While this prosecution of a doctor is among the latest governmental efforts to slow the national epidemic of misuse and death by prescription drugs, especially painkillers, another tactic is examining the suppliers to doctors and pharmacies.
Drugmakers usually sell to wholesalers, who then resell products to other distributors, drugstore chains, mail-order companies, independent pharmacies, hospitals and some doctors. Some drugs prone to abuse are classified as controlled substances, requiring those along the supply chain to register with the Drug Enforcement Administration.
The three biggest wholesale companies are McKesson, headquartered in San Francisco; Cardinal Health, of Dublin, Ohio, and Amerisource Bergen, based in Valley Forge.
After a federal judge in Washington ruled early in 2012 that wholesalers had an obligation to "self-police," Cardinal Health settled with the DEA over allegations that it did not adequately monitor prescription painkiller shipments from its Lakeland, Fla., distribution center to certain pharmacies. Cardinal lost its license to sell controlled substances from that facility for two years and its 28 other facilities are under greater scrutiny.
AmerisourceBergen said in an August filing with the Securities and Exchange Commission that it was subpoenaed by the U.S. Attorney in New Jersey and the DEA for documents related to "specific customers' purchases of controlled substances," and its program for controlling and monitoring such sales.
The three biggest wholesalers control an estimated 90 percent of the market, but a DEA spokesman said the agency issued licenses to about 874 distributors, including 53 in Pennsylvania and 37 in New Jersey.
Undercover agents made videotaped drug buys from Minicozzi as part of the investigation by the U.S. Attorney's Office in Philadelphia, the Philadelphia Police Department, FBI and DEA. But investigators also obtained records from two small, local distributors that shipped drugs to Minicozzi.
Wesley Pharmacal Company Inc., of Warminster, Bucks County, was paid $211,544 between January 2005 and June 2010 to supply Minicozzi with Xanax and Vicodin, according to court records. C.O. Truxton, Inc., of Bellmawr, Camden County, got $85,646 for supplying Xanax.
Neither of the family-run and privately held companies was accused of any crime in this case. Both have licenses with the DEA and their respective states.
"He had a legitimate license with the state and he had his DEA number," Mary Claire Rossi, daughter of Wesley Pharmacal's late founder, Cliff Crawford, said of Minicozzi. "We dotted the I's and crossed the T's."
Minicozzi's lawyer, Jeff Miller, said that his 79-year-old client shows signs of dementia and that the wholesalers are guilty of profiting from the unusually high volumes Minicozzi ordered.
"They had a legal, ethical and moral responsibility to notify the appropriate authorities in Pennsylvania or the DEA," Miller said, adding it doesn't excuse Minicozzi's actions.
Bunk, said Truxton owner Paul Devine.
"We reported that man a couple times," Devine said, meaning to the DEA. He said his company stopped selling to Minicozzi in 2007. "We run a reputable company, and we can't control what people do with any of the drugs. If we have a record of what we sold and who we sold it to, that is the extent of our responsibility."
Contact David Sell at dsell@ phillynews.com or 215-854-4506. Read his blog at www.philly.com/phillypharma and on Twitter @phillypharma.