Senator, NABP Call for Better Detection of Drug Interaction After Chicago Investigation

The National Association of Boards of Pharmacy and U.S. Senator Dick Durbin (D-IL)are calling for new pharmacy safety policies after a Chicago Tribuneinvestigation found that pharmacists at several drug store chains filled scripts with dangerous drug combinations.

In its investigation, the newspaper tested 255 Chicago-area pharmacies to see how often stores would dispense dangerous drug pairs without warning patients. Unfortunately, 52% of pharmacies dispensed drugs without mentioning the potential interaction.

Independent pharmacies had the highest failure rate at 72%, followed by CVS at 63%, and Target at 62%. Walgreens had the lowest failure rate at 30%.

Now, Durbin is calling for new pharmacy policies to protect consumers from bad drug combinations. In a letter to the Centers for Disease Control and Prevention, Durbin asked the agency to issue guidelines to state boards of pharmacy and to private pharmacy associations on prescribing practices. Durbin is "deeply concerned by what appears to be an underlying problem of misplaced emphasis on quick service over patient safety,” he wrote in a letter to CDC.

"It's hard for me to believe that, in this age of computers and software, we would still be dealing with such a fundamentally dangerous issue. You would think that, at this point, with records being kept and the vast amount of knowledge on these drugs, the pharmacists could wave off prescriptions that are dangerous to customers,” Durbin told the Chicago Tribune.

Meanwhile, Carmen Catizone, executive director of NABP, is also urging creation of tougher state laws that would require pharmacists to counsel patients when they pick up their scripts. States should also publicly disclose pharmacy medication errors and authorities should consider minimum staffing levels for pharmacies, Catizone said, according to Chicago Tribune.

However, the National Association of Chain Drug Stores and the National Community Pharmacists Association told Drug Topics that they don’t believe additional regulations on drug stores are needed.

In its letter responding to Durbin’s concerns, NACDS “emphasized patient safety and health as pharmacy’s top priority, and that any incident that leads to a serious drug interaction is one too many,” Chris Krese, a spokesperson for NACDS, told Drug Topics. “We noted safeguards already in place, as well as pharmacy’s eagerness to learn from any situation to continuously enhance patient safety, as reflected by the comments of NACDS member companies in the Chicago Tribune article.”

Plus, after the Chicago Tribune investigation, other publications have noted the significance of doctors’ roles in partnering with pharmacists and patients to help prevent potentially harmful drug interactions, Krese said.

NCPA Chief Executive Officer B. Douglas Hoey, RPh, also does not believe additional regulations are needed. “Regulations exist in several states that either require or encourage reporting of medication errors to the state boards of pharmacy. In addition, some state boards of pharmacy require CE specific to patient safety as part of their annual license renewal requirement,” he wrote in a letter to Durbin

In addition, the findings of the Chicago Tribune investigation are not “representative of the more than 20,000 independent community pharmacies throughout the United States as a whole,” Hoey wrote. “As you noted in your letter, pharmacists are the last point of communication a patient has before a prescription is dispensed and are in a unique position to identify risks. This is a role our members embrace and take very seriously.”

To that end, NCPA sent an email to all members in late December urging pharmacies to “use this red flag warning to review existing pharmacy processes and procedures, to make sure technicians are trained to alert the pharmacist when the pharmacy management system flags a DDI (drug-drug interaction), to check the interaction severity settings on pharmacy dispensing system software, and to make time for a refresher on DDIs,” Kevin Schweers, a spokesperson for NCPA, told Drug Topics.