Some of society’s most vulnerable patients, including seniors and those battling cancer, face a significant struggle to obtain medications prescribed to alleviate crippling pain, according to a survey of 1,000-plus community pharmacists conducted by the National Community Pharmacists Association (NCPA). In addition, surprise disruptions in an unpredictable supply chain make it impossible for many community pharmacists to assure patients that their prescription for these controlled substances can be filled the following month, the survey found.
“Vulnerable patients are increasingly and tragically becoming collateral damage in the country’s battle against the abuse of prescription drugs, particularly narcotic painkillers,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “In the survey, community pharmacists repeatedly cited having their supplies or shipments of controlled substances abruptly shut off by their wholesalers, which may have done so due to perceived pressure, intimidation or a lack of clear guidance from law enforcement officials, such as the Drug Enforcement Administration (DEA).”
Key points from the survey include:
- Approximately 75% of respondents experienced three or more delays or issues caused by stopped shipments with their controlled substance orders, over the past 18 months.
- On average, 55 patients-per-pharmacy were impacted by these delays.
- 89% of impacted pharmacies received no advanced notice of the delay; they only found out when their order arrived and included just non-controlled substances.
- 60% said the delays in receiving these requested medications lasted at least one week.
- 67.9% were unable to procure controlled substances from an alternate source, such as a secondary wholesaler.
- Most reported having to turning patients away and referring them to a local competitor.
The survey included an open-ended section in which community pharmacists shared hundreds of observations, including the following:
- “It is a shame to watch an arthritic 85-year-old do without.”
- “This situation has literally brought customers to tears in our store. I fully understand the diversion and abuse of these powerful chemicals. I agree that something must be done, but to deny pain management to deserving individuals is inhumane at best. We have to find a way to curb the abuse and still provide relief from pain for those truly suffering.”
- “We turn away patients on a daily basis that I am sure are legitimate patients with legitimate prescriptions with legitimate issues requiring pain management. I am one in a long line of pharmacies that turns these patients away because of the limits on what I can dispense monthly.”
- “A few cancer and pain patients who really need their meds went without it for a few days. Has happened too many times.”
- “We try to scrutinize all controlled substance prescriptions, but are made to feel like criminals when trying to service our patients.”
In presentations to Congress and to the Food and Drug Administration and DEA, NCPA has recommended steps to combat prescription drug abuse, while protecting patients. They include electronic prescription drug monitoring programs and tracking systems, more effective education of prescribers, shutting down rogue pain clinics, offering more disposal options for excess medications and more scrutiny of controlled substances delivered by mail order pharmacies.
January 9, 2014
