Whangarei GP exposes pill loophole

Northland doctor Shane Reti has identified another medical loophole, this time in the distribution of Vioxx, a medication for arthritis sufferers.
Vioxx, was withdrawn in October because of concerns it increased the risk of strokes and heart attacks.
But in an article, published in the New Zealand Medical Journal today, Dr Reti raises concerns about pharmaceutical samples given out to patients by GPs, especially when a medication is recalled.
The recent Vioxx recall raised questions about the overall management of pharmaceutical samples in New Zealand, he said.
Unlike prescription medications, no record is kept of samples that are given out.
"When you give out medicines you do it in two ways: You either prescribe and you enter it on your computer. Alternatively, when you get a new product you give out samples. Vioxx gave out lots of samples," Dr Reti said.
If a product was recalled it was easy to track patients who had been prescribed medication but it was extremely difficult to track people who had received the free samples because there is no requirement on doctors to record their details.
"Therein lies the problem. If this had been thalidomide (the drug that caused severe birth defects in the 1960s) we would have definitely wanted to track everyone we had given it out to," he said.
"Vioxx has brought this issue to the fore. We gave it out and no one recorded it, now we can't find people we gave samples to. Once I pointed out the loopholes we all realised it was a huge problem."
He said the Ministry of Health, The Royal New Zealand College of General Practitioners and Standards New Zealand do not have guidelines in place for this area of drug sample management.
A new system needed to be introduced so the distribution of sample drugs to patients could be tracked.
One of the redeeming features of the Vioxx samples was that they only contained two tablets and side-effects were only apparent when large doses of the drug were taken.
Dr Reti also questioned the Health and Disability Commissioner about what responsibilities GPs had if a medication was recalled. He was told that GPs would have some responsibility if the side-effects were significant.
Most doctors would feel this was unfair because ultimately the drug company had got it wrong, he said.
It is the second time this month that Dr Reti's findings have hit the headlines. On May 9 he released a study that showed Salamol - a Government-backed asthma inhaler - contained enough alcohol to fail police roadside breath tests. That research was also featured in the NZ Medical Journal, giving the doctor a rare consecutive double in the esteemed publication.
Manaia PHO director and Bush Rd Medical Centre Andrew Miller said Dr Reti had identified an interesting loophole but doubted that it would present any real danger to the public because of the small dosage of the samples and stringent world-wide testing of new drugs.