ANDOVER — A national mail-order pharmacy based in Andover has reached an $11 million settlement over a lawsuit brought by the state of Massachusetts, Attorney General Maura Healey said.

Injured Workers Pharmacy has agreed to pay the money to the state, subject to court approval, Healey said.

“Injured Workers Pharmacy created an illegal operation that put dispensing speed and volume over patient and public safety," Healey said. "They dispensed thousands of prescriptions for dangerous drugs, including opioids like fentanyl, with a shocking lack of regard for whether those prescriptions were legitimate.

"Combating the opioid epidemic remains a top priority of my office and we will aggressively pursue those who break our laws to profit from this crisis,” Healey said.

The settlement comes nearly a year after Healey's office announced it was investigating Injured Workers Pharmacy, which dispenses drugs to workers' compensation patients. The pharmacy handled the most amount of opioids in Massachusetts between 2006 and 2012 — 34.2 million oxycodone and hydrocodone pills, according to the federal Drug Enforcement Agency.

The company said it did not have to admit any wrongdoing in the settlement.

"This agreement emphasizes IWP’s commitment to a comprehensive and best in class compliance program and to preventing the abuse and misuse of controlled substances; it also eliminates the cost and time associated with a lengthy legal case and allows IWP to focus on providing best in class service to its patients," reads a written statement from Diana Pisciotta, spokesperson for the pharmacy. 

Healey's office said the pharmacy violated Massachusetts consumer protection laws by not having proper policies in place to determine if the prescriptions were legitimate and using unlawful marketing practices like paying law firms for patient referrals, according to court documents.

As a nationwide mail-order pharmacy catering to workers' compensation patients, the company was below average in its volume of opioids handled, the pharmacy's statement said. Since the investigation, the company has been cooperating with the state, according to the statement. It has also changed its leadership and updated its guidelines in handling prescriptions since 2017.

The $11 million settlement also provides stipulations for changes to the pharmacy's business practices. The company must hire a full-time compliance officer to help identify red-flag prescription behavior, and it must have a data analyst and software to help identify at-risk prescribers and patients.

The company must also enact measures to help at-risk patients, including hiring pain management specialists to help review patients' treatment plans with their doctors. The company must also offer to dispense naloxone, a drug used to treat overdoses, at no out-of-pocket cost to the patient, according to Healey's office.

The pharmacy must take precautions to identify problematic prescribers, including using data and dispensing software that allows pharmacists to see a prescriber's entire history, according to Healey's office.

The pharmacy must also disincentivize filling prescriptions of controlled substances by eliminating compensation based on volume and stopping payments for referrals, Healey's office said.

The company has denied that there was compensation based on selling specific drugs, but also stopped certain marketing agreements in 2017.

"Sales and marketing efforts focused solely on educating clinicians and attorneys around the benefits of a specialized workers’ compensation pharmacy," reads the pharmacy's statement. "Sales and marketing staff did not advocate for specific drugs and were not compensated based on type of drugs prescribed. All formal law-firm specific marketing agreements were suspended in 2017; to the extent that an informal agreement with a law firm continued after that date, it was not authorized and the employee responsible was involuntarily terminated in early 2019. At no time has IWP compensated physicians for referrals."

Healey said her office will check on the pharmacy's progress through a one-year compliance audit.

Congresswoman Lori Trahan, D-Westford, thanked Healey for her work in this case against the Andover pharmacy. She reiterated that cases like this are why Congress needs to pass the Medication Access and Training Expansion Act, which she introduced in the House.

The legislation has similar goals to the settlement agreement.

"Ending the opioid crisis is hard enough when everyone is working together," Trahan tweeted. "Injured Workers Pharmacy took full advantage of this crisis to increase their profits at their customers' expense. I’m grateful to @MassAGO for her work to hold IWP accountable."

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