Drug Topics - April 14, 2008 - (Page 22)

22 DRUG TOPICS APRIL 14, 2008 www.drugtopics.com Community Practice Cardinal caught between DEA and pharmacies over diversion control Reid Paul ardinal Healthcare announced that it was discontinuing controlled substance shipments at its Stafford, Texas, distribution center to independent, Medicine Shoppe, and Medicap pharmacies. The facility is the fourth to curtail controlled substance shipments since November under pressure from the Drug Enforcement Administration. “We are working with the DEA and have met with them to further discuss the situation and help them understand what we are doing and the progress we are making,” Mark Hartman, senior VP supply chain integrity and regulatory operations for Cardinal Health, told Drug Topics. “We take this very seriously not just because of the DEA actions, but also because diversion is clearly hurting our industry and hurting people.” According to Hartman, Cardinal is implementing a suspicious order monitoring program initially for retail independents. After the system is rolled out completely, the company Lew Zeidner, CEO of ApothcaryRx, will expand it to include hospitals only sued Cardinal as a last resort. and chain pharmacies. “Retail independents are good people and do great work,” he commented, “but the sector has been identified as having the highest risk of diversion.” C license to distribute controlled substances at its Orlando distribution center. During the suspension the company implemented additional controls to its monitoring system and its license was reinstated in August. According to Nora Beger, manager of public relations, new customers are prequalified, during which a threshold for controlled substances dispensing is established. Suspicious orders are investigated by its corporate security office and the DEA is notified. “We communicate with the customer when an order is put on hold,” she said. In a Security and Exchange Commission filing, McKesson noted it was in discussions with the DEA over claims that it filled customer orders for controlled substances that were not adequately reported. “We have been implementing improvements to our comprehensive controls and reporting procedures to avoid future claims of this type,” the company noted in the filing. Working in good faith Not surprisingly, tightening controls has also drawn complaints from pharmacists. In two separate cases, independent pharmacies have sued Cardinal after it cut off their controlled substances. In December judges in two separate cases ordered Cardinal to restart its shipments to Community Drugstore, LLC and ApothecaryRx’s Ken’s Pharmacy location in Norman, Okla. According to Lew Zeidner, CEO of ApothecaryRx, the company only sued as a final recourse to get Cardinal to restart controlled substance shipments. Ken’s Pharmacy, which ApothecaryRx purchased in 2006, is located next to Norman Regional Health Center and fills a large number of prescriptions from the center. In December Cardinal stopped shipping controlled substances without notice and the pharmacy saw no other alternative. “We all have concerns about diversion, but there also needs to be due process,” Zeidner argued. Still, Zeidner insisted that Cardinal has been cooperative. “We have 11 other stores using Cardinal and we intend to continue using them,” he said. “They appear to be working with us in good faith.” In other instances, pharmacists impacted by the closures have complained about problems with getting shipments on time. (See “Letters” Feb. 11, 2008, p. 12.) “We take very seriously the potential impact on speed of delivery,” Hartman stressed. “If we can’t meet our delivery schedules, we communicate with customers.” Reacting to the DEA Cardinal is not the only wholesaler on the hot seat. In March, Bruce Roberts, R.Ph., executive VP and CEO of the National Community Pharmacists Association, wrote to the DEA complaining about the impact of DEA pressure on all wholesalers. “The DEA’s policies result in restricting or preventing pharmacies from obtaining medications for patients with legitimate pain needs,” he wrote. Roberts also criticized DEA for “sweeping, non-specific directives,” the closures of Cardinal’s Florida and Washington distribution centers, and its targeting of community pharmacy. “It is no surprise that our members report overly broad, uneven, and punitive actions by various wholesalers,” Roberts added. A year ago the DEA suspended AmerisourceBergen’s http://www.drugtopics.com http://www.nxtbook.com/nxtbooks/advanstar/dt021108/index.php?startid=12

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Drug Topics - March 14, 2008 Contents Latebreakers Letters: Students Need Grounding in Chemistry Pharmacy Directors Wary of Heparin Shortages Some E-prescribing Standards are Ready to Go, Others are Not News Briefs Nanotechnology: Big Stakes in a Small World Pay for Performance is Coming to Pharmacy Patient Safety Organizations Still Very Much in Planning Stage Reconciling Medications in Specialty Patients Poses More Challenges Pharmacy Outsourcing Still Much in Use by Hospitals Studied Extensively, New Drug-Eluting Stent Said to be Very Safe Prevention is Key in Treating C. Difficile Infections E-prescribing Grows in Massachusetts, but Other States Lag Behind Active Metabolite Gives New Life to Antidepressant NSAIDS not Recommended for Long-term Use in Osteoarthritis This Time R.Ph.s and States Are Ready for Tamper-Resistant Rx Pads Cardinal Caught Between DEA and Pharmacies over Diversion Control Medicating Kids: Still More Questions than Answers Schnucks Pharmacy: Drug Topics' Chain of the Year Panel Will Ask for a System for R.Ph. Practice Across State Lines FDA Safety Page: How to use Fentora Safely The Shining OTC/HBC Stars of 2007 Take a Look at These OTCs for Eye Health Technology Update: Google Offers a Sneak Peak at its Electronic Records Initiative Recent Advancements in HIV/AIDS Treatment New Products Advertisers Index Classified Viewpoint: Are State Boards of Pharmacy Abusing Their Power?

Drug Topics - April 14, 2008

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