company’s entire pain-product sales force. It also voluntarily withdrew its drug Opana from the market and discontinued the research and development of new opioid products.

Thirty-eight states have enacted emergency orders or laws intended to immunize companies and individuals for care related to the pandemic, according to a tally compiled National Consumer Voice, a nonprofit watchdog organization focused on nursing homes, the Washington Post reported. The public conversation in most of the states was that hospitals, doctors, and long term care facilities should not be held legally responsible for COVID-19 infections and deaths in a viral pandemic that overwhelmed medical systems and long-term care centers. In nursing homes and assisted-living facilities, at least 185,000 people have died of COVID-19 infections, according to the nonprofit, nonpartisan Kaiser Family Foundation. What’s new in North Carolina is that it’s the first state where immunity claims are being cited in court by facilities to defend themselves against cases that are not related to COVID-19 infection and treatment. Such arguments could be more common. Just three of the 38 states with pandemic immunity laws specifically restrict the protections to COVID-19 exposure or infection, according to the survey by National Consumer Voice. The rest of the states have broader language that could cover most forms of harm experienced by patients and residents during the pandemic, according to the organization. North Carolina’s law says immunity applies to the delivery of care “directly or indirectly” impacted by the pandemic. Most of the states have exceptions for acts of “gross negligence” or those in a lack of good faith, higher standards than the usual negligence allegations that are found in nursing home lawsuits over issues like bed sores, falls, dehydration, choking, undiagnosed or untreated infections, and medication errors.

Former Purdue Pharma LP director Mortimer D.A. Sackler testified Thursday he was “shocked and disappointed” when he learned last year the drugmaker his family owns pleaded guilty to federal felonies over its marketing and sale of the opioid OxyContin, saying management assured the board it was complying with relevant laws, WSJ Pro Bankruptcy reported. Sackler said during the second week of a trial in Purdue’s bankruptcy case that before he left the drugmaker’s board in late 2018, briefings by management indicated the company was successfully curbing OxyContin abuse while getting the painkiller to patients with legitimate medical needs. The board got updates on a reformulated, abuse-deterring version of OxyContin as well as an internal program to identify doctors who were overprescribing the drug, Sackler said. He added that management repeatedly told the board that, “Purdue was going above and beyond. We were doing things that no other company had ever done in terms of trying to do that. Trying to reduce prescription opioid abuse.” Purdue filed for chapter 11 bankruptcy protection in September 2019 following an onslaught of lawsuits over OxyContin, the company’s flagship painkiller. The trial is scrutinizing a settlement that would shield Sackler family members from civil litigation accusing them of contributing to the opioid crisis in exchange for a roughly $4.5 billion contribution from them to fund opioid abatement programs. Purdue pleaded guilty last year to three federal felonies over its conduct stretching from 2007, when the company and three of its executives pleaded guilty earlier to federal charges of misleading the public about OxyContin’s addiction risk, to 2017.

Former Purdue Pharma LP president Richard Sackler distanced himself from a program pitched years ago by consulting giant McKinsey & Co. to increase OxyContin sales and denied that his family or the company are responsible for the opioid epidemic, WSJ Pro Bankruptcy reported. Dr. Sackler said that although he remembered having a call with McKinsey about research it had done for the drugmaker, he said during testimony on Wednesday in Purdue’s bankruptcy trial he didn’t recall some details about certain marketing and sale programs including an initiative called “Evolve to Excellence” that federal authorities have alleged led healthcare providers to write medically-unnecessary prescriptions of OxyContin, an opioid painkiller. McKinsey agreed earlier this year to a $573 million settlement with state authorities over advice it gave Purdue and other drugmakers on opioid painkillers, without admitting wrongdoing. Dr. Sackler’s testimony about the E2E program came during the second week of a bankruptcy trial scrutinizing a proposed settlement of litigation against he and other members of Purdue’s controlling family alleging they bear responsibility for fueling the opioid crisis. If approved, the agreement would shield the Sacklers from civil lawsuits over OxyContin in exchange for roughly $4.5 billion from family members to fund opioid abatement programs. The family would also cede control of Purdue under the proposal, which is being challenged by a handful of state and federal authorities.

U.S. states are racing to meet a deadline to commit to a $26 billion opioid settlement with three drug distributors and the drugmaker Johnson & Johnson, as some grapple with local resistance and concerns the amount isn't big enough to address the damage done by an epidemic of addiction, Reuters reported. Fourteen state attorneys general unveiled the proposed settlement with McKesson Corp., AmerisourceBergen Corp., Cardinal Health Inc. and J&J on July 21, kicking off a months-long process for states, counties and cities to sign on. By Saturday, states must decide whether to join settlements that call for the distributors to pay $21 billion and J&J to pay $5 billion, money meant to help fund treatment and other services. The epidemic of opioid abuse has resulted in nearly 500,000 overdose deaths since 1999, according to the U.S. government. The settlement's complex formula envisions at least 44 states participating, but ultimately the companies decide whether a "critical mass" have joined and whether to finalize the deal. North Carolina Attorney General Josh Stein, a lead negotiator, last month said he expected "well north" of 40 states to join. But several are against it, including Washington and New Mexico and communities in West Virginia holding out in hopes of recouping more. Michigan, South Carolina and Nevada say they are still evaluating the deal. Ohio, which was slated to take the distributors to trial next month, is nearing a separate, related $808 million deal with them. In hard-hit New Hampshire, Associate Attorney General James Boffetti said he recently told a judge the state was unlikely to join the deal with J&J, which the state plans to take to trial next year. "That settlement is small in comparison to the harm that they caused in New Hampshire and other places," he said. "It's just not sufficient." The settlement aims to resolve more than 3,000 lawsuits accusing the distributors of ignoring red flags that pain pills were being diverted into communities for illicit uses and that J&J played down the risks of opioid addiction. The companies deny wrongdoing, saying that the drugs were approved by the U.S. Food and Drug Administration and that responsibility for ballooning painkiller sales lies with others, including doctors and regulators. The participation of states is tied closely to that of their local governments, who brought the majority of lawsuits. Ultimately, $10.7 billion is tied to the extent localities participate.

Members of the family that owns OxyContin maker Purdue Pharma won’t contribute billions of dollars to a legal settlement unless they get off the hook for all current and future lawsuits over the company’s activities, one of them told a court Tuesday in a rare public appearance, the Associated Press reported. David Sackler, grandson of one of the brothers who nearly 70 years ago bought the company that later became Purdue, testified at a hearing in federal bankruptcy court in White Plains, New York, that without those protections, “I believe we would litigate the claims to their final outcomes.” “We need a release that’s sufficient to get our goals accomplished,” Sackler said in response to questions from a lawyer for the U.S. bankruptcy trustee. “If the release fails to do that, we will not support it.” That’s the heart of argument over the settlement plans of the family and the company, based in Stamford, Conn. Two offices of the U.S. Justice Department, nine states and the District of Columbia are objecting to the company’s settlement plan largely because it would grant legal protection to members of the wealthy Sackler family even though none of them are declaring bankruptcy themselves.

A member of the billionaire Sackler family that owns Purdue Pharma LP will likely take the stand later this week in bankruptcy court as part of the drugmaker’s opioid settlement trial, Bloomberg News reported. David Sackler, a descendant of Raymond Sackler, provided a sworn, written statement to the bankruptcy court about the sweeping releases he and other family members will receive if Purdue’s bankruptcy judge approves its proposed settlement. He’ll be made available for live questioning sometime this week, lawyers confirmed during the drugmaker’s chapter 11 proceedings on Monday. The exact timing wasn’t immediately disclosed. The testimony will be the first time any member of the Sackler family has appeared live in front of Purdue’s bankruptcy judge. David Sackler testified at a House Oversight Committee meeting in December, denying claims that his family improperly shifted billions of dollars from sales of the controversial opioid-based painkiller OxyContin to offshore accounts. Purdue is in the midst of a multi-week trial over its proposed settlement of trillions of dollars in legal liabilities. The deal, which the company says is worth more than $10 billion in total, would see members of the Sackler family pay about $4.3 billion in exchange for broad protection from OxyContin lawsuits. Some critics of Purdue’s bankruptcy argue that the chapter 11 proceedings have allowed the drugmaker’s owners to avoid accountability for their role in the U.S. opioid crisis. The proceedings are taking place remotely due to COVID-19 protocols, and Sackler would testify by videoconference. Members of the public can listen in by telephone.

Purdue Pharma LP and its owners, members of the Sackler family, are nearing the end of their decades-long association with opioids, seeking court approval to pay billions of dollars and walk away from the business that helped make their fortune, Bloomberg News reported. U.S. Bankruptcy Judge Robert Drain today will begin what’s expected to be an 11-day trial -- the longest in his career -- to review a proposal the company values at more than $10 billion to settle trillions of dollars in liabilities over its addictive painkiller OxyContin. If Purdue’s plan is approved, the family will pay $4.5 billion over nine or 10 years and essentially hand over the keys to the business, with almost all future proceeds benefiting states, counties and cities hit hard by the opioid epidemic. In exchange, the Sacklers get lifetime immunity from a broad array of opioid-related lawsuits. If the settlement is rejected, family members would likely find themselves ensnared in costly litigation that would drag on for years.

Operational expenses continue to outstrip revenues for the Springfield (Vt.) Hospital, which exited chapter 11 bankruptcy in December, according to the hospital’s filings with the Green Mountain Care Board, the Valley News reported. Some of the ongoing revenue issues can be chalked up to the COVID-19 pandemic and a related reduction in visits, as well as recovery from the bankruptcy, but it’s not clear how much. “We’re hopeful that it … ends up being a sustainable venture obviously,” said Andrea DeLaBruere, the executive director of the Vermont Agency of Human Services. Springfield Hospital projects to finish the fiscal year on Sept. 30 with a negative operating margin of $3.35 million, more than 6% of its total budget of $52.6 million, according to filings with the GMCB. That loss is smaller than the $5.3 million negative operating margin the hospital booked last year and the $9 million negative margin it booked in 2019. As of July 15, when it filed its budget proposal with the GMCB, the hospital reported 18 days of cash on hand. This is in spite of being the only hospital in the state to receive financial assistance in the past six months for “necessary expenditures incurred due to the public health emergency with respect to COVID-19,” said DeLaBruere.

OxyContin maker Purdue Pharma LP laid out a defense of its chapter 11 plan, containing a multibillion-dollar settlement with its owners, before a high-stakes bankruptcy trial pitting the company against certain government authorities, WSJ Pro Bankruptcy reported. Purdue said its proposal provides the most money possible to fight the opioid crisis and rebutted legal challenges from nine states, the District of Columbia as well as the Justice Department’s bankruptcy unit in a 232-page legal brief filed in the U.S. Bankruptcy Court in White Plains, N.Y. The filing, submitted on Thursday, previews legal arguments that will be central to the trial, scheduled to start next week. If Purdue prevails and its plan is approved by U.S. Bankruptcy Judge Robert Drain, the business would emerge from bankruptcy as a new company tasked with addressing the epidemic and providing treatment for opioid addiction and overdoses. The plan is backed by most states and is broadly supported by committees representing the interests of opioid victims and local governments. Purdue filed for bankruptcy in September 2019, seeking refuge from lawsuits blaming it for fueling the opioid crisis. The company last year pleaded guilty to federal felonies over its sale and marketing of opioids. On Thursday, Purdue said the plan it forged since its chapter 11 filing dedicates most of its assets “to funding critical and much needed opioid abatement programs in communities that have long been impacted by the opioid crisis.”