Internet Diversion of Controlled Substances

Internet
Diversion of
Controlled
Pharmaceuticals
Matthew C. Murphy, Chief
Pharmaceutical Investigations
Internet diversion of
controlled pharmaceuticals
does not recognize Division
or Field office boundaries
and must be approached as
a National problem
JUNE 2007
DRUG ENFORCEMENT ADMINISTRATION
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C Consumer
Domestic ‘Rx’ Flow
1. Consumer in Montana
orders hydrocodone
on the Internet
Physician
IP
Internet Pharmacy
WC
Web Company
WS
Website Server
S
6. Pharmacy in Iowa
fills order and ships to
Consumer via Shipper
C
WA
P
Shipper
ME
MT
MT
ND
V
T N
H
MN
NY
OR
ID
PA
IA
IA
NV
UT
CT
MI
WY
NE
IL
KS
IN
WV
OK
NM
TX
5. Approved
order
then sent by
Web
Company
to an
affiliated
Pharmacy
NC
SC
AR
MS
TX
MD
VA
KY
MO
AL
P
DE
TNS
AZ
NJ
OH
CO
CA
RI
WI
IP
SD
MA
4. Order is
approved by
Physician in
New Jersey
and returned
to Web
Company
GA
LA
FL
FL
WS
2. Request goes
through Website
Server in
San Antonio, TX
JUNE 2007
WC
3. Web Company
(located in Miami, FL)
adds request to queue
for Physician approval
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DEA’s Strategy - Part 1
1. Use SearchPoint, ARCOS, Internet
search and analysis resources, and
traditional investigative leads to
identify suppliers, distributors, and
pharmacies fueling the nationwide
Internet diversion problem
JUNE 2007
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Excessive One Month Sales of Hydrocodone
to 7 Internet Pharmacies by a Distributor
October 2005
Average Sales to Each
Internet Pharmacy
311,657 dosage units
Total Sales
to Internet
Pharmacies
2,181,600
dosage
units
500,900
DOSAGE UNITS
520,200
Average Sales to
Other Customers
2,418 dosage units
404,400
288,100
254,700
160,300
53,000
Pharmacy 1
Pharmacy 2
Pharmacy 3
Pharmacy 4
Pharmacy 5
Pharmacy 6
Pharmacy 7
SOURCE: SearchPoint Data, DEA E-Commerce Section
JUNE 2007
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Comparison of Hydrocodone Purchases
by Pharmacies Over 4 Month Period
October 1, 2005 – January 31, 2006
DOSAGE UNITS
Targeted
Internet Pharmacies
Average
1,406,029
Average
for State
of
Florida
23,850
U.S.
Average
24,227
SOURCE: ARCOS Data, DEA E-Commerce Section
JUNE 2007
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DEA’s Strategy - Part 2
2. Deployments
• Prepare and execute Administrative
Inspection Warrants
• Acquire pharmaceutical documentation as
evidence for subsequent proceedings
• Identify doctors, distributors, and web sites
affiliated with each Internet pharmacy
• Analyze documentation to target doctors and
web brokers
JUNE 2007
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LIGHTNING STRIKE
„ Operation
Lightning Strike
removed over 1.5 million
dosage units of hydrocodone
from pharmacies fueling the
nationwide Internet diversion
problem
JUNE 2007
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Internet “Pharmacies”
JUNE 2007
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JUNE 2007
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State-by-State Distribution of Drugs
Number of Schedule III-V RXs
Filled by One Internet Pharmacy
1,253
5
3
48
498
558
335
714
103
284
378
586
3,237
60
710
40
63
1,340 526
290
591
854
21
30
152
112
17
123
630
59
967
154
855
397
16
356
1,343
320
761
113
269
358
278
525
790 1,224
1,917
184
55
4,4
635
48
JUNE 2007
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DEA’s Strategy - Part 3
3. Seek administrative action against DEA
registrants found to be contributing to the
illegal distribution of controlled substances
over the Internet
• Orders To Show Cause
• Immediate Suspensions
JUNE 2007
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Lightning Strike Resulting Actions
„ Immediate
Suspensions
• AmerisourceBergen, Orlando FL
• Bellco Drug Corp, Long Island NY
„ Voluntary
Surrender
• Richie Pharmacal, Glasgow KY
„ Order
To Show Cause
• McKesson, Tampa FL
JUNE 2007
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Lightning Strike Results
PHARMACIES CLOSED IN 2007
following Baywatch / Lightning Strike
MEDIPHARM-RX, INC
15,596,380
AVEE PHARMACY INC
9,082,010
ACCUMED RX INC
9,081,976
UNIVERSAL RX
4,733,290
UNITED PRESCRIPTION SERVICES
4,220,840
MEDCENTER, INC
4,564,480
NATIONAL PHARMACY (USA), INC
1,988,600
JEN-MAR PHARMACY SERVICES, INC
1,656,450
GRAND PHARMACY
2,731,420
CRJ PHARMACY INC
1,962,620
ARMENIA PHARMACY INC
YPM TOTAL CARE PHARMACY
TOTAL DOSAGE UNITS
JUNE 2007
Total 2006
Dosage Units
DRUG ENFORCEMENT ADMINISTRATION
793,350
1,051,500
57,462,916
15
DEA’s Strategy Is Working
JUNE 2007
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DEA’s Strategy - Part 4
4. DEA Outreach to Industry
•
Credit Cards – Undercover credit cards, investigative leads
‰
MasterCard
‰
Visa
• Express Parcel Carriers – training, investigative leads
‰
Federal Express
‰
United Parcel Service (UPS)
• Internet – banners, DEA message in search results
‰
AOL
‰
Google
‰
PayPal
‰
VeriSign
‰
Yahoo
JUNE 2007
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Questions / Comments?
JUNE 2007
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