A community pharmacist who supplied a drug addict with "under the counter drugs" has been jailed for 18 months.
Dushyant Patel, 67, a London pharmacist with more than 40 years' experience, had supplied class C drugs to a drug user in Norwich for months in 2020.
Police identified Patel as a suspect four months after the death of drug user, Alisha Siddiqi, whose body was found at a property in Colossus Way, Costessey, in
August 2020.
An initial post-mortem examination was inconclusive, but toxicology results later showed she died from an overdose of prescription medication.
An analysis of her phone revealed that she had frequent communication with Patel between January and August 2020.
Class C drugs sold without prescription
There was also communication regarding transactions relating to the sale of prescription drugs including class C drugs, without a prescription, namely Zolpidem and
Zopiclone.
Patel was identified as a suspect and later charged with drugs offences.
He was jailed at Norwich Crown Court in December after a trial in August when he was found guilty of two counts of being concerned in supplying a controlled drug
between March and August 2020.
Pharmacy contractors will no longer need to print and submit a paper copy of their completed FP34C declaration made through the Manage Your Service (MYS)
portal when submitting their paper prescription bundle to the NHS Business Services Authority (NHSBSA), said the Pharmaceutical Services Negotiating Committee (PSNC).
Instead, from August 2022 (for July 2022 prescriptions), NHSBSA will post out a paper Account Identifier Document along with the red separators and pharmacy address
labels each month.
"The Account Identifier Document should be placed alongside the paper prescription bundle before it is dispatched for payment to the relevant pricing division of
NHSBSA," said PSNC.
With the help of Account Identifier Document, NHSBSA will be able to easily identify the pharmacy that has submitted the prescription bundle, which will help to
speed up prescription processing.
"If the Account Identifier Document is lost or misplaced, contractors will still be able to download and print another copy from MYS. The July 2022 Drug Tariff
will be updated to reflect this change."
A drug dealer who was operating as an "unlicensed chemist" and selling prescription drugs online has been jailed for six years, according to Essex Police.
The convict, identified as 49-year-old Christopher Depp, aka David Jones, was supplying a range of drugs from his home to "vulnerable people" using the postal
service, local police revealed on Friday (February 16).
Police conducted a search operation at his address in Wood Street, Chelmsford, in July last year and found more than 50,000 pills and tablets of varying types,
stashed in toolboxes and spaces around the property.
To process the large-scale sale and shipping of controlled drugs across the UK, Depp had set up a room in his property as an office space.
He promoted the sale of medications through various social media platforms and messaging applications, and accepted payment from his large customer base
using "fraudulently obtained" bank accounts.
Atorvastatin was the most dispensed drug in England in 2021/22 with 53.4 million items, revealed the annual Prescription Cost Analysis (PCA) published by
NHS Business Services Authority.
According to the official statistics, Apixaban (an anticoagulant) was the drug with the highest cost of £401 million.
The statistics revealed that the cost of prescription items dispensed in the community in England was £9.69 billion, a 0.87 per cent increase of £83.7 million
from £9.61 billion in 2020/21.
"The number of prescription items dispensed in the community in England was 1.14 billion, a 2.58 per cent increase of 28.7 million items from 1.11 billion in
2020/21."
FreeStyle Libre 2 Sensor kit (a glucose monitoring system) was the presentation with the largest absolute increase in cost between 2020/21 and 2021/22 of £69.8
million, from £2.84 million to £72.6 million.
Laganside Crown Court, on Friday, sentenced Gerard Cullinan, a 48-year-old pharmacist and Director of Castlereagh Pharmacy Ltd in East Belfast, for
unlawfully supplying controlled prescription medicines, including co-codamol and fentanyl, and for failing to maintain controlled drugs registers.
Cullinan was sentenced to 11 months imprisonment, suspended for three years, and his pharmacy was fined £8,000.
The sentencing follows an investigation by the Department of Health's Medicines Regulatory Group (MRG), which uncovered that Cullinan's pharmacy on Castlereagh
Road had illegally supplied over 300,000 co-codamol tablets between January 2017 and June 2020.
Additionally, the MRG investigation identified significant breaches in record-keeping for Class A controlled drugs such as fentanyl, tapentadol, methylphenidate,
morphine, and oxycodone.
"It is a serious criminal offence to sell or supply prescription only medicines without a prescription," said Peter Moore, Senior Medicines Enforcement Officer at
the MRG, who led the investigation.
The Pharmaceutical Services Negotiating Committee (PSNC) has issued a revised guidance for the dispensing of controlled drugs in instalments on 19 September
that has been declared as a bank holiday for Her Majesty The Queen's state funeral.
PSNC said: "Many instalment prescriptions have already been issued in advance of the upcoming Bank Holiday. Where they contain the Home Office approved wording
"Please dispense instalments due on pharmacy closed days on a prior suitable day" then you will need to plan to make these supplies at an appropriate time. This
wording would also permit the supply of the initial dose of a prescription starting on the Bank Holiday Monday where the date of the signature is before this."
However, PSNC is aware that not all prescriptions will contain such a direction to support the supply, in advance, of a dose for Monday 19 September where the
supplying pharmacy is closed.
"We recognise that this client group are often vulnerable with multi-morbidities and that the risk to them may be significant. You should therefore exercise your
professional discretion in determining when to make an instalment supply for the Bank Holiday Monday. Make the care of the patient your first priority and consider
the potential impact of both making the supply in advance and of not making the supply in your decision making process. The exceptional circumstances that led to
the Bank Holiday and its short notice may inform your decision."
There has been a lot of coverage in the national and pharmaceutical press of the prices being charged to pharmacy owners for certain medicines.
Leaving aside the reasons for steep price rises, I have been asked on social media and elsewhere whether pharmacy owners can refuse to supply prescribed medicines
if they would make a significant financial loss.
Legal obligation
The first thing to point out is that the National Health Service Act 2006 imposes a legal duty on the Secretary of State and NHS England to make arrangements for
people to receive sufficient prescribed drugs.
These arrangements involve the publication of the Drug Tariff.
The Drug Tariff includes reimbursement prices or a method for determining prices. Various factors can be taken into account in determining reimbursement prices. The
Drug Tariff does not provide a pound for pound reimbursement for medicines that pharmacies supply on NHS prescriptions.
Product packaging affects the effectiveness of pharmaceuticals to a great extent. This is why pharmaceutical companies ensure they choose appropriate packaging
for drug products. Drug packaging is not always an easy job. However, the tips in this article will help you select the proper pharmaceutical packaging for drug
products without stress.
What Does Pharmaceutical Packaging Entail?
Pharmaceutical packaging involves using packaging containers with safety closures such as a lidding film to hold pharmaceutical products. This is done to keep them
safe and effective.
The most commonly used packaging materials in the pharmaceutical industry are metals, glass, and plastics. These materials are used for different reasons and
different products. In short, a pharmacist considers several factors regarding a product and its target audience before choosing a packaging material for
pharmaceutical formation.
Why Appropriate Packaging Matters
Many benefits come with appropriate pharmaceutical packaging. These benefits make it essential to package drug products in the best ways possible. When pharmaceutical
items are properly packed, they can reach patients for a safe prescription. As a result, the drug stands a higher chance of achieving its prescription purpose. More
so, properly packaged drug products are safer to consume and can be trusted.
Authorities in Northern Ireland have seized more than 242,000 unlicensed prescription tablets purchased online and destined for addresses throughout NI.
The medicines seized include Diazepam, used for anti-anxiety treatment, Pregabalin, used for epilepsy and anxiety, steroids and Zopiclone.
Other prescription medicines recovered included Tamoxifen, often used in the treatment of breast cancer and Salbutamol inhalers, frequently used in the treatment
of asthma.
"Co-operation between law enforcement agencies and government departments has led to the seizure of over 242,000 illegal and unlicensed tablets purchased online
and destined for addresses throughout Northern Ireland," justice minister Naomi Long was reported as saying.
The minister, together with health minister Robin Swann and assistant chief constable Mark McEwan PSNI were highlighting Northern Ireland's input to the global,
Interpol co-ordinated Operation Pangea XV, which saw multiple packages of tablets intercepted and seized, with a street value of almost £250,000.
She praised the concerted efforts made by PSNI, Border Force and officials from the Department of Health Medicines Regulatory Group during a specific week of action
in June.
The Manchester Crown Court on Friday (9 December) sentenced three men, Cleave Lewis (35) and brothers, Denis Sutherland (58) and David Sutherland (59), to a
total of three years in jail after they pleaded guilty to the illegal sale and supply online of prescription-only medicines and controlled Class B and Class C
drugs, worth more than £1.5m.
They were found in possession of nearly 1.3m tablets of prescription-only drugs, including powerful sleeping pills, painkillers and anti-anxiety meds, when officers
from the Medicines and Healthcare products Regulatory Agency (MHRA) and Greater Manchester Police searched their residential homes and business premises in October
2017.
Following investigations by the agency, they also pleaded guilty to illegally making these medicines available online on three different websites for the public to
purchase without prescriptions.
The officials also recovered controlled medicines, over half a million (525,737) erectile dysfunction, slimming and herbal tablets, with an estimated value of
approximately £500k, from them.
Any prescription for Promethazine hydrochloride 10mg tablets x 56 submitted for payment to the NHSBSA for July 2022 will be reimbursed at the new price of
£17.77 not as per the price concession of £13.45 announced in the 4th concessions update published on 29 July 2022, said the Pharmaceutical Services Negotiating
Committee (PSNC).
In July 2022, PSNC received several reports from contractors unable to obtain Promethazine hydrochloride 10mg tablets (56) at the published Drug Tariff price of
£4.24.
Therefore, it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the
Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine hydrochloride 10mg tablets has
increased from £4.24 to £17.77 for July 2022.
PSNC said, "Following the price change mechanism rules, for generic drugs (excluding drugs in Category M), a price change up to and including the 8th of the month
takes effect for prescriptions dispensed in that same month. Any price change after the 8th takes place in the following month."
Drug shortages have become a global issue, with many countries struggling to maintain a consistent supply of common medications, including antidepressants,
immunosuppressants and drugs to treat type 2 diabetes and ADHD.
Earlier last month, the British Generic Manufacturers Association (BGMA), the trade body for off-patent medicines, warned that 111 products were facing supply
problems, the highest on record in the UK, and more than double the number recorded at the start of 2022.
More than half of products affected (55) are branded generic drugs, which represent 10 per cent of prescription products used in the UK.
The trade body blamed the escalating rebate rate of the government's voluntary scheme for branded medicine pricing and access (VPAS) for these shortages, but
Brexit is also cited as another reason for the problem.
From over-the-counter flu tablets to crucial antibiotics and antidepressants, medicines are running scarce in UK pharmacies this year, causing concerns among
patients, the government, and the wider pharma industry.
Drug shortages have accelerated over the past year due to a clutch of problems including the after-effects of the pandemic on supply chains, the war in Ukraine,
and soaring input costs weighing on manufacturers. More recently, a sudden spike in respiratory infections - another by-product of Covid-19 that neither pharma
companies nor the government were able to predict - has deepened the crisis, with 70 commonly taken drugs out of stock in Britain as of February.
The problem is not unique to the UK. In a recent survey of groups representing pharmacies in 29 European countries, three quarters said shortages were worse this
winter than a year ago, with a quarter reporting more than 600 drugs in short supply. The US is also facing significant shortages of popular prescription drugs like
amoxicillin and Adderall, an ADHD medication.
To some extent, the current disruption is laying bare wider challenges facing the industry for several years that were only exacerbated by the pandemic.
The over-reliance on foreign suppliers for most active pharmaceutical ingredients (APIs) is one of them. This model has left companies more susceptible to supply
shocks, which have in turn increased in frequency and severity due to pandemic lockdowns, the war in Ukraine and other issues such as the shortage of shipping
containers.
Pharma's long and opaque supply chains, alongside regulatory complexities, also mean it is taking longer for drugmakers to reconfigure manufacturing and distribution
in times of additional need.
Data crunched by an online pharmacy delivery company paints a concerning picture for the pharmacy sector in England.
Gophr's 'Prescription For Pressure' initiative reveals a challenging time for the sector and is supported by separate analysis by the BBC showing that the number
of pharmacies in England is at its lowest since 2010.
In addition, new powers being introduced for pharmacists to prescribe common prescription drugs and perform routine tests create an even greater workload for already
overstretched pharmacists.
Gophr's data reveals that:
* Each pharmacy in England serves an average of 6,078 people.
* In 2022, pharmacists dispensed 1.043 billion prescriptions, 26.3 million more than 2021.
* A single pharmacy in England dispensed 248 prescriptions a day on average in 2022.
Based on the most up-to-date statistics from the Office for National Statistics, NHS England and Statista, Gophr's calculations show that pharmacists have around 116
seconds to dispense a prescription, which is less time than the 180 seconds it takes to make a Quarter Pounder at McDonald's.
No one can deny the fact that any sort of addiction is injurious to health despite knowing it many people get involved in the usage of drugs. One of an alarming fact is that people are not only restricted to illegal drugs addiction but people are getting addicted to prescription drugs also...
Novartis on Wednesday (February 1) predicted that core operating income would grow in a "mid single digit" percentage range in 2023 following stagnation last
year, as the Swiss drugmaker prepares to spin off its Sandoz generics business.
Full-year core operating income was broadly flat at $16.7 billion, it said in a statement, coming in slightly below market expectations of $16.8 billion.
Adjusted for overall negative currency effects, group sales in 2022 advanced 4 per cent to $50.5 billion as gains from heart failure drug Entresto and multiple
sclerosis (MS) drug Kesimpta were partly offset by competition from cheap generic copies of established MS drug Gilenya.
Novartis said it was on track to spin off its generics unit Sandoz in the second half of the year as part of its effort to sharpen its focus on its patented
prescription medicines.
Analysts have welcomed a programme unveiled in 2022 to trim costs and cut 8,000 jobs and plans to focus on fewer therapy areas and drug technologies. But the market
has been underwhelmed by prospects for medium-term growth from new drugs.
Pharmacists can dispense Paracetamol 120mg suppositories in accordance with the prescription, as the Department of Health and Social Care (DHSC) has confirmed
that sufficient stocks are available to meet normal demand.
This means the Serious Shortage Protocol - SSP033 - for Paracetamol 120mg suppositories has now expired since 26 August 2022.
Top tips for SSP claims
NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA
processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims.
Any paper prescriptions with SSP claims need to be placed in the red separator provided by the NHSBSA.
Although an SSP cannot be used outside its period of validity, claims can be submitted up to three calendar months after expiry or withdrawal of the SSP to help
manage any owings for other items issued on the same prescription form. For example, for SSP033 Paracetamol 120mg suppositories, which expires at 23.59pm on Friday
26 August 2022, the NHSBSA would continue to look for the "SSP" endorsement on prescriptions for Paracetamol 120mg suppositories that are submitted with the August
batch (submitted by 5 September), September batch (submitted by 5 October) and October batch (submitted by 5 November).
There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their
prescriptions filled or return to their GP to be prescribed alternative drugs.
These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients'
health had been put at risk in the last six months.
In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any
shortages and acts swiftly when any issue arises.
A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly
with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.
The Medicines and Healthcare products Regulatory Agency (MHRA) has launched a consultation on the reclassification of codeine linctus to a prescription-only
medicine after considering multiple Yellow Card reports for its opioid effects, rather than for its intended use as a cough suppressant.
This medication is currently licensed as a pharmacy medicine, which means that it is available to purchase over the counter in pharmacies. If reclassified as a
prescription-only medicine, all strengths of codeine linctus will only be available upon presentation of a prescription.
Dr Alison Cave, MHRA Chief Safety Officer, said: "Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health
consequences.
Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status.
We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered
decision for the benefit of patients, carers, and healthcare professionals across the UK.
Dr Bharat Shah CBE regrets that neither community pharmacists nor pharmaceutical wholesalers in the UK have any control over how Category M reimbursement prices in Part VIII A of the Drug Tariff are determined.
The co-founder and chief executive of Sigma Pharmaceuticals was speaking at a conference organised by Avicenna in West London on Sunday (March 6).
Introduced into the Drug Tariff in April 2005, Category M is used to set the reimbursement prices of over 500 drugs.
The Department of Health and Social Care makes the final decision on the amount of reimbursement (cost of drugs and appliances supplied against an NHS prescription
form) and remuneration (fees paid as part of the NHS community pharmacy contract for the provision of a service).