The practices of many methadone-dispensing pharmacies in B.C. have raised concerns within government and the College of Pharmacists of B.C.

Most targeted pharmacies cut off PharmaCare

Dozens of pharmacies had been red-flagged for violations, many for methadone-dispensing practices

A crackdown by the province has led to 29 Lower Mainland pharmacies closing or exiting the government-funded PharmaCare program after being red-flagged for various improprieties.

The health ministry had notified 46 pharmacies in May that they’d be booted from PharmaCare if they failed to swiftly explain why they should be able to continue billing the publicly funded drug plan.

Most of those pharmacies have since terminated their PharmaCare enrolment or been removed, including 12 in Vancouver, seven in Surrey, four in Burnaby, two each in Richmond and North Vancouver, and one each in Maple Ridge and New Westminster. A few had previously been terminated last December.

Medicine bought at now-excluded pharmacies that remain open is no longer covered by PharmaCare.

Another dozen pharmacies run by two chains can continue to submit claims but are subject to special conditions.

The health ministry has not released specific reasons why each of the pharmacies involved was targeted.

Many were dispensing methadone and may have engaged in improper business practices, such as kickbacks to retain drug-addicted patients.

Billing irregularities were a concern in other cases, including improper filing of drug information for patients into the province’s prescription-tracking network, potentially risking their health.

In other cases, false information had been provided by operators on their enrolment applications.

A recent regulation change allows the government to refuse to pay pharmacies with a history of suspect practices and imposes greater disclosure requirements.

A provincial review of the methadone maintenance program this year found rapid growth in billings for the drug used to counter symptoms of withdrawal from addiction to heroin or other narcotics.

Methadone is now PharmaCare’s second-highest drug cost at $44 million a year for more than 15,000 addicts.

Regulators plan undercover stings

The College of Pharmacists of B.C. is planning undercover investigations over the next three years to target methadone-dispensing pharmacies that are a continuing source of concern.

The college’s draft enforcement plan says it will target the top 20 methadone-dispensing pharmacies, as well as ones that operate in inappropriate premises or have been barred from PharmaCare.

It cites allegations of coercion – cash or housing being offered to retain or attract methadone patients and withholding of doses if patients fail to remain loyal.

Other “significant concerns” the college aims to address include reports of unsanitary conditions such as mold, insects or rodents, failure to witness methadone ingestion, discrimination against ethnic groups, false processing of prescriptions and altering prescriptions to daily doses.

A patient holds a bottle of methadone dispensed by a pharmacy in Surrey. Black Press file photo.

Pharmacies no longer in PharmaCare or subject to conditions