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Drugmaker Teva announced Tuesday that it has agreed to contribute more than $4.3 billion in cash and medications to settle lawsuits in the state and local governments and Native American tribes that claimed the company contributed to the U.S. opioid epidemic.

The deal in principle would rank among the larger ones so far in a yearslong trend of companies settling the complicated lawsuits over the toll from an addiction and overdose epidemic, which has been linked to more than 500,000 deaths in the U.S. over the last two decades.

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In their lawsuits, state governments and others claimed the Israel-based company promoted Actiq and Fentora, prescription opioids approved to treat cancer pain, plus generic opioids including oxycodone for use for non-cancer purposes. The states also said the company downplayed the addiction risks and encouraged doctors to continue to increase the doses they prescribed. The states claimed the company and its distributor, Anda, failed to comply with requirements on monitoring and reporting suspicious orders.

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