Scope of DEA over-sight expanding

[Pharmacist.steve]

http://www.brownsvilleherald.com/news/pharmacies_93411___article.html/substances_controlled.html

When you read this... pay attention that there were OVERAGES & shortages.. there was no PROOF of DIVERSION... it was - most likely -sloppy bookkeeping ..and the fine for this was rather STEEP !

If there was proof of diversion... they would have went after one or more of the Pharmacy staff that was responsible for the diversion...

... this could be a direct/indirect consequence of over-worked/under staffed pharmacy staff trying to get out as many $4 Rxs per man hour that they can.

The question is .. if they were this sloppy with bookkeeping... how sloppy were they in filling Rxs in regards to accuracy?

[Mark N]

Steve, how prevalent are overages or shortages in an average pharmacy? I know this is something that many think should be 100% accurate but like all human endeavors I know it isn't but what should be expected? Does the DEA have a target that pharmacies should make or face a DEA accounting?
Thanks for the article and keeping us up to date on the latest news.

PS this is my first time on Medicare part D would you go with the in house pharmacy or save money and have your meds mailed to your house?

[Pharmacist.steve]

Steve, how prevalent are overages or shortages in an average pharmacy? I know this is something that many think should be 100% accurate but like all human endeavors I know it isn't but what should be expected? Does the DEA have a target that pharmacies should make or face a DEA accounting?
Thanks for the article and keeping us up to date on the latest news.

PS this is my first time on Medicare part D would you go with the in house pharmacy or save money and have your meds mailed to your house?

I have never been a big fan of mail order... for a couple of reasons... if you ever have an original bottle of meds typically they should be stored (per FDAUSP) at something like 58-85F.. the manufacturer , *********r, pharmacy are bound by this UNTIL the pharmacy drops them in the postal/delivery system.. when is the last time you saw a temp controlled delivery vehicle?

Dealing with a "virtual pharmacy" and that is what you are doing with mail order... you don't know who you are talking to on the phone- if you can get to talk to anyone... what do you do if your meds are late... I have heard of turn around times upwards to 14 days with mail order outfits.. If something goes wrong .. at least you can have a face-to-face encounter with the local pharmacist and/or staff to get it resolved...try that with a mail order pharmacy...

As far as the DEA is concerned and bookkeeping errors .. in a pharmacy you are not dealing with bottles .. you are dealing with tabs/caps - broken bottles.. mis-counts happen... Rxs that are never picked up .. are returned to stock and not noted in the computer that the Rx was never picked up.. mis-fills happen that never get caught... say that someone got Hydrocodone 5 got dispensed for Hydrocodone 10... that creates a OVERAGE & SHORTAGE from the same mistake... a invoice got mis-filed or mistakenly shredded - more overages..

This particular incident with Walmart is a joke... every two years a pharmacy has to do a physical DEA inventory - CII - must be a exact count ..the rest a guess-a-mate and you THROW OUT THE PREVIOUS INVENTORY RECORDS.

IMO...the DEA has pulled back from busting docs and now they are trying to put the "fear of god" into the pharmacy community... and since the vast majority of Pharmacists are employees... it is going to work... guess who is going to suffer... people who need controlled substances !!

Just like it is impossible for a doc's practice to be pristine - no bogus patients - given modern day staffing & work loads .. it is impossible for ANY PHARMACY to be "dead-on" in tablet count...

[mrsdoubtfyre]

The DEA went thru my state and gave violations to just about everyone a few years ago.

The truth of the matter? Many chain pharmacies are poorly run. Pharmacists moved in and out frequently. Some don't have regular staff anymore.
When you have mostly temporary help, there is no foundation for good invoice and record control. A temp who comes in for one or two days, is not likely to have the time or energy to track invoices that may be months behind! Add to that that supportive staff help is often non-existant. You should have seen what happened in most K-Mart pharmacies when they started having money trouble. (most of the help was cut). The DEA knows this, and is just taking advantage of a good cash cow. When pharmacies are so busy they can't fill the RXs for the day and have to leave some for the next shift, who is going to be doing paperwork?

WalMart in particular is known to be the WORST to work for...so good people avoid it.

What the DEA does is MAKE MONEY for itself by levying fines like this.
In my state it was $1000 per line on the CII order forms if they were not individually signed upon delivery. Most pharmacists signed the form once prior to that at the bottom.
Some stores were fined thousands and thousands of dollars because each line on each form was blank with only one signature at the bottom.

There is diversion everywhere. On every level. But articles like this only illustrate that the DEA is a money making arm as well as enforcement, IMO.

[Mark N]

Steve, thanks for the info. I haven't used the mail delivery for my meds because of problems I for see but was wondering if I was just costing myself extra money for no real reason.

I know that pharmacies aren't going to be perfect because no human endeavor is. I agree the DEA is looking at pharmacies as a way to control prescription drug abuse but didn't know if your industry was given guidelines the DEA goes by. If they are expecting a perfect count they aren't being realistic because even they aren't perfect in their investigations. Thanks for giving me the info on mail in medication.

[Pharmacist.steve]

What the DEA does is MAKE MONEY for itself by levying fines like this.
In my state it was $1000 per line on the CII order forms if they were not individually signed upon delivery. Most pharmacists signed the form once prior to that at the bottom.
Some stores were fined thousands and thousands of dollars because each line on each form was blank with only one signature at the bottom.

The whole government works this way.. How often does a government entity takes some corporate entity to court because they have harmed people within our society - get a big settlement or fine and the money goes into the general budget - not back to the people that was harmed... the tobacco settlement is a good example.. that money was suppose to go to anti-smoking campaign... Florida legislature is currently in special session and their "tobacco fund" has 1+ Billion in it .. the legislature decided to take 700 million to put in the general fund to help balance the budget... and I have read where some states never spent the first dime on anti-smoking campaigns... all goes directly into the general fund...