Report: 3 firms shipped 1.6B opioid doses to Mo.
Three companies shipped approximately 1.6 billion doses of powerful prescription opioids to Missouri pharmacies from 2012 to 2017, according to a congressional report seeking the root causes of the opioid epidemic.
The report, released by Sen. Claire McCaskill, D-Mo., shows that drug distributors Cardinal Health, McKesson Corp. and Amerisource Bergen funneled the equivalent of about 260 opioid pills for every person in Missouri in the six-year period, during which time the opioid epidemic raged there — and nationwide.
The data, which the companies provided to the Senate Committee on Homeland Security and Governmental Affairs, shows that McKesson and AmerisourceBergen each shipped approximately 650 million opioids to Missouri. McKesson reported 16,714 suspicious orders from 2013 to 2017, while AmerisourceBergen reported 224 from 2012 to 2017. Cardinal Health shipped about 325 million pills and reported 5,125 suspicious orders to the DEA.
“The disparities exist despite the fact that each company employs similar strategies to prevent diversion,” the report states, noting that the companies use analytics to measure and report suspicious orders.
“Something is wrong here,” McCaskill said in an interview. “There is no way you have this divergence of reporting between the three major distributors.”
Cardinal Health was fined $44 million in 2016 to resolve allegations that it failed to report suspicious orders of narcotics. In 2008, Cardinal paid a $34 million fine to settle similar allegations. McKesson agreed to pay $150 million in fines in January 2017 to resolve allegations that it failed to report suspicious orders. In 2008, the company paid a $13 million fine for similar allegations.
Despite the huge fines, the report said that DEA enforcement efforts have declined since 2011, and the DEA issued just 12 immediate suspension orders to distributors between fiscal 2007 and 2017. Former DEA officials reported that the “revolving door between the agency and the distribution industry created an institutional resistance to issuing immediate suspension orders,” according to the report. The DEA did not respond to a request for comment Wednesday.
The report also cites a Washington Post report about how members of Congress allied with drug distributors to pass a law — the Ensuring Patient Access and Effective Drug Enforcement Act — that bowed to industry and undermined efforts to slow the flow of pain pills nationwide.
McCaskill’s report also looked at suspicious order-reporting in Missouri from 2012 to 2017 by four generic manufacturers, according to data the companies volunteered to the Senate: Allergan, Mallinckrodt, Endo and Teva. Mallinckrodt reported 905 suspicious orders from 2012 to 2017 and Endo none. Teva and Allergan’s numbers are unknown. The companies did not respond to requests for comment.