Big Pharma Behind the Scenes: Patients, Profits and Penalties

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Publish Date:
March 31, 2026
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Source:
Drugwatch
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Summary

Nora Freeman Engstrom, the Ernest W. McFarland Professor of Law at Stanford Law School, told Drugwatch that lawsuits serve as an “information-forcing function.”

“Probably the most important thing tort law does … is not about the money obtained, but it’s the information unearthed,’ Engstrom told Drugwatch.

She said that discovery — the formal pre-trial process where parties gather evidence and exchange information about witnesses, documents and facts — “has a way of shaking the pockets of companies.”

The ARCOS data, which Engstrom calls the “Rosetta Stone of the opioid crisis,” showed billions of oxycodone and hydrocodone pills flooding the U.S. from 2006 to 2019. Some small-town pharmacies took millions of doses for tiny populations, like the more than 10 million pills that passed through Tug Valley Pharmacy in Mingo County, West Virginia.

The DEA had the data but did nothing. Lawsuits unsealed it after a media fight, proving “beyond a shadow of a doubt,” as Engstrom put it, the complicity of distributors and pharmacies pumping pills into poor communities.

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