Chemotherapy scandal: Greater scrutiny urged for drug makers
The entire drug manufacturing and purchasing process must be subjected to greater public scrutiny, recommends a legislative committee examining how 1,202 patients in Ontario and New Brunswick received diluted chemotherapy drugs last spring.
A report tabled in the legislature Tuesday by the Standing Committee on Social Policy says drug purchasing companies such as Medbuy, which arranged the purchase of the chemo drugs from Marchese Health Solutions, should be subjected to audits by the Auditor General, and be obligated to publicly disclose employee salaries.
The nine-member, all-party committee also recommends that Health Canada act on its intent to assume oversight of drug mixing companies like Marchese, and that Cancer Care Ontario set labelling guidelines for chemo medication prepared in admixing facilities.
The report addresses a number of gaps in the drug purchasing and manufacturing process exposed by the Star in a series of articles last year in the wake of the chemo drugs scandal.
Health Minister Deb Matthews said she was reviewing the committee’s findings, and noted a bill is currently before the legislature that would allow the College of Pharmacists to inspect and license hospital pharmacies.
The committee found that Medbuy did not specify the drug concentration to Marchese, which included too much saline in the drug cocktail that contained cyclophosphamide and gemcitabine.
The legislators wrote that the outcome could have been far different if “the members of Medbuy’s pharmacy committee noticed the lack of clarity in the list of drugs put out to tender.”
They also noted that staff at Medbuy and Marchese should have paid greater attention to their email correspondence, and that hospital personnel in Windsor, London, Oshawa and New Brunswick should have been more alert to the difference in labelling between the Marchese products and those from the previous manufacturer, Baxter.
It was a pharmacy assistant at a Peterborough hospital who ultimately noticed the difference.
“We think the process should be more open and transparent,” said the chair of the committee, Progressive Conservative MPP Ernie Hardeman.
“The purchasing conglomerates need more oversight. There’s no way you can actually follow through as to how much public money they get and whether the province is getting value for its money if they’re not subjected to the oversight a government organization would get.”
Medbuy president and CEO Kent Nicholson said in a statement his company was still in the process of analyzing the committee’s report.
“We will act with determination to ensure we meet the higher levels of transparency and accountability recommended in the report to ensure we gain the renewed and lasting confidence and trust of the public,” he said.
Marchese president Marita Zaffiro noted in a statement that her company was not singled out for blame in the scandal, saying “there is no doubt we have all learned from this painful incident. Marchese is committed to working collaboratively to make the health care system that we all rely on as safe as it can be.
Nicholson and Zaffiro said they found the committee’s recommendations were consistent with those put forward last year by Jake Thiessen, the pharmacist appointed by the Health Ministry to look into the diluted drugs scandal.
The legislative committee agreed with all Thiessen’s recommendations. It also recommends that public sector groups such as pharmacies pay for the value of the purchasing services, as opposed to a percentage of purchases.
Sylvia Hyland, vice-president and chief operating officer of the Institute for Safe Medication Practices Canada, said she supports the committee’s recommendations, but would go one step further and urge standardized labelling guidelines for all “high-alert” drugs, such as opioids.
