A European community pharmacy-based survey to investigate patterns of prescription fraud through identification of falsified prescriptions.
OBJECTIVE
To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries.


METHODS
A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription forms. For each reported drug, the number of reported falsified prescriptions per thousand inhabitants was estimated. A falsification ratio was calculated by dividing the number of reports by the number of defined daily doses per 1,000 inhabitants per day for this drug, computed from national sale or reimbursement data.


RESULTS
On 862 prescription forms, benzodiazepines (zolpidem, bromazepam, alprazolam), buprenorphine (as an opioid maintenance drug) and tramadol were the most frequently reported. Depending on their level of use in each country, methylphenidate, morphine and flunitrazepam presented the highest falsification ratios, particularly in Spain, Belgium and France.


CONCLUSIONS
Stimulants, opioids and some benzodiazepines were the most frequently reported drugs in this survey on falsified prescriptions, but differences between countries were observed.
University of Toulouse UMR INSERM 1027, CEIP-Addictovigilance, Service de Pharmacologie Médicale et Clinique, CHU, Toulouse, France.
Maryse
M
Lapeyre-Mestre
Mireille
M
Gony
Alfonso
A
Carvajal
Diego
D
Macias
Anita
A
Conforti
Paola
P
D'Incau
Rob
R
Heerdink
Robert
R
Van der Stichele
Ulf
U
Bergman
D000701:Analgesics, Opioid; D001530:Belgium; D001569:Benzodiazepines; D002047:Buprenorphine; D000697:Central Nervous System Stimulants; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005060:Europe; D005602:France; D005607:Fraud / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008774:Methylphenidate; D009020:Morphine; D009426:Netherlands; D010594:Pharmacies / Q000706:statistics & numerical data*; D013030:Spain; D019966:Substance-Related Disorders; D013548:Sweden; D014147:Tramadol
D000701:Analgesics, Opioid; D000697:Central Nervous System Stimulants; D001569:Benzodiazepines; D008774:Methylphenidate; D014147:Tramadol; D002047:Buprenorphine; D009020:Morphine