The Medicine Shoppe v. Loretta Lynch

Identify and discuss the duties and responsibilities of a pharmacist toward a patient.

Pharmacists are responsible for several things when it comes to patient care, including the medicine quality that is supplied; ensuring that the medicines supplied are within the law; ensuring the suitability of the medicines; advising patients on the medicines, how to take the medicines, the reactions that may occur and answering all questions that patients ask(Erstad, 2019). Pharmacists’ other duties include supervising the supply chain of the medicines and ensuring that the systems and premises of the pharmacy are fit for the purposes; advising other healthcare professionals on the effective and safe of medicine use as well as safe and secure medicine supply; responding to the symptoms described by the patient and advise on the available medicines at the pharmacy; providing services such as cholesterol management, blood pressure measurement, and smoking cessation; and supervising medicine production and preparation as well as assessing the quality of the medicines prior to their supply from manufacturers to the consumers (Erstad, 2019).

Provide the details of the assigned case. Based upon your research and assessment of the case, did the pharmacist perform the required duties and uphold patient rights?

On the 7^th of October 2003, the DEA issued an order to The Medicine Shoppe that sought to revoke the COR of the company on the grounds that the pharmacy had frequently filled prescriptions by a specific physician in a way that did not show a legitimate medical purpose. The DEA asserted that the pharmacy had failed in exercising their corresponding responsibility with the prescribing physician to assure that the drawn prescription was issued for legitimate and medical purposes as well as under the DEA legislature’s professional practice usual course of the practitioner. The pharmacy defended its actions by asserting that not only had it contacted the physician before dispensing the medication to Lynch but that both the patient and the physician were known to the pharmacy for several years.

The pharmacy performed the required duties and upheld the rights of the patient. Under Texas law, as well as in other states, pharmacists are obligated to perform the duty to exercise judgment that is sound and professional with respect to the authenticity and accuracy of any dispensed prescription order (Grass, 2015). If, for any reason, the pharmacist has any queries on the authenticity and accuracy of the prescription drug, the pharmacist shall proceed to contact the prescribing physician to verify the prescription before dispensing it.

Is the pharmacy at fault? Why or why not?

The pharmacy is at fault because though it took action and contacted the prescribing physician prior to dispensing the drug, it should have used sound judgment in determining the authenticity of the prescription. The pharmacy should have acted on the red flags and out of suspicion and, despite contacting the physician, withheld giving Lynch the medication. The pharmacy is thus liable as the physician for damages accrued from the poor judgment and criminal actions taken by the physician.

What impact can a pharmacist’s actions have on patients and the community? Consider the current opioid crisis facing our nation in your answer.

More than 1.7 million Americans are addicted to prescription opioids such as codeine, morphine, fentanyl, hydrocodone, and oxycodone. It has been argued that the opioid crisis was fueled by greed (Compton et al., 2019). According to (Chisholm et al., 2019), greed drives overproduction and overselling of the drugs by manufacturers, oversupplying by distributors to the pharmacies; and over-dispensing by pharmacies to patients who then become hooked; and to the criminals who later sell the drugs in the black market to addicts looking for a high. Pharmacies seeking to make bigger profit margins will turn a blind eye to dubious or suspicious prescriptions, and this fuels the addiction crisis.

What precautions can be taken to ensure these types of incidents by allied professionals don’t happen to others? Should there be more regulations in place?

Some states, such as Virginia, have set up measures to monitor the prescription of controlled substances. The pharmacies are expected to enter data weekly into the Prescription Drug Monitoring Program (PDMP) to prevent opioid abuse (Barlas, 2015). The main purpose of database querying in the system is to learn the history of drug dispensing for an individual patient over a specific period to determine the prescription validity or if the patient is doctor-hopping to obtain drugs for illegal and illicit reasons. In Virginia, for example, legislation in place obligates pharmacists to check painkiller prescriptions on the system before dispensing the same.

That said, new legislation, as proposed by the American Pharmacists Association Action (2015), should be put in place where pharmacists are involved in developing uniform and nationwide standards regarding the PDMP. These standards should include the definition of authorized and registered users, reporting requirements, documentation, the system’s response time, information security, minimum data sets to report, and transaction format standards. Additionally, all healthcare workers should mandatorily enroll with PDMP and be required to report as well as make appropriate inquiries in the system in the patient care process where controlled substances are involved. Lastly, integration system development should commence, enabling seamless workflow and consistent utilization of the countrywide PDMP. This would facilitate drug review as part of the patient care process for patients who use opioids.

References

American Pharmacists Association Actions of the 2015 APhA House of Delegates March 27-30, 2015. http://pharmacist.com/sites/default/files/files/2015%20Report%20of%20the%20APhA%20House%20of%20Delegates%20FINAL.pdf. Accessed January 14th 2021

Barlas, S. (2015). Pharmacists step up efforts to combat opioid abuse: the CDC and Congress are trying to pitch in. Pharmacy and Therapeutics, 40(6), 369.

Chisholm-Burns, M. A., Spivey, C. A., Sherwin, E., Wheeler, J., & Hohmeier, K. (2019). The opioid crisis: origins, trends, policies, and the roles of pharmacists. American Journal of health-system pharmacy, 76(7), 424-435.

Compton, W. M., Jones, C. M., Stein, J. B., & Wargo, E. M. (2019). Promising roles for pharmacists in addressing the US opioid crisis. Research in Social and Administrative Pharmacy, 15(8), 910-916.

Erstad, B. L. (2019). The conscience of a pharmacist. American journal of pharmaceutical education, 83(2).

Grass, J. C. (2015). Medicine Shoppe v. Loretta Lynch, et al.: Pharmacists and Prescribing Physicians Are Equally Liable, The. Health Law., 28, 28.

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