Nineteen Illinois counties, including five of six in the Chicago area, are suing some of the country’s largest pharmacy chains because the companies contributed to the overdose crisis by failing to monitor and restrict inappropriate prescriptions.
The lawsuit, filed last week in Cook County, adds to the growing stack of opioid lawsuits filed by state and local governments against drug manufacturers, distributors and retailers.
The plaintiffs in the pharmacy lawsuit include all counties in the Chicago area except Lake. A spokeswoman for Lake County Attorney Eric Rinehart said the county, which is represented by a different law firm than the one used by the other counties, is considering its own lawsuit.
The counties allege that pharmacies run by Walgreens, CVS, Kroger, Meijer, Albertsons, and Walmart “have failed to design and use systems to identify suspicious orders of prescription opioids, enforce effective controls against diversion and detect suspicious orders.” when they were identified, and instead actively contributed to the oversupply of such drugs and fueled an illicit secondary market.”
The lawsuit says some chains used performance metrics that encouraged pharmacists to fill prescriptions without questioning whether they were legit — a sign that the companies are “putting profit over safety.”
Jim Cohn, a spokesman for Walgreens of Deerfield, disputed the allegations.
“As we have said during this process, we have never produced or marketed opioids, nor have we distributed them to the ‘pill factories’ and internet pharmacies that fueled this crisis,” he said in a statement. “We will continue to defend against the unwarranted attacks by plaintiffs’ attorneys on the professionalism of our pharmacists, who are dedicated health professionals who live and work in the communities they serve.”
In similar cases pending elsewhere in the country, lawyers for some pharmacy chains have argued that the blame should be on the doctors who prescribed the drugs, not the druggists who fulfilled the orders.
The county lawsuit, however, argues that the pharmacies had enough information to have viewed some doctors and patients with suspicion. The red flags reportedly included patients who received multiple prescriptions from the same doctor, patients who received prescriptions from different doctors, orders of unusual size and frequency, and orders that were paid disproportionately in cash.
The lawsuit does not ask for a specific amount of damages, although the opioid crisis has cost the Illinois criminal justice system about $50 million a year.
One of the plaintiffs, McHenry County state attorney Patrick Kenneally, said pharmacies, like drug manufacturers and distributors, watched as a flood of opioid pills caused a spike in addiction and overdoses.
“They were supposed to be the sentry at the end of this (distribution) chain who had an interest in making sure (opioids) were prescribed for a legal purpose,” he said. “They failed to do that. As a result of that failure, they must be held accountable and help clean up this mess.”
He said the provinces have taken into account the success other jurisdictions have had in suing pharmacy chains. Last week, for example, an Ohio judge ordered CVS, Walgreens and Walmart to pay two counties more than $650 million.
Local governments in Illinois have been mired in lawsuits with the pharmaceutical industry for years, and some of those efforts are starting to pay off.
In February, the state announced a deal with three drug distributors and drugmaker Johnson & Johnson, allowing most of the state’s counties and municipalities to share in a $760 million settlement.
Illinois Attorney General Kwame Raoul also announced preliminary agreements last month with drug makers Allergan and Teva, whom he and colleagues in other states have accused of fraudulently marketing opioids by downplaying the risk of addiction.
Total settlements come in at $6.6 billion nationwide, though the Illinois cut is unspecified.
On Monday, Raoul announced a “significant win” in yet another opioid-related case, this one involving the manufacturer of an addiction treatment drug called Suboxone.
The drug is used to suppress cravings for opioids, and Raoul and other attorneys general say the manufacturer, Indivior, unlawfully blocked competitors from developing generic alternatives, forcing people to pay artificially inflated prices.
The judge in the case rejected Indivior’s request for summary judgment, meaning the lawsuit can continue.
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The number of opioid prescriptions in the US has fallen since its peak of 255 million in 2012. In 2020, the latest year for which the Centers for Disease Control and Prevention has data, only 143 million prescriptions were issued.
However, the number of deaths from opioids has continued to rise. Experts say most of that is due to illegal fentanyl, not drugs, but Dr. Daniel Ciccarone, the Justine Miner professor of addiction medicine at the University of California San Francisco, says the phenomena are related.
He said the crisis started with an overabundance of prescription painkillers, which caused many pills to hit the streets. When that supply dwindled, some pill users switched to heroin and then fentanyl, a synthetic opioid dealer favored because it’s cheap, potent, and easy to smuggle.
He said that in the latest wave, people are mixing stimulants like cocaine and methamphetamine with opioids, a particularly dangerous combination.
“What would have happened without the opioid pill oversupply?” said Ciccarone. “My expert opinion would be that none of the (consecutive waves) would have happened, or have happened in a much smaller way.”