Walgreens and CVS to pay $10.7 billion

[George K]

https://www.nbcnews.com/business/consumer/cvs-walgreens-to-pay-opioid-settlement-how-much-when-rcna61307/

CVS and Walgreens have agreed to pay a combined $10.7 billion to settle allegations they failed to adequately oversee opioid painkiller prescriptions, thus contributing to America's opioid addiction crisis.

The funds will be distributed to states, local governments and federally recognized tribes and will go toward opioid crisis abatement and remediation programs. CVS will pay $4.9 billion to states and political subdivisions and approximately $130 million to tribes. Walgreens will pay $4.95 billion, plus more than $750 million in fees for attorneys and costs. The payments will be made over time.

The pharmacy chains have also agreed to implement robust controlled substance compliance programs that will require additional layers of opioid prescription reviews and institute new mandatory training programs.

Between 2011 and 2020, the overdose death rate from all opioids tripled, from 7.3 deaths per 100,000 people to 21.4 deaths per 100,000 people, according to the nonprofit State Health Access Data Assistance Center. Even as declines from prescriptions like oxycontin have leveled off, deaths from heroin, which is illegal, and fentanyl, a commonly prescribed painkiller, have surged, the group said.

Waitaminute?

Who's writing prescriptions for heroin and fentanyl?

[Mik]

Since when was fentanyl a 'commonly prescribed painkiller'?

Our opioid crisis stems from the fentanyl pouring over the border from our good buddy China. I still contend that very few people go from prescription opioids to shooting heroin/fentanyl unless they were drug abusers to begin with.

[Jolly]

@Mik said in Walgreens and CVS to pay $10.7 billion:

Since when was fentanyl a 'commonly prescribed painkiller'?

Our opioid crisis stems from the fentanyl pouring over the border from our good buddy China. I still contend that very few people go from prescription opioids to shooting heroin/fentanyl unless they were drug abusers to begin with.

I'm sure the Marcus Welbeys of the world are churning those fentanyl scrips out day and night. Not.

I'd have to some more reasons why these companies are on the hook for so much money. After all, they're filling the scrips, not writing them.

[Mik]

Agreed. Has the look of a shakedown.

[George K]

@Mik said in Walgreens and CVS to pay $10.7 billion:

Since when was fentanyl a 'commonly prescribed painkiller'?

The Duragesic patch has been around for decades. It's a transdermal, slow-release of fentanyl that dispenses a certain dose (anwhere from 50 to 200 ug) per hour. Very effective for some people. Getting the fentanyl out of the patch is damn near impossible.

Oral fentanyl (Actiq) is available as a lozenge that goes between your gum and cheek.

There's also a nasal spray as well as a sublingual spray.

Fentanyl is poorly absorbed from the stomach, but, I imagine with high enough doses, enough gets in as to make it dangerous.

Of course, mixing it with heroin has been a long-standing practice of drug dealers.

Our opioid crisis stems from the fentanyl pouring over the border from our good buddy China. I still contend that very few people go from prescription opioids to shooting heroin/fentanyl unless they were drug abusers to begin with.

The FDA has "resconsidered" its guidelines for prescribing opiates with the "realization" that most opiate deaths are NOT due to chronic pain patients, who, although dependent, are not addicts.

[taiwan_girl]

I read somewhere that they are also going after doctors who wrote abnormal high amounts of prescriptions.

A lot of times, companies will settle a lawsuit because it will cost more to fight it. However, USD$10.7 Billion is an awful lot of lawyer fees. So, maybe they realize they have some responsibility.

These companies are super good at logistics and supply chain.

I think it all of a sudden they started selling 10x the amount of shampoo, I am sure someone in the company would "flag" it and look into reasons why there was the sudden increase. Same with prescriptions.

[Jolly]

@taiwan_girl said in Walgreens and CVS to pay $10.7 billion:

I read somewhere that they are also going after doctors who wrote abnormal high amounts of prescriptions.

A lot of times, companies will settle a lawsuit because it will cost more to fight it. However, USD$10.7 Billion is an awful lot of lawyer fees. So, maybe they realize they have some responsibility.

These companies are super good at logistics and supply chain.

I think it all of a sudden they started selling 10x the amount of shampoo, I am sure someone in the company would "flag" it and look into reasons why there was the sudden increase. Same with prescriptions.

Define abnormally high, especially at a pain clinic.

[George K]

@Jolly said in Walgreens and CVS to pay $10.7 billion:

Define abnormally high, especially at a pain clinic.

And there, friends, is the problem.

FDA came down on docs a couple of years ago, saying that there's a limit to how much narcotic they can prescribe for a patient. I believe it was 90 MME per day.

https://www.mdcalc.com/calc/10170/morphine-milligram-equivalents-mme-calculator

Guess what? People differ, and a one-dose-fits-all approach is stupid.

[Mik]

At some point we need to decide that the doctor and patient know best. We have plenty of controls in place to identify pill mills.

I know several people who have had to endure temporary but significant pain simply because the doctor was either scared or unable to prescribe the proper pain meds.

[taiwan_girl]

@Jolly said in Walgreens and CVS to pay $10.7 billion:

@taiwan_girl said in Walgreens and CVS to pay $10.7 billion:

I read somewhere that they are also going after doctors who wrote abnormal high amounts of prescriptions.

A lot of times, companies will settle a lawsuit because it will cost more to fight it. However, USD$10.7 Billion is an awful lot of lawyer fees. So, maybe they realize they have some responsibility.

These companies are super good at logistics and supply chain.

I think it all of a sudden they started selling 10x the amount of shampoo, I am sure someone in the company would "flag" it and look into reasons why there was the sudden increase. Same with prescriptions.

Define abnormally high, especially at a pain clinic.

I was just thinking in terms of sales at the store level, not at the clinic level. I am guessing that someone in Walgreens or CVS monitors the amount of Brand X shampoo sold in each part of the country. If the sales of Brand X shampoo increase by 10x in a relatively short period of time, I would think that the monitoring guy would ask, "what's going on with Brand X shampoo? Why all of a sudden are sales up 10x?"

Same with opiod. "Hey, why is store X in Wes Virginia needing 10x their normal opiod supply that they have used the last couple of years? Are these numbers correct? Why is it so high?" They must have a medical team that monitors stuff like that.

Maybe they just figured that it wasn't their problem. I certainly dont think that they were the root cause of the problem.

[Jolly]

There are areas of care and responsibility in healthcare. The doctor orders, others carry out those orders.