Judge: DEA Can Suspend Drug Sales at CVS Stores
There’s no doubt that there is a prescription drug abuse problem in the U.S. today. Some pharmacies post signs in stores telling addicts and likely armed robbers that painkillers such as oxycodone are not kept on the premises.
There are, however, a small percentage of pharmacies around the country that do a steady trade dispensing addictive drugs prescribed by physicians to people for reasons outside of legitimate medicine.
Recently the U.S. Drug Enforcement Administration (DEA) has made headlines by taking steps to prevent pharmacies from selling addictive drugs. But instead of the stores being some stereotypical back alley operation, they were CVS pharmacies. The two locations in Sanford, FL had their licenses suspended for what the agency believed were unusually high sales of oxycodone.
CVS had gone to court and gotten a temporary restraining order that blocked the DEA, asserting the agency had acted in an arbitrary manner. But a judge at a U.S. District Court vacated the restraining order yesterday after determining the government had acted appropriately.
According to The Associated Press, CVS argued that it has retrained pharmacists and reduced the level of oxycodone prescriptions in the two stores by 86 percent over the past year.
The DEA countered that, even with the improvement, the locations were dispensing far more than they should be. The government also said that it had met with CVS in 2010 and 2011 to warn it of possible consequences if it did not comply with guidelines to deter prescription drug abuse.
Discussion Questions
Discussion Questions: Ethically speaking and from a business standpoint, what role do you believe pharmacies should have in preventing the abuse of prescription drugs? Should the government be more involved in identifying pharmacies dispensing unusually high volumes of addictive drugs and taking action including the suspension of licenses?
The issue to me is whether the pharmacist has a reason to question the legitimacy of the prescription. If the pharmacist suspects a phony prescription, there is a responsibility to verify. If the DEA suspects illegal prescriptions are being funneled through a specific pharmacy, they have a right to investigate, both the pharmacist, the prescribing physician, and the patient. But it’s not the pharmacists’ responsibility beyond verification and cooperation with the DEA.
The government should certainly identify and investigate pharmacies that are handling unusually high amount of oxycodone and other similar medications. It has no way of knowing/monitoring the doctors who are prescribing the medications other than to investigate the pharmacy and then determine who wrote the scripts. CVS and other drug chains may not have a legal obligation to report unusually high levels of such prescriptions but not doing so has consequences like those being played out in the media currently.
Stephen Needel is spot-on correct. Only thing I’d say is that the DEA has not only a right, but a responsibility, to investigate.
From a business standpoint I think pharmacies should become partners in helping their customers be compliant in using prescribed drugs. Keeping people healthy is probably more beneficial to the government, pharmacies and the general population. Looking out for the abuse of prescription drugs is important, of course, but setting up guidelines and self monitoring programs would be the first step before suspension of licenses. Pharmacies don’t write the prescriptions. They may be a first line of defense in helping people to help themselves. Hence, I see a role in compliance and perhaps reporting the source (aka doctors) of addictive prescriptions that they see.
Taking the government at its word, that it had been in contact with CVS for two years about suspicious dispensing of prescriptions for drugs that are frequently abused, CVS should have never let the situation reach this point.
On the other hand, since DEA deals primarily with illicit drug trade and not retail pharmacy, it may be off base alleging CVS is filling too many scripts for oxycodone or anything else. Certainly CVS should have the data to show the fill rate for oxycodone at the two Sanford pharmacies is not out of line with pharmacies in other communities with similar demographics. (And remember, one pharmacy in a chain of more than 7,000 has to be the No. 1 dispenser of any given pharmaceutical, so it could be Sanford.)
Did CVS do any legwork as to the level of oxycodone abuse in and around Sanford, Fla., vs. other communities?
When the government shuts down a company’s operations, or even a small number of its outlets, it is devastating for a retailer since the allegations are as bad as convictions in terms of public perception. [Anybody remember how Chipotle Mexican Grill was blind-sided by the federal Immigration and Customs Enforcement agents?
To answer the discussion question, YES, retailers have an obligation and moral duty to make sure they are not knowingly or unwittingly participating in fraudulent or illegal use of the goods they sell. Pharmacies have a higher level of responsibility than, say, hardware stores. How many times have retailers been bashed for selling legal products like cigarettes, which are legal, and required to “card” individuals up to the age of 28 for a product they can legally buy years younger?
The government agents believe they were doing their duty. If they were overzealous or acted in error, then it is up to CVS to maintain an early, vigorous defense of its practices and its store-level pharmacists and associates.
Every pharmacist is trained to review prescription medication orders by a doctor to determine if a prescribed medication might present a medical conflict with other medication a patient might be taking. In addition, pharmacists know what safe frequencies for refills are and are trained to consult with a physician if a prescription order or refill seems inconsistent with good practice.
In MOST cases the problem arises with the physician who prescribes medication. Every community now seems to have doctors who practice pill mill medicine and will prescribe any medication requested. The doctor has the right to do this even if it is not good medical practice. Pharmacists catch many of these situations and refuse to fill prescriptions, but they can incur liability if they get this wrong. It would seem a little extreme to place all the blame on the pharmacy. I have to wonder what the DEA is doing to investigate the physicians who are issuing all the prescriptions?
Ethically, I assume a pharmacist has a responsibility to the community in preventing abuse of prescription drugs. From a business standpoint, if the government is forced to become involved, the pharmacies will lose customer trust and patronage.
I would not like to see a task force specifically set up to police pharmacies, however, I do believe the actions taken by the DEA in this case to be correct.