Major Pharmacy Chains Account for a Third of Opioid Distributions

Major pharmaceutical chains, specifically CVS/Caremark, Walgreen’s and Rite Aid, account for over a third of all distributions of opioids according to the Drug Enforcement Agency’s (DEA) ARCOS database from 2006-2014.

The two biggest chains—CVS and Walgreens—each represent over 13 percent of all opioids distributed—largely hydrocodone and oxycodone but also other opioids like fentanyl and morphine. But they also have the most locations: both have over 9,000 in the United States.

But Rite Aid in particular stands out with about 7 percent of all opioids by quantity sent to their stores, yet only having 2,466 locations in 2020. Effectively, Rite Aid received opioids at over twice the rate of CVS or Walgreens.

Walgreens took over Rite Aid in 2014, and in June of this year, the state of West Virginia sued both companies for the flood of opioids into the state.

For CVS, the company had an average of 11,315 opioids sent to them based on 9,700 locations in the U.S. For Walgreens, it was 12,162 based on 9,277 locations. For Rite Aid, it was 24,294. The median for all pharmacies is 5,319.

On a per-pharmacy basis, CVS and Walgreens are ranked around 150th in terms of total opioids purchased. Rite Aid is 45th.

Outside of those three, few pharmacies represented more than one percent of the total, such as pharmacies partnered with hospitals and grocery stores like Wal-Mart, CostCo, Safeway, and Kaiser Permanente.

Kaiser represented 3 percent of total. The Department of Veterans Affairs represented 1.3 percent of totals.

ARCOS data only lists distributions to pharmacies and other providers, but it does not include retail sales by pharmacies to customers. So a mail order pharmacy that might only have one location could sell to many more consumers than a single in-person pharmacy could.

Some sales in the ARCOS data list a purchase to a single retail location, but others are to regional buyers, like CVS of Pennsylvania, who might then redistribute to individual locations.