Drug firms shipped 40M pain pills a year to WV

Over five years, out-of-state drug wholesalers shipped more than 200 million doses of two popular prescription painkillers to West Virginia, while turning a blind eye to suspicious orders from “pill-mill” pharmacies, according to the latest filing in a state lawsuit against the companies.

The release of the pill numbers follows a bid by the drug wholesalers to toss out the lawsuit.

Between 2007 and 2012, 11 drug distributors shipped 59.9 million oxycodone pills and 140.6 million hydrocodone pills to West Virginia, according to the filing by lawyers representing two state agencies.

“That’s an extraordinarily high number of medications in a state with less than 2 million people,” said Delegate Don Perdue, D-Wayne, a retired pharmacist. “If I would have been the firm shipping those drugs or seeing those shipping records, I would have looked at that and said, “What’s going on here?’

Oxycodone and hydrocodone are the most widely abused prescription painkillers, and contribute to more overdose deaths in West Virginia than any other drug.

The wholesalers’ pain-pill numbers were culled from a U.S. Drug Enforcement Administration database, according to the filing.

AmerisourceBergen, the nation’s third largest drug wholesaler, shipped 80.3 million hydrocodone pills and 38.4 million oxycodone pills to West Virginia over the five-year span — the highest totals for both drugs by any company named in the state’s lawsuit, according to the filing.

Miami-Luken Inc. had the next-largest numbers with 20.4 million hydrocodone pills and 8.2 million oxycodone pills sent to West Virginia pharmacies.

Other distributors with high numbers include Anda Inc. and H.D. Smith Wholesale Drug Co.

“The drug distributors provided the fuel for the prescription drug problem in this state,” wrote Charleston lawyer Jim Cagle, a special assistant attorney general who’s representing the state, in a brief filed last week.

The pill numbers cited in the lawsuit exclude shipments from McKesson Corp., the nation’s largest drug wholesaler, and Cardinal Health, the second largest distributor.

Last year, state agency officials asked Attorney General Patrick Morrisey to add McKesson as a defendant in the lawsuit, but he rejected the request, saying his office was investigating McKesson. Last year, Morrisey solicited bids for an outside law firm to assist his office with the investigation, but apparently never awarded a contract.

Two state agencies — the Department of Military Affairs and Public Safety and the Department of Health and Human Resources — are suing Cardinal Health in a separate lawsuit, but Cardinal’s pain-pill shipping totals have yet to be disclosed. Cardinal supplies narcotics to several of West Virginia’s largest retail drugstores.

“Those [pill] numbers are going to go up even more,” Perdue said.

The state agencies allege that the drug wholesalers shipped “massive quantities” of pain pills to West Virginia and failed to report suspicious orders from pill-mill pharmacies that filled questionable prescriptions from rogue doctors.

“That enormous amount of controlled substances distributed to a [West Virginia] population of 1.85 million is so great as compared to the population that many of the orders were obviously suspicious,” Cagle wrote in a May 11 filing. “Defendants failed to know their customers or . . . chose to turn a blind eye to the obvious in order to make sales.”

In previous filings, the drug wholesalers have said raw pill counts can be misleading. The companies argue that their total distribution numbers, and the percentage of sales of controlled substances compared to all drugs, would put the records in better context.

Cagle responded that the state has asked for that information but the drug companies have refused to release it.

As part of the lawsuit, the drug wholesalers are fighting the state’s request to unseal a revised complaint that includes details about the companies’ pain-pill shipments to individual pharmacies. The records would show the number of pills sent to each pharmacy.

The companies cite a November 2013 “protective order” that allows them to label some information “confidential” and “highly confidential.” The drug distributors say they don’t want confidential records getting into the hands of their competitors — including their co-defendants in the ongoing lawsuit.

Cagle has argued that the pill shipment records are “in the public’s interest,” and the state has a “duty of transparency” to disclose them.

The records are voluminous. One wholesaler gave 10,000 pages to Cagle’s law firm, while another company turned over 12 spreadsheets. The first spreadsheet had 44,275 lines of information.

“If I were a manager at one of those wholesalers, the question I would have would be, “Is somebody in my company diverting drugs, based on the amount of drugs we’re shipping to this small state?’ ” Perdue said.

West Virginia has the highest drug overdose death rate in the nation. The state spends about $121 million a year on problems caused by prescription drug abuse, according to the lawsuit.

A lawyer for the drug wholesalers would not comment last week for this report. An AmerisourceBergen spokeswoman said the company would not comment about the case while it is under litigation.

Reach Eric Eyre at ericeyre@wvgazette.com, 304-348-4869 or follow @ericeyre on Twitter.

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