Oklahoma Wins $572 Million From Johnson & Johnson In Opioid Trial. What's That Cover? : Shots - Health News The $572 million judgment against Johnson & Johnson will cover one year of addiction treatment and prevention the judge says. But health economists predict it will take decades to abate the problem.

Oklahoma Wanted $17 Billion To Fight Its Opioid Crisis: What's The Real Cost?

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Now, as we mentioned, Oklahoma was asking for more than $17 billion in this case. That's billion with a B. But the judge awarded only about 3% of that. How did Oklahoma come up with that $17 billion number in the first place? NPR's Selena Simmons-Duffin explains.

SELENA SIMMONS-DUFFIN, BYLINE: That $17 billion figure comes from a report put together by this guy.

CHRISTOPHER RUHM: I'm Christopher Ruhm. I'm a professor of public policy and economics at the University of Virginia.

SIMMONS-DUFFIN: Ruhm had done work on the costs of the opioid epidemic before, and Oklahoma asked him to put numbers to a 30-year plan to abate the opioid crisis. This is looking forward - not the costs of damages for lives lost but, rather, the cost of treatment and prevention.

RUHM: To take one example; addiction treatment services, which includes a variety of things. It includes inpatient services, outpatient services, you know, residential care, a wide variety of things. You're talking a cost there on the order of $230 million per year. And so if you take that over a 30-year period and then you discount it to net present value and all the things economists do, you come up with a cost for treatment services of just under $6 billion.

SIMMONS-DUFFIN: That gets you more than a third of the way there. The rest comes from all sorts of things - public and physician education programs, treatment for babies who are born to mothers who used opioids, data systems for pharmacists to better track prescriptions, grief support groups and on and on. Add up what all of that would cost over 30 years. The number Ruhm got was more than 17 billion.

RUHM: Let's be clear. It is a lot of money. It's also a major public health crisis.

SIMMONS-DUFFIN: Nationally, 46 people die every day from prescription opioids, and more people die from drug overdoses every year than died at the peak of the AIDS crisis or from traffic accidents.

RUHM: You know, it's something that has occurred over a large number of years. It's going to take, you know, a good deal of time to fully deal with it. And yes, it is expensive.

SIMMONS-DUFFIN: Today's verdict does not mean Oklahoma is now going to spend the $570 million it was awarded on all of these things in these proportions. It will be up to state officials and lawmakers to decide how to actually use the money it ultimately gets, and that will probably be nowhere near Ruhm's projection of what's needed.

Health economist Kosali Simon at Indiana University says, actually, the $17 billion figure didn't seem that big to her.

KOSALI SIMON: In general, these numbers tend to be large because we're thinking over a long time period. We're thinking about a 30-year horizon.

SIMMONS-DUFFIN: She compares Ruhm's report to what economists did after the Exxon Valdez oil spill in 1989, estimating what it would cost to return the environment as closely as possible to pre-spill - except in this case, there isn't one oil spill. There's an opioid epidemic in every state.

SIMON: This report is going to be a very important and useful baseline against which other states can consider their own situation.

SIMMONS-DUFFIN: She says, nationally, it would cost way more than taking Oklahoma's numbers and scaling them up. The country needs to invest in research on what treatment options work best, develop better addiction treatment drugs, et cetera. Then there's the question, once you have fully accounted for all of these costs, of who should pay.

SIMON: The economist's job is to think, how much money does it take now to abate the setting? Whose pocket that should come from is an entirely different and, I think, much more difficult question for society to answer.

SIMMONS-DUFFIN: Today, the judge said a drugmaker should pay at least some of those costs. There are hundreds of other opioid cases around the country, and those judges might come to different conclusions.

Selena Simmons-Duffin, NPR News.

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