Tuesday, May 1, 2012

2 Fla. CVS stores scrutinized in pill mill case

By Donna Leinwand Leger
4.30.12

USA TODAY:

ARLINGTON, Va. – Two CVS pharmacies in Florida did not ignore growing oxycodone abuse when they dispensed more of the powerful painkiller than any other pharmacies in the state, attorneys for the drugstore chain said in a federal administrative court.

The lawyers argued that the pharmacies in Sanford, Fla., should be allowed to keep the federal licenses that allow them to fill prescriptions for controlled substances.

The Drug Enforcement Administration (DEA) suspended and is seeking to revoke the licenses after it found evidence that pharmacists there had dispensed hundreds of thousands of tablets of the popular painkiller, including filling multiple prescriptions for out-of-state customers. A judge is expected to rule after May 21.

After years of cracking down on Florida doctors who dispense drugs from clinics known as pill mills, the DEA is attacking the prescription drug abuse problem at the top of the supply chain. In addition to CVS, the agency has accused Cardinal Health, a Fortune 500 company, of endangering the public by selling excessive amounts of oxycodone to four Florida pharmacies, including the two CVS stores, and suspended its license to distribute controlled substances from its Lakeland, Fla., hub. A judge will hear Cardinal's case May 7.

The Centers for Disease Control and Prevention says prescription drug abuse is a major health threat and that more people die from overdoses of narcotic painkillers than from heroin and cocaine combined.

At the CVS hearing, CVS attorney Catherine O'Neil said volume by itself doesn't indicate that the drugs are being dispensed to addicts, rather than legitimate patients. The pharmacists "will tell you they never knowingly fulfilled an illegitimate prescription," she said. "These were big, busy pharmacies."

Will Abbott, vice president for CVS Caremark pharmacy operations, testified that CVS has retrained its pharmacists, cut off 21 doctors and replaced the pharmacists in the Sanford store. "Given the elevated level of drug abuse that's been observed broadly in Florida, CVS didn't want to contribute to that," he said.

DEA investigators said CVS failed to take significant actions to curb oxycodone dispensing until the agency served warrants that indicated an investigation into the stores.

Susan Langston, DEA's diversion program manager for the Miami office, said pharmacists at CVS appeared to ignore "red flags" signaling drug abuse, including prescriptions of the same combinations of drugs in the same amount from a cluster of South Florida doctors. Langston said CVS pharmacists acknowledged the problems, but didn't stop filling suspect prescriptions until it learned of the DEA investigation.

"It's no secret that we have an incredible pill problem in the state of Florida," Langston said. "People come from all over the United States to go to these pill mills. Sometimes they drive thousands of miles. It has completely devastated our state."

Dispensing records from the Sanford CVS stores, located in central Florida, show pharmacists there dispensed thousands of pills to residents of Kentucky and Tennessee who had visited doctors in South Florida. DEA records show one of the CVS pharmacies in Sanford ranked 23rd among pharmacies nationwide in the amount of oxycodone it ordered, DEA Diversion supervisor Gayle Lane said.

"Someone from Kentucky who travels to a doctor in Fort Lauderdale and presents a prescription for oxycodone in Sanford, Fla., is to me a huge red flag," said Paul Doering, a professor emeritus at University of Florida's School of Pharmacy. "I can't speak for every pharmacist in the world, but this pharmacist is not going to fill that prescription."

No comments: