After negotiating through the night, Israeli generics giant Teva – which is a leading supplier of the US market – and the three biggest US drug distributors on Oct. 21 reached a $260 million settlement with two Ohio counties that were seeking to prosecute the companies for contributing to the nation’s opioid crisis.

Without a settlement, a lawsuit brought by Cuyahoga (Cleveland) and Summit (Akron) counties would have been heard in an Ohio federal court, beginning the same morning. The bellwether trial was expected to provide guidance for additional proceedings.

Across the US, more than 2,600 lawsuits against pharmaceutical manufacturers and distributors are still pending, but participants in those are now seen as gaining some breathing space to reach a settlement, potentially on a national level.

State and local governments, Native American tribes, hospitals and other interest groups have sued the companies over the opioid crisis, which is blamed for more than 400,000 deaths in the US over two decades. Ohio federal judge Dan Polster has been working to achieve a multi-party settlement for nearly two years.

According to the national newspaper Washington Post, Ohio had the second-highest death rate from drug overdoses in the US in 2017, behind West Virginia.

As proposed earlier, drug distributors AmerisourceBergen, Cardinal Health and McKesson will now pay a combined $215 million to settle the two counties’ claims, while Teva is to contribute $20 million in cash and $25 million worth of generic Suboxone, a drug used to treat opioid addiction.

The distributors have been accused of failing to flag and halt suspicious orders for opioids and the drugmakers of promoting benefits while playing down risks. In their defense, distributors said they were shipping FDA-approved medicines prescribed by doctors.

While saying they strongly dispute the allegations made by the two counties, the distributors said in a joint statement they believe settling the case in Ohio is an “important stepping stone to achieving a global resolution and delivering meaningful relief.”

After declaring bankruptcy, OxyContin manufacturer Purdue Pharma exited the Ohio litigation. In September, it reached a tentative settlement  with the counties that could be worth up to $12 billion if accepted by the states and many local governments still opposing it.

The only defendant left in the trial that would have started on Oct.21 is Walgreens, which is being sued both a distributor and a pharmacy. Reports said the this case will likely go to trial within six months.

Other drugs industry defendants whose names might have been on the Ohio court’s docket this week include opioid manufacturers Johnson & Johnson, Mallinckrodt, Endo International and Allergan. The four previously reached out-of-court settlements with the two counties worth altogether $66.4 million.