The Darkside of Hospital Pharmacy Outsourcing?

Implications: A new article is highly critical of the pharmacy outsourcing businesses run by the big 3 wholesalers -- AmerisourceBergen (ABC), Cardinal Health (CAH), and McKesson (MCK). But after reading the article, I’m still not sure whether (a) there systemic flaws in the wholesalers' pharmacy outsourcing business or (b) the story simply highlight the tragic mistakes of a few individuals at a single facility.

Analysis: This article describes the sad case of Alyssa Shinn, a premature baby who died after being given a fatal overdose of zinc from her intravenous nutrition bag, apparently due to a mistake made in the hospital pharmacy.

As it turns out, the hospital pharmacy had been run by each of the big 3 wholesalers at some point during the past 10 years.  However, UHS was apparently managing the pharmacy at the time of Alyssa's death. This story was also featured on the TV show Nightline. (Watch the video clip.)

According to Katherine's article, about 440 U.S. hospitals outsource the management of their pharmacies.  After I read the article, I asked Katherine for her perspective on independent pharmacy managers (such as Comprehensive Pharmacy Services) versus pharmaceutical wholesalers. According to Katherine: "From what my reporting is telling me, I think they probably are better -- in large part because their sole focus is to improve pharmacy performance."

But just in case you miss the point, the article's subtitle reads: "Hospital pharmacies across America are being contracted out to companies with little or no medical expertise. Patients are paying the price."  

For those who don’t know, Katherine Eban is the muckraking author of 2005's Dangerous Doses, a critical look at the since-ended practice of secondary trading by large drug wholesalers.