World news wrapup: 24 October 2019

tribunal hearing legal case

Pharmacist jailed for overcharging NHS; pharmacist jailed for role in fentanyl ring; new pharmacists outraged at response to exam cheating

South Wales, UK: A pharmacist has been jailed for 16 months after he was found to have intentionally overcharged the NHS £76,000 (AUD$142,733) reports Chemist + Druggist.

Michael Lloyd, who had previously been the co-director of five pharmacies in south-east Wales, charged the sum for more than 1,500 “tampered” scripts at one of the pharmacies, the Talbot Pharmacy at Heol Y Gyfraith, Talbot Green, Rhondda Cynon Taf.

Over five years, Mr Lloyd had on several occasions claimed that he had dispensed medicines in liquid form – which is more expensive – but in reality had dispensed the tablet version of the medicines.

“Some tablets for dementia, such as memantine and donepezil, cost as little as £3, but [Mr] Lloyd claimed for the more expensive liquid formulation, which sometimes cost the NHS as much [as] £300 each time,” said the NHS Counter Fraud Service Wales.

“Lloyd sometimes altered the prescription forms – which had often already been honestly endorsed by staff to show that tablets had been dispensed – by crossing out their entries to claim for the much more expensive items, such as liquids and dissolvable or dispersible tablets.”

The patients did receive the correct medications to treat their conditions, it said.

Mr Lloyd repaid the overcharged amount in full earlier this year and admitted to the offences.


Toronto, Canada: A pharmacist has been jailed for 13 years for her part in a plot with a doctor to illegally dispense thousands of fentanyl patches.

Shereen El-Azrak was convicted of trafficking in fentanyl and possession of the drug for the purposes of trafficking between dates in 2015 and 2016, reports the Sudbury Star.

Ms El-Azrak reportedly hoped for leniency due to her circumstances as a single parent with a rare disease, but this did not occur.

The Court heard that she admitted to dispensing 2,780 fentanyl patches via false scripts given to her by the Toronto doctor with whom she colluded. The doctor was convicted of one count of fentanyl trafficking earlier this year, and has yet to be sentenced.

The pharmacist was reportedly paid CAD$500 (AUD$558) per patient, while the doctor was paid CAD$1,500.

A delivery driver for Ms El-Azrak’s pharmacy was the intermediary for everyone involved in the ring.

Ontario Superior Court Justice Chris de Sa said in sentencing that Ms El-Azrak would have received a longer sentence if it were not for her medical condition.

“As a pharmacist, Shereen was entrusted with the control of this deadly drug’s distribution … She abused this position for personal gain,” he said.

“While the funds were not located, Shereen clearly trafficked in fentanyl for profit. As a pharmacist, she would have also been aware of the deadly effects of this drug in the hands of addicts.”


Los Angeles, California: At least 1,400 graduate pharmacists are now expected to retake California’s state licensing examination following the online leak of more than 100 of its questions.

According to the Los Angeles Times, any pharmacist who has sat for the test since July 2019 will need to take it again, after the state’s regulator was alerted to possible “widespread” cheating on the exam.

“We are fully aware of how destructive it’s been for them, but we’re a consumer protection agency,” said Bob Davila, a spokesperson for California’s State Board of Pharmacy.

“We want to make sure that anyone who does get a license in California is in fact competent to take care of California patients.”

Pharmacists are reportedly upset by the Board’s decision to make them re-sit the examination, telling the Times of lost wages and opportunities.

Layla Mina from Anaheim told the paper that she had been offered a job as a pharmacist at a nearby CVS, but the offer was withdrawn as she was not able to become licensed to practise without a valid examination score. She is now working in a clothing store.

“That CVS is close to my house, and every time I go in and get gum or whatnot, it makes me sad — that could’ve been me,” Ms Mina said. “It’s not really fair to any of us.”

Some graduate pharmacists are planning to protest the Board’s decision.


Chicago, Illinois: One in eight American pharmacies closed down between 2009 and 2015, new research has found: and independents were more likely to have been affected.

Researchers from the University of Illinois published data in JAMA Internal Medicine which showed that 9,654 pharmacies across the United States closed during the period they studied.

The researchers examined how pharmacy, community and market characteristics influenced the risk of a pharmacy closing.

According to their analyses, independent pharmacies in both urban and rural areas were three times more likely to close than chain pharmacies.

“Independent pharmacies are often excluded from preferred pharmacy networks and 340B contracts, which are both increasingly important aspects of the pharmacy market, so it is not surprising that independent stores are at greater risk for closure,” said Dima Mazen Qato, senior author of the study and associate professor of pharmacy systems, outcomes and policy at the UIC College of Pharmacy.

“Efforts to improve access to prescription drugs have focused almost exclusively on reducing drug costs, but affordable medications aren’t easily accessible when a local pharmacy closes. We need policies that specifically address pharmacy closures because such closures negatively impact access and adherence to prescription drugs,” A/Prof Qato said.

In previous studies, A/Prof Qato and her colleagues have shown that pharmacy closures are associated with non-adherence to prescription medications. These declines in adherence also were shown to be worse in patients using independent pharmacies that subsequently closed.

“Although efforts to promote pharmacy access have focused on addressing pharmacy closures in rural areas, we found that pharmacies located in low-income, urban areas are at greater risk for closure,” she said.

They report that approximately one in four pharmacies located in urban, low-income neighbourhoods closed, compared with one in seven pharmacies located in rural, low-income neighbourhoods.

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