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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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