For Injured Workers Pharmacy (IWP), speed and volume trumped patient and public safety, and the Andover, Mass. business is paying the price for its questionable practices—to the tune of $11 million.

The Massachusetts Attorney General’s Office alleged that the mail-order pharmacy took inadequate safety measures for reviewing the legitimacy of prescriptions. The AG’S complaint further alleges that the pharmacy paid law firms for patient referrals, just one of several illegal marketing practices, in an effort to push a dangerous product—opioids.

As a result of IWP’s negligence and violation of state consumer protection laws, thousands of possibly illegitimate controlled substance prescriptions were shipped across the United States, a country that continues in its life-and-death struggle with an opioid epidemic.

“Injured Workers Pharmacy created an illegal operation that put dispensing speed and volume over patient and public safety,” Massachusetts Attorney General Maura Healey said. “They dispensed thousands of prescriptions for dangerous drugs, including opioids like fentanyl, with a shocking lack of regard for whether those prescriptions were legitimate.”

When Profit Takes Priority

IWP primarily serves thousands of worker’s compensation patients across the nation. According to the AG, the company began pressuring pharmacists to speed up their dispensing of prescriptions, willingly sacrificing patient protection, as well as the prevention of diversion, which is the transfer of controlled substances to someone other than the patient for whom the drug was prescribed. 

The AG also alleged that the pharmacy’s dispensing and sales tactics prevented it from meeting statutory mandates and filling only legitimate prescriptions.

Not only did IWP unquestioningly dispense potentially illegitimate prescriptions, but the company also aggressively sought to boost its profits with unlawful sales tactics, including paying for patient referrals and paying sales staff on dispensing volume. The latter incentivized staff to look the other way when red flags presented themselves in the course of business.

Many of the prescribers who wrote the opioid prescriptions that IWP dispensed were eventually either convicted, indicted, or disciplined for their prescribing practices. Still, prescriptions continued to be dispensed by IWP long after they should have been aware of potential problems with the prescriptions.

Besides dispensing high-dose prescriptions for dangerous fentanyl formulations, IWP dispensed thousands of other dangerous drug combinations. Many of these combinations should have served as red flags to IWP personnel, as the mixtures typically indicate drug misuse and a strong likelihood for overdose. One example of such a combination is that of a muscle relaxant, a benzodiazepine, and an opioid—a concoction known as the “holy trinity.”

Terms of the Consent Judgment

The proposed consent judgment against IWP, which still must be approved by the court, demands many operational changes to the company. For starters, IWP would have to hire a full-time Chief Compliance Officer to keep an eye on use of proper procedures for blocking and reporting prescribers, as well as reading red flag behaviors. The company would also be required to hire a data analyst to monitor trends in dispensing data, as well as a pain management specialty pharmacist to counsel at-risk patients and their physicians.

Last, but not least, IWP will pay $11 million to the Commonwealth if the court approves the consent judgment.

She’s Only Just Begun

These actions are not AG Healey’s first, nor would one suspect, her last against pharmaceutical companies she faults for facilitating the nation’s opioid crisis. She has been investigating drug makers, manufacturers, and distributors since September 2017, including a lawsuit against Purdue Pharma in June 2018. 

Sara Stephens is a freelance writer who has developed a hefty portfolio of work across several industries, with a strong emphasis on law, technology, and marketing. Her work has appeared in the New York Times, as well as various technology and consumer publications, both print and online. Sara also works as a freelance book editor, having developed and edited manuscripts for bestselling and novice authors alike, and as a verbal strategist for a Miami branding consultancy.