Pubdate: Thu, 29 Dec 2016
Source: Baltimore Sun (MD)
Copyright: 2016 The Baltimore Sun Company


Pharmaceutical distributor settles claims it failed to report suspicious
orders from Maryland, elsewhere

One of the nation's largest pharmaceutical distributors has agreed to pay
$44 million to resolve federal claims that it did not report suspicious
orders of the prescription painkiller oxycodone from pharmacies in
Maryland, Florida and New York.

Dublin, Ohio-based Cardinal Health Inc.'s civil settlement is one of the
largest ever in a drug diversion case, according to the U.S. Department of

The settlement comes as federal law enforcement works to curb a stubborn
opioid epidemic that was linked to almost 1,100 overdose deaths in
Maryland last year. More than 350 were linked directly to prescription

The monetary settlement stems from an agreement reached in 2012 that
barred the health care services and products company from distributing
such prescription painkillers for two years.

"Pharmaceutical suppliers violate the law when they fill unusually large
or frequent orders for controlled substances without notifying the DEA,"
said Rod J. Rosenstein, U.S. attorney for Maryland. "Abuse of
pharmaceutical drugs is one of the top federal law enforcement

Looking to stem tide of addiction, DEA collects unused prescription
medications (Meredith Cohn)

The U.S. Drug Enforcement Administration has worked with local authorities
to reduce illegal supplies of oxycodone and other addictive prescription
painkillers on the streets.

Most states now have prescription drug monitoring programs that doctors
and pharmacists can use to see how many prescriptions a patient has
obtained. And the U.S. Centers for Disease Control and Prevention has
issued guidance for doctors aimed at reducing how much is prescribed.

"These agreements allow us to move forward and continue to focus on
working with all participants in addressing the epidemic of prescription
drug abuse," Craig Morford, chief legal and compliance officer for
Cardinal Health, said in a statement.

"To combat the scourge of opioid abuse successfully, this must be a
collaborative effort that includes all parties -- the regulators, who set
and license supply; the manufacturers, who produce medications; the
physicians, who treat patients and prescribe medications; and the
pharmacists, who fill those prescriptions," he said.

"Collectively, we must focus on combating the ever-changing tactics
employed by those determined to divert medications for illegitimate use."

DEA licenses distributors and pharmacies under the Controlled Substances
Act and regulates drugs based on their accepted medical use and their
abuse potential. Oxycodone and other opioids are considered Schedule II,
which means they have a high potential for abuse and can lead users to
become dependent.

As authorities have cracked down on opioid misuse, addicts have
increasingly turned to heroin because it has become cheaper and easier to
access, said Todd Edwards, a spokesman for the DEA's Baltimore district

Overdose deaths related to heroin and fentanyl, a more powerful opioid
often mixed with heroin, now cause more deaths than prescription

"Many people start their addictions with prescription painkillers, so
there is still a big link," Edwards said. "Settlements like the one with
Cardinal do send a message. Really the only way the DEA and government can
get the message across is to hit a company where it hurts, and that means
taking their money."

All large companies, including Cardinal, have so-called anti-diversion
programs, where they aim to stop legal drugs from entering the illicit
market. Still, Edwards said, many distributors get caught from time to
time for failing to maintain effective controls.

Justice officials said Cardinal agreed to implement better security
measures as part of the 2012 agreement.

Cardinal's website reports that it supplies 25,000 pharmacies nationwide
and has several distribution facilities. The federal claims stemmed from
activity at a facility in Lakeland, Fla.

According to the settlement agreement, Cardinal admitted that from January
2009 to May 2012, it failed to report suspicious orders to the DEA.

The company said in a statement that its anti-diversion program uses
"advanced analytics, technology and the deployment of teams of
anti-diversion specialists and investigators embedded within our supply

The settlement did not disclose which pharmacies were involved in the
suspicious orders, but Justice officials said in Maryland most were CVS
pharmacies. CVS Pharmacy Inc. reached its own federal settlement in

That settlement claims some CVS stores in Maryland were dispensing
oxycodone, fentanyl and hydrocodone without proper prescriptions.

CVS said it has implemented enhanced procedures to ensure that its
pharmacists exercise their responsibility to determine whether a
controlled substance prescription was issued for a legitimate medical
purpose before filling it.
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