World news wrapup: 4 March 2021


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Irish pharmacists could be given work at a third of agreed pay rates; Kenya cracks down on illegal pharmacies; US pharmacist facing lawsuit over controlled substances

Ireland: Concerned about the disparity in pay between negotiated rates and jobs being advertised, the Irish Pharmaceutical Union has advised pharmacists not to participate in the country’s COVID-19 vaccination program.

“The fees agreed between the IPU and the HSE are about three times higher than the rate on offer in the recruitment drive,” writes reporter Michael Clifford in the Irish Examiner.

According to a regulatory deal signed earlier this year, pharmacists are to be paid €70 (AUD$108) an hour for working in mass vaccination centres – meaning an equivalent annual salary would be around €142,000 (AUD$219,343).

But positions have been advertised by a recruitment company for a salary ranging from €35,000 (AUD$54,063) to €50,000 (AUD$77,233).

“The advertisement has prompted the IPU to notify its members that they may be recruited to do vaccination work and then find themselves with a contract worth around a third of what has been agreed directly on their behalf,” the Examiner reports.

 

St Louis, Missouri: The US Justice Department has filed a lawsuit against Creve Coeur pharmacist Elizabeth Dembo, whom it alleges unlawfully dispensed controlled substances to patients during her time as the pharmacist-in-charge of Olive Street Pharmacy.

The Department alleges that Ms Dembo repeatedly filled prescriptions while disregarding ample warning signs of diversion, or “red flags,” indicating the prescriptions were not legitimate.

The complaint accuses Ms Dembo of routinely filling prescriptions for Subsys, an oral fentanyl spray, which is subject to heightened FDA restrictions and indicated only for opioid-tolerant patients experiencing breakthrough pain due to cancer. 

The complaint states Ms Dembo dispensed high dosages of Subsys to patients despite knowing they did not qualify for the drug. The complaint also states the vast majority of the Subsys Dembo dispensed was prescribed by Philip Dean, a Warrenton, Missouri neurologist who pleaded guilty to illegally distributing prescription opioids in 2018, including to women with whom he had lived and with whom he had had personal relationships. 

The complaint alleges Ms Dembo knew Dr Dean was having intimate relationships with at least one of the women for whom he was prescribing controlled substances, but nonetheless continued to dispense Dr Dean’s controlled substance prescriptions to her and others.

Other red flags described in the complaint include what the department calls “clear instances” of tampering with written prescriptions; dangerous combinations of drugs commonly sought after for recreational purposes; and amounts of opioids that exceeded CDC guidance by as much as 17.5 times the recommended maximum daily dosage. 

Despite these warning signs, the complaint alleges, Ms Dembo continuously dispensed prescriptions she knew or should have known had no medical purpose.

“As we continue to battle a national health emergency involving opioid abuse, we rely heavily upon pharmacists to do their part in ensuring prescriptions for controlled substances are filled and dispensed for legitimate medical purposes,” said Inez Davis, Diversion Program Manager of the Drug Enforcement Administration St. Louis Division.

“Now more than ever, due diligence on the part of the entire medical community is needed to ensure prescription opioid medications are prescribed and dispensed appropriately. Pharmacists can be considered a last line of defense in preventing the diversion of prescription drugs.”

 

Kitui, Makueni and Machakos counties, Kenya: The Pharmacy and Poisons Board has closed 95 illegal pharmacies, which were allegedly selling medicines without being authorised sellers.

To date the crackdown, which aims to reduce the number of illegal pharmacies operating in the country, has been conducted in three counties in Kenya’s Lower Eastern Region.

At this stage 61 people have been arrested and 85 containers of medicines have been seized.

Deputy Director Inspectorate, Surveillance and Enforcement at the PPB Dr Dominic Kariuki, who led the operation, told The Star that, “The seized medicines will be analysed and disposed as per PPB guidelines on disposal of pharmaceutical waste”.

“The list of closed premises has been shared with county administration and Kenya Police Service for enforcement of closure,” he said.

A number of people have been charged with operating the business of a pharmacist without the presence of a pharmacist.

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