Does anyone know the law regarding redispensing returned meds in an MD’s
office? When patients D/C their meds or die, the meds are brought here to
the office and we like to give them to needy patients. I know pharmacies
don’t do this (perhaps they should!), but is it OK (i.e., lawful) to do
it here? We always put expiration dates on drugs we dispense. Thanks.
in response to your question about redispensing meds returned to a
physicians office—i don’t think it is legal. i do know that when a
customer/patient returns meds to the pharmacy (ex md d/c’d the med) the
pharmacy cannot take them back. i would think it holds the same for the
doctors office. yes, there are expiration dates on the bottles but–those
only hold if meds are stored under ideal conditions and also, is for the
patients info to know when the meds need to be destroyed. as wonderful as
it sounds to give those meds to needy people, unfortunately, i don’t think
you can.
maddie teller-kook, pharm.d., r.ph.
In <33vapv$…@search01.news.aol.com> nap…@aol.com (Nap531) wrote:
>Does anyone know the law regarding redispensing returned meds in an MD’s
>office?
I’m fairly certain this is legal as long as they are not controlled
medications (i.e. Class II or III). However, from a liability
standpoint you must realize that the medication has been out of your
control for an extended period of time – older, out of date meds
could have been put in a newer ‘in date’ bottle, temperature or
light sensitive meds could have been left on the dash of the car
for a week, etc. I would think you might be better off to call
your local pharmaceutical representative and request professional
samples.
Ian Wendt
In article <33vapv$…@search01.news.aol.com>, Nap531 <nap…@aol.com> wrote:
>Does anyone know the law regarding redispensing returned meds in an MD’s
>office? When patients D/C their meds or die, the meds are brought here to
>the office and we like to give them to needy patients.
U.S. Pharmacy Law varies from state to state. Many states have
laws which explicitly prohibit this (I don’t have my law books handy so I
can’t check the states I’ve got books for, nor can I check the
federal law right now). You need to check with a lawyer in your state or
whatever other jurisdiction you’re under.
Even if it is legal you may still be responsible for the for the strength
and purity of what you dispense. For example, it’s very reasonable to
expect that many of the patients stored their drugs under conditions
where the drug would degrade very rapidly. e.g. in a hot steamy bathroom.
Thus if the drug had broken down to toxic or inactive products and the
patient got sick due to a toxic breakdown product or whose medical
condition did not improve or even got worse because you were giving them
a medication with no active drug in it, you would be responsible. For
example, redispensing an oral contraceptive which had been improperly
stored and had such a low amount of contraceptive hormones, that
the patient became pregnant. Thus even female
physicians and pharmacists can be liable in paternaty suits. Or take
many of the caridac meds, small changes in dose can often have
significant clinical consequences.
Nor is it that far fetched that someone could give you a drug that has
been tampered with, or was contaminated in some way. Failure to consider
this very possible scenario (remember the Tylenol tapering case) would
leave you open to liability if a patient got hurt.
Thus regardless what the law explicitly prohibits, it is your
responsibility to consider what are the risks
which can be reasonably expected to be associated with redispensing
drugs, and to guard your patients from these risks.
I’ld say lack of potency, toxic breakdown products, and tampering are
risks that it would be reasonable to expect would happen.
>We always put expiration dates on drugs we dispense. Thanks.
How do you select these ‘expiration dates’. Manufacturers expiration
dates are based on keeping the drugs in the original sealed container
under specified storage conditions. Even hospitals which repackage
medications for individual use within the hospital, and really don’t have
to worry so much (because they store drugs under these conditions) only put
limited expiration dates on their repackaged
drugs (i.e. much shorter that the manufacturers expiration date). So since
you have no idea how these medications were stored, nor
are prescription vials always ideally suited for keeping drugs long term
how can you possibly know that the drug isn’t bad before you even
repackage it. Or do you even repackage it. If you simply put a new label on
it, without putting it in a new safety vial you’re probably violating the
poison prevention packaging act (US federal law). Also do you take the
time to properly
label the drug and keep records. The physician is bound by the same laws
and requirements as the pharmacist. Which reminds me, how do you know
what are the lot numbers of medications you dispense, it’s usually not
put on a prescription label. What if there’s a recall of
a specific lot of a medication, how do you know if you’ve dispensed it,
and are you going to be able to contact your patients to tell them to
return it.
Also check with the manufacturer. Sometimes they have programs to
provide medications to needy patients.
Ian –
Wait a second or two…someone returns drugs to a physician’s office
and the drugs are dispensed to another patient…what is wrong with this
picture:
Why are the drugs returned? Death, Did not work, Wrong meds?
Who are the meds being dispensed to? Poor? How much did you pay?
How much is the carrier paying?
When is this occuring? Ultra highcost drugs – interferons,
oncologly preps…?
How does this practice occur? Physician? Office Nurse? Unskilled
office worker repackaging unwanted, used prescriptions?
.
Seems to me that the boards of medicine and pharmacy should be asked
to comment.
In article <33vl43$…@ixnews1.ix.netcom.com>,
Ian Wendt <IanWe…@ix.netcom.com> wrote:
>….. temperature or
>light sensitive meds could have been left on the dash of the car
>for a week, etc.
I’m always amazed at how most people have no concept of proper medicine
storage. In cars in the summer sun; medicine cabinets in humid, steamy
bathrooms; kitchen counters/cabinets right next to (or above) the stove,
oven, coffeemaker. I’ve also seen many instances of what could be an
especially unpredictable practice, which is storing many pills/capsules
of different types, in the same bottle! Women do this all the time so
that multiple bottles don’t clutter up their purses. I’m sure that
99% of the time, none of this really matters very much, BUT it could…..
– laure…@fx.net
In article <33vapv$…@search01.news.aol.com>, nap…@aol.com (Nap531) says:
>Does anyone know the law regarding redispensing returned meds in an MD’s
>office? When patients D/C their meds or die, the meds are brought here to
>the office and we like to give them to needy patients. I know pharmacies
>don’t do this (perhaps they should!), but is it OK (i.e., lawful) to do
>it here? We always put expiration dates on drugs we dispense. Thanks.
Illegal, Illegal, Illegal! At least here, in Illinois. Once a drug
leaves a pharmacy (or MD office), it may not be returned to stock and
redispensed. The law stands because once a drug leaves the custody of a
pharmacy, there is no way to assure that the drugs have been appropriately
stored and/or not tampered with.
-Paul Sovcik, PharmD University of Illinois
- Hide quoted text — Show quoted text -
In article <33vl43$…@ixnews1.ix.netcom.com> IanWe…@ix.netcom.com (Ian Wendt) writes:
>In <33vapv$…@search01.news.aol.com> nap…@aol.com (Nap531) wrote:
>>Does anyone know the law regarding redispensing returned meds in an MD’s
>>office?
>I’m fairly certain this is legal as long as they are not controlled
>medications (i.e. Class II or III). However, from a liability
>standpoint you must realize that the medication has been out of your
>control for an extended period of time – older, out of date meds
>could have been put in a newer ‘in date’ bottle, temperature or
>light sensitive meds could have been left on the dash of the car
>for a week, etc. I would think you might be better off to call
>your local pharmaceutical representative and request professional
>samples.
>Ian Wendt
Redispensing drugs is not legal….
Most health professionals try to help people, not provide a vehicle to
spread disease; through redispensing drugs…
Reed Bonham
- Hide quoted text — Show quoted text -
In article <33vqfh$…@news.u.washington.edu> k8821…@u.washington.edu (Ronald Kavanagh) writes:
>In article <33vapv$…@search01.news.aol.com>, Nap531 <nap…@aol.com> wrote:
>>Does anyone know the law regarding redispensing returned meds in an MD’s
>>office? When patients D/C their meds or die, the meds are brought here to
>>the office and we like to give them to needy patients.
>U.S. Pharmacy Law varies from state to state. Many states have
>laws which explicitly prohibit this (I don’t have my law books handy so I
>can’t check the states I’ve got books for, nor can I check the
>federal law right now). You need to check with a lawyer in your state or
>whatever other jurisdiction you’re under.
>Even if it is legal you may still be responsible for the for the strength
>and purity of what you dispense. For example, it’s very reasonable to
>expect that many of the patients stored their drugs under conditions
>where the drug would degrade very rapidly. e.g. in a hot steamy bathroom.
>Thus if the drug had broken down to toxic or inactive products and the
>patient got sick due to a toxic breakdown product or whose medical
>condition did not improve or even got worse because you were giving them
>a medication with no active drug in it, you would be responsible. For
>example, redispensing an oral contraceptive which had been improperly
>stored and had such a low amount of contraceptive hormones, that
>the patient became pregnant. Thus even female
>physicians and pharmacists can be liable in paternaty suits. Or take
>many of the caridac meds, small changes in dose can often have
>significant clinical consequences.
>Nor is it that far fetched that someone could give you a drug that has
>been tampered with, or was contaminated in some way. Failure to consider
>this very possible scenario (remember the Tylenol tapering case) would
>leave you open to liability if a patient got hurt.
>Thus regardless what the law explicitly prohibits, it is your
>responsibility to consider what are the risks
>which can be reasonably expected to be associated with redispensing
>drugs, and to guard your patients from these risks.
>I’ld say lack of potency, toxic breakdown products, and tampering are
>risks that it would be reasonable to expect would happen.
>>We always put expiration dates on drugs we dispense. Thanks.
>How do you select these ‘expiration dates’. Manufacturers expiration
>dates are based on keeping the drugs in the original sealed container
>under specified storage conditions. Even hospitals which repackage
>medications for individual use within the hospital, and really don’t have
>to worry so much (because they store drugs under these conditions) only put
>limited expiration dates on their repackaged
>drugs (i.e. much shorter that the manufacturers expiration date). So since
>you have no idea how these medications were stored, nor
>are prescription vials always ideally suited for keeping drugs long term
>how can you possibly know that the drug isn’t bad before you even
>repackage it. Or do you even repackage it. If you simply put a new label on
>it, without putting it in a new safety vial you’re probably violating the
>poison prevention packaging act (US federal law). Also do you take the
>time to properly
>label the drug and keep records. The physician is bound by the same laws
>and requirements as the pharmacist. Which reminds me, how do you know
>what are the lot numbers of medications you dispense, it’s usually not
>put on a prescription label. What if there’s a recall of
>a specific lot of a medication, how do you know if you’ve dispensed it,
>and are you going to be able to contact your patients to tell them to
>return it.
>Also check with the manufacturer. Sometimes they have programs to
>provide medications to needy patients.
I WOULD BE INTERESTED IN A STATE THAT ALLOWS REDISPENSING?
PLEASE EMAIL ME WITH THAT STATE?
REED
All I can tell you is that Connecticut Pharmacy Law prohibits pharmacies from
I I can tell you is that Connecticut Pharmacy Law probohibits pharmacies from
redispensing returneerned drugs because of concerns about "uncontrolled
contamination"that is to say,improper storage conditions,dating,recalls from
specific batatch numbers,etc
You don’t know what,where,or how these drugs have been stored,or
whatconditions they may have been exposed to. I applaud your humanitarian
ambition, but I think a physician’s office should adhere to the same rigoorous
restraints that applyy to pharmacies
Hope this helps.