State Office for Pharmacy Services

This is a Massachusetts State Auditor performance audit of the State Office for Pharmacy Services, which manages pharmacy services and drug purchasing for many state agencies.

“I am pleased to provide this performance audit of the State Office for Pharmacy Services.”

Auditors reviewed whether SOPS was doing its job: providing state agencies with pharmacy services in a cost-effective way.

“In accordance with Chapter 11, Section 12, of the Massachusetts General Laws, the Office of the State Auditor conducted an audit of SOPS for the period July 1, 2010 through February 28, 2013 to determine whether SOPS was fulfilling its mission of providing comprehensive pharmacy services to state agencies in a cost-effective manner.”

This matters because the audit involved public money, state health services, patient safety, and public trust in how pharmacy contracts were managed.

“Potential conflicts like this, if they are not properly identified and effectively and transparently mitigated, can create a perception of misconduct that could undermine the public’s trust in SOPS and the integrity of its services.”

For an ordinary citizen, the issue is whether taxpayer-funded pharmacy services were being run safely, efficiently, and with proper oversight.

“By not meeting USP requirements, SOPS significantly increases the risk of patients’ exposure to contaminated pharmaceuticals, serious infections, and possibly death.”

The Auditor found that SOPS had multiple oversight and compliance problems, including possible extra costs, weak fee controls, and safety standard issues.

“As a result of various issues (system incompatibilities; online prescription ordering systems not being used at all pharmacy locations; and prescriber, nursing, and pharmacy personnel not maximizing the use of SOPS’s pharmacy information and ordering system), as much as $10 million was unnecessarily charged to state agencies for additional labor costs in order to compensate PDC pharmacists and pharmacy technicians for performing prescription data reentry and reverification tasks.”

The report recommended tighter conflict-of-interest rules, better computer systems, stronger fee controls, required legislative reporting, full sterile compounding compliance, and action on agencies that were not using SOPS as required.

“SOPS should establish adequate internal controls over program contract fees, including written policies and procedures as well as documentation of the program contract fees charged to each agency, the services provided, and the use of the fees.”

The report is significant because SOPS handled large pharmacy contracts and purchases, including more than $27 million paid to CPS during the audit period.

“For our audit period, SOPS disbursed more than $27 million to CPS for pharmacy-management services on behalf of state agencies receiving services through SOPS.”

Pharmaceutical compounding means a pharmacist or technician custom-mixes or changes ingredients to make a medicine for a specific patient’s needs.

“Pharmaceutical compounding is a practice in which a licensed pharmacist or pharmacy technician combines, mixes, or alters ingredients in response to a prescription to create a medication tailored to the medical needs of an individual patient who may, for example, need the alterations because of allergies to regular pharmaceuticals or need the medication in a different form, such as pill or liquid, that is not currently available.”