City workers bill health plan $1.9 million for erection drugs
Beverly Romeo-Beehler said Tuesday that city workers claimed $1.9 million worth of sex enhancers last year.

thestar.com
By David Rider
Oct. 25, 2016

City workers made millions of dollars in questionable claims for large quantities of erectile dysfunction pills and highly addictive opioids including Fentanyl, the city’s auditor general says.

Beverly Romeo-Beehler said in a report Tuesday that workers claimed $1.9 million worth of sex enhancers Viagra and Cialis last year alone, noting the benefits plan funded by the city and managed by Manulife includes no maximum.

Her findings on the anti-impotence pills include:

• For Cialis pills, 16 claimants were reimbursed between 395 tablets (a 13-month supply) and 600 tablets in at least one of the years 2013, 2014 and 2015.
• A “number” of them were also reimbursed for on-demand erectile dysfunction drugs in addition to the Cialis once-a-day drug.
• The city’s cost for erectile dysfunction drugs rose 18 per cent between 2013 to 2015.
• Some 65 claimants were reimbursed an annual quantity of 180 tablets or more in at least one of the years studied.
• “It is possible that the large quantities of drugs reimbursed may be medically justified. However, it is important that City staff follow up with Manulife,” the auditor-general concluded.

She notes that the city reimburses another $2 million-plus per year for prescription opioids, including Oxycodone and Fentanyl, plus $500,000 annually for prescription sedatives and $700,000 for prescription stimulants.

Her findings include:

• Sixteen claimants were reimbursed an equivalent of 2 years or more supply of Oxycodone and/or its brand-name version within a one-year period.
• The annual quantities reimbursed for “several” claimants were at least four times the maximum annual supply.
• Thirty-two claimants, including four retirees, were reimbursed for more than 18 months’ supply of Fentanyl patches over one year. The annual quantity provided to them at taxpayers’ expense ranged from 19 months to more than six years of supply.
• Some 44 claimants were reimbursed for a two-year supply of prescription sedatives, including benzodiazepines, within one year. Three of them were reimbursed annual quantities equivalent to four to six years of supply.

Over the five-year period from 2011 to 2015, the city spent, in total, more than $250 million for drug benefits.

Romeo-Beehler made 18 recommendations for tightening controls that she said could save the city $900,000 a year, and a one-time sum of $180,000 that could be recovered from Manulife.

She also noted that Manulife’s contract to oversee the city’s drug benefits ends this year, and her findings should strengthen the city’s oversight of benefits in a new five-year contract with Green Shield Canada.

Councillor Stephen Holyday, a member of the audit committee that will discuss the report Friday, said he felt “a real sense of urgency from the auditor” to fix the problems. “This is all taxpayer money and at the end of the day it’s important we keep an eye on it.”

Holyday said he has no medical expertise but questioned the huge amounts of sex-enhancement drugs being claimed and also the drugs including Fentanyl.

“If there are people on the job using those quantities of opioids, you really have to ask if anybody’s monitoring that - and I don’t have confidence we are,” he said.