Drug Topics - February 11, 2008 - (Page 12) 12 DRUG TOPICS FEBRUARY 11, 2008 www.drugtopics.com Letters How supply-chain kinks can affect you t has been reported by your publication and others that recently DEA suspended three Cardinal Health distribution centers in Washington, Florida, and New Jersey from selling controlled substances due to their failure to adequately monitor “suspicious” accounts. I would like to share our pharmacy’s experience with Cardinal following these developments so that other pharmacist owners/managers can learn from our experience. Initially, Cardinal’s only “option” was for a subsidiary, ParMed (New York), to distribute a very limited number of generic opioid products to pharmacies in Washington state. The company had no better contingency plan in effect to cover the loss of the Auburn, Wash., facility (no other distribution centers were licensed in Washington state). Had the entire facility been shut down due to natural disaster (earthquake, flooding, etc.), over 600 Cardinal accounts statewide would not have been able to obtain any medication for their clients. It took several days for Cardinal to obtain emergency licensure of its Sacramento facility in Washington state (and several accounts, including ours, provided assistance by calling our board of pharmacy to expedite this matter). The week prior to the official DEA shutdown, Cardinal sales reps contacted their accounts (including ours), advising them to increase their on-shelf inventory of controlled substances in order to cope with the pending logistical nightmare. In our case, we significantly increased our controlled substance inventory in order to provide continued support for our patients. This also happened to be just before our annual inventory, but being a hospital-owned and on-campus facility, we really didn’t have any choice but to raise our inventory of these products regardless of the financial consequences. Then, perhaps in order to placate the DEA and show the agency that it really had a process to identify scofflaws and diverters, Cardinal cancelled the ability of several West Coast accounts (including our outpatient pharmacy department) to order controlled substances. This jeopardized our pharmacy’s ability to support our hospital’s discharging surgical, inpatient, hospice, and oncology patients. Notification from Cardinal came in the form of a fax sent by the corporate director of qual- I ity and regulatory affairs late on a Monday (after the sender, based in Ohio, was no longer available for contact). The fax stated that our account was cancelled in part due to “recent excessive quantities ordered” as well as “a risk that diversion will occur if we continue to fill controlled substance orders.” It took several days to fix this with Cardinal. To be lumped by your wholesaler into the same category as an illegal Internet operation is both personally and professionally insulting. This is especially insulting since we’d been advised by Cardinal reps to increase our orders! The lessons learned here are many and include researching just what your wholesaler’s contingency plans are in the event of emergency or disaster, making sure the wholesaler has a real plan to prevent diversion, and making sure your local sales rep will be able to intervene on your behalf when situations like this arise. And they continue to arise: Cardinal’s most recent pronouncement is that now it can’t supply Allegra-D from the Auburn, Wash., facility since it contains a controlled substance. So the problem continues. Richard Molitor, R.Ph. Manager Evergreen Professional Center Pharmacy Kirkland, Wash. rmolitor@u.washington.edu More safeguards needed against workplace violence Regarding your Nov. 5 cover story on workplace violence, I greatly appreciated your article because our state, Indiana, is No. 2 on the top 10 list of states with the highest number of robberies, as reported to RxPatrol. You’ve confirmed what I have found—that no one is addressing this issue and boards of pharmacy don’t want to risk taking on large corporate chains. Most chain pharmacies have a policy of no resistance to robbery (good idea) but with no cameras or other security, robbery is very easy and the chances of capture even less. Stolen drugs are sometimes replaced by drug companies at no charge, so from a business standpoint, chains just let the drugs go, keep people working, and keep making money. This is good for the bottom line, Letters (including e-mail) should be as brief as possible and sent with the writer’s name, address, daytime phone number, and date of the issue you are referencing to: Editor, Drug Topics, 123 Tice Boulevard, Woodcliff Lake, N.J. 07677-7664. E-mail address: drugtopics@advanstar.com. Correspondence may be edited for length and clarity. http://www.drugtopics.com
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