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TRINIDAD – Thieves sell cancer drug to private docs

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The lives of thousands of cancer patients are at stake because of a racket in which millions of dollars’ worth of cancer drugs have gone missing from the pharmacy at the St James Medical Complex and the Chaguaramas building where the Ministry of Health’s drugs are stored. The drugs, mainly used in chemotherapy, are ending up in the private offices of doctors on the “outside,” Health Minister Dr Fuad Khan disclosed yesterday as he told what his ministry had uncovered in ongoing investigations.

A lot of cancer victims who receive treatment at the St James Medical Complex have written to him about what they are told is a shortage of drugs at the institution, he said. The traumatised patients said to get the drugs they now have to pay very high prices for them at private doctors’ offices. “Patients are obtaining the drugs,” he said. “Someone is giving it to them. A lot of them have written to me but they are afraid of victimisation, that they will be denied the drugs.

“We are purchasing a lot of cancer medication and it’s extremely expensive, about $12,000 to $15,000 per vial. Sometimes one patient needs ten to 12 vials. They are mostly second-line drugs, which are used when first-line drugs are not effective enough. “What we uncovered is that a lot of cancer drugs, which are in the pharmacy at the St James Medical Complex and are distributed to the wards of the various hospitals, find their way outside of the hospitals, in private medical practices.”

Khan said a system had been put in place to minimise the loss of drugs, whereby both the doctor and patient at St James had to sign the prescriptions. “Patients have to sign to receive them too. When I last checked, this system of dual signatures was in place.” He said what remains a mystery is who are the pharmacists and people distributing the drugs, since there are no records of the names of the people on duty.

“We are trying to figure out who are the pharmacists and people assigned, but it has been challenging, because of a lack of attendance records,” Khan said. “Pharmacists from the Port-of-Spain hospital are sometimes assigned to St James, but there are no records of pharmacists signing in or out.” As a result, he said, “There is a shortage of drugs, and no attendance records of pharmacists. I have to be suspicious.”

The ministry’s medical drugs are procured and stored and managed by the National Insurance Property Development Company at the C-40 building in Chaguaramas. Khan said there has also been “leakage” at C-40 and blamed careless security for this. “Security is not stringent enough,” he said. “There is protracted loss at other levels, at the pharmacy (in St James).” The Government allocates $120 million yearly for the treatment of cancer, reportedly the second leading cause of death in T&T.

The T&T Guardian yesterday spoke to a medical source at the St James Medical Complex, who confirmed there is a shortage of five chemotherapy drugs there. He said he had also heard about medical personnel using fictitious documents to acquire cancer drugs. “I have heard stories of medical personnel who present these fictitious prescriptions to the pharmacists for the cancer drugs and then take them to private facilities where patients are charged exorbitant fees for treatment.”

He said there has been a rapid growth in the number of cancer patients at the institution and, at one point, there were about 1,000 new patients every year. The source said there is no alternative treatment that cancer patients at the institution can be offered. “They just have to wait until we get.” He said without their treatment, these patients face the risk of earlier death.

Yesterday, Khan said it is for this reason that the ministry wants to introduce the health card, which contains, in a microchip, a patient’s medical history and what medication they are using. “This will track where the drugs are going and into who. A patient will not get the drugs until he presents the card.” The minister also disputed charges that the Government was not buying a sufficient amount of drugs and that suppliers were not being paid on time.

Asked how the ministry was dealing with cancer patients who did not get their drugs at the St James Complex, Khan said: “Once there is a shortage, there is no substitute. “As the pharmacy and C-40 request, we buy it, make an order for more. If it’s being pilfered, it’s like putting water into a hole. There are always shortages and we are always replenishing.”

Head of the T&T Cancer Society Dr Jacqueline Sabga, who runs Vitas House Hospice, a home for dying cancer patients at the St James complex, said yesterday she was not aware of a shortage of cancer drugs and there is no shortage for patients at her facility. But she added, “This doesn’t mean it does not exist.” She said a patient’s life would be in danger if they did not get their medication.

A patient’s ordeal

A cancer patient who was diagnosed with the disease last year cried when she went to the St James Medical Complex, where she had been receiving treatment, and was told there was no medicine for her. This was around May, she said. “A nurse handed me a prescription and said they don’t have any drugs. I sat down and started to cry. I was scared. I felt so hurt,” she told the T&T Guardian, asking that her identity be protected. “I normally get two sets of drugs, one to be taken intravenously and one orally.”

She said she returned recently and was told the same thing. She related the experiences of other cancer victims who were also turned away. “Avastin, one of the main drugs we use, is not available at the hospital,” she said. “There are other types of drugs missing. Those who have breast cancer say they are not getting the medication for their specific condition. “When some of them hear this, they are afraid they will die.”

The source said even simple drugs which cancer patients use outside of chemotherapy, like B-6 pills and creams for their hands, are not available. Asked how she fared after the hospital told her the drugs were not available, she said: “I went without it. I didn’t feel any major difference but tests showed that the lack of treatment had a negative effect on the disease.”