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A lawyer for several large California communities accused four drugmakers of causing a deadly wave of opioid addiction with their aggressive marketing of pain pills, while defense attorneys said the firms followed the law, on the opening day of a trial closely watched by the pharmaceutical industry. “Without an avalanche of prescription opioids, there wouldn’t be an opioid epidemic,” said Fidelma Fitzpatrick, a plaintiffs’ lawyer hired to represent the counties of Los Angeles, Orange and Santa Clara and the city of Oakland. (Randazzo, 4/19)

A California judge may soon provide a clearer picture of what it will cost drug makers including Johnson & Johnson and Teva Pharmaceutical Industries Ltd. to resolve liability for their role in the U.S. opioid epidemic. The first trial against opioid companies in almost two years started Monday in Santa Ana, where four California municipalities are demanding at least $50 billion for what they claim was the illegal marketing of pain pills. The case, which will be decided without a jury and tried virtually, may be a road map for thousands of similar claims pending against drug makers, distributors and pharmacies. (Feeley, 4/19)

The family behind the OxyContin maker Purdue Pharma was already under intense legal and public scrutiny when they learned in 2019 that comedian John Oliver was planning to do a segment about them on his show, “Last Week Tonight.” But being the target of a social commentary like Oliver’s struck a chord for at least one member of the Sackler family. (Joseph, 4/20)

Dozens of patient advocacy groups are angry over an unusual move by a health insurer that recently began offering $500 debit cards to people who agree to switch psoriasis medicines after it removed a widely used drug from several of its formularies. At issue is a decision by Cigna (CI) to offer the debit cards as an incentive to psoriasis patients to try alternatives to a Novartis (NVS) treatment called Cosenytx. (Silverman, 4/19)

Proposed state legislation filed in response to a years-long feud between an Asheville neighborhood and a local needle exchange could threaten syringe exchanges across North Carolina. Senate Bill 607 seeks to ban mobile exchanges, require engraved needles, background checks, forced treatment and more. Meanwhile, opioid overdose deaths are at an all-time high. (Knopf, 4/20)

The owner of Parexel International Corp., which helps drugmakers run clinical trials, is working with an adviser on a potential sale that could value the company at several billion dollars, according to people familiar with the matter. Private equity firm Pamplona Capital Management is also considering taking Parexel public, said one of the people, who asked to not be identified because the matter isn’t public. It has drawn takeover interest from private equity firms and other companies, the people said. (Davis, Baigorri and Porter, 4/19)