Rep. Elijah Cummings (D-Md.) launched an investigation into secondary drug distributors last year, alleging that some of the closely held distribution companies are engaged in drug speculation.
Last week, Cummings, along with Sens. Jay Rockefeller (D-W.Va.) and Tom Harkin
(D-Iowa), released a report providing information about the secondary drug distribution market and participated in a Senate Commerce Committee hearing about the gray market.
“Gray-market drugs leak out of authorized distribution chains, often through pharmacies that sell to wholesale distributors, and are sold to end users at aggressively marked-up prices,” the report's authors wrote. “The questionable business practices of the distributors and pharmacies engaged in gray-market sales result in higher healthcare costs and potential risks to patients.”
The report analyzed 300 drug pedigrees and found that distributors acquired nearly 70% of drugs sold into the gray market from pharmacies.
The California State Board of Pharmacy reached a similar finding after an investigation last year. Virginia Herold, the pharmacy board's executive officer, testified during the Senate hearing that the investigation was prompted by a pharmacist who inquired about the legality of buying drugs in short supply with the sole intention of selling them to a distributor.
The board found that 55 pharmacies in California had purchased drugs in short supply and sold them to Priority Pharmaceuticals, a San Diego-based secondary distributor, more than 500 times. The board cited and fined the pharmacies and pharmacists. Some of the pharmacies and pharmacists have appealed. Although Priority is listed in the citations, the board's investigation into the company is ongoing.
Patricia Earl, an industry analyst for the National Coalition of Pharmaceutical Distributors, a trade group that represents secondary distributors, argued during the hearing that secondary distributors are a valuable part of the supply chain, in part because they provide drugs to healthcare providers during off hours and to remote regions. Secondary distributors also serve as a backup source for pharmacies, according to the National Community Pharmacists Association.
As drug shortages have gained attention from lawmakers, so have the gray-market practices of some distributors. Several members of the Senate committee expressed concern about distribution chains that show a drug being bought and sold multiple times, each time with a markup in price.