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Did major chain pharmacies and distributors contribute to the opioid epidemic in Oklahoma?
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.”
Up next: The 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.”