The U.S. government is suing Rite Aid, saying the drugstore chain and its employees ignored "obvious red flags" in opioid prescriptions for years, contributing to an epidemic that continues to kill tens of thousands of Americans annually.
The Justice Department complaint states that, between May 2014 and June 2019, Rite Aid pharmacists filled hundreds of thousands of prescriptions for controlled substances, including opioids, that were "medically unnecessary" or that should have aroused suspicions, because they "lacked a medically accepted indication or were not issued in the usual course of professional practice."
The agency said Rite Aid pharmacists either "ignored these red flags" or made no or too little effort to investigate. Rite Aid management, for its part, turned a blind eye and, at times, reprimanded employees who raised concerns, in an apparent violation of federal laws, the Justice Department said.
"The Justice Department is using every tool at our disposal to confront the opioid epidemic that is killing Americans and shattering communities across the country," Attorney General Merrick Garland said Monday in a statement.
Rite Aid did not immediately respond to a request for comment. Rite Aid is one of the largest pharmacy chains in the United States, with over 2,300 stores and 6,300 pharmacists in 17 states.
The federal government's complaint says Rite Aid pharmacists repeatedly filled prescriptions for a trifecta of opioids, benzodiazepines and muscle relaxants, known as "trinities," and refilled opioid prescriptions early, even though patients' supplies should not yet have ran out. They also filled prescriptions for suspiciously high doses or excessive quantities of opioids, as well as prescriptions from clinicians who had already been flagged as "writing illegitimate prescriptions."
The agency says "at least hundreds of thousands" of prescriptions that "did not meet legal requirements" were filled, in an apparent violation of the Controlled Substances Act. As prescriptions were filled, Rite Aid submitted "false or fraudulent claims" for reimbursement to federal health-care programs like Medicare and Medicaid -- a violation of the False Claims Act, according to the complaint.
When Rite Aid employees flagged concerns internally, these were often dismissed. According to the complaint, the group's Government Affairs Department directed another Rite Aid department to delete warnings left by employees in Rite Aid's dispensing software that could indicate problems. This included notes like "writing excessive dose[s] for oxycodone" and "DO NOT FILL CONTROLS."
In 2015, an analyst in Rite Aid's Government Affairs Department reprimanded a pharmacist after the pharmacist left a note on a prescriber profile that read, "this may be a cash only pill mill??? verify and notate." The analyst said the note would be removed and advised the pharmacist to "remember to always be very cautious of what is put in writing."
These actions "opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid's stores," Associate Attorney General Vanita Gupta said.
The Justice Department joined a whistleblower lawsuit in the Northern District of Ohio that was originally filed in 2019 by two Rite Aid employees who worked in pharmacies in North Carolina and West Virginia.
Principal Deputy Assistant Attorney General Brian Boynton said the lawsuit is a "reminder that the Justice Department will hold accountable any individuals or entities, including pharmacies, that fueled this terrible crisis."
Last year, CVS Health and Walgreens, two of the nation's largest retail pharmacies, agreed to pay about $10 billion to states, cities and Native American tribes over 10 to 15 years to settle all opioid lawsuits against them. As part of the settlement agreement, the companies did not admit wrongdoing.
Bentonville-based Walmart said last year it will pay out $3.1 billion to settle all lawsuits and potential lawsuits filed by state, local and tribal governments claiming that opioid prescriptions filled by Walmart's pharmacies caused financial harm to their communities.
There were more than 106,000 drug overdose deaths in the United States in 2021.
Information for this article was contributed by Rachel Lerman and Meryl Kornfield of The Washington Post.