Note: This is very different in topic and tone from what is usually published on this site. However, drug quality control is an important issue and by reposting from Facebook, a link is generated that can be shared beyond its “walled garden.”

June 20, 2017

ATTN: Sandoz | Novartis | Sandoz Global re The Drug Safety Team:

My 90 year old mother has been taking Triamterene, a blood pressure medication for years. Since she’s made it to 90, it’s been a boon. Thank you. However, a radical reconfiguration of the pill shape in the most recent refill of her prescription at Walgreens caused her concern. It did not match the “bow tie” illustration on the prescription, nor did it match any of the pill shapes that came up for the Triamterene on a Google image search. We talked to the pharmacist who showed us the bottle from which the new pills had come, noting that the bar code for the medication had also changed.

To be absolutely sure that it was the correct drug, my mother — a retired librarian who was in charge of buying science books for a major library and who knows a thing or two about chemistry — tried to reach Sandoz. She got a run-around, so I tried.

1) The first time I called, I was connected to the Drug Safety department where I went through several rounds on hold (listening to some notably depressing music) alternating with a recording of “All our customer service representatives are busy…” Eventually, I was offered the option to leave a message. Questions about drugs can be life and death issues. If a customer is concerned enough to call, the customer does not want to “leave a message” hoping that someone will eventually listen to it.

2) I called back to ask for an executive in charge of Quality Control. The man who answered the phone identified himself as a security guard who did not have the authority to connect me to a department unless I could supply a specific name. It seemed remarkable that a security guard, likely being paid by the hour, was public-facing literal gatekeeper of a sophisticated multinational pharmaceutical company such as Sandoz. How can that be possible?

3) Since I have a strong background in science and technology journalism, I knew I could find names of executives, so I did. Messages were left for Peter Goldschmidt, President, and Victor Carbone, VP Quality, but so far have not been returned. I finally got through Leslie Pott, VP of Communications, who understood the potential seriousness of the issue and promised to forward my concerns to someone who could provide and answer.

4) A few hours later, I received a voicemail from a Drug Safety Team member who had seen the image I have attached to this post, which had been sent in emails to Ms. Pott and to Kevin Cook, VP Supply Chain (his response via phone, btw, was spot on: concerned and appreciative of the feedback). The customer representative did not give his name, but provided a general call back number.

5) I called back this morning and spoke to someone named TJ. I offered to email the pictures so he could see for himself the different pill configurations to better understand the issue.

a) It turns out that there is no way for the Drug Safety team to receive or send email with customers. TJ could only provide a verbal answer. I want a written response, something I can share with my mother and have for our files.

b) I asked to speak to a manager. I was put on hold while TJ looked for one, but no manager was available. TJ offered to take information to send in a report. If my question was deemed worthy, someone would get back to me. The implication was that if the question weren’t deemed worthy, they wouldn’t. Again, drug questions can be life and death, so that option seemed pointless. I need an answer now.

c) I asked who was in charge and was told that the regular manager was away for the day and there was no one available.

At the risk of sounding like a stuck record, drug questions can be life or death so a quick response based on as much information as can possibly be supplied, including emailed photographs, not only is important, but critical.

I told TJ that I would post this on social media, hoping that the potential embarrassment would prompt some common sense action. Apparently not.

Drug companies use suppliers from all over the world. Pills can come from India as easily as Indiana. Quality control is key and the pharmaceutical companies are in the best (only?) position to assure customers.

So… Mr. Goldschmidt, Mr. Carbone, please take some responsibility for your company, look at the evidence and respond in writing confirming whether the pill on the left and the pill are right are in fact the same drug at the identical dosage, or not.

I would appreciate an answer today.