Tag Archives: pharmacy

More patients aren’t filling brand-name prescriptions

It hasn’t had quite as much impact as some earlier health-related recession trend stories, but the rise in prescription abandonment rates, detailed in this post by Pharmalot’s Ed Silverman, is starting to snag a few headlines.

According to market research agency Wolters Kluwer, the number of prescriptions for brand-name submitted to a pharmacy but never picked up as crossed the 10 percent threshold, with patients now skipping out on twice as many prescriptions as they did before the recession. The number has been on the rise for a while now, as you can see in this Wall Street Journal graph. The agency releases the numbers every six months.

For more on the issue, I recommend the comment section of this related Pharmalot post.

Who monitors pharmacies’ systems to curb pseudoephedrine sales?

CVS Pharmacy has been in the news recently after it agreed to pay $75 million in penalties and forfeit $2.6 million in profits made from illegally selling pseudoephedrine. Scott Hensley did a nice job of explaining why the retailer got in trouble, which boils down to a defect in the electronic system the chain used.

As most allergy sufferers know, federal laws (and some state laws) limit how much pseudoephedrine consumers can buy. Retailers are left with the chore of monitoring who buys how much of the drug, which also can be used to make methamphetamine.

As the CVS case seems to show, and my personal experience backs up, retailers apparently can set up their own systems for tracking the sale of pseudoephedrine as long as they meet some basic requirements:

Regulated sellers are required to maintain a logbook, written or electronic, to record sales of products containing ephedrine, pseudoephedrine, or phenylpropanolamine. The seller must enter into the logbook the name of the product, and quantity sold. The customer must write or enter into the logbook their name, address, date, and time of sale. The customer must also sign the logbook. You may not sell the product unless these requirements are met.

What isn’t clear is who is regulating those systems.

If a retailer’s system doesn’t prevent someone from making multiple pseudoephedrine buys and exceeding the federal limit – as happened at CVS – or if a retailer’s computer program mistakenly calculates the wrong amount of pseudoephedrine contained in a medication, then the system is failing. In the case of CVS, the problem happened for more than a year at multiple locations.

Now, for that personal experience I mentioned earlier …

After recently being told I had met my limit of pseudoephedrine at a neighborhood pharmacy, despite the fact that I take less than the maximum dosage to control my allergies, I asked to look at the store’s records.

A sympathetic pharmacist showed me the log of my purchases and I discovered that when I bought a package of 18 pills, the store’s computer recorded it as a package of 18 pills, but it calculated the amount of pseudoephedrine in that package to be the same as what would be in a 36-count package. That amount of pseudoephedrine was what triggered the computer to tell the pharmacy not to sell any more to me.

Once I pointed out the error, the pharmacist got out a calculator and eventually concluded I was right. He was rather incredulous that the error could happen. He tells me that he’s put in a request with the company’s help desk to fix the problem.

However, I’m left wondering whether my name is flagged in a computer database somewhere because of the store’s error and how many other innocent people are also flagged. Not to mention how many allergy sufferers have been left unable to breathe properly because computer systems show they’ve bought more pseudoephedrine than they actually have.

Perhaps more importantly, what about the methamphetamine criminal cases that have been brought as a result of authorities examining these records? There was recently a large raid on meth labs in my area based on pharmacy records and the pharmacist I talked to said he’d been in court testifying recently in meth cases. Could errors in pharmacy records be a defense attorney’s dream?

Network to warn pharmacists of drug errors

The Wall Street Journal‘s Laura Landro spotlighted a new national network designed to send e-mail alerts to as many as 55,000 pharmacists.

The network is designed to alert pharmacists of dangerous and life-threatening errors as well as to educate them on how to prevent those specific errors from also occurring in their own respective practices. The system is intended to help the same errors from being repeated time after time across the country.

medsPhoto by jypsygen via Flickr.

Landro wrote that “Medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States,” and added that there are some indications that the weakening economy has had a negative impact on medication safety.

Here’s Landro explaining the new network:

The non-profit Institute for Safe Medication Practices, which is certified by the federal government to collect error reports and other information about quality breaches, and the American Society of Health-System Pharmacists are launching a new National Alert Network for Serious Medication Errors. The network, which was unveiled last month, will be used to send email alerts to 35,000 pharmacists working in hospitals and health systems, as well as physicians and nurses, when a dangerous or life-threatening error is reported to ISMP. The two organizations are also in discussions to extend the network to as many as 26 other organizations that promote safe medication use. The hope is that widely spreading the word about such errors will cause doctors and pharmacists to be more cautious—and ultimately prevent future mix-ups. Relevant alerts will also be sent to 20,000 drugstore pharmacists.

Landro also mentioned ISMP’s consumer med safety alert portal and the FDA’s consumer-focused error reporting tool. She also goes into greater detail as to how drug mishaps happen, and into what can be done to prevent them.


TV report leads to $2.25 million HIPAA settlement

A report by Bob Segall of WTHR-Indianapolis prompted the federal investigation that led to CVS Pharmacy’s agreement to pay $2.25 million for violating consumers’ privacy by not properly disposing of “protected health information such as labels from prescription bottles and old prescriptions.”

The acting director of HHS’ Office for Civil Rights said Segall’s award-winning investigation “formed the basis of the [federal] investigation.”

Segall won a 2006 Award for Excellence in Health Care Journalism for his investigation. He also wrote about how he reported the story in an article for AHCJ: How we did it: Diving into prescription privacy.

CVS will pay $2.25 million and initiate a plan to protect consumer privacy. (Photo by afagen va Flickr)

CVS will pay $2.25 million and initiate a plan to protect consumer privacy. (Photo by afagen via Flickr)

“I think I was as surprised as anyone when i got a call from HHS” telling him about the settlement. Segall says that for the past two-and-a-half years, he has been calling the Office of Civil Rights every 60 to 90 days to find out the status of its investigation.

“After two years, I wasn’t expecting their investigation would lead to anything,” Segall says. “It’s not every day that they impose fines for HIPAA violations.”

He says the victims in Indiana were pleasantly surprised, though some are disappointed they won’t be seeing any of the $2.25 million.

“As a journalist who deals with the repercussions of HIPAA on almost a daily basis, there are so many times brick walls are put up for journalists” in the name of HIPAA privacy rules. Segall says he is gratified to see the law “really does have some teeth and the Office of Civil Rights is really going to pursue cases like this one.” While he says we’ve all seen alleged violations in which nothing is done, this settlement will send a message to companies that deal with consumer health information.

“I think it’s nice to see that this law, that for journalists does nothing but stand in the way, does help consumers.”