City Council hears push to bolster drug safety at pharmacies

Warning that pharmacies are putting "profits over people," a drugstore pharmacist urged Chicago aldermen on Tuesday to approve a city proposal designed to improve customer safety by easing pressure on pharmacists to speed through prescription orders...

City Council hears push to bolster drug safety at pharmacies

Warning that pharmacies are putting "profits over people," a drugstore pharmacist urged Chicago aldermen on Tuesday to approve a city proposal designed to improve customer safety by easing pressure on pharmacists to speed through prescription orders...

07 April 2017 Friday 05:38
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City Council hears push to bolster drug safety at pharmacies

Warning that pharmacies are putting "profits over people," a drugstore pharmacist urged Chicago aldermen on Tuesday to approve a city proposal designed to improve customer safety by easing pressure on pharmacists to speed through prescription orders and limiting their work hours.

Jeremy Aguila, of Chicago, who works at a CVS store in Skokie, joined a top Teamsters official in support of the proposal brought before the City Council Finance Committee by Chairman Ald. Edward Burke, 14th. The ordinance was inspired by a 2016 Tribune investigation that found 52 percent of 255 pharmacies tested in the Chicago region and nearby states failed to warn customers about prescription drug interactions that could be harmful or fatal.

Pharmacists are "missing all of these interactions" because employers don't give them enough time or provide enough staff to check prescriptions properly, Aguila said.

"As a result, speed has taken a priority," Aguila said. "And getting things done fast is given 10 times more importance over getting things done correctly."

He said he is thrilled when CVS performs well financially. "But I don't like it being done at the expense of my patients' safety and my conscience at the end of the day," Aguila said.

Pharmacies miss half of dangerous drug combinations Sam Roe, Ray Long and Karisa King

The Tribune reporter walked into an Evanston CVS pharmacy carrying two prescriptions: one for a common antibiotic, the other for a popular anti-cholesterol drug.

Taken alone, these two drugs, clarithromycin and simvastatin, are relatively safe. But taken together they can cause a severe breakdown...

The Tribune reporter walked into an Evanston CVS pharmacy carrying two prescriptions: one for a common antibiotic, the other for a popular anti-cholesterol drug.

Taken alone, these two drugs, clarithromycin and simvastatin, are relatively safe. But taken together they can cause a severe breakdown...

(Sam Roe, Ray Long and Karisa King)

The proposal would require pharmacies in Chicago to limit the hours that pharmacists work, restrict how many prescriptions they could fill per hour, require that they get meal and break time, and provide whistleblower protection when they flag problems.

Pharmacists struggle to meet management demands and still properly serve customers, Mike Ciaccio, a political point man for Teamsters Joint Council 25, told the committee. Aguila is a member of Teamsters Local 727, which represents about 650 Chicago-area pharmacists and interns at multiple CVS and Jewel-Osco stores.

Burke said he patterned his city-only proposal on state legislation sponsored by Rep. Mary Flowers, D-Chicago, adding that he hoped the Chicago effort would serve as a catalyst for Illinois lawmakers to pass a statewide statute to relieve "harried and frantic" pharmacists.

"Here in Chicago, we have a greater likelihood of taking action," Burke said, saying special interests are slowing down action in Springfield.

Burke said he wanted to hear from pharmacy interests at a future hearing for opponents of the city proposal. Pharmacy lobbyists have called Burke's proposal unconstitutional because their industry can be regulated only by the state. But Burke, citing Chicago's inroads on such workplace issues as minimum wage and paid sick leave, said the city has a legal pathway, and he hoped to win approval.

In a company statement, CVS Health said the company "is committed to delivering safe and effective pharmacy care, as well as providing our pharmacy teams with the support and resources they need to serve their patients in a prompt and safe manner."

New plan aims to protect Illinois pharmacy customers from dangerous drug interactions Ray Long and Sam Roe

Responding to a Tribune investigation that found drugstores frequently failed to warn customers about potentially dangerous drug interactions, Gov. Bruce Rauner is unveiling a major plan designed to improve public safety at pharmacies throughout the state.

The administration's proposal would require...

Responding to a Tribune investigation that found drugstores frequently failed to warn customers about potentially dangerous drug interactions, Gov. Bruce Rauner is unveiling a major plan designed to improve public safety at pharmacies throughout the state.

The administration's proposal would require...

(Ray Long and Sam Roe)

"Any new law enacted by the city or state needs to preserve the ability of our pharmacists to provide the highest standard of care to patients, while maintaining the level of safe, timely service that our customers expect to receive from us," CVS wrote.

The Tribune's investigation, published in December, found pharmacists frequently race through legally required drug safety reviews or skip them altogether. In Illinois, pharmacies are required to conduct several safety checks, including whether the dose is reasonable and whether the medication might interact with other drugs the patient is taking.

Among the seven pharmacy chains tested, CVS had the highest failure rate at 63 percent. Walgreens had the lowest, at 30 percent. Independent pharmacies had the highest failure rate overall, at 72 percent.

CVS, Walgreens and Wal-Mart each promised to take significant steps to improve patient safety nationwide. Combined, the actions affect 22,000 drugstores and involve additional training for 123,000 pharmacists and technicians. Wal-Mart had a 43 percent failure rate in the Tribune's tests.

Following the Tribune report, Republican Gov. Bruce Rauner responded with proposals to require pharmacists to counsel patients about risky drug combinations and other significant issues when buying a medication for the first time or when a prescription changes. Illinois now requires pharmacies to merely offer counseling, something often achieved by asking a brief question at the cash register, such as: "Any questions for the pharmacist today?"

The counseling initiative is working its way through a state regulatory process. The governor also directed state inspectors to put more emphasis on adverse drug reactions and plans to deploy "mystery shoppers" to check on pharmacy performances.

Pharmacy groups talk reforms after Tribune report on risky drug interactions Ray Long and Sam Roe

Citing a Tribune investigation into dangerous drug interactions, the head of the nation's top association of pharmacy regulators is urging states to enact tough laws to require pharmacists to counsel patients when they pick up medications.

"Counseling has to occur," said Carmen Catizone, executive...

Citing a Tribune investigation into dangerous drug interactions, the head of the nation's top association of pharmacy regulators is urging states to enact tough laws to require pharmacists to counsel patients when they pick up medications.

"Counseling has to occur," said Carmen Catizone, executive...

(Ray Long and Sam Roe)

In Springfield last month, Flowers and Rep. Mike Zalewski, D-Riverside, saw pharmacy lobbyists put up heavy opposition to her legislation in a sometimes-contentious House committee hearing, but no vote was taken.

The two Democrats hope to gain leverage by setting a tight timetable. The state's pharmacy act is set to expire Jan. 1, 2018, a common process in regulatory laws that gives legislators a chance to consider whether changes are needed. Typically, legislators renew regulatory laws for 10 years.

But Zalewski has filed an amendment that would renew the pharmacy act for only one year instead of 10. The amendment, approved 15-0 in a committee Wednesday, would create the task force and have it report back Sept. 1, 2018 — only months before the law would again expire on Jan. 1, 2019.

Rob Karr, president of the Illinois Retail Merchants Association, which includes small independent pharmacies and major chains, opposed the tougher initial Flowers legislation but said his group is "OK with the task force."

When asked whether his group could reach a compromise, Karr cautioned that the issues are not simple. "We'll see what the discussion bears out," he said.

Flowers contended pharmacists need relief from distractions that range from giving flu shots to chasing down doctors about drug interactions.

"This is a life-and-death situation," Flowers said. "This is too important of an issue for us to get it wrong."

rlong@chicagotribune.com

Twitter @RayLong

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