State’s expert admits bias against opioids

An attorney for opioid manufacturers on Wednesday played a recording of the state's star witness acknowledging she was biased in a $50 billion false advertising trial in which several local governments accused Purdue Pharma and other drugmakers of downplaying in promotion materials the risks of prescription drug addiction.

Testifying via Zoom Tuesday, Dr. Anna Lembke of Stanford School of Medicine, a key witness for the state, said one in four patients become addicted after being prescribed opioids for pain; a fact directly contradicting drugmakers' marketing messages that prescription opioid addiction is rare.

However on cross examination Wednesday, Endo Pharmaceuticals Inc.'s attorney Moez Kaba of Hueston Hennigan LLP, played an NPR radio interview in which Lembke said she had a bias against opioid drugs formed by her experience treating patients for addiction.

"Since you're only seeing the patients who are addicted, and you're not seeing patients for whom opioids...or whatever worked really effectively, do you think that you're biased...?" radio show host Terry Gross asked in 2016.

"I'm totally biased... I mean, there's no doubt about it," Lembke replied.

"No further questions, your honor," Kaba said after playing the tape.

The outcome of the monumental bench trial being tried remotely before Superior Court Judge Peter Wilson could provide a roadmap for thousands of settlements in lawsuits filed nationwide by states and local municipalities that claim Purdue and other opioid producers fueled a crisis by deceptively marketing their drugs and downplaying the risk of addiction. Filed by four California municipalities, the people seek $50 billion in funds to abate the opioid crisis in the plaintiff counties and city, according to attorneys involved in the suit. People v. Purdue Pharma et al., 14-00725287 (Orange Super. Ct., filed May 21, 2014).

On redirect, Rhode Island plaintiffs' attorney Fidelma L. Fitzpatrick of Motely Rice LLC, played another segment of the NPR interview in which Lembke explained she never meant to say all opioid medications are bad but only wanted to emphasize the lack of awareness among doctors and patients of the risks of addiction.

"Was that context important?" Fitzpatrick asked.

"Yes, that context was very important," Lembke replied.

"My use of that word [biased], in retrospect, I regret," she said. "I was trying to say I had a strong and well-founded opinion based on research and experience."

The four main defendant companies are Teva Pharmaceuticals, Endo Pharmaceuticals Inc., Allergan PLC, and Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc. Purdue, also a named defendant, is sitting out the civil trial pending its bankruptcy proceeding in New York.

Each of the four drug makers are individually represented at trial and were each given a chance to cross examine Lembke on Wednesday.

Johnson & Johnson attorney Steven Brody of O'Melveny & Myers LLP also raised questions about Lembke's alleged prejudice by comparing Lembke's monthly expert witness salary that exceeds $22,000 and is paid by plaintiff attorneys in various opioid litigations. Brody compared Lembke to New York doctor Russell Portenoy, director of the Institute for Innovation in Palliative Care, who Lembke said Purdue paid to make statements downplaying the risks of opioid addiction.

When presented with the comparison, Lembke said she never received money from an opioid manufacturer and there was a "fundamental difference" between her and Portenoy.

The people's case,which is nearing a month in length, is expected to end early next week. As of now, the four drug companies have 45 potential witnesses on their list to call in the coming weeks, according to Fitzpatrick. However the defense is expected to trim that list when the people conclude their case in chief, the judge said.