MANCHESTER — A scathing 40-page complaint filed by state regulators seeks discipline against Walgreens Pharmacy, up to and including revoking the chain’s license to dispense medication in Vermont.
The complaint alleges that the company unreasonably restricted consumer access to medication by closing stores without notice; that it failed to comply with federal and state professional standards; and that it engaged in “conduct of a character likely to deceive, defraud or harm the public.”
The complaint further alleges Walgreens “failed to comply on an egregious scale” with state law by operating stores without a pharmacist-manager present, including locations in Bellows Falls and on Canal Street in Brattleboro.
It also alleges that the company failed to identify or address “conditions that interfere with a pharmacist’s ability to practice with competency and safety or create an environment that jeopardizes patient care” by failing to mandate rest periods.
Some of the complaint’s most serious accusations stem from allegations involving Southern Vermont Walgreens locations:
• The Canal Street store in Brattleboro, which the complaint says ran without a pharmacist-manager in violation of state law, reported more than 20 medication errors to the corporation between Jan. 1 and Nov. 15 of last year.
• The Manchester store, which was closed so often that the town manager wrote the Office of Professional Regulation seeking an inquiry, gave a student a refill for an anti-anxiety medication five times the amount prescribed, leading to hallucinations and other symptoms that kept them from attending school.
• The Putney Road, Brattleboro, pharmacy was found in such disarray by a re-assigned pharmacist that the company closed it for several days — without informing customers.
MORE THAN AN INCONVENIENCE
Because of closures, the complaint alleges, patients could not readily obtain medication they needed for conditions including tick-borne illnesses, epilepsy and addiction. If they had the means, patients often paid out of pocket for their prescriptions.
“Lack of adequate pharmacy staff resulted in over three hundred and twenty-five days in which unexpected and unscheduled Walgreens retail pharmacy closures occurred throughout the state between July 2020 and April 2022, leaving thousands of patients without access to prescription medications,” the complaint said.
The Department of Professional Regulation, which operates under the Secretary of State’s Office, conducted the investigation and filed the complaint.
The allegations were filed June 21. Under the statute, Walgreens has 20 days to respond to the allegations, which the Office of Professional Regulation will then be asked to prove before the state Board of Pharmacy.
Deerfield, Illinois-based Walgreens, operates 32 stores in Vermont, accounting for more than 25 percent of the state’s pharmacies, according to the complaint. That includes two locations in Brattleboro and stores in Bennington, Bellows Falls, Manchester and Wilmington.
The company — the second-largest pharmacy chain in the nation — declined comment on the allegations.
“We won’t be making any statements at this time,” Fraser Engerman, Walgreens’ senior director of external relations, said in an email Friday.
Walgreens’ license to operate in Vermont expires July 31, 2023. The state asked that the Board of Pharmacy “revoke, suspend, reprimand, condition or otherwise discipline” Walgreens’ license to operate in the state.
According to the complaint, during the investigation, “Walgreens Corporation refused to disclose specific information Walgreens Corporation utilizes to determine pharmacy staffing requirements, claiming it was proprietary information.”
“Pharmacies play a critical role in the health care of Vermonters, who deserve safe and reliable access to the important medications they depend on, Secretary of State Jim Condos said in a statement. “Many local pharmacists and pharmacy technicians work diligently and with the care of their customers at the forefront of their work.
“Before an enforcement action is final the state must prove the allegations in the specification of charges before the Board of Pharmacy. This can take time to complete,” Condos said.
NATIONAL CHAIN, LOCAL PROBLEMS
For the past two years, complaints have percolated throughout Southern Vermont about Walgreens pharmacies closing without notice, leaving customers needing medication in the lurch.
The closures were more than an inconvenience: They also led to billing and prescription-filling complications for Vermonters.
Because the company’s computer system processes and bills prescriptions and refills, regardless of whether a store is closed, the patient is not able to have the prescription filled elsewhere “unless Walgreens reverses the billing or the patient pays out-of-pocket, even though the patient cannot retrieve the filled prescription due to an unexpected Walgreens pharmacy closure.”
That in turn led to patients going without medication, because they could not afford the out-of-pocket expense, the complaint said.
In Manchester, after a series of closures over two years — including a lengthy closure for a fire — Town Manager John O’Keefe wrote the Office of Professional Regulation seeking answers.
“Needless to say, a pharmacy is an essential or critical service. With only two pharmacies in the region, having one close multiple times and for months has a very big impact on the community,” O’Keefe wrote in January. “The on-again, off-again status of the store is frustrating Manchester and Northshire residents, and having a real impact on the health of residents of the area.”
That real impact includes an allegation within the complaint that the Manchester Walgreens incorrectly filled a prescription for a student with doses of 50 mg per pill instead of 10 mg. The increase in dose went unnoticed at first but led to symptoms including “shaky hands, blurred vision, nausea, balance issues, hallucinations and high blood pressure.”
According to the complaint, the pharmacist indicated the 50 mg bottle was in the wrong location, and that rather than scan each bottle, the technician scanned the same bottle five times.
Another allegation against the Manchester store claimed that it did not submit a patient’s vaccine information to the state Health Department after they received a COVID booster.
Staffing was reportedly a serious issue at the Canal Street, Brattleboro, location, the complaint said.
“In the months leading up to and including November 2021, [the store] experienced unsafe pharmacy conditions due to inadequate staffing levels for the pharmacy workload and due to the lack of a pharmacy-manager,” the complaint states.
That included several days in November 2021 in which the store “processed an estimated 600 prescriptions with only one pharmacist.”
“A pharmacy staff member reported that between January 1, 2021, and November 15, 2021, [the Canal Street store] reported over 20 medication errors to the company,” the complaint says.
At the Putney Road, Brattleboro, location, a re-assigned pharmacist came to work on May 12 to find the pharmacy “in a state of significant disorganization, with prescription vials and pills on the floor, two unlabeled vials on shelves with a variety of pills in them, cluttered counter space and generally unclean conditions.”
The next day, according to the complaint, Walgreens’ corporate offices ordered the Putney Road store closed. It remained closed for days, and there was no information at the store or on its phone system, advising customers what was happening or what they should do, the complaint alleges.
According to the complaint, the health ramifications of the Putney Road store closures were numerous:
• A patient missed multiple doses of medication for a tick-borne illness, finally resorting to driving across the river to New Hampshire to obtain a refill.
• The parents of a child needing refills to treat epilepsy and other health conditions waited on the phone with the Putney Road location for 40 minutes, and waited at length in person when the store re-opened.
The unexplained and unannounced closures also extended to Bellows Falls just two months ago.
According to the complaint, a nurse informed the Office of Professional Regulation that closures of the Bellows Falls site had a significant effect on patients needing suboxone, a medical treatment for opioid addiction, because they could not obtain refills.
The suboxone prescriptions were written for one week at a time, and when the Bellows Falls location closed unexpectedly in May, some patients were unable to travel to the nearest location.
“For some patients, when [the Bellows Falls store] had already billed their insurance for suboxone, Walgreens was unable to reverse the billing so that the patients could get their suboxone at a different pharmacy,” the complaint states. “In May 2022, in at least separate three instances, patients were able to get their doctor’s office to send a replacement suboxone prescription to another local pharmacy. ... In those three instances, the patients were required to pay out-of-pocket to the non-Walgreens local pharmacy for their suboxone.”
The Wilmington location also was closed for several days in January 2021 because of a lack of staff, and closed again without notice on several occasions.
The pharmacist manager at the Essex Junction store was asked to work 12 hour days and reached out to the company for help, but was told to “be patient” and “be a leader,” according to the complaint. The pharmacist manager eventually resigned.