DEA and CVS

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It's only the Cardinal facility in Lakeland, FL whose DEA license has been suspended. My Cardinal order comes from another location and is thus fine.
 
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Personally, i find it awesome that cardinal got a court order reinstating its license within ~8 hours of the DEA announcement. Other than that.. just typical saber rattling and overextending on behalf of the DEA. DEA is making all kinds of statements about bogus prescriptions... who exactly is complicit? I would guess the pharmacists themselves, but, more importantly and puzzlingly, is at what level in CVS corporate was there a whole lot of looking the other way ?

Old timer, what is your opinion, do you think CVS corporate *clearly* knew what was going on and decided to look the other way at some level, or was it likely just a local manager deciding his bonus was worth not paying too close attention ?
 
If CVS agreed with the DEA action then they would be showing that they actually care about the public's health and not just $$$$. These pharmacists should've known they were being taken. They were either complicit,dumb or unethical. CVS should've suspended these pharmacists while conducting an investigation.
 
Doctor M said:
http://www.reuters.com/article/2012/02/06/us-dea-raids-idUSTRE8151NA20120206

just discuss...
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CVS actually send out at least 5 memos via workload manager and email since the new year that we do not fill prescriptions if we suspect that it is fake or not being prescribed for the right reasons.

There were actually guidelines in them describing what fake prescriptions look like and what to do if we get one.

They include things like cash when they have insurance and not medicare, MD and location not from around the area, and telling us not to send it to another CVS if we think it is fake.
 
I think it's time that the DEA requires anyone with a DEA number to have a pager or cell phone associated with the phone number available on the NPI database.
 
The DEA can't really prove that CVS has done anything wrong. Everything the DEA says is just what they feel that CVS has done wrong. Cardinal allowed these particular CVS stores to order 3 millions pills in 1 year. In my eyes, it is very difficult to prove that CVS has done anything wrong other than fill prescriptions pursuant to a prescription. Knowing or not knowing if a prescription is legit is very difficult to determine. Filling a "fake" is a whole different story than filling a prescription in which the physician did not perform a physical examine, therefore the prescription is not legit. The DEA has gone to far in suspending the licenses of the Lakeland division of Cardinal and the licenses of CVS. The court of Law has already sided with Cardinal and CVS temporarily. The DEA needs to step back and go about this a different way. All the DEA has are allegations. I do not understand how they can take a license away without due process.
 
I once read on here about a district manager from a chain who would rather fill narcotics for everyone than deny a legit patient their narcotics. The way the DEA is today, it is NOT possible to do this.
 
Doctor M I understand your defense of not knowing if a script is legit or not. I guarantee that if you spent one day in this pharmacy you would know something was up. Groups of individuals coming in together with a half dozen scripts for oxycodone and all paying cash. Not to mention the fact they look like drug dealers. There is something called a moral obligation that should've prevented these pharmacists from filling these scripts. Legally CVS may be in the right here and the DEA may have overstepped their bounds but that doesn't make them right in the court of morality. I know of CVS DMs who have pressured their pharmacists to fill questionable CII's. These directives certainly come from high up the chain.
 
Unchained said:
Doctor M I understand your defense of not knowing if a script is legit or not. I guarantee that if you spent one day in this pharmacy you would know something was up. Groups of individuals coming in together with a half dozen scripts for oxycodone and all paying cash. Not to mention the fact they look like drug dealers. There is something called a moral obligation that should've prevented these pharmacists from filling these scripts. Legally CVS may be in the right here and the DEA may have overstepped their bounds but that doesn't make them right in the court of morality. I know of CVS DMs who have pressured their pharmacists to fill questionable CII's. These directives certainly come from high up the chain.
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The court doesnt look at the court of morality. Did CVS commit a crime? Nothing has been proven. Should those Scripts of been filled? Perhaps not. Should CVS lose their DEA license? Probably not. Should the CVS pharmacists be reprimanded for filling questionable prescriptions? At the very least they should be investigated by the State Board and the DEA. The DEA has proven nothing, all they have are allegations. It is disgusting that the DEA can strip a license without due process. The DEA is a Federal agency, given its privilages by the Attorney General. The DEA, in my eyes has NO rules and no due process. Many of you know my feelings for CVS. But in this case, I believe the DEA have gone too far in suspending the licenses without due process. A federal judge agrees.

Understand I am disagreeing with the fact the DEA can strip a license with only allegations. I am not disagreeing with them being investigated. If after the DEA has investiagted fully, and it is found that CVS was reckless in the handling of controlled substances and a danger to the public, then yes, strip the license and let them drown.
 
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Laws are too slow to catch up with the drug abusers. Physicians who are "pill mills" just pack up and move across state lines when the DEA starts to investigate them. The chains don't care because all the want are the sales. The DEA has to push the line to have success against the prescription drug epidemic because their hands are tied by the bureaucracy and the powerful lobbyists. Once again we as pharmacists do have a moral obligation to reduce the amount of fraud in the system.
 
Just imagine every single day for an entire year, you had 40 people come in for a script of 200 oxycodone tablets. You would still be short the volume that these guys were selling. Outrageous.
 
Unchained said:
Doctor M I understand your defense of not knowing if a script is legit or not. I guarantee that if you spent one day in this pharmacy you would know something was up. Groups of individuals coming in together with a half dozen scripts for oxycodone and all paying cash. Not to mention the fact they look like drug dealers. There is something called a moral obligation that should've prevented these pharmacists from filling these scripts. Legally CVS may be in the right here and the DEA may have overstepped their bounds but that doesn't make them right in the court of morality. I know of CVS DMs who have pressured their pharmacists to fill questionable CII's. These directives certainly come from high up the chain.
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Enlighten me...what does a drug dealer look like? I don't suspect that it is as easy as keeping an eye out for Boris the Burglar.

 
297point1 said:
Enlighten me...what does a drug dealer look like? I don't suspect that it is as easy as keeping an eye out for Boris the Burglar.
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Jay-and-silent-bob.jpg


hth
 
type b pharmD said:
Personally, i find it awesome that cardinal got a court order reinstating its license within ~8 hours of the DEA announcement. Other than that.. just typical saber rattling and overextending on behalf of the DEA. DEA is making all kinds of statements about bogus prescriptions... who exactly is complicit? I would guess the pharmacists themselves, but, more importantly and puzzlingly, is at what level in CVS corporate was there a whole lot of looking the other way ?

Old timer, what is your opinion, do you think CVS corporate *clearly* knew what was going on and decided to look the other way at some level, or was it likely just a local manager deciding his bonus was worth not paying too close attention ?
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I don't think filling fake rx's to increase volume is a motivation for rph's at retail chains where the bonus for increased volume isn't that much. I think either the pharmacist gave up policing because they don't have the time and help, or had too many complaints from pts about giving a hard time about narcotics that the supervisor threaten them not to get complaints, or the pharmacist just didn't care anymore.
 
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museabuse said:
I don't think filling fake rx's to increase volume is a motivation for rph's at retail chains where the bonus for increased volume isn't that much. I think either the pharmacist gave up policing because they don't have the time and help, or had too many complaints from pts about giving a hard time about narcotics that the supervisor threaten them not to get complaints, or the pharmacist just didn't care anymore.
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Ahh. Good points:thumbup: I hadnt had any retail exp . This seems like a more realistic situation
 
museabuse said:
I don't think filling fake rx's to increase volume is a motivation for rph's at retail chains where the bonus for increased volume isn't that much. I think either the pharmacist gave up policing because they don't have the time and help, or had too many complaints from pts about giving a hard time about narcotics that the supervisor threaten them not to get complaints, or the pharmacist just didn't care anymore.
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Sounds about right...it is too bad that is has come down to us being the police.
 
It doesn't matter. The damage has been done. CVS got some really bad press as a result of this. It also cost them in disruption to business, lawyer fees....etc. The DEA likely knew this would happen. It probably won't stop them and it puts it in the public eye. CVS might be tempted now to work with the DEA and not against them.
 
Unchained said:
It doesn't matter. The damage has been done. CVS got some really bad press as a result of this. It also cost them in disruption to business, lawyer fees....etc. The DEA likely knew this would happen. It probably won't stop them and it puts it in the public eye. CVS might be tempted now to work with the DEA and not against them.
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Well, unfortunately, this even has cost me some business. Being a customer of Cardinal and not getting out control order over this was ridiculous. The DEA should not be able to come in and shut things down until they have determined that an unlawful act had been committed.

If an a medication is written and a legitimate Florida approved prescription blank, then the pharmacist/pharmacy/distributer should not be held responsible if that rx was obtained in an unlawful manner, there is no way we can know.

Unfortunately, we are forced to profile in order to protect ourselves. There are people we assume are obviously looking for medication to divert, multiple people in the same car, scripts from 2-3 hours away, etc. But then there are some people who "look" like drug addicts, but then what does a drug addict look like. There are Dr's and Pharmacists who are popping Oxy's everyday, who look just as normal and professional as everyone else.

It's unfortunate that the pharmacists are having to play police. I wonder how many patients I have turned away that are real chronic pain patients.
 
Kvl I'm sorry to hear it has affected your business. I think you should be angry at CVS however. Their excessive distribution was egregious. 3million doses vs 70,000 per year average. Prescriptions with fake #'s and misspelled names. They track these #'s at their corporate office and obviously chose to ignore them.
 
Unchained said:
Kvl I'm sorry to hear it has affected your business. I think you should be angry at CVS however. Their excessive distribution was egregious. 3million doses vs 70,000 per year average. Prescriptions with fake #'s and misspelled names. They track these #'s at their corporate office and obviously chose to ignore them.
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I agree to some extent. 3 million units is a lot of Oxy:eek:

I was talking with our Cardinal rep, he was in doing some damage control after the whole debacle. I don't know how much of this is true, but he was saying that Cardinal doesn't do much volume to CVS, because they utilize their own distribution centers, like most of the big chains.

He was also saying they recently shut down control accounts at over 25 pharmacies in Florida, so Cardinal must be doing something to help squash out these pill mills. I just don't think the DEA should have the power to walk into cardinal and slap a lock on the control vault and say nope you can't send anymore controls until we finish our investigation. It should be business as usual until their investigation determines negligence or criminal activity.

Our rep said one of the pharmacies they shut down was purchasing over 500 bottles of oxy 30 per month.

I can you one thing, it has made me paranoid and I run control reports to check our Oxy dispensing volumes. I dont think we have ever done more than 20 bottles in month.
 
kvl1027 said:
I agree to some extent. 3 million units is a lot of Oxy:eek:
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Averages out to about 8300/day. That is just insane.
I was talking with our Cardinal rep, he was in doing some damage control after the whole debacle. I don't know how much of this is true, but he was saying that Cardinal doesn't do much volume to CVS, because they utilize their own distribution centers, like most of the big chains.
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When I heard the story, I was actually surprised to hear that Cardinal and CVS are involved at all. I've never worked for them, but I assumed they used their own warehouses to distribute, especially with hearing about "truck day" and the like.
 
Ackj said:
Averages out to about 8300/day. That is just insane.
When I heard the story, I was actually surprised to hear that Cardinal and CVS are involved at all. I've never worked for them, but I assumed they used their own warehouses to distribute, especially with hearing about "truck day" and the like.
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CVS definitely uses their own distributer. I know theu utilize cardinal for some specialty items or when their own warehouse is out, but I am not sure Cardinal should take a fall for the CVS thing. Perhaps, they are guilty of completely unrelated transgressions, but the article is paiting them with the same brush as CVS.
 
Unchained said:
Doctor M I understand your defense of not knowing if a script is legit or not. I guarantee that if you spent one day in this pharmacy you would know something was up. Groups of individuals coming in together with a half dozen scripts for oxycodone and all paying cash. Not to mention the fact they look like drug dealers. There is something called a moral obligation that should've prevented these pharmacists from filling these scripts. Legally CVS may be in the right here and the DEA may have overstepped their bounds but that doesn't make them right in the court of morality. I know of CVS DMs who have pressured their pharmacists to fill questionable CII's. These directives certainly come from high up the chain.
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I agree. You can kind of tell. It already makes me slightly uneasy when I mother and daughter come in to fill methadone together from same doctor (legit doctor though) at the same time. That being said, how am I supposed to be the police here, alone and basically no backup. I don't have a tech most of the day, and one more tech is not going to save my life either. Am I supposed to turn them in? I don't even know how that works. Our corporate policy has something like we can't turn our customers in at the store unless the prescriber request us to do so.

Right now what I'm doing is:
1) check the script to see if it looks legit
2) check if it's a legit prescriber in town
3) check state controlled substance monitoring database to see if it's due to be filled
4) if it's out of state I check to make sure the rx meets my state's rx requirement. I also call the pharmacy in that state/city to check on the prescriber, etc
 
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Clachan, you are doing the most you can given your situation. If your company is unsupportive they will pay the price eventually. You shouldn't be placing your job or your safety on the line. I would recommend being out of stock in situations where you feel fraud is likely. You will develop this sixth sense over time.
 
Nice find Dr M. Case closed on this one. Cardinal wasn't even following their own policies with respect to conducting due diligence regarding oxycodone orders. Those CVSs experienced an increase of 800% oxy sales in the course of two years. All of this after Cardinal was fined 34 million back in 2008 for similiar infractions.DEA gave them ample warnings.
 
I read an article today where an investigator from Cardinal went to a pharmacy in Fort meyers to find that a pharmacy they sold controls to had dispensed 462,000 pills of oxycodone in 2 months. The owner of the store asked for an increase. Cardinal apparently gave this guy the increase. After reading that, i guess cardinal needs a hard lesson. Thats a whole crap load of oxy to fill in 2 months. Read the story here:

http://www.usatoday.com/news/nation/story/2012-02-27/painkiller-abuse-DEA/53275844/1
 
Doctor M said:
I read an article today where an investigator from Cardinal went to a pharmacy in Fort meyers to find that a pharmacy they sold controls to had dispensed 462,000 pills of oxycodone in 2 months. The owner of the store asked for an increase. Cardinal apparently gave this guy the increase. After reading that, i guess cardinal needs a hard lesson. Thats a whole crap load of oxy to fill in 2 months. Read the story here:

http://www.usatoday.com/news/nation/story/2012-02-27/painkiller-abuse-DEA/53275844/1
Click to expand...

There is a lot of pain in the world Dr. M....alot of pain.
 
Doctor M said:
I read an article today where an investigator from Cardinal went to a pharmacy in Fort meyers to find that a pharmacy they sold controls to had dispensed 462,000 pills of oxycodone in 2 months. The owner of the store asked for an increase. Cardinal apparently gave this guy the increase. After reading that, i guess cardinal needs a hard lesson. Thats a whole crap load of oxy to fill in 2 months. Read the story here:

http://www.usatoday.com/news/nation/story/2012-02-27/painkiller-abuse-DEA/53275844/1
Click to expand...
And to think, Cardinal will only sell us ONE bottle of HC/APAP 10/650mg #100 per day. :mad:


I see a lot of suspect dealers with hoodies?!
images
 
Got a call yesterday from our Cardinal rep telling us that the Judge ruled in favor of the DEA and they have shut done Cardinal's Lakeland division from dispensing any controls......I guess Cardinal was the example.
 
Does anyone think there's a meticulous layering of when to act & no act - with the DEA? Don't you think there's an aspect of the DEA wanting to toss out penalties based on revenue generation? I am not saying the ENTIRE DEA is corrupt but I am saying based on the government's discrepancies over the past 6 months (especially) that the DEA needs an internal investigation with regards to their "fine" practices with Wholesalers & Community Pharmacies. :(
 
i thought all this happened somewhere else in florida and Cardinals/Walgreens were involved. didnt they learn their lesson?
 
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