World news wrapup: 7 November 2019

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Pharmacist sentenced over huge pain cream fraud; mail order pharmacy sued over patient death in landmark case; economic evidence for “hub and spoke” queried

Hattiesburg, Mississippi: A pharmacist has been sentenced to 10 years in prison after he pleaded guilty to filing US$243,550,503 (AUD$353,148,229) in false claims with a military health benefits program.

Thomas Spell Junior was also ordered to pay the entire amount back to Tricare, the program in question.

The claims, made by Mr Spell as well as other workers at a Medworx warehouse, concerned expensive pain creams and vitamin pills, some of which cost up to US$15,000 (AUD$21,750) each.

The compounded medicines were meant to be formulated for specific patient needs, but they were instead prescribed on “preprinted prescription pad,” reports the Hattiesburg American.

Despite the fact that the creams included a controlled substance, many of the patients involved had never seen a prescribing doctor and many were ultimately judged to have not needed the creams at all.

US Attorney Mike Hurst had previous called the incident one of the largest health care fraud schemes ever investigated and prosecuted in the southern state.


Fayetteville, North Carolina: A mail-order pharmacy is being sued after family members of an elderly woman who died alleged that it sent her the wrong medication, the Fay Observer reports.

Bertha Autry Small, 74, had a number of conditions including high blood pressure, diabetes, kidney dysfunction and a history of stroke. She used a wheelchair and was undergoing dialysis.

In 2013, the patient was sent a prescription refill of six medications – but according to court documents, she was sent medicine intended for another patient, a person who resided in California.

While the packaging did identify the medicines and have the other patient’s name on them, the pills looked enough like her regular medication that the “barely literate” Ms Small took them anyway.

The suit claims that this led to a significant reduction in blood pressure, resulting in memory problems, hallucinations and confusion, including the idea that Ms Small would be able to walk again.

When trying to walk, Ms Small had a severe fall and broke her left leg in at least two places.

After hospitalisation, she developed an elevated white blood cell count, sepsis and pneumonia, and passed away following a heart attack.

The case, which had previously been dismissed, was revived in an appeals court and a jury will now decide whether the mail order pharmacy, which has denied that it was negligent, should be held responsibility in any way.

The Observer notes that the case is significant in that it has had an effect on whether patients have been able to file suit against other mail order pharmacies in similar cases.


UK: Britain’s controversial “hub and spoke” dispensing model has no evidence to support its economic use, the Pharmaceutical Journal reports.

Pharmaceutical Services Negotiating Committee chief executive Simon Dukes has told the Journal that pharmacy negotiators have not been presented with any evidence to support the model, which had been lauded by Government as a way of saving money.

He said that “the government’s side was adamant that there were efficiencies to be had within the sector… and, therefore, it would proceed with legislative change to change the current situation with regard to hub-and-spoke”.

Instead of allowing this to happen unchallenged, the PSNC decided to engage with the government and help “steer that dialogue”.

Mr Dukes said that given the pressures on community pharmacy, there could be some benefit in freeing up pharmacist time by extending hub and spoke models.

“But does it save money? I don’t think any of us have seen any evidence that it would,” he said.

Andhra Pradesh, India: Two people have been killed after an explosion tore through a pharmacy, the Times of India reports.

The owner of the pharmacy, Rama Rao, and an employee were both killed.

The shop, the Long Live Medical Distributors shop, was destroyed, and several adjacent premises in the multi-storey building damaged.

Police are now investigating the cause of the blast, which was initially supposed to be caused by an accident while filling air conditioning gas, though this has now been excluded as a cause.

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