Letters: January 14, 2008

January 14, 2008

Drug samples should be replaced by vouchers as a way to reduce the incidence of drug diversion.

This letter is in response to the actions of a local (New Jersey) pharmacist who was recently arrested for selling samples. The case was reported in The Record and Drug Topics Daily News (Nov. 16). This is the second such incident to come to light in 2007, and in both incidents a local pharmacist was involved. The selling of samples is despicable and reprehensible.

The board of pharmacy in the state of New Jersey prohibits the use of "samples" in a pharmacy, especially a hospital. They do allow doctors and specialty areas that serve indigent patients to stock and dispense samples. However, such practice is fraught with potential disaster, such as who is checking expiration dates, what happens if samples are recalled, what happens if samples are not used prior to expiring, and are they creating an added waste burden on an already-taxed disposal system?

It is time for our state and national representatives to put an end to the use of medication samples. Understandably, samples are a way for doctors to try new medications on naïve patients without the cost burden; however, the use of samples increases the cost of all medications.

A voucher system would provide medications to patients who need drugs and cannot afford them. It would provide information to the companies providing the vouchers. It would eliminate the cost of producing samples; tracking them, since a log is supposed to be kept; and it would reduce the waste when samples are disposed, thus keeping them out of the wrong hands and waste/treatment system.

I graduated from St. John's College of Pharmacy more than 30 years ago, and, unfortunately, the diversion of samples was going on at that time. Isn't it time for New Jersey, the "pharmaceutical state," to put a stop to this outdated and unsafe practice?

Rosario (Russ) J. Lazzaro, M.S., RP
Holy Name Hospital - HNH
Director of Pharmacy Services
lazzaro@mail.holyname.org

Chemistry is crucial to education

Regarding your Nov. 10 Viewpoint on the teaching of chemistry in pharmacy education, I strongly believe that the attitude toward medicinal chemistry displayed in this article is representative of the view of medicinal chemistry by many community pharmacists and some pharmacy faculty. In my view, a pharmacy education without medicinal chemistry will cause schools to produce clinical specialists who have an incomplete knowledge of drug action. The author, Dennis Miller, probably uses biochemistry and medicinal chemistry more than he knows in his practice each day, since these sciences are foundational to all other courses in our curricula.

A reduction in chemistry content in the pharmacy curricula would severely jeopardize the future of the discipline. In the future, drug therapy will expand to include more protein therapeutics, and eventually gene therapy will be commonplace. If pharmacists do not incorporate these areas into their practice, other disciplines will. How can a practitioner understand concepts like recombinant protein production, or gene transfer, or RNA therapeutics with no understanding of chemistry? How will it be possible for a pharmacist to understand and evaluate literature on these topics without a chemistry background?

Patrick M. Woster, Ph.D.
Professor, Department of Pharmaceutical Sciences
Wayne State University
Detroit, Mich.
pwoster@wayne.edu