In a significant development, Attorney General Peter F. Neronha has announced the finalization of settlements exceeding $56 million with national pharmacy giants CVS, Walmart, and Walgreens. This marks a crucial step in a multistate initiative aimed at holding these pharmacies accountable for their role in exacerbating the opioid epidemic in Rhode Island and across the United States.
Consent judgments have been formally filed with each pharmacy in Rhode Island state court. Pending court approval, these judgments will set in motion the terms of the settlements. The anticipated disbursement of funds, totaling $56.26 million, is scheduled to commence in 2024 and extend through 2037. The allocation of these funds will follow the guidelines established in a memorandum of understanding. Under this agreement, the State will receive 80% of the settlement funds, while the remaining 20% will be directly distributed to cities and towns within Rhode Island.
To date, the Office, under Attorney General Neronha’s leadership, has successfully recovered an impressive sum exceeding $329 million in both cash and life-saving medication. These recoveries have been achieved through settlements with opioid manufacturers, distributors, and consultants. According to the negotiated memorandum of understanding, all funds retrieved through Rhode Island’s opioid settlements are earmarked for exclusive use in opioid treatment, prevention, and recovery initiatives, playing a pivotal role in the ongoing fight against the epidemic.
The State’s share of the settlement funds will be directed to the Rhode Island Statewide Opioid Abatement Fund. This fund, administered by the Executive Office of Health and Human Services (EOHHS) with oversight from the Opioid Settlement Advisory Committee, ensures that the funds are strategically utilized to address the persisting impact of the opioid epidemic in the state.
Attorney General Neronha emphasized, “There is no question that at the relevant points in time, these national pharmacies decided to put profits over the people of Rhode Island, and indeed all Americans. While no amount of money can fully undo the harm caused, these finalized settlements enable us to continue funding essential resources for treatment, prevention, and recovery efforts.”
Echoing this sentiment, Secretary Richard Charest of the Rhode Island Executive Office of Health & Human Services stated, “Improving the health and well-being of Rhode Islanders is one of the McKee Administration’s top priorities. We will deploy these new funds to support our ongoing efforts and those of our dedicated community partners to address the overdose crisis, saving and improving lives.”
The Office’s Complaint, supported by data from the federal Automation of Reports and Consolidated Orders System (ARCOS), the Drug Enforcement Administration’s comprehensive drug reporting system, underscores the gravity of the allegations against the pharmacies and their impact on the opioid crisis.
- Per capita opioid sales in Rhode Island were well above the national average from 2006 through 2014. In 2014 alone, the volume of opioids sold in the state would provide every man, woman, and child in Rhode Island roughly one hundred sixty-one (161) 10mg pills.
- For the time period from 2006-2019, CVS, Walgreens, and Walmart together held the majority of market share as buyers of opioids in Rhode Island.
- From 2006-2014, CVS was by far the largest buyer of opioids in the state. During this timeframe, CVS purchased over 148 million dosage units, or 46% of the market share.
- During this same period, Walmart and Walgreens were among the top five buyers of opioids in the State, with each purchasing 41.3 million dosage units (Walgreens) and 9.6 million dosage units (Walmart).
- From 2007-2014, CVS and Walgreens failed to report to the DEA a single suspicious order or shipment of controlled substances to their pharmacies or distribution centers in Rhode Island.
According to ARCOS data obtained by the State, some CVS and Walgreens branches purchased and dispensed alarming quantities of prescription opioids given the size of their communities:
- In 2014, an East Providence CVS purchased over 800,000 dosage units, or over 25 million morphine milligram equivalents (MME), in a community of just under 48,000 people.
- In 2012, a CVS location in North Smithfield purchased enough dosage units of opioids to supply 80 dosage units to every resident of the town.
- Further, between 2006 and 2014, one Woonsocket (population approx. 42,000) Walgreens purchased 5.4 million pills.
This influx of opioids into the State has had devastating public health consequences. The United States saw a nearly four-fold increase in the annual number of opioid pills dispensed by pharmacies between 1999 and 2014. This increase contributed to numerous instances of opioid abuse, dependence, addiction, and overdose deaths in the State of Rhode Island. Over 430 Rhode Islanders lost their lives to accidental overdose in 2022, with over 380 of those deaths attributed to opioids. The proliferation of prescription opioids also contributed to a sharp increase in the use of even more powerful drugs such as fentanyl and heroin, which are sometimes used by themselves, and other times used in combination with prescription opioids.
As alleged in the Complaint, Defendants had a crucial role to play in stopping the diversion of opioids but failed to do so. The law makes pharmacies and pharmacists the last line of defense in preventing the illegal diversion of controlled substances. But as alleged, these pharmacies failed repeatedly to carry out their legal responsibility and designed, or applied, their policies in such a manner that they were ineffective controls against diversion. Further, this allegedly manifested itself in huge quantities of opioids being dispensed through these pharmacies. The Complaint alleges that the numbers alone should have made clear to the defendants that additional and better controls were needed to control against the diversion of drugs.
Finally, as noted in the Complaint, these pharmacies had been the subject of prior legal action brought by the DEA and the United States Department of Justice concerning their opioids business practices:
- In April 2019, CVS Pharmacy, Inc. reached a $535,000 settlement related to allegations that several Rhode Island pharmacies filled prescriptions for Percocet that they had reason to know were forged.
- In August 2015, CVS Health Corporation reached a $450,000 settlement with the U.S. Attorney’s Office for Rhode Island to resolve allegations that several of its Rhode Island stores violated the Controlled Substances Act.
- In 2013, Walgreens entered into a settlement with the DEA by agreeing to pay $80 million in civil penalties, marking the largest settlement in DEA history at that time.
- Over the past ten years, CVS has agreed to tens of millions of dollars in settlements related to allegations that their pharmacies violated state and federal law at pharmacies across the country.
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