Each year, more and more Americans are taking prescription drugs. In fact, according to a recent study published in the Journal of the American Medical Association, more than 59% of American adults take at least one prescription drug. The same study also concluded that 15% of Americans are taking five or more prescription drugs, up from a reported 8.2% in 2000. The headlines have largely focused on the national opioid epidemic, but the majority of drugs prescribed in America include other types of pharmaceuticals, such as high cholesterol treatments, diabetes medications, and antidepressants. While these medications can improve and prolong patient lives, taken together in the wrong combinations, they can result in dangerous drug interactions – which Illinois pharmacies may not be doing enough to prevent.
Dangerous Drug Interactions: A Brief Explanation
Drug interactions are situations that occur when one drug impacts the activity of another drug when both are taken at the same time. While these interactions may positively enhance the effects of these both drugs by design, sometimes the drug interactions can have negative effects, leading to bodily harm or death. According to the U.S. Food and Drug Administration, “Medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States.” Dangerous drug combinations alone hospitalize tens of thousands of Americans per year. And with the sheer number of prescriptions on the rise, the likelihood of such deadly errors may also increase.
Lines of Defense
The first and most important means of preventing dangerous drug interactions is the doctor. A doctor is responsible for prescribing the correct medications for the patient, ensuring both that a single drug itself will not cause an adverse reaction and that the drug will not interact negatively with any other drugs the patient is already taking so as to cause serious bodily harm or worse.
While doctors are the chief means of preventing drug injury, in many ways pharmacies provide the last line of defense. In fact, pharmacies are in a unique position to note any potential dangerous drug interactions. For example, an individual doctor may not know what another doctor may have prescribed a given patient. Because a pharmacy typically fills all of a given patient’s prescriptions, on the other hand, it can look for potential interactions and warn a patient of any possible harm. Recently, however, an investigative report by the Chicago Tribune found that far too many of the state’s pharmacies are failing to perform this duty adequately, potentially putting their customers at risk.
Failure to Warn
According to the Illinois Department of Financial and Professional Regulation, state law requires pharmacies to conduct multiple safety checks to determine whether recommended doses seem reasonable or whether there might be negative interactions between certain prescriptions and other drugs that customers may be taking. Pharmacists who detect potentially dangerous drug interactions are required to contact the prescribing doctors, verify that the prescriptions are correct, ask if alternative therapies are available, and then warn the patients of the dangers.
In 2016, the Chicago Tribune conducted an investigation into 255 Illinois pharmacies to see if they followed those basic safety guidelines, and the results were alarming. Undercover reporters presented the pharmacists with prescriptions for drug pairings known to be potentially dangerous, with such side effects as loss of consciousness, birth defects, gangrene, strokes, the breakdown of muscle tissues, multiple organ failures, and death. 52% of these prescription pairings were filled without a warning.
Independent pharmacies, which often emphasize customer service as their chief attraction, fared the worst, with a 72% failure rate. Chain pharmacies averaged together had a 49% failure rate. Among the major chains, CVS Pharmacy performed the worst, with a 63% failure. Walgreens performed the “best” overall, with a failure rate of only 30%.
The Impact of Speed on Safety
Pharmacies are increasingly high-volume businesses. For example, one pharmacist interviewed by the Chicago Tribune said that she usually filled an average of one prescription every 2.7 minutes within a typical nine-hour shift.
With drive-through windows and walk-in clinics more and more common, customers tend to expect quick service almost akin to fast food. But at many companies, this expectation of speed is not just a vaguely internalized feeling. At CVS, for example, speed is a carefully measured metric used to grade and rank its pharmacies, sometimes at the expense of safety checks, a policy about which many of its pharmacists have complained.
Given the pressure to produce, many pharmacists were noted to race through or even skip the legally required drug safety reviews, possibly in an attempt to shave off time. While the computers in most pharmacies feature software that flags dangerous drug interactions, some experts suggest that the warnings become so common over time that pharmacists ignore them as a result of a phenomenon called “alert fatigue.”
As the report suggests, this emphasis on preparing such a high volume of medications at such a high speed and in so short of time can lead to inattention to detail. It is this inattention that may be one of the chief culprits for allowing dangerous drug pairings to be dispensed without the appropriate warnings – potentially with disastrous results.
Proposed Changes in the Law
When the Chicago Tribune contacted the investigated companies with the results, most promised to make changes to improve their systems. But for Illinois lawmakers, these promises may not be enough.
In the wake of the investigative report, Gov. Bruce Rauner proposed beefing up state pharmacy oversight. This would include launching a “mystery shopper” program to test how well pharmacists follow the law. Pharmacy inspectors would also be directed to place more emphasis on dangerous drug interactions. Gov. Rauner further recommended imposing tougher counseling standards, with requirements for pharmacists to inform patients about risky drug interactions and other issues whenever prescriptions change or if they are taking certain drugs for the first time.
Additionally, the Illinois House sent a bill to Gov. Rauner to create a task force on pharmacy safety. Sen. Dick Durbin has also called upon the Centers for Disease Control and Prevention to develop concrete steps to increase consumer safety, issue guidelines to state boards of pharmacy and private industry groups, and study whether company speed and medication output metrics increase pharmacy errors and negatively impact patient health.
If you have suffered severe bodily injury because you were prescribed multiple medications, without warning of any potentially dangerous drug interactions, you may be entitled to financial compensation. Please contact the GWC for a free consultation today.