Fiscal Year of 2004: Federal Bureau of Prisons Pharmacy Services Statistics
Compiled by K. Cole
The Federal Bureau of Prisons' (BOP) stated mission is "to protect society by confining offenders in the controlled environments of institutions and community-based facilities that are safe, humane, cost efficient, appropriately secure, and that provide work and other self-improvement opportunities to assist offenders in becoming law-abiding citizens. [Drug] Treatment programs assist the inmates in identifying, confronting, and altering the attitudes, values, and thinking patterns that led to criminal behavior and drug use."
The BOP is comprised of six major types of institutions, each of which generally have pharmacies:
(1) Medical Referral Centers (medical centers)
(2) Federal Correctional Institutions (FCIs)
(3) United States Penitentiaries (USPs)
(4) Metropolitan Correctional Centers (MCCs)
(5) Federal Detention Centers (FDCs)
(6) Federal Prison Camps (FPCs).
The BOP medical centers provide acute medical services, including surgery, cancer treatment, and long-term care. Although there are only seven BOP medical centers, they account for the largest amount (37 percent) of the BOP's total prescription medication costs, as shown in Figure 1.
FIGURE 1. THE BOP PRESCRIPTION MEDICATION COSTS BY INSTITUTION TYPE FOR FY 2004
In FY 2004, the BOP spent $50.73 million on prescription medications and related supplies, representing an increase of 10 percent over the prior fiscal year. On average, there has been a 23-percent annual increase in the BOP's prescription medication costs since FY 2000. Furthermore, in FY 2004 the BOP spent a daily average of $0.92 per inmate on prescription medications. On average, the daily prescription cost per inmate has increased annually by 16 percent since FY 2000, as shown in Figure 2.
FIGURE 2. BOP DAILY PRESCRIPTION MEDICATION COSTS PER INMATE
As of March 2005, there were a total of 6,910 inmates who were being treated with one or more psychiatric medications within the BOP.
BOP - Clinical Practice Guidlines for Psychiatric Evaluations
In FY 2004, $12 million of the $50.73 million in total BOP prescription medication costs were related to psychiatric medications, as shown in Figure 3.
FIGURE 3. THE BOP PRESCRIPTION MEDICATION COSTS BY TYPE
FOR FY 2004 (in millions)
Prescription Medications Purchasing
The BOP utilizes the Federal Supply Schedule (FSS) for the majority of its prescription medication purchases. The FSS has a price catalog of over 23,000 prescription medications that are available for purchase by federal agencies. In addition to the FSS, the BOP utilizes specific contracts with prescription medication companies administered by the Veterans Administration (VA). The BOP purchases over 40 prescription medications through “Mandatory National Contracts” administered by the VA, which require that each institution buy specific prescription medication brands. These contracts provide the BOP with prices lower than the FSS, and include some frequently used medications, such as Tylenol®, Advil®, Aleve®, and Zocor®.
The lack of internal controls over the purchasing of prescription medications at BOP institutions allowed a Chief Pharmacist at the El Reno FCI to illegally purchase four different brands of non-formulary prescription medications. An OIG investigation found that he stole a total of 30,600 doses between July 2002 and February 2004, for his personal consumption. This individual's purchases included Fioricet®, Soma®, Ultram®, and Mobic®, and cost the BOP approximately $1,567 with a retail value of approximately $28,700. In lieu of prosecution, the Western District of Oklahoma offered the pharmacist a 1-year Pretrial Diversion Program and if all conditions are met, he will not be prosecuted. Adequate segregation of duties for purchasing and receiving of controlled substances would likely have prevented this theft.
References:
http://www.usdoj.gov/oig/reports/BOP/a0603/intro.htm
http://www.usdoj.gov/oig/reports/BOP/a0603/findings.htm#IIe
