Toronto’s auditor general is calling for a review of drug benefit claims for erectile dysfunction medication and opioids by city workers after “excessive quantities” of the drugs were reimbursed.
In a report to the city’s audit committee, Beverly Romeo-Beehler made 18 recommendations aimed at tightening up the claims process after her office analyzed reimbursement data from 2013 to 2015 and found several “instances of potentially excessive claims.”
Romeo-Beehler looked at controlled substances and learned 27 claimants were dispensed the same prescription opioid at different pharmacies on the same days.
In another instance, she found 16 people had a two to five years’ supply of oxycodone in at least one year. She also found 32 people who had 19 months to over six and a half years’ worth of Fentanyl patches in at least one year.
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Romeo-Beehler also reviewed claims for erectile dysfunction drugs and found the city spent $1.9 million on the medications. Five people were each reimbursed over $5,000 last year and 37 people submitted claims each for over $3,000.
The City of Toronto doesn’t have a maximum coverage limit on erectile dysfunction drugs, but Romeo-Beehler said the city could potentially save $750,000 if a $500 annual cap was put in place.
She said the city could potentially save over $900,000 annually as well as recovering $180,000 in dispensing fees.
Mayor John Tory said during a press conference Wednesday that the findings from the auditor general’s report should be pursued on “a very aggressive basis.”
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“Anybody who is found to have defrauded the system should be dealt with very harshly and I would suggest that termination is an appropriate kind of penalty for that sort of thing,” Tory told reporters.
Tory said the city might consider putting a cap on erectile dysfunction drug reimbursements.
Councillor Stephen Holyday, who is vice chair of the audit committee, said he wants to see information from other large organizations on how the drug claims compare.
“It certainly is a lot of money and we have to remember it’s taxpayer money that is paying for this … but the auditor has certainly caught their attention, and it’s caught ours as well.”