Imagine going to your pharmacy and getting your prescription filled and later out finding out you didn’t get the brand of medication your doctor wanted you to get. You got some other brand generic. I would be pissed!!! The problem is you probably wouldn’t catch it unless your insurance company asked you what your prescription was filled with. In Canada, sixteen Saskatchewan pharmacists and pharmacies have been fined after a crackdown on pharmacists submitting false information to the provincial drug plan.
The Saskatchewan College of Pharmacists was trying to stop a practice called DIN spinning. A DIN is a drug information number, and each brand of a medication has one that’s unique. DIN spinning is a way for pharmacists to potentially make extra money – or in some cases, get rid of unwanted stocked drugs. So let me explain: your doctor prescribes you Lipitor for your bacon cheeseburger fest you had. The pharmacy fills in generic Lipitor (same active) but bills your insurance company for Lipitor and not the generic. They get to keep the difference in price and any other financial perks.
The practice could put patients at risk. If a specific brand of drug is recalled, and pharmacy records are wrong, a patient taking a recalled drug might never know. So say a certain lot of prescription drug was contaminated and caused severe side effects. Guess who is never going to find out? That is correct, you health has just been put in harm’s way.
How They Got Caught
At the time, Saskatchewan had special purchasing agreements for about 100 medications; pharmacists were supposed to buy and dispense one brand exclusively. Unless a prescribing doctor specifically states a patient needs a certain brand of medication, Saskatchewan pharmacists must dispense the selected (plan Participating) brand of drug. Amlodipine was one of them – Saskatchewan pharmacists were compelled to sell pills made by Pfizer.
Tracking the movement of just one medication – the heart and blood pressure drug amlodipine – the drug plan got sales data from wholesalers, and matched it with dispensing patterns from Saskatchewan pharmacies. They found a large discrepancy and filed a complaint.
In many DIN spinning cases, the pharmacy buys brands of drugs that are in competition with the pre-arranged drugs. If a pharmacist tries to enter the DIN of a different branded drug into the provincial database, the computer won’t accept it. So what did they do? Many pharmacists caught in the act gave patients the incorrect brand of drug, but entered the DIN for the correct brand to cover their tracks.
Some pharmacists put the wrong information on the medication labels given to patients. So you had incorrect side effects listed. Others gave patients accurate information. Others yet falsely added a “no substitute” note to the file, claiming the doctor had prescribed that brand with no substitutes allowed. The catch is that only the prescribing doctor, nurse practitioner or pharmacist is allowed to add the “no substitute” label.
Some pharmacists did this to get rid of extra stock of the wrong brand so it wouldn’t go to waste. Some mistakenly believed there was a shortage of the right brand. Others got kickbacks from drug companies, such as free products or discounts. All in all they got caught putting the consumer at risk.
They did have to pay fines but no licenses were lost. Do you trust your pharmacist?