US pharmacy chains to appear in court over opioid crisis

Two counties in the US state of Ohio are set to argue in court that four major pharmacy chains are responsible for flooding their communities with addictive pain pills that were part of a wider opioid crisis in the country.

The Ohio counties of Lake and Trumbull allege that oversight failures at pharmacies run by Walgreens Boots Alliance Inc, CVS Health, Walmart Inc and Giant Eagle Inc led to excessive amounts of opioid pills flooding their communities.

Lawyers for both the counties and the pharmacy chains will deliver an opening statement in the case on Monday.

While previous cases have targeted drug distributors and manufacturers, the trial in Cleveland is the first to specifically target pharmacies and could set the tone for government entities to make similar claims going forward.

Lawyers for the counties have said about 80 million prescription painkillers were dispensed in Trumbull between 2012 and 2016, or about 400 for every county resident. About 61 million pills were dispensed in Lake County during that five-year period, or 265 pills for every resident.

The trial will be the fourth in the US this year to test claims brought by governments against part of the drug industry over the toll of prescription painkillers.

The number of deaths in the US from opioid overdoses has exploded in the last 20 years, with nearly 50,000 deaths in 2019 – six times the number in 1999.

The US Centers for Disease Control and Prevention estimates that number increased to just shy of 70,000 in 2020. Public health experts have blamed the increase on overprescribing by physicians fuelled by aggressive marketing by pharmaceutical companies.

Pharmacies say federal regulators to blame

In the Ohio case, lawyers for the pharmacy chains have argued that the companies did not manufacture the drugs and their pharmacies were filling prescriptions written by physicians for patients for what they were told were legitimate medical needs.

The lawyers have also argued the companies followed and exceeded guidelines established by the US Drug Enforcement Administration (DEA) and the state of Ohio in how their stores were supplied with pain pills.

CVS Health in a statement said licensed wholesalers, not the company, distributed painkillers to its pharmacies and that it’s a “leader in the fight against prescription opioid abuse”.

“Since 2013, the DEA has refused to share with pharmacies the names of any doctors whose opioid prescriptions it believes are problematic,” the statement said.

“Many of these doctors continue to be licensed by the DEA to prescribe opioid medications.”

Lawyers for Illinois-based Walgreens, say the Lake and Trumbull counties used “confused and contradictory legal theories against other defendants before they landed on the idea to sue retail pharmacy chains”.

Pittsburgh-based Giant Eagle said in a trial brief that the company not only complied “with all laws and regulations designed to prevent diversion, it actively assisted law enforcement in their efforts to prevent diversion”.

Lawyers for Walmart said their stores dispensed only a small percentage of the pain medication prescribed in Lake and Trumbull and said the lawsuits “fail to distinguish legitimate from potentially illegitimate prescriptions”.

The trial came after the three largest US distributors that supply pharmacies – McKesson Corp, Cardinal Health Inc and AmerisourceBergen Corp – and the drugmaker Johnson & Johnson in July proposed paying up to $26bn to settle cases against them.

Meanwhile, a bankruptcy judge in August approved a settlement by OxyContin maker Purdue Pharma LP and its wealthy Sackler family owners that the company values at more than $10bn.