Pharmacy in Vancouver’s Downtown Eastside ordered to close amid crackdown

Amid a provincial crackdown on problem pharmacies, the College of Pharmacists of B.C. on Friday ordered a Downtown Eastside pharmacy to close, citing problems that included rat droppings, dirty washrooms and merchandise that was haphazardly stored.

College representatives went to the facility – Native Vancouver Pharmacy at 50 East Hastings Street – Friday morning to deliver an official notice and to post signs informing clients that the pharmacy's licence would be suspended on June 12 and that it would not be accepting any new clients between now and that date.

The "extraordinary action" was necessary to protect public health, said College board chair Anar Dossa, adding that she was "appalled" by conditions investigators found during a recent inspection of the store.

Outside the pharmacy, clients who had come for their daily dose of methadone were met by police who were on hand to observe the enforcement action.

"I can't believe it – another pharmacy closed," said one woman, who said she had only begun patronizing the store after a nearby store at which she used to obtain her methadone closed a few weeks ago.

"Now I'm going to have to find a new one."

The college's action comes as the province wrestles with the costs and regulatory headaches associated with its Methadone Maintenance Payment Program, which includes lucrative dispensing fees and has resulted in some pharmacies catering nearly exclusively to methadone clients.

A provincial review earlier this year found methadone and its associated fees now account for the second-highest drug expense, at $44-million, for PharmaCare, B.C.'s $1-billion provincial drug plan. (The highest expense, at about $61-million, was for Infliximab, a drug used to treat conditions including rheumatoid arthritis.)

The review also noted that the provincial health ministry has been dealing with cases of impropriety in methadone dispensing, such as improper billing of methadone claims and offering inducements, for more than a decade.

It is not clear if the Native Pharmacy is among nearly 50 pharmacies targeted in a crackdown by the Ministry of Health, which earlier this month told 46 pharmacies that their applications to re-enroll with PharmaCare, B.C.'s provincial drug plan, would not be approved by a June 1 deadline. That deadline has since been extended until June 19 and the names of the pharmacies are expected to made public after that.

The college did not mention methadone in a statement it issued on the shutdown of the Native Vancouver Pharmacy, instead citing issues such as the lack of hot running water and mould found in floors, walls and food containers inside the dispensary.

Despite its name, the pharmacy has no association with either the First Nations Health Authority, a provincial health program, or Vancouver Native Health Services, a nearby agency, the college said.

The provincial pharmacy crackdown followed a government review earlier this year that found methadone costs had grown by an average of 7.6 per cent since the program was introduced in 2001 and that methadone dispensing fees – introduced to help make methadone more readily accessible throughout the province – had resulted in unintended consequences, including improper billing of methadone claims.

B.C. has the most generous compensation fee for methadone in Canada – with a $10 dispensing fee and a $7.70 fee for witnessed ingestion – and is one of only three jurisdictions with an interaction fee. (The other two are Saskatchewan and the federal Non-Insured Health Benefits Plan.) The review also found clusters of methadone-dispensing pharmacies in certain parts of the Lower Mainland, including the Downtown Eastside and parts of Surrey.

Dispensing methadone to a single patient could generate nearly $6,500 a year in fees, the review said, and daily dispensing fees for other drugs could push that tally up to $13,800 a year.

In 2010, the Ministry of Health and the College conducted a joint investigation related to methadone dispensing to look at issues including billing of methadone claims and offering inducements to customers. Out of that investigation, six pharmacies had their PharmaCare access terminated, and the pharmacies subsequently closed; one pharmacy was sold; and one case is outstanding, the ministry says.