OTTAWA REPORTS PROGRESS IN DRUG FRAUD CRACKDOWN

Officials audit Indian and Inuit health program

OTTAWA - Health Canada concedes its health-benefits program for native
people is being defrauded by drug abusers and traffickers, but says it is
making progress in an ongoing crackdown.

But officials stress the problem is not an ``aboriginal problem'' and they
are targeting physicians and pharmacists in a bid to end the fraud.

Audits are under way aimed at two longstanding problems - the
overprescribing of drugs and the fraudulent billing of the government,
officials said yesterday

Health Canada officials were reacting to CBC Radio reports this week on the
problem.

But they say they took action long before the broadcast reports. ``It's
almost impossible to define how big the problem is,'' said Jay Wortman, a
senior Health Canada official.

``We're in the process of devising ways to run a tighter ship, so we're not
as vulnerable.''

The federal program, available to some 656,000 Indians and Inuit in Canada,
has long been easy prey for those who use it to acquire painkillers,
tranquilizers and the so-called benzodiazepine drugs through physicians who
overprescribe and pharmacists who look the other way.

The program does not require the patient to do any paperwork. The billing
is between the dispensing pharmacist and Ottawa.

Ottawa spends more than $1 billion on aboriginal health care each year,
$180 million of that on prescription and over-the-counter drugs and medical
supplies.

In his autumn, 1997, report to Parliament, Auditor-General Denis Desautels
highlighted the problem of pharmaceutical use among Indians.

He said the staggering misuse of prescription drugs ``holds serious
consequences for native health.''

Although Health Canada had been aware of the problem for 10 years,
Desautels found no change in the ease with which prescriptions were
obtained.

His staff, over a three-month period, were able to identify 15,000 people
who had prescriptions filled at three or more pharmacies, another 1,600 who
were able to obtain more than 15 different drugs and more than 700 persons
who had more than 50 prescriptions filled.

Maurice Switzer, a spokesperson for the Assembly of First Nations, said any
program that size is vulnerable to unscrupulous behaviour and glitches.

``We're as concerned as anyone that the problem exists,'' he said. ``But
we're concerned people tend to think of these things as `Indian problems.'
It's not. It's a pharmacists' problem.''

Federal Health Minister Allan Rock said a system now in place will allow
pharmacists at the point of sale to determine whether prescriptions are
fraudulent.

Ongoing Health Canada audits search for patterns which could pinpoint
doctors, pharmacists or patients who are abusing the system.

The first crackdown in Alberta has had positive results.

Dr. Harry Hodes, Health Canada's assistant regional director for community
health programs, said over the past two years there has been a 25 per cent
reduction in the dispensing of anti-anxiety drugs and a 20 per cent drop in
dispensing of painkillers.

As a result of the Alberta crackdown, Hodes said, four doctors voluntarily
retired from practice, six others were sent for retraining and an
unspecified number were warned by the Alberta College of Physicians and
Surgeons.

Action has also been taken in Manitoba against doctors and pharmacists.

Hodes said there has been a $200,000 saving to the government. ``I think
you'll start seeing similar results across the country,'' he said.

Both officials said studies showed the fraud rate to be identical, if not
higher, in provincial drug plans.

Checked-by: (Joel W. Johnson)