While government officials from the White House to Capitol Hill have insisted they are trying to tackle the U.S. opioid epidemic, a news investigation revealed how former Drug Enforcement Administration, or DEA, agents and lawyers worked with industry and some members of Congress to weaken the agency's authority to rein in the problem.
"Some of the best and brightest former DEA attorneys are now on the other side and know all of the weak points," Jonathan Novak, a former attorney at the agency, told CBS' "60 Minutes" and the Washington Post, which had conducted a joint investigation into the opioid crisis. "Their fingerprints are on memos and policy and emails."
The report revealed that in recent years, 46 DEA investigators, attorneys and supervisors had left to work for the pharmaceutical industry or law firms that represent drug manufacturers or distributors — Washington's notorious revolving door.
The Post and 60 Minutes alleged that their investigation uncovered documents showing that one former associate chief counsel at the DEA, who now works for healthcare distributing giant Cardinal Health Inc. — a company he used to regulate — helped to craft the legislation that curtailed the agency's enforcement powers. The bill, enacted last year, has made it more difficult, if not impossible, for the DEA to freeze shipments of opioids from distributors to rogue pharmacies, Novak said.
"The drug industry — the manufacturers, wholesalers, distributors and chain drugstores — have an influence over Congress that has never been seen before," Joseph Rannazzisi, a former deputy assistant administrator in the DEA's Office of Diversion Control, told 60 Minutes and the Post. "These people came in with their influence and their money and got a whole statute changed because they didn't like it."
Rannazzisi had frequently testified before Congress about the opioid crisis and also testified before the FDA during a two-day public meeting in January 2013, where he warned about the ease with which hydrocodone combination products were obtained by abusers.
The Republican sponsors of the DEA bill — Reps. Tom Marino of Pennsylvania and Marsha Blackburn of Tennessee and Sen. Orrin Hatch of Utah — received large political contributions of over $100,000 each while the legislation was being pushed through Congress, according to the 60 Minutes and Post report.
Marino was nominated in September by President Donald Trump to be the next director of National Drug Control Policy. Trump vowed on Aug. 10 to declare the opioid crisis a national emergency but has yet to complete the legal paperwork to do so.
Biden ignored at 'moonshot' partnership launch
At an Oct. 12 press briefing to unveil a repacked initiative from the Obama administration, officials from the National Institutes of Health, or NIH, tiptoed around, if not completely ignored, the key driving force behind the public-private partnership: former Vice President Joe Biden.
Former President Barack Obama had declared in his last State of the Union address on Jan. 12, 2016, that he was creating a new national effort to address cancer similar to the type of initiative that put humans on the moon — a program he charged Biden to lead.
The then-vice president had already been working for months on getting such an initiative underway, after declaring in October 2015 that he would not make a run for the White House and wanted to instead help speed up development of treatments and cures for cancer, which had taken the life of his son, Beau, earlier that year.
"I believe that we need a moonshot in this country to cure cancer," Biden said Oct. 21, 2015, from the White House Rose Garden.
"The science is ready," Biden later wrote in a Jan. 12, 2016, Medium article, saying he was ready to take on the cancer moonshot mission.
Part of that effort was a planned public-private partnership with a dozen drugmakers, known as PACT — the Partnership for Accelerating Cancer Therapies — which the Obama White House first disclosed as part of Biden's June 29, 2016, Washington summit held at Howard University.
But at the Oct. 12 briefing, neither NIH Director Francis Collins nor any other official acknowledged Biden's work in getting the moonshot project underway and his influence and effort in getting Congress to allot the PACT funds — much of which are coming from the 21st Century Cures Act, signed by Obama in December 2016.
Also avoided was any discussion about Trump's request to cut the NIH's 2018 budget by over $6 billion — a demand lawmakers from both sides of the aisle have indicated that they do not intend to fulfill.
The companies participating in PACT are AbbVie Inc., Amgen Inc., Boehringer Ingelheim, Bristol-Myers Squibb Co., Celgene Corp., Roche Holding AG U.S. unit Genentech, Gilead Sciences Inc., Johnson & Johnson unit Janssen Pharmaceutical, Novartis AG and Pfizer Inc.
Merck & Co. Inc. had initially been interested and was included in the design phase, but elected not to join PACT, Abbey Meltzer, director of communications at the Foundation for the NIH, told S&P Global Market Intelligence.
Collins — who has remained on the job under Trump after nearly eight years with Obama — told reporters in June 2016 at the Biden summit that he had reason to be optimistic that such a public-private partnership could be successful because of a similar ongoing $230 million collaboration targeting medicines for Alzheimer's, type 2 diabetes and the autoimmune diseases rheumatoid arthritis and systemic lupus erythematosus.
While the costs are equally split in the $230 million Accelerating Medicines Partnership, the government is funding most of the $215 million for PACT: $160 million from taxpayers, versus $55 million from industry.
Halting subsidies will trigger dire consequences, groups warn
The backlash continued through the weekend over the Trump administration's Oct. 12 decision to end subsidies paid under the Affordable Care Act, or ACA, intended to help eligible Americans cover their out-of-pocket costs for prescription drugs and doctor visits.
If Congress does not step in and take action, "there will be serious consequences," the U.S. Chamber of Commerce and some of the nation's largest medical, hospital and insurance groups warned in a joint Oct. 14 letter to House and Senate leaders.
The decision to discontinue the cost-sharing reduction payments "stands to hurt the most vulnerable individuals and families, raising cost for them and the federal government," a cadre of physician groups said in a separate statement.
"Hospitals should see rising bad debt in 2018," as copayments and deductibles go unfunded, Mizuho Securities USA analyst Sheryl Skolnick said in an Oct. 13 analyst note. "We would expect rising numbers of no-pay heads in hospital beds, even more than we thought might happen prior to this order."
Trump's decision to scrap the annual $7 billion in subsidies has already drawn one multiparty lawsuit from attorneys general of 18 states and the District of Columbia, and more legal disputes could come.
What Trump has done is "affecting the ability of vulnerable people to receive health care right now," Sen. Susan Collins, R-Maine, said during an Oct. 15 appearance on CNN's "State of the Union."
An executive order Trump signed Oct. 12 aimed at dismantling certain portions of the ACA also would negatively affect Americans' access to healthcare and the costs they pay, Collins added on ABC's "This Week."
But her Republican colleagues Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — the co-authors of the latest failed attempt to repeal the ACA — argued on separate Sunday political programs that Trump had made the right moves with stopping the cost-sharing reductions and signing his executive order.
Cassidy, who was on Fox News Sunday, and Graham, who appeared on CBS' "Face the Nation", however, agreed with Collins that Congress needs to pass a bill with some short-term ACA fixes, including continuing the cost-sharing reduction payments for a period.
Graham, who played golf with Trump over the weekend, said the president on Oct. 14 had called Sen. Lamar Alexander, R-Tenn., who is negotiating on a bipartisan deal with Sen. Patty Murray, D-Wash.
"He's encouraging him to get a bipartisan deal that would have some flexibility," Graham said about Trump's call. "But it's got to be a good deal."