Four US drugs giants have approved to pay $26bn to resolve claims they helped fuel an opioid addiction crisis.
Three drugs distributors are expected to pay $21 billion, according to the proposal revealed by a group of state attorney generals on Wednesday.
Drug-maker Johnson & Johnson (J&J) will pay $5 billion over the next five years.
The New York attorney general Letitia James said in a statement the firms fuelled “the fire of opioid addiction for more than two decades”.
“While no amount of money nor any action can ever make up for the hundreds of thousands of lives lost or the millions more addicted to opioids, we can take every action possible to avoid any future devastation.”
The proposed agreement would resolve nearly 4,000 claims in federal and state courts against the four companies, if approved by a significant number of states and governments.
McKesson, Cardinal Health and AmerisourceBergen were accused of ignoring shipments of painkillers being diverted to illegal channels, while J&J allegedly downplayed the the risk of addiction in its marketing materials for opioids, which the firm stopped making in 2020. All companies have denied the allegations.
Opioids are a class of powerful drugs found in opium poppies that can be used to block pain signals between the brain and the body.
They can be found as legal prescription medications, but they can also be found as illegal street drugs, such as heroin.
Opioid addiction to both legal and illegal drugs has been a serious, ongoing problem in countries such as the US, which had nearly half a million deaths from overdoses between 1999 and 2019, according to the US Centers for Disease Control and Prevention.