Pharmacist: Misleading CVS Caremark Card May Have Led To Cancer Pill-Fluoride Mix-Up

Company Also Under Investigation For Using Technicians Behind The Counter

CHATHAM, N.J. (CBSNewYork) — There were new details Friday on a stunning medication mistake, a story CBS 2 first brought to bring you Thursday night.

How did a popular pharmacy mix up children’s fluoride pills with the breast cancer drug tamoxifen?

CVS Pharmacy is the second largest drug store chain in the United States. So to hear about a major medication mix-up at its location in Chatham has a lot of people who live in that area on edge.

“To mix that up for children who are obviously grade-school age, that’s pretty scary,” one person told CBS 2’s Emily Smith on Friday.

CVS has confirmed that over the last 60 days its Chatham location may have given as many as 50 children’s parents the breast cancer fighting drug tamoxifen, instead of fluoride tablets.

CVS apologized for the mistake in a written statement saying: “…most of the families we have spoken to did not indicate that their children received any incorrect pills. We will continue to follow up with families who believe that their children may have ingested incorrect medication.”

At this point it’s not known if any children actually ingested the wrong pill, but they do look identical. Though tamoxifen is not chewable, the fluoride pill tastes like cherry or grape.

Pharmacist Alan Brown, from Liberty Pharmacy in Chatham, said he blames the mistake on CVS being too busy. Brown said it’s partly due to a misleading insurance card from popular insurance provider CVS Caremark.

“I think people are led to believe they must go to CVS. That’s not true. They can go to any pharmacy,” Brown said.

Currently, the Federal Trade Commission has an investigation underway looking into CVS that includes the confusing CVS Caremark benefits card.

CVS has also come under fire for having pharmacist technicians behind the counter. They are not pharmacists, yet can legally fill prescriptions.

CVS has denied having a higher ratio of technicians in proportion to the industry average.

No matter the cause, some customers said they’ll be waiting for an answer as to how this happened. Otherwise, they’ll be taking their business elsewhere.

If a child has taken one tamoxifen pill it’s not going to have a negative impact on their health. It’s highly unlikely a child would even be able to consume multiple pills, due to the strong taste.

Please offer your thoughts in the comments section below …

  • NJ

    This is a horrible mistake to happen, as I do work in a pharmacy as a technician. First and foremost, any work that a technician performs is checked by a pharmacist, nothing leaves a pharmacy without the approval of a licensed pharmacist. Secondly this seems to be a system error because of the amount of times it occurred. In light of this incident maybe people will stop complaining when they have to wait for their prescription, don’f forget you and 20 others are most likely waiting who all claim to be direly sick. I told a person 30 minutes for their RX, they flipped. People need to relax and let the pharmacies do their jobs, the only reason why corporations push their pharmacy staff to be faster is because of the consumers. Many people forget the fact that drugs, which alter our bodies metabolically, are given at pharmacies and NOT cheeseburgers, we can not fill 500 prescriptions in 5 minutes safely.

  • MBC

    I wonder houw many women with breast cancer have been swallowing flouride tablets instead?

    • Sabrina

      I can agree with this question.

  • Jackson

    The only way I can think of resulting in this mixup of 50 patients is if the tamoxifen tablets were put into the scriptpro machine and the warning alarm was turned off. The alarm sounds when the wrong med is scanned when someone is refilling an empty cassette, in this case fluroide. Most stores have fluoride in their scriptpro so regardless of who filled the cassette, a technician, pharmacist or anyone else with a password, the alarm was not on as the proper procedures would require. Otherwise, if there are “pharmacist technicians” which is an oxymoron, since you cant have a pharmacist as a technician, it would be either or not both, in this situation, then it is possible that a technician filled and dispensed the RX. I doubt a pharmacist or “pharmacist technician” would have filled the prescription 50 times with tamoxifen.

    Lastly, CVS is forcing pharmacists to do 100 things a minute and realistically, CVS pharmacists are unable to properly provide the type of attention required to fill a prescription. Just like the first commenter said, CVS pharmacists cant fill prescriptions, answer the phone, do consultations, give an immunization, attend the drive through and whatever else, ALL in 15 minutes, per customer. For CVS, speed is the essence, not patient care or welfare. Time is money. That is their motto. Patients beware of CVS. They are a dange to the community.

  • Kenneth Eisenstock, R.Ph,JD

    Perhaps this should lead to Federal regulations prohibiting chain pharmacy management from demanding unreasonable metrics from their pharmacists. You cannot answer the phone, attend the drive thru window, give advice to patients and immunizations all within timelines that management dictates. Perhaps CVS home office should have a drive thru for pharmacists to demand better working conditions and to be treated as professionals.

  • fifi mcree

    CVS is dangerous. Bottom line. They are guilty of working with too few people and asking them to fill too many prescriptions.

  • nyscof

    Studies of Fluoride Supplements: No Evidence of Safety – No Benefit

    According to the Cochrane Oral Health Group, fluoride supplements fail
    to reduce tooth decay in primary teeth, permanent teeth cavity-
    reduction is dubious and health risks are little studied (1). Further,
    “When fluoride supplements were compared with topical fluorides or
    with other preventive measures, there was no differential effect on
    permanent or deciduous teeth,” write Cochrane researchers Ismail et

    In the early 1980’s, Robert Wood Johnson Foundation research first
    revealed fluoride tablets and mouth rinses failed to reduce tooth

    Fluoride supplements “have not been found by FDA to be safe or
    effective,” according to the US National Library of Medicine.(3)

    Before testing was required, fluoride supplements slipped into common
    usage without FDA approval (4) based on the presumed safety and
    effectiveness of water fluoridation. But, tooth decay crises occur in
    all fluoridated cities, states and countries. (4a) and fluoridation’s
    safety is deeply in doubt. (4b)


    The NJ Legislature is proposing to add fluoride drugs into the public’s water supply. If pharmacists can make mistakes, do you think water comapany employess can also?

  • Vernon Hell

    You cannot trust that the pills dispensed are the right medication, especially when they come from a thieving, shortcut-taking corporation like CVS. Solution — go online, look up the prescribed mediation and find a site with pictures.

  • Gerard

    Technician pharmacist? Really? Do you mean to say cvs has come under fire for having pharmacy technicians? Wait that still doesn’t make sense….basically you are saying all pharmacy technicians should be fired because only pharmacist should be working in a pharmacy….apply that logical to a hospital….fire everyone who is not a doctor.

  • Robert A. Rosenberg

    Pharmacist Derek Lorenzo of Tiffany Natural Pharmacy in Westfield showed CBS 2 how a fluoride pill looks almost exactly like Tamoxifen.

    The images shown in the report show a Flluoride pill that has an embossed code on it and a Tamoxifen pill that does not. Unless the shown pill was code side down, they are simple to tell apart. When the pills are placed into the counting tray it is impossible for all the pills to be code side down. Thus the lack of a code on the Tamoxifen or two different codes (especially if one was embossed and one printed) should have been seen as the pills were counted and slid into the vial.

    • A S

      I agree completely. Even the bottles are different and the labels should be a give away as well.

      • Esmerelda

        Whats the difference how they look – for them to be mixed up, they would
        have to be loose or the labels were wrong.
        So far no one is saying how this mix up happened and it was not a one
        time occurrance.

  • chatsum

    Sorry, but those are very poor excuses. They should be ashamed to report they are “too busy”

    • A S

      Totally agree

      • JE

        1. A competitor pharmacy said the CVS was “too busy”. CVS itself did not give that excuse so should not be ashamed. About that anyway. 2. One incorrect filling is more understandable than 50. One is picking up the wrong bottle and not following proper procedures. 50? Sounds like a system error from the outside (I do not work for CVS although I am a pharmacist.) 3. No one can memorize what 10,000 different tablets look like. The new systems have a picture of the tablet the pharmacist checks the tablet against on the computer. I assume CVS has this or will soon have this. Again, picture or not, 50 different families on a fluoride drug I don’t even stock because no one is on it? Must be a rural area with no fluoride in the water supply. Still, 50? Maybe they are contacting everyone that received the drug in the past year. Wait. Got it. Dispensing machine. Filled the canister with the wrong tablet. Disregard.

        • Robert A. Rosenberg

          In the original report at there is a message in the comment section that states “As for the prescription mix at the Chatham N J CVS it is important to note that the tomoxifen was mixed in with the floride. For a 90 day prescription filled in Dec.when checked in Feb with 40 pills remaining there were 35floride pills and 5 tomoxiphen.”.

          This would seem to point either at a dispensing machine which was reloaded with the wrong tablets OR that the master bottle from which the tablets were taken from for hand counting and dispensing was filled by the supplier with a mixture of both tablets (or was refilled with the wrong tablets). Getting a prescription that has both medicines would imply that the source used to fill it had both NOT that the wrong bottle was used (which would have resulted in all the pills being wrong).

        • Tammy

          I agree. To fill a prescription at CVS, you must scan the rx label and scan the bar code of the drug before filling the prescription. THEN the pharmacist scans the label and the vial and a picture of the drug comes up on ths screen so that it may be easily identified.

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