Pharmacy 4 Less, LLC
Outcome
DEA issued Order to Show Cause July 5, 2018, after a June 2017 audit; DEA revoked Certificate of Registration No. FP5459082, published October 1, 2021, for filling controlled substance prescriptions including opioid-buprenorphine cocktails with unresolved red flags.
Details
Pharmacy 4 Less, LLC — DEA Order to Show Cause and Revocation (2017–2021)
Outcome: DEA issued an Order to Show Cause on July 5, 2018, following a June 2017 audit, and revoked Pharmacy 4 Less's DEA Certificate of Registration No. FP5459082 in a Decision and Order published October 1, 2021, for filling controlled substance prescriptions with multiple unresolved red flags including dangerous opioid-buprenorphine combinations.
Pharmacy 4 Less was a small independent pharmacy at 805 Douglas Avenue, Altamonte Springs, Florida. On June 6, 2017, a DEA audit identified record keeping and regulatory violations. On July 5, 2018, the DEA issued an Order to Show Cause proposing revocation of the pharmacy's Certificate of Registration No. FP5459082, alleging the pharmacy's continued registration was inconsistent with the public interest.
Administrative hearings were held in Orlando, Florida on November 5-7, 2018, and continued in Arlington, Virginia on February 25, 2019. The government presented expert testimony regarding how Pharmacy 4 Less filled controlled substance prescriptions without resolving red flags, despite maintaining due diligence files.
The DEA's expert identified multiple specific red flags the pharmacy failed to resolve: one prescription for 112 tablets of oxycodone 20 mg priced at $290 presented red flags based on the drug itself, the large quantity, the relatively high dosage, and the cash price. More significantly, the pharmacy dispensed oxycodone 20 mg prescriptions in conjunction with buprenorphine prescriptions for the same patients — buprenorphine being a drug used to wean patients off opioids, meaning prescribing an opioid and an anti-opioid treatment simultaneously created an inherent clinical contradiction that required resolution before dispensing. The DEA revoked the registration in the Decision and Order published October 1, 2021.
Primary Source: Pharmacy 4 Less; Decision and Order (Fed. Reg. Oct. 1, 2021)
How Crucible Prevents This
DEA found Pharmacy 4 Less filled prescriptions for oxycodone combined with buprenorphine — a combination where an opioid is prescribed alongside a drug used to treat opioid addiction — without resolving this clinical contradiction as a red flag. Crucible's drug interaction and therapeutic contradiction controls would have automatically flagged this prescription combination as requiring documented clinical resolution before dispensing.
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