Pharmacy pushed drug designed for addicted pregnant women
Buprenorphine — intended only for addicted pregnant women and nursing mothers — was quickly becoming a hot product on the opioid black market, and this Johnson City pharmacy wanted its cut of the profits, records show.
In a city with a population of fewer than 65,000, Blankenship Pharmacy ordered so much buprenorphine — more than 300,000 doses in eight years — even one of the drugmakers was suspicious.
“We can find no information demonstrating that this retail pharmacy is specializing in treating pregnant women or nursing mothers, nor can we find any
relationship with any medical practice that appears to specialize in treating pregnant women or nursing mothers,” an investigator with Teva Pharmaceuticals wrote.
“This pharmacy appears to have been the largest retail purchaser in the U.S.”
Blankenship defended its purchases and insisted opioid supplier AmerisourceBergen keep shelves stocked — as quickly as possible and without drawing the attention of the U.S. Drug Enforcement Administration, a lawsuit reveals.
“We were the first pharmacy in the area to offer these medications and have, therefore, developed close relationships with the physicians, clinics and staff,” the pharmacy replied when questioned about its ordering habits. “The percentage of controlled substances dispensed is a natural result.”
The pharmacy is among a dozen labeled chief conspirators with AmerisourceBergen in what state Attorney General Herbert L. Slatery III says was a plot to promote and profiteer from the opioid epidemic in Tennessee.
Pharmacy owner Boone Drugs, a North Carolina firm, did not respond to a request for comment.
Slatery’s office has been using the pharmaceutical industry’s own records to build a civil racketeering case against opioid makers, distributors and dispensers and seek to hold them financially responsible for the epidemic.
The lawsuit against Amerisource-Bergen is the third in a series filed in Knox County Circuit Court but the first against a pharmacy supplier — and the first to reveal the role pharmacies played in creating and fueling the state’s opioid epidemic.
‘Bump it up again’
AmerisourceBergen, records show, knew most of Blankenship’s customers paid in cash and sought out a drug combo popular on the black market — opiates and addictive anti-anxiety narcotics.
The firm knew, records show, Blankenship courted the business of overprescribing doctors operating opioid pill mills and bought hundreds of thousands of opiates from several suppliers each month to avoid triggering DEA order review “thresholds.”
But while Teva saw trouble in Blankenship’s ordering habits, AmerisourceBergen saw profit potential, records show.
“Should we bump up their calculated (threshold) override one more time?” an AmerisourceBergen staffer asked.
The answer was immediate.
“Yes, please bump it up again,” the reply read.
AmerisourceBergen then told Teva to mind its own business.
“If Teva feels additional information is necessary … we suggest that you obtain that information directly from the end customer,” an AmerisourceBergen staffer wrote in an email.
In just eight years, AmerisourceBergen would supply Blankenship nearly 4 million opiates, earning the tiny pharmacy ranking as one of its top four most profitable customers in the state.
Even now, the lawsuit reveals, Blankenship remains one of Amerisource-Bergen’s best buprenorphine customers.
“Faithful as ever, Amerisource was still shipping buprenorphine to a pharmacy they knew had ongoing abuse and diversion for years,” the lawsuit stated.
“Out of all the pharmacies in Tennessee … the potency of the opioids being dispensed by Blankenship Pharmacy was incredibly high.”