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The theft of non-narcotic, high-value cancer, antiviral and other medications is a risk that every hospital faces — especially amid the rising cost of these lifesaving drugs.
By Tom Knight, CEO of Invistics
On July 6, a pharmacy technician was indicted for stealing prescription HIV medications worth more than $10 million from the pharmacy of the Veterans Affairs Medical Center (VAMC) in East Orange, New Jersey.
This incident is not an isolated event, as soaring costs for medications for COVID-19, HIV, cancer, and other diseases, coupled with social determinants like poverty, is fueling black market demands in the U.S. and abroad.
Today a growing number of healthcare organizations risk a similar fate, because they’re not sufficiently equipped to detect the diversion of medications — especially high-value prescription drugs that are not controlled substances, and for which theft is undoubtedly more difficult to detect. In fact, about half (47%) of the healthcare executives polled for a recent Invistics/Porter Research survey on drug diversion felt that staffing changes spurred by COVID-19 made it more challenging to track drug diversion. Additionally, 38% of respondents said their organization’s resources for drug diversion investigations were reallocated due to budget cuts because of the pandemic.
This suggests that individuals who are interested in diverting medications for resale or personal use face fewer obstacles. Chances are, they know it.
Understanding Prescription Drug Diversion
As the VAMC’s HIV medication theft demonstrates, our most reputable medical institutions are vulnerable to all types of drug theft — not just addictive opioids or other controlled substances — especially as the economy fluctuates while COVID-19 continues to overburden healthcare systems. While opioid theft is most commonly reported, incidents of alleged non-narcotic diversion are reported to HealthcareDiversion.org every month.
The cost of prescription drugs is 2.5 higher in the U.S. than other countries, according to a Rand report released in early 2021. Healthcare premiums and deductibles continue to rise and, as reports point out, many individuals who steal drugs from healthcare facilities have financial motivations.
The risk is exacerbated by the reality that many health systems are seeing a resurgence of COVID-19 with the delta variant, and have shifted their focus, understandably, toward mitigating spread of the virus.
Also, with overdose deaths from the opioid crisis surging, healthcare leaders might focus too much on narcotics associated with opioid abuse. They’re trained to look for signs of drug abuse within their colleagues and patients. Clinical supervisors, too, are on high alert for evidence such as inconsistencies in pain-level reports among patients who are administered opioids.
While preventing diversion of narcotics is important, healthcare leaders must also prevent the theft of high-value, non-narcotic drugs.
Protecting High-Value Drugs from Theft and Resale
Most healthcare systems have checks and balances in place for prescribing, procuring, and administering controlled substances, for example, requirements that at least two clinicians must be present to dispose of unused controlled substances.
Yet when healthcare leaders were asked about their confidence levels on a scale of 1 to 5 (with 5 being very confident), slightly less than half (47%) indicated they are “very confident” that the drug diversion program at their facility meets audit requirements for their state Board of Pharmacy or Joint Commission, according to the Invistics/Porter Research survey.
While there’s no one-size-fits-all solution, there are a few ways an organization can boost its processes and technologies, or build on existing solutions, to minimize risk.
Change starts from the top. And a comprehensive drug diversion prevention program starts with informed leadership, and healthcare compliance teams to proactively manage that program. However, as many as three in five healthcare professionals say they are not confident in the effectiveness of their organization’s drug diversion program, and many don’t employ at least one dedicated diversion professional on site. Healthcare organizations need to ask themselves whether they have room to improve.
Training and education of frontline workers is also critical. Healthcare leaders should not only educate clinicians to recognize signs of opioid drug abuse within their ranks, but also emphasize all the other drugs that might be diverted. Knowing, for example, that the pharmacist accused of stealing HIV medication for profit faces up to 20 years in prison and at least $250,000 in settlements could cause someone to think twice before swiping a medication.
Technology used to detect diversion is also helpful: 73% of respondents to the Porter Research survey say that machine learning software is an effective tool to uncover drug diversion and 88% support advanced analytics.
Healthcare organizations should consider solutions that can utilize broad data sets to isolate patterns or behaviors associated with the theft of all high-value medications.
Recent incidents should be a warning sign to healthcare organizations. While drug diversion has always been a problem in healthcare settings, the resurgence of COVID-19 hospitalizations, rising healthcare costs, economic hardships, and other factors have raised the stakes. By implementing stronger policies, more comprehensive training programs, and more robust technology solutions, healthcare organizations will be far less likely to suffer the consequences of drug diversion.