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REPORT FraudulentMedication

Fraudulent Medication Reports received by Counter Fraud Services (CFS) have increased by 677% in the past 4 financial years

• Handwritten prescriptions for more than one item where the style of how each item recorded is different e.g. writing seems different, colour or type of pen used seems different.

• A handwritten item added to a computer generated prescription.

• Telephone calls requesting the release of an early instalment of multiple dispensing prescriptions or the request from a GP for an emergency supply; especially for those medications liable for abuse.

What is Fraudulent Medication? Incidents of Fraudulent Medication involves a person practising some form of deception or forgery, or a combination of both in order to obtain medication in greater quantities than originally prescribed or not prescribed at all. These persons may obtain or attempt to obtain the medication to consume themselves or for the diversion to others.

These incidents may seem at first glance to be of little importance as the actual cost of the medication obtained is usually of low value and in some cases no medication has been obtained; but this is somewhat misleading.

There is a potential risk to either the perpetratorsí own health as a result of taking medication that was not prescribed for them or to the health of others if they are obtaining the medication for diversion to others. Falsely obtaining or attempting to obtain medication is also a criminal offence with the potential of receiving a heavy penalty.

Pharmacy Contractors should have appropriate systems and procedures to ensure that, where possible, attempts to obtain fraudulent medication are not successful.

Common Types of Fraud Medication Activity

• Altered Prescriptions Prescriptions that are inappropriately altered by patients with the intention to increase the quantities or the strength of medication prescribed. Medication not prescribed but added to a prescription is also considered to be as an altered prescription.

Electronic prescriptions can also be inappropriately altered with the perpetrator including the GPís initials to increase the possibility of the


alerted medications being accepted as genuine and therefore dispensed.

• False Details Reports received by CFS show that contacts via telephone have been received by Pharmacies from callers impersonating GP Practice staff, GPs or other patients in order to obtain an early instalment of a multiple dispensing prescription. Callers have also impersonated GPs requesting an emergency supply of medication. These callers have knowledge of the correct procedures, jargon and patient identifiable information which may lead the Pharmacist to believe that the conversations are genuine and therefore increasing the chances of medication being dispensed.

In 2014/2015 some the fraudulent medications obtained or attempted to be obtained are as follows:

• Diazepam • Lorazepam • Temazepam • Nitrazepam • Amitriptyline • Co-Codamol • Codeine Phosphotate • Paracetamol • Solapadol • Tramadol • Dihydrocodeine • Lyric/Pregabalin • Lamotrigine • Zopiclone • Cyclizine • Fluxetine • Oxycontin • Quetiapine

Warning Signs • Printed or hand-written prescriptions that have been manually altered, normally to increase quantity and/or strength of medications; especially those liable for abuse.

• Poorly spelt or laid out prescriptions that use incorrect dosage or other prescribing abbreviations that are not in keeping with the rest of the prescription.

• Prescriptions from practices that are not from your local area or regular patients that also contain some of the warning indicators above.

• Prescription items being collected by someone other than the patient where the collecting person is not aware of the patientís particulars e.g. date of birth, address

In incidents of this nature, it is appropriate that pharmacists follow guidance issued by the Health and Social Care Board and/or the Pharmaceutical Society of Northern Ireland.

What can a Community Pharmacist do? Staff safety is paramount so in the detection and/or reporting of potential fraud, staff should be mindful and take steps to mitigate any potential personal safety/security risks.

• Consider taking steps to delay filling the prescription such as stating that

you are unable to fill the prescription at the moment and would they mind coming back later to give you time to carry out the next few actions.

• Contact the prescriber and establish if the prescription or information is accurate. If unable to speak to the prescriber and you have strong suspicions about the validity of the prescriptions, the medication should NOT be dispensed.

• If you are suspicious as to the validity of the prescription, consider taking a photocopy or scan of the prescription in case the person demands it back and you need to return it to avoid confrontation.

• Observe their demeanour and reaction to the above information. If they become agitated and/or ask for the prescription back or react in a manner out of proportion with the request, this may again be a sign of potential fraudulent activity.

• If you become suspicious of the validity of a telephone call from a GP Practice member of staff consider calling the practice back to confirm the call. Obtain the practice telephone number from a trusted source and not the caller.

• Contact CFS during working hours to discuss your concerns and report the matter, if appropriate.

• Report all confirmed instances of unauthorised alterations of prescriptions to the Police Service of Northern Ireland (PSNI) on 101 (or 999 in the case of an emergency), as they are criminal offences whether medication was obtained or not.

•Where medication has been dispensed take a photocopy of the

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