A CVS store. (Photo by Lynne Terry, Oregon Capital Chronicle, States Newsroom.)
The U.S. Justice Department is suing pharmacy giant CVS, accusing it of putting profits over patient safety and thus fueling the opioid crisis. The accusations bear similarities to violations for which the Ohio Board of Pharmacy last year fined the company, and the DOJ complaint cites some of board’s findings in its suit.
The complaint was unsealed last week in Providence, R.I.
In essence, it accuses CVS of understaffing its pharmacies to such an extent that pharmacists and technicians could not ensure they were filling opioid prescriptions properly. Additionally, it accuses CVS of even graver conduct.
“CVS also allegedly filled large quantities of prescriptions for controlled substances written by prescribers it knew to be engaged in ‘pill mill practices’ — that is, prescribers who issue large numbers of controlled substance prescriptions without any medical purpose,” a statement announcing the lawsuit said. “According to the complaint, CVS ignored substantial evidence from multiple sources, including its own pharmacists and internal data, indicating that its stores were dispensing unlawful prescriptions.”
Particularly notorious pill mills were located in and around Portsmouth, Ohio, in a region that was particularly hard hit by the opioid epidemic.
In a statement, CVS said it has already worked law enforcement on opioids.
“We have cooperated with the DOJ’s investigation for more than four years, and we strongly disagree with the allegations and false narrative within this complaint,” it said. “We will defend ourselves vigorously against this misguided federal lawsuit, which follows on the heels of years of litigation over these issues by state and local governments—claims that already have been largely resolved by a global agreement with the participating state Attorneys General.”
CVS added that it has taken extensive action to stop overprescription of opioids.
“CVS Health has been an industry leader in developing innovative programs to fight opioid misuse,” the statement said. “As one example, 12 years ago CVS Pharmacy pioneered a first-of-its-kind program to block controlled-substance prescriptions written by doctors of potential concern. To date, we have blocked more than 1,250 practitioners, including nearly 600 prescribers who the government continues to license. This program is not required by any statute or regulation, and CVS Health repeatedly has defended lawsuits from those alleging we go too far in blocking opioid prescribers. “
However, the Justice Department is accusing CVS of not wanting to spend enough money to staff its pharmacies adequately to operate safely. The Ohio Board of Pharmacy concluded the same thing in February, when it fined the company $250,000, placed a CVS store in Canton on indefinite probation and imposed sweeping new rules in an attempt to ensure adequate staffing. CVS later paid $1.25 million in fines to settle violations the Board of Pharmacy said it found at 22 Ohio CVS stores.
Inspection reports from those stores described waits as long as a month to fill prescriptions, expired and adulterated drugs on shelves and a lack of controls as hundreds of doses of opioids such as oxycodone and hydromorphone went missing. Current and former CVS employees told the Capital Journal that upper management didn’t listen when pharmacy workers pleaded for extra help. They added that the problems weren’t limited to CVS’s Ohio stores.
The Justice Department suit cited the Ohio findings and leveled similar charges.
“The complaint alleges that CVS’ violations resulted from corporate-mandated performance metrics, incentive compensation, and staffing policies that prioritized corporate profits over patient safety,” it said in the statement announcing the suit. “CVS set staffing levels far too low for pharmacists to both meet their performance metrics and comply with their legal obligations. CVS also allegedly deprived its pharmacists of crucial information (including, for example, by preventing pharmacists from warning one another about certain prescribers) that could have reduced the number of unlawful prescriptions filled. The complaint alleges that CVS’ actions helped to fuel the opioid crisis and that, in some particularly tragic instances, patients died after overdosing on opioids shortly after filling unlawful prescriptions at CVS.”
The suit was brought as a result of a whistleblower complaint by a former employee. Under federal law, whistleblowers are entitled to a share of the money recovered in such suits.
Among its demands, the Justice Department suit asks for triple damages, other financial penalties and a permanent injunction requiring it to dispense opioids in accordance with its legal obligations.