Attorney General Neronha finalizes more than $56 million in opioid settlements with CVS, Walgreens, and Walmart

Published on Thursday, December 14, 2023

Attorney General Peter F. Neronha today announced the Office’s final step in effectuating more than $56 million in settlements with national pharmacies CVS, Walmart, and Walgreens as part of a multistate effort to hold them accountable for their role in furthering the devastating opioid epidemic in Rhode Island and across the country.

The Attorney General filed consent judgments with each of the three pharmacies in Rhode Island state court, which once approved by the court will effectuate the terms of the settlements. Following the Court’s execution of these consent judgments, funds totaling $56.26 million are expected to begin flowing into Rhode Island beginning in 2024 and through 2037. The funds will be distributed in accordance with the same memorandum of understanding that governs previous opioid settlements, with the State receiving 80% of the settlement funds and 20% of the settlement funds going directly to each of the state’s cities and towns.

For a breakdown of the settlement amounts, please see the table at the bottom of the release.

To date, the Office has recovered more than $329 million in cash and lifesaving medication for Rhode Island in settlements with opioid manufacturers, distributors, and consultants who advised those companies. Pursuant to the MOU negotiated by the Attorney General, all funds recovered through Rhode Island’s opioid settlements must be used for opioid treatment, prevention, and recovery efforts to combat the opioid epidemic. The State’s settlement funds will go into Rhode Island’s Statewide Opioid Abatement Fund, which is administered by the Executive Office of Health and Human Services (EOHHS) with the guidance of the Opioid Settlement Advisory Committee, to ensure that the funds are used to address the ongoing impact of the opioid epidemic in the State.

“There is no question that at the relevant points in time, these national pharmacies decided to put profits over the people of Rhode Island, and indeed all Americans,” said Attorney General Neronha. “And while no amount of money will ever be enough to undo the harm they have caused to Rhode Islanders and their families, through these now-finalized settlements, we can continue to fund desperately needed resources for treatment, prevention, and recovery efforts. These efforts are already underway and making a real difference in the lives of Rhode Islanders. As just one example, funds already delivered by this Office have been directed for 70 additional badly needed in-patient treatment beds.”

“Improving the health and well-being of Rhode Islanders is one of the McKee Administration’s top priorities,” said Rhode Island Executive Office of Health & Human Services Secretary Richard Charest. “We will deploy these new funds to support our ongoing efforts and those of our dedicated community partners to address the overdose crisis, saving and improving lives.”

As alleged in the Office’s Complaint, and according to data compiled from the federal Automation of Reports and Consolidated Orders System (ARCOS), the automated, comprehensive drug reporting system of the Drug Enforcement Administration:

• Per capita opioid sales in Rhode Island were well above the national average from 2006 through 2014. In 2014 alone, the volume of opioids sold in the state would provide every man, woman, and child in Rhode Island roughly one hundred sixty-one (161) 10mg pills.
• For the time period from 2006-2019, CVS, Walgreens, and Walmart together held the majority of market share as buyers of opioids in Rhode Island.
• From 2006-2014, CVS was by far the largest buyer of opioids in the state. During this timeframe, CVS purchased over 148 million dosage units, or 46% of the market share.
• During this same period, Walmart and Walgreens were among the top five buyers of opioids in the State, with each purchasing 41.3 million dosage units (Walgreens) and 9.6 million dosage units (Walmart).
• From 2007-2014, CVS and Walgreens failed to report to the DEA a single suspicious order or shipment of controlled substances to their pharmacies or distribution centers in Rhode Island.

According to ARCOS data obtained by the State, some CVS and Walgreens branches purchased and dispensed alarming quantities of prescription opioids given the size of their communities:

• In 2014, an East Providence CVS purchased over 800,000 dosage units, or over 25 million morphine milligram equivalents (MME), in a community of just under 48,000 people.
• In 2012, a CVS location in North Smithfield purchased enough dosage units of opioids to supply 80 dosage units to every resident of the town.
• Further, between 2006 and 2014, one Woonsocket (population approx. 42,000) Walgreens purchased 5.4 million pills.

This influx of opioids into the State has had devastating public health consequences. The United States saw a nearly four-fold increase in the annual number of opioid pills dispensed by pharmacies between 1999 and 2014. This increase contributed to numerous instances of opioid abuse, dependence, addiction, and overdose deaths in the State of Rhode Island. Over 430 Rhode Islanders lost their lives to accidental overdose in 2022, with over 380 of those deaths attributed to opioids. The proliferation of prescription opioids also contributed to a sharp increase in the use of even more powerful drugs such as fentanyl and heroin, which are sometimes used by themselves, and other times used in combination with prescription opioids.

As alleged in the Complaint, Defendants had a crucial role to play in stopping the diversion of opioids but failed to do so. The law makes pharmacies and pharmacists the last line of defense in preventing the illegal diversion of controlled substances. But as alleged, these pharmacies failed repeatedly to carry out their legal responsibility and designed, or applied, their policies in such a manner that they were ineffective controls against diversion. Further, this allegedly manifested itself in huge quantities of opioids being dispensed through these pharmacies. The Complaint alleges that the numbers alone should have made clear to the defendants that additional and better controls were needed to control against the diversion of drugs.

Finally, as noted in the Complaint, these pharmacies had been the subject of prior legal action brought by the DEA and the United States Department of Justice concerning their opioids business practices:

• In April 2019, CVS Pharmacy, Inc. reached a $535,000 settlement related to allegations that several Rhode Island pharmacies filled prescriptions for Percocet that they had reason to know were forged.
• In August 2015, CVS Health Corporation reached a $450,000 settlement with the U.S. Attorney’s Office for Rhode Island to resolve allegations that several of its Rhode Island stores violated the Controlled Substances Act.
• In 2013, Walgreens entered into a settlement with the DEA by agreeing to pay $80 million in civil penalties, marking the largest settlement in DEA history at that time.
• Over the past ten years, CVS has agreed to tens of millions of dollars in settlements related to allegations that their pharmacies violated state and federal law at pharmacies across the country.

Previous settlement agreements

The settlement announced today is the latest in a series of settlement agreements reached by Attorney General Neronha. These settlements will bring nearly $330 million in cash and lifesaving medication to Rhode Island.

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