Servier Pharma - PBS Contents short filling

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This is my first post here. Rather it was a bit more upbeat but this is a rort. I just posted this Servier International’s FB page. Has anyone else had this experience & where is the best place to complain?

My doctor has prescribed perindopril arginine 2.5mg for high blood pressure. I have been buying it Prexum which is your product packed at 8 Cato Street, Hawthorn, VIC 3122 Australia. More than half of the sealed containers have less than the 30 tablets the label says. They are often 1-2 tablets short and I have found one that was 6 tablets short. That’s 20% down on what was supposed to be in the bottle. They are never over the 30 tablets. I can only assume that this is deliberate rorting of customers by Servier. So greedy you have to rip off sick people.

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Welcome.

Thank you for sharing your observations and the cautionary.

The first place to go could be the dispensing chemist. If the script is for 30 day’s supply it is what should be dispensed. If the chemist can’t supply an alternative, ask them to count the contents out before you accept the product and pay for it, given your observations.

It may be worthwhile going to a different chemist in future if the that is reasonable and asking for them to ensure you receive a full 30 days supply.

All our PBS medications now come in blister packs, although I have seen some other products loose in bottles. The quantity is assured by the packs.

And yes, there may be a broader issue if the system permits or the supplier is able to short fill the containers without industry recourse.

Note:
There are three PBS listed brands, although one of these has a premium cost.

http://www.pbs.gov.au/medicine/item/9006B

The product provided under the Apotex branding was the subject of a recall in 2017, if that is a guide to that suppliers reliability?

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What does the labelling on the medicines indicate…is it contains 30 or contains approximately 30?

I assume from your response that it is ‘contains 30 tablets’ or similar.

Maybe not. It is possible that there could have been a counting issue with the batch of medicines when dispensed into the bottle. If one fill a prescription using the same pharmacist, one could be buying the same batch(s) of medicines each month which have a counting error.

It is possible that Servier is not aware of the issue and once known, may be able to work out affected batches. It is worth adding to your FB post the batch number of the perindopril arginine as this will do two things, prove that you have purchased the medications making it more likely that Servier will respond…and secondly, allow Servier to investigate further based on the batch number and take action where necessary (e.g. advising pharmacist of the potential under-counting with some batches or ask for the affected medicines to be returned to Servier).

The batch number will be printed or stamped somewhere on the packaging. Note; every dispensed medicine under the PBS is required to have batch numbers on the packaging.

@mark_m is also correct to raise this with the pharmacist and to get the pharmacist to also count the number when dispensing the prescription. If the pharmacist confirms the under-counting of tablets in the bottle, they can also rectify this for you when dispensing and also follow up Servier as well (which they are likely to do to get credit for missing tablets they now will have to make up from other bottles)…

Just for information, the under-counting would come under the responsibility of the National Measurement Institute. The NMI is responsible for product, including healthcare, weights and measures.

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Prexum should be 30 count according to healthdirect.

Contact the chemist who dispensed it as a first ‘stop’. It would be best if you got their reply in writing/email rather than verbal. Verbally communicated problems sometimes get lost or fobbed off.

As a prescription drug it is not obvious the National Measurement Institute is the best place to complain but it could not hurt. The Therapeutic Good Administration oversees all medicines and should be interested. They have a page explicitly referencing problems with packaging and storage including a link to the appropriate form.

Please let us know what responses you receive as it would be broadly educational.

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Thank you. That’s useful.

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It definitely says 30 tablets. The reason I say it is deliberate is because it is always less, never more. If it was a counting problem then you could assume that sometimes there would be more.
I’ll take your advice & find the batch number. I’ve had this medication from 3 different chemists & it has occurred with 2 of them. The 3rd I only bought from once.

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I have spoken to 2 of the chemists. The first one the staff were useless. He just walked away, didn’t know how to handle it. I will take it up again with the chemists & mention that it’s not a very good look for them if a supplier is under-counting.

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Great that you have raised it with two of the chemists.

Hopefully you were talking to the head pharmacist and not just one of the everyday counter staff?

The link to the TGA form per @PhilT is also a very useful option. Someone will have to respond, in particular if you can provide details of the product, batch no’s and chemists. Sometimes it helps to approach an issue using more than one strategy.

Handing each Chemist a written complaint in person might help with keeping the Pharmacists attention, looking for their email contact or asking them for it and emailing the complaint is another way to heighten interest. It also as @PhilT suggests creates a permanent record of the complaint.

It may be the pharmacist simply accepts the prepackaged tablets as is. It is still their responsibility to remedy with the customer any issues with the supply of the product.

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No, most counting machines for tablets count up.

They are either trays/racks which have holes for the tablets to fall (say 30 hones per tray) and they are released from the tray/rack into the containers. In such case, if a hole for example is restructed for some reason and a tablet can’t go in, it means that the container will contain less tablets.

Another type of counters is optical sensor whereby they count the number entering the bottle. It is possible that the counter is counting phantom pills. In such case it would be counting more than actual tablets entering the container. An optical sensor may have a fault where it fails to could all tablets which would result in over-counting (more tablets in a container).

The third method is a weighing method whereby the mass of say 30 tablets is known. The containers are filled until the required mass is achieved. I understand that weighing is less common for small tablets as the variation in container weights can impact on the amount of the contents.

If I get a chance, I’ll see if I can find some videos of the above tablet machines.

I wouldn’t be jumping to any conclusions as it is likely that the filling machines are more likely to under count that over count.

I also wouldn’t be complaining to say the TGA until you have heard back from Servier. It is possible it can be resolved without regulator intervention. The regulator should only be involved if the response from Servier is not acceptable.

They might also advise the TGA is aware of the problem, which means complaining to the TGA might be a wasted effort or result in additional impacts on Servier and the TGA as both may need to investigate and respond to a cpmplaint.

It is possible that Servier do a particular medicine container filling in batches at different times based on demand. Most companies do as it reduces setup and cleanup costs…which can be significant where decontamination is required as that which I imagine would be the case for medicines. Decontamination would be required for medicines to prevent one medicine contaminating another during processing and container filling.

For example, they may produce tablets in containers every three months, store and then ship out when orders come in. If the under counting has occurred during the whole of the bottling run, they may have month(s) worth if stock affected, which is why one may go to a number of different pharmacists and find the same problem…as they were all produced at the same time.

You are lucky to pick it up as many people possibly don’t count every bottle. They (Servier) hopefully will appreciate your sleuthing efforts.

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Here are some examples of

Apologies if you decide to watch them as they are not the most rivetting videos one will ever see.,but it is interesting to see how they separate bulk tablets into packed sizes. There are also similar videos for blister sealed packaging as well…techniques are generally similar to the tray type systems for containers.

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While there could be myriad reasons for a short fill, the reality is there are reported to be more than one instance of being shorted. That implies poor QA at the best.

The TGA should be notified regardless in my opinion, because if it happened again for any reason there would be no record of oversight.

I trust you do have some kind of evidence, and if not perhaps should wait for a documented repeat of the shorting before formalizing a complaint.

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You do need to complain to the TGA, the under dispensing of medication is a very serious issue. One is that the PBS system may have paid for a set quantity and this then can be fraud as the company is gaining a benefit while failing to supply the required amount to match that benefit or another can be at the very least an indication that the company has no proper quality control that is required under the legislation.

If Servier are contacted as well that is a personal option to do so but not contacting the TGA is unwise because this may be a systemic issue at Servier and TGA will need to investigate.

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Yes, mechanisation is a marvel that we all accept as the perfect solution?

Who knows where the product was packaged, or by what means the product was counted. Perhaps it was done locally and manually using any one of a number of more traditional methods. It’s speculation that does not resolve the issue at hand.

I ‘d prefer to know what Servier’ have to say to the TGA.

@Spinner has sensibly asked if any one else in the community has a similar experience. As a jogger it also asks whether we should also check the count in loose fill containers.

It appears @Spinner has sourced product with the same short count problem from more than one pharmacy. Should the customer need to be the detective? As a consumer it should be enough to raise the issue with the supplying pharmacy, and if not to escalate as appropriate. The TGA’s role is self evident.

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