there are no words…
The Food and Drug Administration has issued an alert about two pharmacies in Baltimore suspected of distributing expired or counterfeit drugs. The agency said patients who have received the following drugs should contact their physician for new prescriptions:
- Lisinopril (20 milligrams)
- Guaifenesin/Dextromethorphan (600 mg and 1000 mg)
- Gabapentin (100 mg, 300 mg and 400 mg)
- Metoprolol (50 mg)
- Nifedipine (30 mg)
- Diclofenac Sodium (30 mg)
- Glucophage (500 mg Extended Release)
- Glucovance (125 mg and 500 mg)
- Glipizide/Metformin (2.50 mg/250 mg)
- Furosemide (20 mg)
- Tamoxifen Citrate (10 mg)
- Metformin HCl ER (500 mg)
- Calcitrol (0.25 micrograms)
The two pharmacies in question are at 8035A Liberty Road and 5900 Reisterstown Road and are managed by Pamela Arrey, R.Ph. According to Joseph Kum, an attorney for Arrey, his client denies the charges and maintains that the drugs under investigation were obtained from charitable organizations and were never meant for interstate commerce. Rather, some drugs were in drums being prepared for inspection and some drugs were in totes getting ready for destruction. They were not on the pharmacies’ shelves for sale, he said. FDA said pharmacies outside of these two locations show no evidence of being involved.
Drug Topics contacted Medicine Shoppe’s parent, Cardinal Health, for a response and got the following reply: “Medicine Shoppe International, Inc. (MSI), the franchisor of Medicine Shoppe pharmacies, has learned that two of our system’s Baltimore-area pharmacies, located at 8035A Liberty Road and 5900 Reisterstown Road, were recently found by the Food and Drug Administration (FDA) to have sold expired medications. Medicine Shoppe pharmacies are franchised businesses and the individual pharmacist or franchisee who owns the store is responsible for all business decisions and practices. MSI is taking this matter very seriously. The health and welfare of our customers is our system’s main priority, and we do not condone these types of infractions by our licensed pharmacies. Medicine Shoppe pharmacists have received national recognition as dedicated professionals who provide excellent customer service.”
How could there be any words?
Ethically, there were just a few basic maxims we learned from law in that first professional year that were repeated over and over and discussed in different scenarios. Things that were just not right no matter what. Examples: above all, don’t do anything at all that will hurt the patient; there is no room for liars in the profession; one never sells a drug for less than it costs; never label a generic as the brand; and the mantra–never, ever dispense expired drugs.
Pharmaceutics and kinetics were the next semester when we learned about half-lives, FDA, expiration dates, etc., so it seemed that there a reasonable explanation, but the duty had been made pretty clear.
Things started to gray a little when I started my first hospital job and questions from the public started coming in. I remember one weekend question from a physician whose patient was very ill and not close to a drugstore and he wanted to know if it was still okay for a patient to take a prochloperazine suppository that had expired a few weeks before.
As for the seriousness of selling expired drugs, I think I remember not that long ago, when some Japanese execs committed suicide when it was discovered that some of the drugs involved in a national program were expired. On the other hand, I remember once when an empty dark brown pint-size glass suspension bottle was left in the back sink from when it was being rinsed out, and someone came along and put it back on the shelf. It was quite a shock to the checking pharmacist to find soapy water in a bottle that was going to be sent up to the patient as Sumycin, or Carafate, or something else. Most people can understand that ‘accidents’ happen, but also with so many expired drugs dispensed, it seems either it was no accident, or if was, there is negligence for allowing conditions to continue that a significant amount of prescriptions were filled with expired drugs.