Nationwide pharmacy chains CVS, Walmart and Walgreens have been ordered to pay $650 million to resolve opioid claims in a case involving two Ohio counties. Initially filed back in 2018, the ruling in the case was issued by a federal judge late last month and the funds are set to go towards counteracting the devastating effects the epidemic has had on these communities.Mark Lanier, the Texas attorney who led the plaintiffs’ trial team, said, “These companies are rending the fabric of society apart. They should not only show remorse, they should show they need to rectify what they’ve done. And they won’t do it. So, the judge is doing it.”The pharmacy chains will also be monitored moving forward and report new prescribing practices within three months to make sure they are improving how they dispense opioid drugs and flagging any suspicious orders. They’ve also been ordered to install hotlines for anonymous callers phoning in about questionable sales. A compliance officer will oversee internal processes.The three chains have allegedly reported that they plan to appeal the judge’s decision, arguing that they did not feed pill mills by filling larger than expected orders. However, the plaintiffs in showed at trial that there were a number of substantially high orders filled that would normally be flagged and that the pharmacy teams didn’t report these to the Drug Enforcement Administration (DEA) per protocol.

Photo by Karolina Grabowska- from Pexels

In May, Walgreens reached a $683 settlement with Florida in a similar case, while CVS agreed to pay the state $484 million in March. These chains and others are currently facing similar accusations in Illinois with a number of Chicagoland counties filing a joint lawsuit just last month. Many other players in the opioid supply chain, including drug makers, their top executives and sales managers, the family behind Purdue Pharma, a consulting firm, distributors and physicians have all faced litigation in recent years for their alleged roles in fueling the crisis.Pharmacies have previously argued that they’ve operated lawfully, filling orders for patients written by doctors, and that if underhanded orders are being written, doctors should be the ones to be held accountable.While the latest judgment is a win for the two Ohio communities that sued the defendants, some experts and patient advocates are concerned that these strict prescribing procedures now in place will be far too limiting, and restrictions on what the pharmacies are able to dispense moving forward could harm some patients. Despite 2016 guidelines drafted by the Centers for Disease Control and Prevention (CDC), studies have shown that not all patients who are taking opioids (i.e., chronic pain patients with no history of drug misuse or addiction) need to be taken off these medications. They may continue to rely on their pain medications and now it may become more difficult for them to access the treatment they need.Walmart, for example, recently decided to stop filling prescriptions for some controlled substances via telehealth altogether without an in-person visit first (something that’s hard for many people). It’s unclear whether other chains will decide this is the easier route and follow suit.For example, “While well-intentioned, this ruling has the potential to cause further damage by spooking pharmacies from dispensing buprenorphine, a life-saving addiction treatment medication,” said Zack Gray, co-founder and CEO of virtual opioid treatment provider Ophelia. “This decision sends pharmacists a dangerous message: you’re expected to overrule doctors, and not doing so can be costly.”

Sources:

Walmart, CVS and Walgreens Must Pay $650M for Filling Prescriptions to Pill Mills in Opioid CrisisWalmart has a new policy denying some telehealth prescriptions for controlled drugs. It’s implicating patients in recoveryStable, Long-term Opioid Therapy Safer Than Tapering?Chicago-area counties sue pharmacy chains for allegedly feeding opioid crisis