Walmart allegedly fueled the opioid epidemic by filling thousands of invalid prescriptions and failing to report suspicious orders to authorities, the Justice Department claimed in a lawsuit filed Tuesday.
Managers across Walmart's 5,000 U.S pharmacies denied its pharmacists the authority to refuse to fill prescriptions from known "pill mills" and withheld related compliance data from their workers, federal regulators alleged in the complaint filed in federal court. While Walmart stopped distributing controlled substances in 2018, it had received hundreds of thousands of suspicious orders that it failed to report to the Drug Enforcement Administration, according to the lawsuit, which is seeking what could be billions of dollars in damages and limitations on its prescribing privileges.
Physicians allegedly directed their patients to Walmart to get their opioid prescriptions filled when other pharmacies weren't filling them, said Robert Higdon Jr., U.S. attorney for the Eastern District of North Carolina.
"Our office prosecuted a physician for illegal opioid distribution," Higdon said in prepared remarks, adding that the doctor was convicted and sentenced to 20 years in prison. "As it turns out, that physician expressly directed patients to Walmart to have their opioid prescriptions filled. Walmart's own pharmacists reported concerns about the doctor up the corporate chain, but for years, Walmart did nothing—except continue to dispense thousands of opioid pills."
Walmart said that it has always allowed its pharmacists to refuse to fill problematic opioid prescriptions. The company plans to defend its pharmacists and fight the lawsuit in court.
"This lawsuit invents a legal theory that unlawfully forces pharmacists to come between patients and their doctors, and is riddled with factual inaccuracies and cherry-picked documents taken out of context. Blaming pharmacists for not second-guessing the very doctors the Drug Enforcement Administration approved to prescribe opioids is a transparent attempt to shift blame from DEA's well-documented failures in keeping bad doctors from prescribing opioids in the first place," Walmart said in a statement, noting that it already sued the DOJ and DEA to clarify the roles and responsibilities of pharmacists and pharmacies under the Controlled Substances Act.
DOJ alleges that Walmart pressured its pharmacists to fill prescriptions as fast as possible "because shorter wait times (kept) patients in store," according to an email cited in the complaint. This purportedly left pharmacists little time to determine whether the prescriptions were valid.
One pharmacist wrote in a 2014 survey that their manager chastised them for not having high enough numbers, "instructing (us) to cheat the system." Another wrote that they "often take shortcuts in filling and counseling that could lead to patient safety issues."
"If patient safety is the concern, numbers should not matter more than the patient's health. Market manager and store manager are too preoccupied with sales numbers," one response in the complaint reads.
Walmart rarely reported suspicious orders, regulators claim. Walmart shipped around 37.5 million controlled-substance orders to its pharmacies over a four-year span, only reporting 204 orders to the DEA during that period, according to the lawsuit. Walmart's back-up distributor, McKesson Corp., which filled an order only when Walmart could not, reported more than 13,000 questionable orders over that span.
If suspicious orders were detected, the prescriptions were often already delivered and not requested back, according to the complaint.
Walmart allegedly violated the Controlled Substance Act hundreds of thousands of times. Each unlawful prescription filled carries an up to $67,627 fine; each unreported suspicious order could result in a $15,691 fine.
In October, a West Virginia court ordered Walmart to disclose internal opioid dispensing documentation supplied to state and federal agencies investigating the retail giant's alleged role in the opioid epidemic.
In another consolidated case, more than 3,000 states and local governments are suing pharmaceutical manufacturers, distributors and pharmacies—including Walmart—over the opioid crisis.