Could your healthcare just come down to “numbers” ?

Cherokee Nation Sues CVS, Walgreens, and Others Over Opioids

Did major chain pharmacies and distributors contribute to the opioid epidemic in Oklahoma?

http://drugtopics.modernmedicine.com/node/435207

The Cherokee Nation has filed a lawsuit against six major pharmacy chains and PBMs for failing to prevent the spread of illegally prescribed opioids in the Cherokee Nation.

The lawsuit was filed against McKesson Corporation, Cardinal Health, Inc., AmerisourceBergen, CVS Health, Walgreens Boots Alliance, Inc., and Walmart Stores, Inc. The lawsuit is reportedly the first of its kind, according to a Cherokee Nation press release, because it is “holding retailers responsible or perpetuating the opioid crisis in the 14 counties in northeast Oklahoma that comprise the Cherokee Nation.”

The move is not entirely unprecedented, however. In March, Cabell County in West Virginia filed a lawsuit against drug wholesalers and several chain pharmacies. However, one of the attorneys working on the case, William Ohlemeyer, told Drug Topics that this lawsuit is unique because the Cherokee Nation is such a large political entity. He said that the lawsuit should be thought of in the same way as if a state were suing the companies, and added that it was the first state-wide claim against pharmacies and distributors.

Oklahoma, and Native Americans in particular, has been deeply impacted by the opioid epidemic. In the state of Oklahoma, 10.14% of the population aged 18 to 25 admitted to abusing prescription pain killers in the last year. The rate of opioid abuse among Native Americans is almost twice that of the general U.S. population. When former U.S. Surgeon General Vivek H. Murthy, M.D. visited tribal representatives in 2016, he said that the “prescription opioid epidemic that is sweeping across the U.S. has hit Indian country particularly hard.”

The petition filed by the Cherokee Nation claims that “the brunt of the epidemic could have been, and should have been, prevented by the defendant companies acting within the U.S. drug distribution industry, which are some of the largest corporations in America. These drug wholesalers and retailers have profited greatly by allowing the Cherokee Nation to become flooded with prescription opioids.”

Evidence

The lawsuit alleges multiple wrongdoings on the part of the defendants. These include allegations that the defendants “regularly filled prescriptions in circumstances where red flags were present,” “have not adequately trained or supervised their employees,” that “monetary compensation programs” for filling a certain number of prescriptions created incentive to ignore “red flags,” and “consciously oversuppl[ied] the market in and around Cherokee Nation with highly-addictive prescription opioids.”

Ohlemeyer argues that “it’s a very simple, straightforward claim,” and that he expects to prove that the defendants “recklessly or knowingly oversupplied opioids.” When asked about other states such as West Virginia, where the source of many illicitly obtained opioids came not from major chains but from community pharmacies, he argued that these drugs had to have come from the distributors. He said that looking at the data based on prescription drug monitoring programs can pinpoint where drugs are being over-distributed, and that “there is no question that pharmacies get their drugs from these distributors.”

The petition states that Walgreens, CVS, and Walmart each have “one or more pharmacies ranked in the top 10 of Oklahoma pharmacies that fill prescriptions for opioids, some of which are operating within or in close proximity to the Cherokee Nation.” Pharmacies, Ohlemeyer argued, “are supposed to figure it out. They are supposed to figure out that they [opioids] are being distributed [incorrectly] before they get out.”

Ohlemeyer summed it up this way: pharmacies and distributors failed in their “duty to make sure suspicious claims aren’t filled,” and there is “no other explanation for why there is so much of this drug on the street. It’s not because legitimate prescriptions are being written.”

Though this lawsuit is the first of its kind in terms of scope, Ohlemeyer believes that similar lawsuits will follow.

Walgreens declined to comment on the litigation. CVS Health Senior Director of Corporate Communications did not mention the lawsuit specifically in a statement to Drug Topics, but did say that CVS Health has “stringent policies, procedures and tools to ensure that our pharmacists properly exercise their corresponding responsibility to determine whether a controlled substance prescription was issued for a legitimate medical purpose before filling it.”

 

Typically chain stores will tell customers that they do have the authority to tell a Pharmacist to fill a prescription, because the Pharmacist is granted professional discretion by the Pharmacy practice act and the chain store only has a permit to operate a prescription dept… provided that there is a licensed Pharmacists that is designated as “Pharmacist in charge” (PIC) and is legally responsible to the board of pharmacy ( BOP) for the legal operation of the Rx dept.  Technically/legally the chain/permit holder has no authority in the Rx dept.. they only have the right to hire and fire the personnel working in the Rx dept.

Where is the BOP’s “friend of the court” statement regarding the limited legal rights of the permit holder in the operation of the Rx dept.

Strangely missing is lawsuits against the PIC and/or other Pharmacists working in the Rx dept… the lawsuits against the prescribers… someone had to write all of those opiate prescriptions that were filled in those chain drug stores.

Wholesalers are being sued for selling opiates to legally licensed pharmacies… which in turn had filled prescriptions written by legally licensed prescribers… the wholesalers have no access to the pt, to the pt’s records nor any direct information about the prescriber.

If some/any of these lawsuits against those who are part of the prescription distribution system prevail… against those that have no direct involvement in pt care… could we see more “cookie cutter medical care” based on some determination as to what is “average ” from some spread sheet(s).

Unfortunately, pts are generally spread out over your typical “bell curve” and their medical treatment should also be as individualized likewise.

Below is a link to a article from the National Institute on drug abuse that claims that Native Americans are 2-3 times more likely to be alcoholics than the rest of the USA population.  Since our Surgeon General recently stated that addiction is a mental health issue and not a moral failing… one would expect that the potential for abuse/addiction to other substances would be expected ?

https://www.drugabuse.gov/about-nida/noras-blog/2014/09/substance-use-in-american-indian-youth-worse-than-we-thought

3 Responses

  1. These lawsuits are beyond ridiculous. No one, and I mean no one, held a gun to these people’s heads and forced them to manipulate doctors by faking pain, which is against the law. These people filing these lawsuits are adults. Adults are supposed to be accountable for their own actions. Once again, personal responsibility is no longer expected. It’s always someone else’s fault.

    Perhaps victims and their families of drunk drivers should start filing lawsuits against alcohol manufacturing companies and stores that sell alcohol instead of the drunk drivers and their insurance companies … We have to remember it’s not the drunk driver’s fault that they chose to get drunk, then drive and kill an innocent person. (sarcasm) …

    I’m sorry, but our country is going to hell in a handbasket. We no longer have or expect adults to be accountable for their own actions. We have a society full of idiots who lack personal responsibility, logic, and common sense … Just sheep following the herd. It’s too bad they can’t figure out how to pull their heads out of their asses.

  2. why isn’t the Cherokee Nation acting like f-ing adult men?women???!!!!and taking responsibility for their own behaviors,,instead of blamming the MEDICINE!!!!!mary

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