The US Department of Justice has accused Walmart of helping to fuel America's opioid crisis.
Walmart, the world's largest retailer, operates more than 5000 pharmacies at its stores across the US. Photo: AFP / Robert Sullivan
In a lawsuit filed on Tuesday, prosecutors said the retail giant filled hundreds of thousands of questionable prescriptions, "knowingly" violating vetting rules.
Walmart revealed in October that it had been threatened with such a suit.
At the time, Walmart said the US was imposing "unworkable requirements that are not found in any law".
Walmart, the world's largest retailer, operates more than 5000 pharmacies at its stores across the US and for years has also acted as a drug distributor.
According to the lawsuit, the company pressured staff to fill prescriptions as fast as possible and withheld information from pharmacists, collected by its compliance unit, which indicated such orders did not have valid medical purposes.
Jeffrey Bossert Clark, acting assistant attorney general of the Department of Justice's civil division, said Walmart's actions "contributed to the epidemic of opioid abuse throughout the United States".
"As one of the largest pharmacy chains and wholesale drug distributors in the country, Walmart had the responsibility and the means to help prevent the diversion of prescription opioids," he said.
"Instead, for years, it did the opposite - filling thousands of invalid prescriptions at its pharmacies and failing to report suspicious orders of opioids and other drugs placed by those pharmacies."
For example, when pharmacists reported problematic orders to the compliance unit, it did not share information about the prescribers more widely, according to the lawsuit.
Walmart also did not respond to concerns from distribution staff that they did not have enough time to evaluate orders, it said.
This created a "defective" detection system, according to the lawsuit, which said Walmart reported just 204 "suspicious orders" to authorities over four years, out of an estimated 37.5 million shipments.
Prosecutors said Walmart "substantially benefited" from its actions, avoiding the expense of creating proper compliance procedures and profiting from the extra business - in some cases from so-called "pill mill" prescribers who steered their patients to the firm's stores.
The government is seeking financial penalties for the alleged misconduct, which it said dated to 2013. It said the fines could amount to "billions of dollars".
Rock and hard place
In its response, Walmart said the justice department is "demanding pharmacists and pharmacies second-guess doctors" and is putting them "between a rock and a hard place with state health regulators who say they are already going too far in refusing to fill opioid prescriptions".
In a strongly-worded statement, Walmart said the lawsuit "invents a legal theory that unlawfully forces pharmacists to come between patients and their doctors, and is riddled with factual inaccuracies and cherry-picked documents taken out of context."
Walmart said it had sent the DEA tens of thousands of investigative leads, and blocked thousands of questionable doctors from having their opioid prescriptions filled at its pharmacies.
Roughly 450,000 people have died from overdoses related to prescription painkillers and illegal drugs since 1999.
The lawsuit against Walmart is the latest effort by the Department of Justice to respond to the public health crisis.
In October, it announced that Oxycontin-maker Purdue Pharma would pay more than $US8 billion and admit to enabling the supply of drugs without legitimate medical purpose.
- BBC