Pubdate: Sun, 7 Sep 2008
Source: Province, The (CN BC)
Copyright: 2008 Canwest Publishing Inc.
Contact: http://www.canada.com/theprovince/letters.html
Website: http://www.canada.com/theprovince/
Details: http://www.mapinc.org/media/476
Author: Susan Lazaruk, The Province
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/topic/Downtown+Eastside
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

METHADONE KICKBACKS INVESTIGATED

At Least One Pharmacy Allegedly Gave Cash to Addicts for Prescriptions

A pharmacy in Vancouver's Downtown Eastside is being investigated for 
offering heroin addicts cash in exchange for filling their methadone 
prescriptions.

The methadone maintenance program can be lucrative for pharmacies, 
representing as much as $54 million a year in provincially paid 
dispensing fees.

"We have received at least one complaint; there may be more," said 
Health Minister George Abbott. "We received one letter from a 
Vancouver physician in January" about the practice at the pharmacy.

He said the ministry, the College of Pharmacists of B.C. and the 
College of Physicians and Surgeons, which administers the program, 
are investigating the pharmacy, which he wouldn't name.

"There is an investigation and all of us are concerned of any 
potential violation," said Abbott. He said he didn't know how many 
pharmacists are being investigated.

Spokeswoman Lori DeCou of the College of Pharmacists confirmed there 
was an investigation but wouldn't disclose any other details.

The physicians' college spokeswoman, Susan Prins, didn't respond to a 
request for comment.

Untreated heroin addicts who opt for methadone to reduce cravings 
require daily doses. Because of the fear they will resell the drug on 
the streets, most are required to visit a pharmacy daily and ingest 
it under a pharmacist's observation.

The pharmacist receives the regular dispensing fee of $8.60 for 
filling the prescription and an additional $7.70 fee for witnessing 
the ingestion -- or up to $6,000 per user a year. The province also 
reimburses the pharmacy for the cost of the methadone, at around $1.40 a visit.

That amounts to a possible $54 million in dispensing fees for the 
estimated 8,400 methadone users in B.C.

In the 2007-2008 fiscal year, PharmaCare reimbursed pharmacists $27 
million through the methadone maintenance program, according to B.C. 
Health spokeswoman Michelle Stewart.

Under the province's PharmaCare regulations, pharmacists are not 
allowed to offer cash or other incentives, including air miles, 
loyalty points or bus passes, to methadone users or to advertise drugs.

Some pharmacies in Vancouver's Downtown Eastside post signs in the 
windows advertising methadone and openly hand out cookies and coffee 
to those filling methadone prescriptions.

Addicts report getting cash, too.

Kickbacks to addicts are a problem in Surrey.

Mayor Diane Watts said there are pharmacies in the downtown area in 
the Whalley district that dispense only methadone.

"The issue is when some of the dispensaries pay for some of the 
clients' prescriptions," she said.

Pharmacists who follow the rules have complained to the Downtown 
Surrey Business Improvement Association that methadone clients expect 
payment for filling their prescriptions at their pharmacies.

"They tell them they've been offered money to take their 
prescriptions elsewhere," said executive-director Leslie Tannen.

She said heroin addicts are typically also addicted to crack, cocaine 
or prescription drugs and dealers set up next to the methadone 
dispensaries and openly traffick to them as they leave the pharmacies 
with cash in hand.

Watts said council intends to pass a bylaw that would allow only 
full-service pharmacies. Surrey is also expected this fall to pass a 
new bylaw to restrict new pharmacies from setting up within 400 
metres of existing drug stores.

And about five years ago, council hiked the yearly business licence 
fees for pharmacies to $10,000 from $195, a fee that was later 
reduced to the $3,000 yearly maximum.

"Let's just say nothing's changed," said Tannen.

She said the college of pharmacists needs to do more to control its 
members, and she doesn't buy the excuse the payments are hard to prove.

She said she supports harm-reduction for addicts but asked, "Why is 
the taxpayer paying the bill for the vast majority of people on 
methadone who are getting cash inducements to buy more drugs?

"Taxpayers need some comfort that the program is administered in a 
medically appropriate and fiscally prudent way.

"Perhaps the whole program has to be examined," Tannen said. 
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MAP posted-by: Richard Lake