The Justice Department, together with the Drug Enforcement Administration, has announced a $50 million settlement with Walmart Inc to resolve allegations that Walmart pharmacies illegally filled thousands of invalid prescriptions for opioids and other controlled substances in violation of the Controlled Substances Act.    

The government’s complaint—filed on December 22, 2020, and amended in 2022 in the U.S. District Court for the District of Delaware—alleged that since June 26, 2013, Walmart filled invalid prescriptions through the knowing actions of individuals on its compliance team and the knowing actions of its pharmacists.

The United States alleged that members of Walmart’s compliance team knew that certain prescribers were operating as “pill mills” but filled invalid prescriptions written by those prescribers anyway.

Members of the compliance team allegedly knew of the prescribers’ egregious conduct because Walmart’s pharmacists reported it to Walmart’s corporate compliance team, including through thousands of “refusal-to-fill” forms.

The compliance team, however, prioritised other goals over CSA compliance. As one director on the compliance team acknowledged in an email, rather than analysing the refusal-to-fill reports, the compliance team viewed “[d]riving sales and patient awareness” as “a far better use of our market directors and market manager’s time”.

“Today’s (Friday) settlement proves this Department is committed to putting Americans’ flourishing first,” said associate attorney general Stanley Woodward. “Congress enacted laws to promote responsibility and accountability for companies who dispense controlled substances to protect Americans. This Department will never shy away from vigorously enforcing pharmacies’ obligations to comply with those protections, ensuring that potential profits never justify aiding our Nation’s opioid epidemic.”

Walmart pharmacists also allegedly filled prescriptions they knew were invalid.

The pharmacists knew these prescriptions were invalid because they were either written by a known “pill mill” prescriber or the prescriptions had obvious red flags such as dangerous combinations of opioids, “cocktails” of opioids and non-opioids, excessively repeated fills of high-dosages of often-abused opioids, or repeated requests for early fills of often-abused controlled substances.  

In addition to the monetary payment announced Friday, Walmart entered into a memorandum of agreement with the DEA to address its future obligations in dispensing controlled substances.

This agreement requires Walmart to establish a hotline for employees and patients to report suspected illegal dispensing of controlled substances, proactively monitor dispensing patterns at its pharmacies to identify and address potentially illegal dispensing, and establish a process to evaluate prescribers suspected of illegal prescribing.