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Chapter 19: CVS: “Fired Up” about Social Responsibility: 19-2c Overdistribution of Oxycodone Book Title: Business Ethics: Ethical Decision Making and Cases Printed By: Kennisha Holloman (kholloman@grantham.edu) © 2019 Cengage Learning, Cengage Learning

19-2c Overdistribution of Oxycodone

In 2012 CVS faced challenges with another federal agency—the Drug Enforcement

Administration (DEA). The DEA suspended the company’s license to sell controlled

substances at two Florida locations, only a few miles apart from one another. These

locations were found to have ordered a total of three million oxycodone tablets in 2011. The

average order for a U.S. pharmacy in the same year was 69,000 pills. Intensifying the

matter, abuse of narcotics pain medications, especially oxycodone tablets, was prevalent in

the area. In fact, some local clinics had become known as “pill mills” for their liberal

distribution of prescriptions for pain pills. This prompted the state of Florida to implement

legislation responding to and attempting to control the rampant misuse and diversion of pain

medications.

CVS responded to the DEA’s investigation by notifying some of the area doctors that it

would not fill prescriptions written for oxycodone (Schedule II narcotics). However, it also

requested a temporary restraining order against the DEA, which would disable the

temporary suspension of selling oxycodone. The DEA suspension decreased the amount of

such narcotics being distributed to the two CVS locations by 80 percent in a period of three

months, limiting their ability to make a profit. When the matter came before a federal judge,

he ruled that the company was at fault for lack of proper oversight in distributing oxycodone

and other narcotics. The ruling further implied company negligence since such a large

number of dispensed pills should have been noticed as a blatant abnormality.

Later that year, the DEA completely revoked the licenses of the two locations to sell

controlled substances—the first time this has occurred with a national retail pharmacy chain.

CVS claims that it has improved procedures regarding distribution of controlled substances;

however, the DEA’s claims explicitly assigned negligence on the part of pharmacists in light

of obvious “questionable circumstances.” These circumstances included the fact that

several customers were coming to Florida from out of state to fill prescriptions. Many lacked

insurance and paid in cash, red flags that can suggest drug abuse. This was in addition to

the heavy prescription drug abuse problem in the area that had already prompted state

legislation.

Testimonies from employees indicated company negligence as many had knowledge of the

top prescribing doctors in the area and awareness that daily oxycodone quotas were being

depleted—sometimes within 30 minutes of the pharmacy opening. Pharmacists also

indicated that they set aside pills for those patients they considered to have a real need for

them because they had strong suspicions that most of the people purchasing the pills were

abusers. They did not feel at liberty to refuse prescriptions to customers, however, because

they are not trained to diagnose illnesses. In 2013 CVS announced a review of its database

of health care providers to find abnormalities in narcotic prescriptions. It found and notified

at least 36 providers to whom it would no longer fill orders due to high prescription rates.

In 2014 another incident involving the disappearance of 37,000 pain pills in four California

stores brought the DEA and CVS together again. These stores have a history of not being

able to account for several pain prescription drugs. This incident carries up to 2,973

violations of the Federal Controlled Substances Act and could cost the company up to $29

million in penalties. In 2012 the DEA investigated missing prescription drugs in a store

wherein an employee admitted taking approximately 20,000 pills. This piqued the curiosity

of investigators, who found three retail locations that each had thousands of pills missing.

Chapter 19: CVS: “Fired Up” about Social Responsibility: 19-2c Overdistribution of Oxycodone Book Title: Business Ethics: Ethical Decision Making and Cases Printed By: Kennisha Holloman (kholloman@grantham.edu) © 2019 Cengage Learning, Cengage Learning

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