Pharmacist who dispensed over 143,000 OxyContin tablets banned

A NSW pharmacy owner has been struck off the register for “gross breach of his professional obligations”

In a hearing before the NSW Civil and Administrative Tribunal late last year, a NSW pharmacist and owner – who cannot be named for legal reasons – was reproached for his conduct regarding the dispensing of Schedule 8 medications.

The pharmacist was found to have filled hundreds of scripts for OxyContin 80mg between December 2012 and March 2014, purported to have been issued by a single doctor (who also cannot be named for legal reasons) to 46 different patients in circumstances where the scripts were for large quantities and high strengths of the drug – generally 112 tablets of 80mg.

The scripts were presented at short intervals over prolonged periods.

For example, during 2010 the respondent’s pharmacy dispensed 14,000 OxyContin 80mg tablets on scripts issued in the name of a single doctor, and during 2011 this amount more than doubled to 31,000 – staying at this volume for 2012.

In 2013 the amount dispensed increased to almost 52,000 OxyContin 80mg tablets.

And in the first 11 weeks of 2014 – just prior to seizure by the Pharmaceutical Services Unit (PSU) – the pharmacy had already dispensed 13,400 OxyContin 80mg tablets.

This amounted to a total of 143,884 OxyContin 80mg tablets prescribed by one doctor, the bulk of which were dispensed by the pharmacy owner personally over a four-year period to a single person – who was presenting multiple scripts, multiple times per week, and paying cash amounts of up to $2000 at a time.

In a recent hearing to decide sanctions, the Health Care Complaints Commission (HCCC) submitted that the pharmacist’s conduct “represents multiple extremely significant departures from the proper legal and ethical standards applicable to a registered pharmacist” and that he had acted with “moral turpitude” in the course of his practise of pharmacy.

Meanwhile the practitioner provided a brief statement informing the tribunal that he was halfway through an educational course on ethics and dispensing.

He was also no longer working as the pharmacist in charge at his own pharmacy, and had been abiding by conditions placed upon his registration since the first hearing.

However the tribunal stated that “the well-known nature of the threat to public health posed by the diversion and misuse of prescription pharmaceuticals, including poisoning, overdose and death, is evidenced by a number of press articles by the Commission.

“General deterrence and denunciation are particularly important in this case given the risk to the community posed by the inappropriate dispensing of opioid medication and the potential misuse and abuse of such drugs.

“These drugs represent a very real threat to the health and safety of the public, a threat which [the pharmacist] disregarded in gross breach of his professional obligations over a sustained period,” the tribunal found.

“While [he] expressed remorse in the course of the Stage 2 hearing we find that he nonetheless would pose an unacceptable risk to the public in terms of the repetition of inappropriate professional conduct, even if conditions were in place which prevented him from handling S8 medications.

“[The pharmacist] did not put professional obligation, concern for patients or the public above his own pecuniary interest, even as the volume of drugs he sold rose and continued to rise over time. He sought no advice and made no report. Nor did he cease the misconduct until he was literally forced to stop by the PSU.”

Due to the gravity, repetition and prolonged nature of the misconduct, the tribunal ruled that an order of cancellation of registration was the only appropriate outcome.

The pharmacist was reprimanded for his actions and cancellation of his registration was ordered, with costs of the proceedings to be paid to the HCCC.

The practitioner may not apply for a review of the order for two years.

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