3 drug distributors shipped 1.6B doses of opioids to Missouri in 5 years

Cardinal Health, McKesson Corp. and AmerisourceBergen distributed 1.6B opioids in Missouri between 2012 and 2017, which equates to about 260 pills per resident, according to an investigative report Sen. Claire McCaskill, D-Mo., released July 11.

Here are five things to know about the report:

1. Ms. McCaskill's latest report on the opioid epidemic examines the large amount of opioids that flooded into Missouri, along with the number of suspicious orders the three companies reported directly to the Drug Enforcement Administration. The Controlled Substances Act requires companies to report unusually large medication orders to the DEA as a preventative measure to limit excess pills resold to the black market.

2. McKesson and AmerisourceBergen both distributed 650 million doses of opioids to Missouri during the five-year time period, the report found. McKesson reported 16,714 suspicious orders to the DEA between 2013 to 2017, and AmerisourceBergen reported 224 order between 2012 to 2017. Cardinal Health distributed roughly 325 million pills, reporting 5,125 suspicious orders to the DEA.

"Something is wrong here," Ms. McCaskill told The Washington Post. "There is no way you have this divergence of reporting between the three major distributors."

3. Both McKesson and Cardinal Health have previously paid several large fines to settle allegations they failed to report suspicious narcotics orders. However, the report claims DEA's enforcement efforts have decreased since 2011, with the DEA suspending only 12 distribution orders from 2007 to 2017.

"It's easy sometimes to forget that these are real people and real families that are struggling both with overdose deaths and addiction and it’s easy to make this about data," Ms. McCaskill told The Washington Post.

4. Becker's Hospital Review reached out to Cardinal Health, McKesson Corp. and AmerisourceBergen for comment and was referred to a statement released by the Healthcare Distribution Alliance, which represents all three distributors.

"Pharmaceutical distributors applaud the recent efforts by policymakers to identify and advance legislative solutions to the current opioid abuse epidemic. Our members have urged congressional leaders to prioritize a range of policy solutions as part of a more comprehensive, real-time response to the opioid crisis," said Jon Gray, President and CEO of HDA. "At the same time, the recent report from Sen. McCaskill relies on debunked, inaccurate statements without acknowledging the need for broader reforms across the pharmaceutical supply chain.

5. AmerisourceBergen also shared a separate statement with Becker's Hospital Review via email.

"We are committed to addressing the epidemic of opioid abuse," the company said. "As the Homeland Security and Governmental Affairs Committee Report states, among the many things that we do around our shipping of controlled substances, we file daily reports of controlled substance sales, provide DEA with detailed information about quantity, type and receiving pharmacy of each order of opioids, and we regularly report suspicious orders after extensive analysis of each order captured in our order review system."

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Bulk of Ohio physicians still overprescribe opioids, despite legislation
Ohio allocates $3M to drugmaker creating abuse-proof opioid

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