Following the Money


    There’s no arguing that a lot of people make a lot of money off illegally prescribed  pharmaceuticals.  Most of the time we focus on the prescribing physician or the patient.  This is not a bad place to focus but it certainly isn’t the only place.

    When you read stories of massive prescriptions being written by one doctor (e.g. 500,000 oxycodone prescriptions written by a doc now on his way to jail), don’t you sometimes wonder where this large supply comes from?  Does the pharmacy who fills these ridiculous scripts have no suspicion of what they are doing or are they merely content to receive the business?  How about the distributors?  When a pharmacy in rural Kentucky uses 100 times more oxycodone than the national average, is the distributor just “happy to be in business”? How about the manufacturer who supplies the distributor?  You get the idea.  

    Apparently, so does the DEA.  According to Donna Leinwand Leger in USA Today, recently in Florida the DEA charged both a distributor (Cardinal Health) and two retail pharmacies (both CVS) with violating their licenses to sell powerful pain killers. Cardinal is a $1.3 Billion company who says it’s not their fault. They sold only to stores that held valid state and federal licenses.  That’s kind of what they said in 2007 when the DEA suspended their license for selling 18 million hydrocodone in 9 months from their Washington State facility.  And it’s what they said when they sold 605,000 pills to one store in Burlington, WA in a 7-month period.

     As for CVS, it wasn’t their responsibility either. Granted when they refused to fill scripts for a handful of Florida docs, their oxycodone business dropped off 80% in two stores. CVS is mighty proud and asserts that this was due in large part to their action and that DEA knew about it. Yes, indeed, the DEA is growing smarter in continuing to follow the money and they’re beginning to reach the bigger fish.

    At OMCA we conduct independent pharmaceutical utilization reviews every day. We know how to follow the money.  Call us.  We can do better.

Posted in Group Benefits Programs, Medical Cost Containment, Workers’ Compensation