USA — Two of the largest U.S. pharmacy chains, CVS Health and Walgreen Co., have announced agreements in principle to pay about US$5 billion each to settle lawsuits nationwide over the toll of opioids.

Under the tentative plans, CVS would pay US$4.9 billion to local governments and about US$130 million to Native American tribes over a decade.

Walgreens would pay US$4.8 billion to governments and US$155 million to tribes over 15 years. The exact amount depends on how many governments join the deals. Neither CVS nor Walgreens admitted any wrongdoing

The developments could amount to the final round of large settlements following years of litigation over the drug industry’s role in an overdose crisis that has been linked to more than 500,000 deaths in the United States over the last two decades.

In the lawsuits, governments said pharmacies filled prescriptions they should have flagged as inappropriate.

The deals call for most of the funds from Woonsocket, Rhode Island-based CVS, and Deerfield, Illinois-based Walgreens to be used to fight the opioid crisis through such efforts as expanding treatment and support programs for people with addiction, along with providing overdose antidotes and launching prevention efforts.

The companies noted they have launched educational programs and installed safe disposal units for drugs in stores and police departments, among other measures designed to reduce misuse of opioids.

As one of the largest pharmacy chains in the nation, we remain committed to being a part of the solution, and this settlement framework will allow us to keep our focus on the health and wellbeing of our customers and patients, while making positive contributions to address the opioid crisis,” Walgreens said in a statement.

The proposed agreements bring the total amount of finalized and completed settlements between companies and governments in the United States to more than US$50 billion.

Prescription drugs were initially involved in the majority of the nation’s opioid overdose deaths. People addicted to them increasingly switched to heroin, which proved more lethal, as governments, doctors, and companies took steps to make them harder to abuse and obtain.

In recent years, opioid deaths have reached record highs of around 80,000 per year. The majority of those deaths are the result of an illicitly produced version of the powerful lab-made drug fentanyl, which is becoming more prevalent in the illegal drug supply in the United States.

A congressional report last month put the economic toll of the opioid crisis in 2020 alone at US$1.5 trillion.

The settlements were announced as litigation over pharmacies’ roles in the opioid crisis intensified. Other 18 companies, the majority of which are pharmacy-related, submitted reports to a judge overseeing opioid litigation outlining the locations where they face lawsuits.

Only a few opioid settlements have been worth more than the CVS plan. This year, distributors AmerisourceBergen, Cardinal Health, and McKesson reached a US$21 billion settlement, while drugmaker Johnson & Johnson reached a US$5 billion agreement.

Purdue Pharma, the maker of OxyContin, and members of the Sackler family, who own the company, have proposed a settlement involving up to US$6 billion in cash plus the value of the company, which would be transformed into a new entity with profits used to combat the epidemic.

A court has put that plan on hold.

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