JAMA Report: HIV Drugs Targeted for Black Market Resale in the United States
A new report in the Journal of the American Medical Association examines how suspicious prescriptions for HIV medications indicate that HIV drugs are being diverted for resale on the black market.
The September 17th 2014 issue of the Journal of the American Medical Association (JAMA) reports that HIV medication is being purchased by devious means and then resold on the black market. Titled “HIV Drugs Targeted for Black Market,” the report theorizes, “expensive HIV medications are likely being targeted for resale on the black market.”
The report’s author, Bridget M. Kuehn, MSJ, cites a recent study by the Department of Health and Human Services (HHS) which found that of Medicare Part D claims for HIV medication in 2011-2012, “almost 1,600 Part D beneficiaries had questionable utilization patterns for HIV drugs.”
The HHS study found that questionable HIV medication beneficiaries “had no indication of HIV in their Medicare histories, received an excessive dose or supply of HIV drugs, received HIV drugs from a high number of pharmacies or prescribers, or received contraindicated HIV drugs (i.e., HIV drugs that should not be used in combination with one another). In total, Medicare paid $32 million for HIV drugs for these beneficiaries.”
The HHS study also found that beneficiaries that were questionable were most likely to live either in New York or Miami. The report describes a few examples of HIV drug prescription dispensations that were particularly egregious.
One example HHS cited was someone who had no medical record of ever having HIV: “In 2012, Medicare paid $33,536 for HIV drugs for a 77-year old Detroit woman who had no indication of HIV in her Medicare claims history. She had prescriptions for 10 different types of HIV drugs prescribed by 6 different doctors. There is no evidence that she visited any of these doctors.”
Another example cited a beneficiary with a high number of pharmacies and prescribers. A 48-year-old Miami resident received HIV drugs from 28 pharmacies using 16 unique prescribing physicians, which included 15 different types of drugs. The beneficiary received excessive doses and excessive supplies during the year. In total, Medicare paid $198,272 for the HIV drugs for this beneficiary.”
Ms. Kuehn spoke with Dr. Aaron S. Kesselheim of Harvard Medical School, who warned physicians to guard against identity theft by protecting access to Drug Enforcement Administration numbers, prescription pads, and other medical information. “Physicians should be aware of the potential for identity theft because substantial profits can be made from diversion of prescription drugs,” Kesselheim said.
In the last year there have been at least three different high profile HIV drug diversion cases in the United States. The Department of Justice (DOJ) describes a 2013 case from Texas, where two prescription drug wholesalers pleaded guilty to running a prescription harvesting scheme for HIV drugs.
In New York, indictments have been handed out to a Queens pharmacist who is alleged by the DOJ to have purchased HIV medications and other prescription drugs from poor patients for resale on the black market. Additionally, the DOJ reports that several arrests have been made at a Bronx grocery store that trafficked in expensive HIV medications purchased from local residents who had them prescribed for their HIV infections.
To learn more about the problem of HIV drug diversion in the United States, download Black Market HIV/AIDS Drugs in the News, 2006-2013.