A NSW pharmacist dispensed up to 52,000 OxyContin 80mg tablets to a single patient in one year, and nearly 150,000 over four years
The pharmacy owner, who cannot be named for legal reasons, has been slammed by the NSW Civil and Administrative Tribunal for his conduct regarding the dispensing of Schedule 8 medications.
In particular, he was found to have filled hundreds of scripts for Oxycontin 80mg between December 2012 and March 2014, which were 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 which would lead to a dosage exceeding recognised therapeutic standards (one tablet twice a day).
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 in the name of this one doctor.
In total, this amounted to 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.
The PSU had decided to investigate the pharmacy after reviewing its wholesale records in September 2013 and finding the pharmacy had purchased an unusually high quantity of OxyContin 80mg in the period reviewed.
The pharmacist did not concede that any of his conduct was unsatisfactory professional conduct or professional misconduct, and defended himself against the allegations.
“His account was that in certain circumstances he telephoned the prescriber to ask, ‘Is this script okay?’ and if the doctor said it was ‘okay’ then his duties were discharged,” found the tribunal.
The pharmacist stated in a meeting with the PSU that he understood the dose of OxyContin 80mg to be two tablets up to four times per day.
He also stated he did not notice that some of the scripts were missing phone numbers and script ID numbers, and “at times” parts of the scripts were covered by a black marker.
During the tribunal hearing, evidence revealed it was possible some of the scripts came from script pads that had been stolen from the prescriber’s office.
A PSU investigator concluded that at least six different prescription pads were used to produce 600 scripts issued in the doctor’s name.
The tribunal found the pharmacist’s explanations of his conduct and understanding of his professional obligations in dispensing Schedule 8 medication were “implausible and unconvincing”.
“On key issues [the pharmacist] embellished and altered his account, and we find … that aspects of his evidence were plainly false,” it said.
“The amount dispensed was clearly in excess of the prescribed dose and also outside of what [the pharmacist] contended was the therapeutic range.”
The tribunal concluded that the pharmacist was “well aware that OxyContin should not be taken more than twice a day, and that his account to the PSU investigator and the … hearing was an ill-considered attempt to justify what was plainly his dispensing of excessive quantities.”
It continued that the pharmacist’s conduct “demonstrates at best a wilful disregard of his professional obligations”, and concluded his conduct had been “improper and unethical”, amounting to professional misconduct.
Costs have been reserved until orders are decided at an upcoming hearing.