Sick pharmacies

A LOT OF attention is paid to the ills of our hospitals. But the role played by pharmacies in the overall healthcare system cannot be overstated. The most careful diagnosis and treatment by doctors can be effectively scuttled if there are problems at the dispensary.

A recent Newsday examination of practices at our pharmacies paints a worrying picture. The system is plagued with profiteering and lack of information, confusion over the role of the pharmacist, and lax regulation.

None can take comfort in the assertion by pharmacist Jameel Rahaman that when it comes to the war between brand-named drugs and generics, the pharmaceutical market is “one huge racket.”

“The patient is the one who is suffering,” Rahaman said.

According to him, medical officials prescribe brands over generics even when generics are composed of the same chemicals and, in some cases, subject to higher quality standards.

On the other hand, some doctors may well say there are legitimate concerns about generics, especially given problems in ascertaining their true source and the degree to which they have been subject to quality controls.

Either way, there is need for greater collaboration between doctors and pharmacists. There is also something to be said for greater interaction between pharmacists and patients. The State also has a role to play by enforcing existing price controls. The most rigorous rules will not prevent abuse if nobody is implementing them.

Regulation is also needed to deal with the serious problem of counterfeit drugs. These are drugs that are mislabelled or which claim to have chemical components or doses that they, in fact, do not. Alarmingly, there is very little in place to effectively deal with this problem. The unregulated suitcase trade has mushroomed, there are no random checks of drugs on the shelves, and controls are limited to the registration and import phase.

Additionally, according to president of the Council of the Pharmacy Board, Andrew Rahaman, laboratories are not equipped to do the kind of checks required to detect fake drugs. And there is not enough manpower at the Chemistry, Food and Drug Division.

The pharmacy system is clearly sick. Suitcase trading should be outlawed, laboratories should be properly manned and equipped, and while there are rules in place at State medical facilities in relation to the prescription of generic versus brand drugs, greater education needs to occur: private doctors should be required to explain the options for treatment so that a patient gets to choose between two identical but differently-priced medicines. Otherwise, countless complications, abuses and deaths that have thus far slipped the net may continue to occur.