Ohio's 650 Million Opioid Ruling Against Big Pharma Could Spook Pharmacists - MedCity News

CVS, Walgreens and Walmart must pay $650 million of two Ohio counties for their involvement in the opioid epidemic, a judge ruled Wednesday. It would “address a small part of a terrible, persistent and escalating national tragedy,” said U.S. District Judge Aaron Polster. But some say the solution has the potential to cause further harm by scaring off pharmacists.

The ruling indicated that Polster believes the three companies’ oversupply of prescription opioids contributed to the epidemic in Ohio’s Lake and Trumbull counties. It ruled that pharmacies should be responsible for one-third of the total reduction costs, with drug manufacturers, distributors and dispensers of prescription opioids also responsible.

There are more than 3,000 cases that are part of the multi-district litigation over the opioid epidemic. So far, most drug manufacturers and distributors have reached populated areas with counties filing lawsuits against them. Wednesday’s decision represents the first ruling by a judge against large, well-known retail pharmacies.

However, some say the pharmacies are not to blame. Zach Grayco-founder and CEO of OpheliaA direct-to-patient digital health provider that combines telemedicine with life-saving medication-assisted treatment (MAT) to treat opioid use disorder (OUD) called the decision “well-intentioned” but says it sends the wrong message.

“Although well-intentioned, this decision has the potential to cause further damage by scaring pharmacies away from dispensing buprenorphine, a life-saving addiction treatment drug,” Gray said. “Buprenorphine is a controlled drug used to treat opiate use disorder, and pharmacies across the country are now unwilling to give it away out of fear that it might trigger an investigation by the Drug Enforcement Administration (DEA). This decision sends a dangerous message to pharmacists: you are expected to overrule doctors – and not doing so can cost you dearly.”

Gray says the DEA needs to issue clearer guidance to pharmacists about prescriptions for opioid addiction treatment. The agency has publicly committed to allowing telemedicine for buprenorphine beyond a pandemic but it should be clear that remote prescribing of this drug is in line with his agenda, Gray said. This is especially important because buprenorphine prescribing is already highly regulated with prescribers requiring a special DEA license to dispense the drug. There are also strict limits on how many patients each prescriber can provide this treatment to.

As pharmacists grapple with the impact of this decision, the spotlight on retail pharmacies isn’t going away anytime soon.

Walgreens is on the hook in California, where it is a judge in the Northern District earlier this month found that the pharmacy has “substantially contributed to the opioid epidemic.” The second phase of the trial will help determine Walgreens’ responsibility for containing the problem it helped create.

CVS Health, Walgreens and Walmart did not immediately respond to a request for comment.

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