North Carolina pharmacy regulators weren't inspecting a fifth of the state's 2,700 drugstores over a period of at least six years, and mistakes such as dispensing the wrong medications or shorting patients on prescriptions may have been overlooked, state Auditor Beth Wood's office said Thursday.
The North Carolina Board of Pharmacy's seven-person inspection team and lack of deadlines for site inspections meant that more than a third of the state's pharmacies hadn't been checked for four years or more during the yearlong period of the audit, ending in September 2012, according to the findings.
State Auditor Beth Wood said it would be impossible for inspectors to see every pharmacy a year. "If you look at how many pharmacies there are and then you look at how many people they have and you look at how long it takes to perform one inspection — it's easy to see each inspector would have to perform one inspection per day, 365 days a year," she said.
The board regulates more than 2,700 pharmacies, 10,600 pharmacists, 15,000 pharmacy technicians, and hundreds of other physicians, nurse practitioners and others. The board receives no state funding; its activities are supported entirely by about $3.5 million in licensing and other fees.
Person Street Pharmacy in Raleigh was recently inspected by the board. Owner Mike James said the inspection process is extensive, Its owner told us the process was quite extensive looking at everything from records to how pharmacists interact with customers.
"Most pharmacies have been in business a long time - have practice standards in place and they know what they are doing," James said.
The pharmacy board says it acts on complaints and concentrates on about 300 inspections a year at pharmacies where there may be a problem. The pharmacy board said that means routine inspections get a lower priority, but each is scheduled to be checked every four years. Initial applications for a pharmacy permit also get thorough reviews, the board said in its response to the audit.
"This reduces the risk of 'bad actors' obtaining a permit in the first instance," pharmacy board's response said.
The board said the audit pointed out that tracking on paper which pharmacies have gotten routine inspections had record-keeping shortcomings that "did not sufficiently guarantee that pharmacies selected for inspections were completely new every year." The board's database has since been overhauled to run electronic reports.