Big Pharma Under Fire in Florida

A growing group of Florida pharmacists are denying critically ill patients pain meds for fear of being forced out of business. Some of those pharmacists, speaking to The Fix, blame the business practices of Florida’s largest wholesale pharmaceutical supplier, Cardinal Health Inc. Rather than warn pharmacies of its accepted maximum order levels for controlled substances, Cardinal simply cuts off their supply, they say. In return, pharmacists cut off seriously ill customers to ensure that they'll stay open.

Dr. Rich Lawrence of Ft. Myers Prescription Shop says he hates turning away desperate patients. “The wholesalers, even the smaller ones, all have established unknown limits on what I can buy. If I exceed the limits, they can turn off my abilities to serve my customers, including terminal cancer patients.” Cardinal cut Lawrence off in December. “Cardinal never spoke to me before, during, or after the cut off," he tells us. "They never once said that I was selling too much, was filling for bad doctors, was filling illegitimate prescriptions, wasn't doing my due diligence, was filling for known or suspected dealers or "doctor shoppers", or exceeding my [unknown] limits or percentages," he adds. "And no one will return my phone calls or emails.” Cardinal spokesperson Debbie Mitchell responds, “While we cannot comment on individual customer circumstances, we regret if a customer feels they weren’t dealt with fairly and we strive to keep those situations to a minimum.”

Cardinal also cut off John Ward, owner and pharmacist at John’s Pharmacy, Bonita Springs, Florida. He complains, “There’s no warning. That’s the way they do it. It is impossible to know ahead of time. I ordered the normal amount that I do every week. They cut me off in January. I feel like if it’s legitimate I should be able to sell it if it seems reasonable. I’m sending away people every day. It [Cardinal] is a dirty little secret.” Mitchell tells us, “We have made every effort to develop a best practice anti-diversion program based on the information we have available to us as a distributor.”

Still, Cardinal has reason to be wary of its own ability to remain operational. The DEA ordered the immediate suspension of controlled substance distribution by one of its 24 US distribution centers in Lakeland, Florida facility last month, saying it posed an “imminent danger” to public safety due by failing to take adequate steps to prevent Cardinal’s top four pharmacy customers from unlawfully diverting controlled substances. That suspension was temporarily blocked earlier today. Court records show that the DEA suspended the operations of four Cardinal distributions in 2007 and 2008—including Lakeland for 10 months—and Cardinal paid fines of $34 million. The $16.5 million for Lakeland was the largest such fine ever.