VA Health Care

Pursuant to a congressional request, GAO examined how Department of Veterans Affairs (VA) pharmacies controlled prescription drugs that were potentially addictive and assessed VA procedures for: (1) safeguarding those prescription drugs; and (2) detecting thefts of such drugs for personal use or resale.

GAO found that: (1) VA had inadequate internal controls over many addictive prescription drugs used in its health care system; (2) drugs were categorized, based on their potential for abuse or addiction, in one of five groups or schedules, with the lower schedules having the highest potential for abuse; (3) VA required its hospital directors to report thefts and significant losses of scheduled drugs to the Drug Enforcement Administration; (4) working stocks of lower scheduled drugs were at significant risk of theft, given the large numbers of pharmacy employees and others who routinely had access to the drugs; (5) of the nine pharmacies visited, only one locked up all lower scheduled drugs; (6) VA required each pharmacy to maintain an internal audit system that included unannounced inspections of higher scheduled drugs; (7) VA required pharmacies to maintain drug receipt and dispensing records and to make annual counts of all lower scheduled drugs, but did not require reconciliation of the records with the physical counts of those drugs; and (8) lack of inventory controls hampered theft detection and investigation, making it impossible to know the magnitude of lower scheduled drug losses.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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