Director's Rethink-Nordisk Case

Erica Lindsay, PharmD, MBA, JD, is a health care attorney practicing in the greater Chicagoland area. She has worked in pharmacy management and compliance for more than 15 years. Dr. Lindsay consults clients through complex pharmacy regulations and guidelines, including 340B, Medicare and Medicaid billing, and HIPAA compliance. She is on faculty of PharmCon providing instruction on pharmacy legal and regulatory issues. Dr. Lindsay is active in various organizations including the American Bar Association where she is Vice of the Nursing and Allied Healthcare Professionals Task Force and members of the Health Care Compliance Association, Cook County Bar Association, and the Chicago Bar Association. She is a graduate of Florida A&M University

Nurses should be encouraged to question the doctors if a wrong drug is prescribed. They should also restrain from taking verbal orders. Written signed orders should be mandated.

Even though Rite Aid was not in within compliance by disposing of patients pill bottles incorrectly and allowing everyone to view many person’s personal information against proper protocol. These actions are surely against HIPAA act violations, the privacy rules have caused the office of the HHS Office for Civil Rights (OCR) and the FTC to made an initiative and file a formal investigation against the largest drug store chain. Throughout the investigation it was concluded that Rite Aid was legally in violation with the HIPAA privacy act and the review indicated several issues concerning the failures of disregarding of patient’s personal information. Consequently, after all discrepancies were identified Rite Aid agreed to settle the HIPAA case

I think this particular ethical dilemma encompasses three of the APhA Code of Ethics principles. The principles involved are as follows: “pharmacist promotes the good of every patient in a caring, compassionate, and confidential manner”, second “pharmacist acts with honesty and

Wow, thank you for sharing your personal experience and provoking questions. I do resonate with you that it is difficult to label the conduct of covert medication as ethical or unethical since it can be different from case to case. The goal for care providers is to provide care with patients’ best interest. When a patient is not in a good state of mind, necessary interventions like you have mention in the post are appropriate.

Do you think this is a case of putting profits first? Explain. Maybe so, but since this is a well known Pharmaceutical Company, I am quite sure they did not want their name/reputation tarnished.

The Pharmaceutical industry has been in the spotlight for decades due to the fact that they have a reputation for being unethical in its marketing strategies. In The Washington Post Shannon Brownlee (2008) states, “We try never to forget that medicine is for the people. It is not for the profits. The profits follow.” This honorable statement is completely lost in today’s world of pharmaceutical marketing tactics. These tactics are often deceptive and biased. Big Pharma consistently forgets their moral purpose and focuses primarily on the almighty dollar. Big Pharma is working on restoring their reputation by reforming their ethical code of conduct.

While Walgreens is exposed to all the general ethical conundrums of the business world, the highly regulated “Pharmacies and Drug Stores” industry does not give much room for them to act unethically.

Over the past couple of decades, a sudden change has started to take over the way business is done. The time when no rules applied, and anyone could do what they pleased at the cost of others or the environment is rapidly ending. Instead, companies today have become aware that it is essential for them to employ ethics and morality in their actions, if not they will be heavily scrutinized and rejected by the public. This way of thinking also applies to the pharmaceutical industry, which over the past century has been rapidly expanding. Do to the fact that this industry can determine the health and lives of millions of people, it is imperative that this industry follow an ethical and moral path.

While I was on my clinical rotation at Wal-Mart, I counseled a patient on her Warfarin prescription. During this rotation, I was doing most of the counsels under the direct supervision of the pharmacist. This particular experience, however, stood out from the rest of the consultations because she seemed very angry when picking up the medicine. I approached her and was prepared to deal with an angry patron. I started counseling her regarding her medication and she stated, “don’t worry, it doesn’t work anyway. My INR keeps going down even though they are upping the dose, and nobody cares about it.” This really raised a red flag with me because of the class of medication this is. I informed her that we cared and asked her what I could do to help her.

The pharmacy is the final point in the distribution chain and is the link to you. If the pharmacist fails to give you adequate warnings and instructions, then your pharmaceutical drug Injury Lawyer Leamington can also include him/her as a

The other allegation of pharmacists tricking patients into declining their counseling is hilarious in my opinion. This scenario is like any other prejudice view, a couple of bad pharmacists make the entire profession look bad. Although I have never worked in a pharmacy, I would rather believe that a pharmacist would not do that to a patient. I have more faith in the profession. If, however, this is a common practice, there is not really much anyone can do about it. The only thing you can do is be the best pharmacist you can be, and if you do the right thing people will follow you and do the right thing.

Saying that you'll respect and protect all personal and health information. They have to have all respect for the customers. “Act bans pharmacists from attempting to harass or humiliate any patients attempting to fill or get a prescription.” (Quinn, 2007) It also bans them from refusing to return it to the patient, or otherwise detaching them from having the prescription filled. The pharmacists are not doctors and they do not qualify to decide which drugs people can and can't take only because of their religious beliefs. In my opinion pharmacists should just not put their religious beliefs into play while at work, they should just do what they are supposed to do and that it giving prescriptions to patients and let them go on their way. Different people believe different things and it will just cause bigger problems that what the person is already causing. We should just all respect what people believe and let it be. In the end you will probably never even have to see this person again in your lifetime so just give them their medications and let them go on their

In 2015, the drug industry experienced the emergence of so-called “captive pharmacies”; pharmacies that enter into arrangements to be owned or operated by pharmaceutical manufacturers. A captive pharmacy is defined as one that derives “the vast majority of its prescription volume from one manufacturer or one product”. These pharmacies typically promote the manufacturer’s products instead of other lower-cost, generic and just as effective medications, with the intent to circumvent formulary management programs designed to protect the patient and the plan sponsor from unnecessary high-cost medications. One of the most high-profile captive pharmacy arrangements is (was) between Valeant Pharmaceuticals International and Philidor Rx Services: Valeant has encouraged doctors to submit prescriptions for its products to Philidor rather than send patients to the corner drugstore, making it more difficult for pharmacists and insurers to subsidize less expensive alternatives. More strikingly, Valeant did not disclose its relationship with Philidor until very recently, even though the company paid $100 million for an option to acquire the pharmacy at no additional consideration (1).

However, the difference here is that unlike the majority of other high retailers, a community pharmacy is run by registered healthcare professionals who have to follow precise guidelines and make ethical decisions, this may conflict with the idea of putting profit first instead of patients. It could be suggested that pharmacists should recommend buying a non-evidence based medication to a patient only when there is no evidence based medication available. This is because as a registered healthcare professional, a pharmacist’s first thought process should be to a sell a medication which they know will actually help their customer, it is their moral obligation to provide their customers with the highest quality of care.