Who joins Purdue on pharma's top 10 settlements list? Merck, GSK and Pfizer, for starters

Purdue’s pending opioid settlement with thousands of cities and counties, worth between $10 billion and $12 billion, could rank as the largest deal ever inked by a pharma if it passes a Cleveland federal judge’s muster. But where do pharma’s other major settlements fall on that list?

The top 10 largest federal settlements list is a who’s who of some of pharma’s biggest companies, including Merck, Pfizer, Johnson & Johnson and Eli Lilly.  

If Purdue’s deal is approved, it would more than double the amount from the closest federal settlement—Merck takes an ignoble second place with a Vioxx settlement signed in 2007—but it could be eclipsed by other drugmakers ensnared in national opioid lawsuits.

Here’s the list of pharma’s top 10 largest U.S. settlements.

1. Purdue Pharma—$10 billion to 12 billion*

Purdue’s path to the negotiating table was a long one, as the OxyContin maker and its billionaire founding family, the Sacklers, have become the face of the nation’s opioid epidemic. On Wednesday, the drugmaker reportedly inked a $12 billion deal with thousands of cities and counties and 23 states that would immediately send the drugmaker into bankruptcy and restructuring. The deal isn’t just a hit to the company: The Sacklers would be required to shell out $3 billion of their own money as part of the deal.

*Note: Purdue’s settlement is still pending approval.

RELATED: Purdue inks multibillion-dollar opioid deal with thousands of local governments, 23 states: reports

2. Merck & Co.—$4.85 billion

Once thought to be a potential $25 billion liability, Merck’s $4.85 billion settlement over arthritis drug Vioxx’s heart risks was considered a bargain at the time despite holding down first place in pharma’s settlement rankings for years. The nearly $5 billion payout wasn’t the last time Vioxx gave Merck headaches. As recently as 2016, Merck settled for an additional $830 million, which followed separate deals of $950 million and $220 million in 2011 and 2012, respectively. All told, the drug cost Merck at least $6.85 billion in settlements.

RELATED: Merck settling Vioxx claims for $4.85B

3. American Home Products Corp. (now Wyeth)—$3.75 billion

The oldest settlement on the list is also one of the largest. In 2000, American Home Products Corp. agreed to pay $3.75 billion three years after its weight loss combo “fen-phen” was linked to serious heart valve problems. $1.5 billion of that settlement was divvied up among injured patients based on severity, with an additional $1 billion set aside for future medical checkups, Reuters notes.

4. GlaxoSmithKline—$3 billion

GlaxoSmithKline settled a raft of accusations with its $3 billion deal in 2012, making it the single largest healthcare fraud agreement in U.S. history. As part of the deal, GSK agreed to plead guilty to a three-count criminal information, including two counts of introducing misbranded drugs, Paxil and Wellbutrin, into interstate commerce and one count of failing to report safety data about the drug Avandia to the FDA.

RELATED: GlaxoSmithKline to Plead Guilty and Pay $3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data

5. Pfizer—$2.3 billion

Pfizer was knocked hard by the DOJ in 2009 for various marketing infractions for a range of drugs, leading to a then-record $1.3 billion criminal penalty as part of its overall settlement. Pain drugs Bextra and Celebrex proved to be particularly costly for Pfizer, with the drugmaker as recently as 2016 agreeing to shell out $486 milion to settle a long-running shareholder suit alleging Pfizer withheld information on the drugs’ cardiovascular risks.  

RELATED: Pfizer's Bextra settlement tagged at $486M

6. Takeda—$2.3 billion

Facing cancer risks for its diabetes drug  Actos, Takeda reached a sweeping $2.3 billion deal in 2015 to clear the air over the drug. The deal was reached soon after a Louisiana judge ordered the drugmaker to pay $9 billion over its health concerns. That verdict was eventually cut to a much more manageable $36.8 million. The settlement was a major coup for then-new CEO Christopher Weber, who had taken over the role only five months earlier.

RELATED: Takeda gets enough takers to complete $2.3B Actos settlement

7. Johnson & Johnson—$2.2 billion

Following eight years of accusations that it marketed antipsychotic drug Risperdal off label—including for use in children and teens before the drug was approved for those age groups—and shelled out doctor kickbacks, J&J agreed to settle with the DOJ for $2.2 billion. The settlement also closed probes into other J&J drugs, including antipsychotic Invega and heart drug Natrecor. The $1.2 billion in criminal penalties ranked as the second largest fine ever levied at the time.

RELATED: J&J to pay $2.2B to wrap up long-standing Risperdal marketing probe

8. Abbott Laboratories—$1.6 billion

Abbott cleared the deck of long-running off-label marketing claims when it settled with the DOJ for $1.6 billion in 2012. Abbott pleaded guilty to a single misdemeanor violation of the Food, Drug and Cosmetics Act, acknowledging that it fielded a sales force specifically trained to market Depakote in nursing homes for off-label use in elderly dementia patients. The promotions continued after adverse events prompted Abbott to stop a clinical trial testing Depakote as a dementia treatment.

RELATED: Abbott to pay $1.6B to wrap up Depakote marketing probe

9. Eli Lilly—$1.42 billion

Off-label marketing accusations led to Eli Lilly’s $1.42 billion deal in 2009—including the largest criminal penalty of its time just months before Pfizer beat its record. Prosecutors said Lilly pushed Zyprexa for off-label uses in children and elderly dementia patients and sought to have physicians use the drug as primary care despite its label. Lilly pleaded guilty to a misdemeanor misbranding charge for promoting Zyprexa off-label, paying $515 million and forfeiting $100 million.

RELATED: Eli Lilly - Zyprexa

10. Reckitt Benckiser—$1.4 billion

Another drugmaker wrapped up in opioid litigation, Reckitt Benckiser—from which Suboxone film maker Indivior was spun out—agreed to pay $1.4 billion in July to settle claims the company illegally boosted sales of the opioid addiction treatment. Reckitt's settlement only covered allegations dating to the period before Indivior's 2014 spinoff, and Indivior is still facing a federal probe for its role.

RELATED: Indivior's former parent ponies up a whopping $1.4B to settle Suboxone marketing probe