I don't know, I just read Empire of Pain and didn't notice anything about any pharmaceutical companies targeting Appalachia, they were targeting everywhere.
Maybe WV did all that you claim in the past. More so the reason for their own Senator to go along with programs that will reward them for their hard work, Manchin is not.
How can a Senator vote against Fed money to alleviate problems in his own hurting state? It seems like Americans are, in fact, trying to express their gratitude to places like WV and Manchin won't let us.