Cardinal Health works around the clock so that life-saving medicine gets to those who need it – safely, securely, and on time.
Behind every dosage unit of prescription opioids available for use by a consumer is a prescription that was issued for its use by a state-licensed medical professional and filled by a state-licensed pharmacy. As a wholesale pharmaceutical distributor, we do not manufacture medicine, diagnose medical conditions, nor write prescriptions. We also are unable to see clinical prescribing decisions or the patients for whom prescriptions are written.
Like the Drug Enforcement Administration (DEA), which until 2014 steadily increased allowed production quotas for opioids based on what they determined was the nation’s legitimate medical need, wholesale pharmaceutical distributors were affected by the change in the practice of medicine starting in the late 1990s. Our pharmacy customers ordered more opioids from us to keep up with demand driven by more patients getting more prescriptions from doctors for more pills.
Steps

A patient visits his or her healthcare provider with a medical issue and the provider issues a prescription.
Regulations
Doctors and other prescribers are licensed by the state and required by the Drug Enforcement Administration (DEA) to issue prescriptions only "for a legitimate medical purpose."

A patient has his or her prescription filled at one of the country's more than 85,000 pharmacies.
Regulations
Pharmacists, licensed by the state, are required by the DEA and the state pharmacy board to verify the validity of a prescription before dispensing it, especially when it is for controlled substances.

Pharmacies restock medications, when needed, by placing orders with pharmaceutical distributors.
Regulations
The DEA registers distributors and requires them, when filling orders with their pharmacy customers, to report all transactions of certain controlled substances, to operate systems for spotting suspicious orders and to report all suspicious orders.

Distributors receive pharmaceutical products from manufacturers and securely transport them to licensed pharmacies.
Regulations
DEA establishes an annual aggregate quota for the total production of Schedule II opiates to meet the legitimate medical needs of the United States. In addition, each state has entities responsible for regulating and overseeing prescribers, such as doctors, and pharmacies – often a state board of medicine (that licenses physicians to practice medicine) and/or a state board of pharmacy (that licenses pharmacies and pharmacists and often regulates sites that distribute controlled and non-controlled medications).
To learn more about the pharmaceutical supply chain, see these additional resources:
- Cardinal Health Anti-Diversion and Regulation Infographic
- Department of Justice Inspector General Report: Review of the Drug Enforcement Administration’s Regulatory and Enforcement Efforts to Control the Diversion of Opioids
- Healthcare Distribution Alliance: Fighting an Epidemic, Combating Prescription Drug Misuse and Diversion
- Healthcare Distribution Alliance: Primary Pharmaceutical Distributors, Providing a Smart, Secure, and Sophisticated Supply Chain
- Healthcare Distribution Alliance: Pharmaceutical Supply Chain Security, Protecting the Integrity of a Complex Delivery Network