An executive of Walgreen Co. abused his position as the Indiana Board of Pharmacy (IBOP) President to help gain approval for a controversial Walgreens pharmacy model called “Well Experience,” an ethics complaint filed today alleges.
Change to Win (CtW) Retail Initiatives and Common Cause Indiana filed the complaint with the Office of the Inspector General. The watchdog groups charge that Ethics Code violations by Walgreens Manager of Pharmacy Affairs Bill Cover and pharmacy board staff corrupted the regulatory process and led to the board approving a pharmacy format that creates risks to public health and patient privacy.
Indiana law prohibits state appointees from participating in decisions in which they or their employer have a financial stake in the outcome. Heavily redacted e-mails obtained through the state’s Access to Public Records Act show that Cover was central to the Board’s Well Experience decision-making process and that he used his position on the board to secure special privileges for Walgreens.
The e-mails illustrate inappropriate involvement in the approval process including: Cover’s collaboration with IBOP staff to provide information from Walgreens to other board members; his deliberation on regulatory issues regarding Well Experience with the board’s executive director; and his solicitation of board members’ concerns before any public discussion about Well Experience.
According to the complaint, Cover and the board improperly kept the approval process from public view. The board held secret meetings with Walgreens management in Illinois deliberately arranged to circumvent Indiana laws requiring open meetings.
“Walgreens and the Board of Pharmacy’s disregard for Indiana’s executive branch ethics policies is deeply disappointing,” said Julia Vaughn, Policy Director of Common Cause Indiana. “Good policy is rarely made behind closed doors, and it is simply unacceptable for anyone to take advantage of their position in state government to advance the interests of a private company.”
Additionally, neither Cover nor the board appear to have sought an opinion from the Ethics Commission regarding Cover’s conflict of interest, as required by state statute.
“We believe Well Experience is a deeply flawed pharmacy model that increases risk to patient privacy and public health, and in Indiana, there was an equally flawed process to approve it,” said Nell Geiser, Associate Director of Retail Initiatives at CtW.
Conflicts with State Pharmacy Regulations
The complaint further alleges that the model was not in compliance with Indiana pharmacy regulation, and that Walgreens was aided in its efforts to obtain board approval by Cover’s behind-the-scenes lobbying.
Well Experience moves pharmacists out of their traditional work area to highly visible, public desks. At the time the model was approved, Indiana statute required pharmacists to work within reasonable visual and vocal distance of the technicians they supervised, yet pharmacists in this model are separated by a wall from technicians. In Well Experience pharmacies a single pharmacist generally remains responsible for the entire pharmacy operation, including overseeing technicians, and carries out these supervision duties using digital pictures and live video feeds. In 2013, the board created new pharmacy rules to allow the use of this type of technology to supervise technicians—two years after Well Experience was approved.
Increased Risks to Hoosiers with Well Experience
The relocation of pharmacists and inadequate staffing create problems for consumers. Well Experience has come under scrutiny from consumer advocates as well as state and federal regulators.
In September 2013, CtW released an investigation that found patient privacy violations in 65 percent of Indianapolis-area Well Experience stores and inadequate medication security in 35 percent. A follow-up investigation, released this month, found privacy breaches in 60 percent of Indianapolis locations and prescription drugs left unattended in 30 percent.
CtW also found new types of interruptions and distractions to pharmacists at Well Experience pharmacies. Distractions have been associated with higher rates of medication errors in academic studies.
This month, the Wall Street Journal reported that the US Department of Health and Human Services is investigating patient privacy violations at Well Experience pharmacies. Several state boards of pharmacy have either prohibited the pharmacy format or have required modifications.
The Indiana Board of Pharmacy was the first in the nation to approve the model in July 2011. Walgreens has roughly 50 Well Experience pharmacies in the state. Cover remains a member of the pharmacy board and was its president from February 2011 to January 2012.
Common Cause Indiana is a grassroots lobbying organization that works for open, honest and accountable government.
CtW Retail Initiatives is a project of the Change to Win labor federation. Since 2005, it has been an active stakeholder in the pharmacy industry, advocating on behalf of workers and the general public for consumer protections, health care access, drug price transparency and other safeguards.