The nation’s healthcare system has been hit by a double blow that once again showed there are plenty of unscrupulous people ready to exploit regulatory gaps, leaving patients at risk and families in mourning.
While much of the attention has been focused on a counterfeiting scandal involving a widely prescribed drug, an early-morning fire yesterday at a nursing home in Taoyuan left at least four of the elderly residents dead and 13 injured.
Boxes of counterfeit drugs finding their way into hospitals, clinics and pharmacies, and a deadly nursing home fire — we have been here before.
Six people dead and 28 injured at the Le Huo Nursing Center fire in New Taipei City in July last year; 12 dead and more than 70 injured in the Beimen Sinying branch of Tainan Hospital in October 2012 — and yet the Taoyuan facility in yesterday’s tragedy was able to stay open despite overcrowding, a shortage of caregivers and repeated fire code violations in the past year alone.
In the counterfeiting case, tablets containing atorvastatin, a lipid-lowering drug, were found in packages of AstraZeneca’s Crestor (rosuvastatin), one of the drugs most widely prescribed in the nation to treat high cholesterol. The counterfeits were found mixed with two batches of Crestor and reportedly had been distributed to 570,000 National Health Insurance patients.
A study published by the New England Journal of Medicine in 2011, the year that Pzifer’s substance patent for its Lipitor drug (atorvastatin) expired, found that Lipitor and Crestor were equally safe and effective in lowering cholesterol and possibly reversing plaque build-up — so patients who took the counterfeits are unlikely to have suffered any harm.
It is the National Health Insurance Administration, taxpayers and the public’s trust that have taken the hit.
Since atorvastatin has been off-patent since November 2011, it can be legally produced cheaply by firms other than Pzifer — just as rosuvastatin can be when AstraZeneca’s substance patent expires in July. However, there appears to be no shortage of people willing to exploit that legality for illegal ventures.
New Taipei City prosecutors on Monday said they had detained two people in connection with the fake drugs after a raid on a Sijhih District (汐止) factory and warehouse on Sunday, and Minister of Health and Welfare Chen Shih-chung (陳時中) on Thursday told lawmakers that the ingredients for the fake tablets had been mailed from China.
Premier Lin Chuan (林全) has pledged to review existing procedures and overhaul the nation’s drug safety standards — the same kind of platitude trotted out after every disaster whether natural or man-made.
We heard the same thing after the previous nursing home fires and after a counterfeiting operation was discovered in December 2007 in Taibao Township (太保), Chiayi County, that had been producing several fake prescription drugs, as well as glucosamine tablets and Tiger Balm –— with most of the ingredients sourced from China.
The suspects in the latest fake drug case, if convicted of contravening the Pharmaceutical Affairs Act (藥事法), could face up to 10 years in prison or a fine of up to NT$100 million (US$3.22 million).
That is apparently not much of a deterrent — the main suspect in the Taibao case was out on bail at the time pending a final verdict after being sentenced to 20 years and 10 months on two previous charges of selling counterfeit drugs.
A huge thank-you is due to the New Taipei City pharmacist who last month spotted the fake tablets and sent them off for testing, but so many others — the authorities who allowed a nursing home to stay open despite multiple code violations or those responsible for a leaky pharmaceutical purchasing and oversight system — should face public opprobrium.
This article has been corrected since first published to indicate that the main suspect in the Taibao case was free on bail at the time of that incident, not still out on bail today.
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