The Drug Enforcement Administration (DEA) has moved to revoke the controlled medication licenses of two pharmacies because the pharmacies were filling prescriptions for oxycodone (the painkiller) in excess of their monthly allowances for controlled substances. In addition, the DEA alleges that the pharmacies' corporate entities failed to conduct on-site inspections and failed to notice that \(42 \%\) to \(58 \%\) of all the sales of the substances were cash sales, something that is considered a red flag in the sale and distribution of controlled substances. In addition, the number of prescriptions filled continued to escalate.

The two pharmacies won an injunction against the revocation in federal district court. However, the DEA is hoping to persuade the judge to lift the injunction once it is able to show that the corporations should have known a problem existed. The rate of cash sales at these pharmacies was eight times the national rate for filling prescriptions with cash. Pharmacists at the drug stores, in interviews with the DEA agents, indicated that the customers paying cash for the oxycodone were "shady", and that they suspected that some of the prescriptions were not legitimate. One of the companies adjusted (increased) the levels of shipment of oxycodone to the pharmacies five times. In one on-site visit by a DEA agent, the following information emerged: one of every three cars that came to the drive-thru window had a prescription for oxycodone; many patients living at the same address had the same prescriptions for oxycodone from the same doctor.

Both companies, CVS and Cardinal Health, have indicated in court filings that they have changed their practices and provided training to pharmacy personnel so that they can spot these types of illegal prescriptions and report suspicious activity. Both pharmacy companies have terminated customers, meaning that they will no longer fill prescriptions for those customers. As these cases evolve, Walgreen's agreed to pay a fine of \(\$ 80\) million to settle charges that it too did not have sufficient internal controls in place to stop widespread distribution of this narcotic. \({ }^{125}\)..........

Discussion Questions
1. Why is there responsibility for drug distribution when there is not direct knowledge?
2. Interviews with pharmacy employees indicated that many were aware of a problem and concerned. Consider the following statements and explain why they did not speak up and tell someone at their companies about their concerns.
- "We have goals for revenue."
- "This is a busy pharmacy, and I am oversubscribed for my full shift. Who has time to worry about this?"
- "Who's to know?"
- "Nobody else seems to see it."
- "There are lots of orthopedic patients in this area. It's possible."
- "Not my place. Other people watch for this stuff."
- "If I say something, they'll get someone else, and l'm unemployed."
3. What should the companies have done to encourage the employees to raise their concerns?