World news wrapup: 19 October 2017

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NZ pharmacists oppose codeine upschedule; most Zambian pharmacies operating illegally; Chicago moves to reduce script pressure

New Zealand: Radio New Zealand has detailed a debate over the potential upscheduling of OTC codeine-containin preparations, reporting that pharmacists are lobbying against the move.

NZ’s medicines regulator, Medsafe, was to make a decision on the future of low-dose codeine in May 2017, but deferred its decision in order to seek more submissions on the subject.

Many of the submissions were sent in by pharmacists opposing the potential upschedule, Radio NZ reports.

One pharmacist, Greymouth’s Julie Kilkelly, expressed concern about patients needing to access a GP for pain relief, as well as the potential for doctor shopping. She suggested a “centralised nationwide system” for recording codeine purchases.

The potential change is a “knee-jerk” reaction based on the Australian upschedule, she said.

Another pharmacist, Shane Heswell from Whangarei, said that a codeine monitoring tool currently being used in Northland and Auckland was working well and should be extended to the rest of the country.

Medsafe’s Medicines Classification Committee will make its decision in November.


Chicago, Illinois: Chicago’s City Council Finance Committee has approved a move to cap the number of prescriptions a Chicago pharmacist can fill, the Chicago Tribune reports.

As well as guaranteeing breaks for food and bathroom visits, the measure will require that pharmacists not fill scripts for more than 10 patients per hour.

Pharmacies will also have to clearly display a list detailing which pharmacists and pharmacy technicians have been on shift for longer than eight hours.

The plan would also prohibit stores from using “staff metrics or productivity quotas” to direct pharmacists to participate in activities not related to filling scripts, such as flu vaccination and other services.

The move follows a Chicago Tribune investigation in 2016 which found pharmacies often did not tell patients – including Tribune reporters posing as patients – about potentially deadly drug interactions.

The proposal was sponsored by alderman Edward Burke, chairman of the Committee, who says that it would help reduce “undue levels of stress” placed on pharmacists by retailers, as well as risk to the public.


Zambia: Most community pharmacies in Zambia are operating illegally, the Times of Zambia reports.

The Zambia Medicines Regulatory Authority has taken the step of warning pharmacy owners not to employ unqualified staff.

The Authority’s spokesperson, Ludovic Mwale, said that stores registered as entities to sell medicine were required to employ trained pharmacists, and that the regulations are very clear.

“The Authority had observed that most drug stores operating in communities were staffed by unqualified staff and were also operating illegally,” the Times reports.

Mr Mwale warned that pharmacy owners illegally employing unqualified staff were at risk of losing their licences and being prosecuted.

He said such pharmacies also had a tendency to sell expired drugs.


New Zealand: Complaints about side-effects have led to a GP uncovering a significant dispensing error, Pharmacy Today reports.

The GP’s patient, a 77-year-old man, complained of symptoms including a “dull headache,” light-headedness while driving, a tendency to bump his shoulders and elbows while going through doors, stomach and gut pain, tremors, cramps and giddiness.

These symptoms followed his commencing on Sinemet 100mg earlier that month.

The GP rang the pharmacy to enquire about the original prescription and discovered the pharmacist had dispensed 200mg of Sinemet instead of the prescribed dose.

The pharmacist was found to be in breach of the Code of Health and Disability Services Consumer’s Rights. He has since apologised to the patient and reviewed and familiarised himself with the pharmacy’s standard operating procedures, as well as arranging for training and an assessment via the New Zealand College of Pharmacists.

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