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Presbyterian’s Drug Policy Dangerous

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As a cancer doctor who has worked closely with the Presbyterian system since 1983, I am concerned and disappointed that Presbyterian Senior Plan has adopted a new policy that puts the safety of cancer patients at risk, perhaps for financial reasons.

At New Mexico Cancer Center, we recognized long ago that special care must be taken with chemotherapy drugs to ensure that the right patient gets exactly the right dose of the right drug, properly handled and stored, at the right time. We established a dedicated oncology pharmacy on site at the center and instituted a series of checks and double checks to prevent errors.

Presbyterian’s new policy no longer allows the New Mexico Cancer Center’s oncology pharmacy to obtain, prepare, double-check and dispense either oral or injectable chemotherapy drugs for Presbyterian Senior patients. Instead, patients must get their chemotherapy from Presbyterian’s Specialty Pharmacy.

We strongly objected, and shared our superb safety record and our concerns with Presbyterian.

Presbyterian said the new policy stays.

New Mexico Cancer Center has a long-standing arrangement to purchase chemotherapy that we can be confident is not counterfeit, diluted or mishandled. We cannot in good conscience inject dangerous drugs into patients when the drugs are provided by an unknown pharmacist who is not part of our safety team.

Sadly, there are already several patients who have been exposed to harm by this new policy. Among them is a young patient with a brain tumor being treated by a combination of radiation and chemotherapy. The chemotherapy prescription was written very clearly, but the pills that Presbyterian’s pharmacy sent to the patient were less than 10 percent of the prescribed dose. The error was not discovered until the patient had received the first third of the course of chemo-radiation. We cannot be certain of the harm that may have come from this error.

Presbyterian claims its new policy will improve quality of care. But how is quality better when the doctor cannot be sure the patient got the right medicine? It’s hard to justify a claim of improved safety when our existing safety record is impeccable.

Presbyterian will also claim that we want to fill prescriptions here just for the money. Last year, New Mexico Cancer Center lost about $200,000 treating Presbyterian Seniors. The $1.50 dispensing fee doesn’t make much difference. Our concern is with patient safety.

This policy allows Presbyterian to make a lot of money. Because Presbyterian Hospital qualifies for participation in a federal program for indigent care, it can purchase drugs about 30 percent cheaper than retail.

Medicare pays Presbyterian Senior Plan a set amount to cover all the costs for seniors, including drugs. Presbyterian Senior Plan can keep money not spent. When the health plan can pay 30 percent less for expensive drugs, that savings becomes profit. So a program designed to help poor people benefits a health insurance plan instead.

Presbyterian says it will pass the savings to patients. We hope it lives up to its promise.

New Mexico Cancer Center has a long-established reputation for the highest quality care. Our patient safety policy requires that we not administer medications that we have not obtained, prepared, stored and safety-checked in our dedicated oncology pharmacy. We recognize that having to go elsewhere to receive chemotherapy may greatly inconvenience our patients covered by Presbyterian Senior Plan, but we simply cannot be responsible for medications that are not under our control.

We sincerely hope that Presbyterian Senior Plan will reconsider this ill-advised policy of forcing all of our patients to obtain chemotherapy medications from Presbyterian.

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