World news wrapup: 12 August 2021


NZ pharmacist’s tramadol script suspicions spark enquiry; Lloydspharmacy boss says pharmacist shortage, self-isolation rules cause closures; Canadians waste Moderna jab

Dunedin, New Zealand: A pharmacist’s concerns about a script for tramadol set off an investigation into a doctor’s self-prescribing, the Otago Daily Times reports.

The doctor, whose name cannot be published due to an interim suppression order, faced a hearing of the Health Practitioners Disciplinary Tribunal after he allegedly wrote a script for himself, for tramadol and two other medicines.

The doctor is also accused of altering a second script to add tramadol as well as a prescribed medicine.

He reportedly took the scripts to pharmacies to be filled. The first pharmacist filled the first script, apart from the tramadol.

The second pharmacist, however, was concerned about the script, and voiced these concerns, resulting in the inquiry.

The prosecuting lawyer says his conduct constituted malpractice or negligence, while the doctor’s lawyer pointed out that the doctor had recently been injured, and queried the thoroughness of the investigation.

 

UK: The superintendent pharmacist for the Lloydspharmacy chain has penned an opinion piece warning that a shortage of trained pharmacists and self-isolation rules to combat COVID have sparked an “epidemic” of temporary pharmacy closures.

Victoria Steele wrote in Chemist+Druggist that not only has the sector failed to attain the recognition and investment given to other health providers, it is now facing a pharmacist shortage.

“This shortage is the driving factor behind the rising number of partial closures the sector is currently experiencing, which in turn is driving a sometimes aggressive and toxic culture of debate in parts of our sector – particularly online – about the current situation,” she wrote.

The profession needs to recruit “bright and compassionate” people, Ms Steele writes, adding that despite new roles opening up, fewer people are choosing pharmacy for a career.

“Thirdly, an acute problem we are facing is the need for pharmacists to self-isolate when ‘pinged’ by NHS Test & Trace.

“While the opt-out for some healthcare workers is welcome, in reality many of our colleagues do not meet the very strict criteria, and so we are dealing with very high levels of absence.”

In this Ms Steele echoed the comments of Sydney pharmacist Catherine Bronger, who told the AJP last week that pharmacists are being forced to isolate despite wearing full personal protective equipment while serving patients.

“Where we fail to secure a pharmacist, we have made a strategic decision to adopt a part-closure policy,” Ms Steele said of Lloydspharmacy.

“This means that instead of one pharmacy being closed for a full day, we will ask a pharmacist to open one pharmacy in the morning, and another in the afternoon.

“While LloydsPharmacy continues to address this ongoing issue in the ways that we can, as a sector we need to start acting smarter.”

 

Sundre, Canada: Alberta pharmacist Chris Aingworth has told CBC News that he is having to waste many doses of the Moderna COVID-19 vaccine, as demand for the jab has fallen away.

He said that because each Moderna vial has to be used within 24 hours of opening, most of the 14 doses in each vial are simply being thrown away.

“We’ll open up the vial, give the shot and then just hope that more people come in so that we can use up the excess,” Mr Aingworth told the station.

“The last few days, I’ve had to waste, like, 12 doses each day, which is criminal, in my opinion.

“You know, you’ve got countries around the world that could really do with the vaccine. And here we are, throwing the stuff away.”

Pharmacists in Alberta are required to order at least a minimum of 140 doses at a time, contributing to the problem.

A spokesperson for Alberta Health told CBC that shipping smaller amounts to pharmacies would introduce risk, as it would involve wholesalers having to open, repackage and relabel the vials.

“However, distribution of smaller amounts of vaccine to pharmacies is being discussed with our distributors as the demands for vaccine across the province are changing,” she said.

 

Greensboro, North Carolina: The former owners of a now-closed Hillsborough compounding pharmacy have paid out more than US$1 million to resolve False Claims Act allegations.

David and Lois Tsui paid US$1,082,991.94 (AUD$1,475,435.81) to resolve the allegations that they submitted false claims for payment to TRICARE, the United States military’s health program.

Mr Tsui had been previously convicted of health care fraud, and in 2009 was excluded from participating in federal health care programs such as TRICARE, the US Attorney’s Office, Middle District of North Carolina said in a statement.

However authorities contended that Wellcare Compounding, the pharmacy owned by Mr and Ms Tsui, intentionally concealed his involvement and ownership, instead claiming that Lois Tsui owned the business.

The United States also asserted that Wellcare made improper payments to physicians and “marketers” in exchange for prescriptions or referrals for prescriptions, in violation of the Anti-Kickback Statute.

Wellcare encouraged medically unnecessary prescriptions consisting of high-margin ingredients to maximise the pharmacy’s reimbursement, the US Attorney’s Office said.

The United States contended that through these actions, the Tsuis and Wellcare knowingly caused false claims to be presented to the TRICARE program.

“This settlement sends a strong message that individuals who defraud federal health care programs cannot rely on the passage of time or the use of straw owners to conceal their wrongdoing,” said Acting United States Attorney Sandra Hairston.

“We will continue to identify those who seek to seek to exploit federal programs for personal gain and will hold them accountable.”

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