In Florida, a paramedic was arrested after his supervisor allegedly directed him to falsify forms in order to help him steal doses of a COVID-19 vaccine.
In New York, a community health network reportedly to have fraudulently obtained COVID-19 vaccine and diverted it to members of the public.
Tom Knight, founder and CEO at Invistics, says he’s sure these aren’t the only instances: Many instances of drug diversion – medication theft – are never detected.
“Our experience has been the closer you get to the patient, the greater the risk of diversion,” Knight said in an interview with Healthcare IT News.
Invistics, a Georgia-based supply chain-management company, specializes in monitoring risk reduction when it comes to controlling drugs that might be stolen. In the past, those have often been medications like opioids, which could be stolen by providers to sell or use. Now, it may mean other high-value therapeutics – such as the COVID-19 vaccine.
Supply chain logistics have proved to be an enduring issue during the initial rollout of COVID-19 vaccines, with the importance of the “cold chain” looming large in preserving the medications’ integrity as it makes its way from distributor to patient. But those logistics present another potential snag: diversion.
“In a manufacturing plant you could have armed guards,” who prevent theft, Knight pointed out. But as a medication moves through the “chain of custody,” he said, “the closer you get to the patient, the less oversight there is and the easier it is to steal the vaccine or the medication.”
The decentralized and often ad hoc approach to COVID-19 vaccine management in many locations around the U.S. hasn’t helped matters.
“The fragmented controls are definitely a challenge and will lead to more diversion,” said Knight. He pointed out, for example, that in many areas pharmacists are being put in charge of delivering medications in their personal vehicles to nursing homes.
Most pharmacists, of course, are fulfilling their job duties in this regard – but the general lack of oversight means “the pharmacist could pocket vials for their own use,” he said. Similarly, Knight noted that some organizations are doing a “great job” investing in security and infrastructure. But not every facility has enough resources to do that, particularly amid “efforts to get this into arms.”
Invistics uses machine learning and analytics to flag suspicious signs of strange medication behavior. But, as other experts pointed out, the danger of vaccine stealing may go beyond physical security: There’s a potential cyber element as well.
“If sensitive formulas or research are stolen on how to produce the vaccine, other rival nation-states or even rogue laboratories could potentially produce illegal vaccines and sell them on the black market,” noted Trevor Daughney, vice president of product marketing at Exabeam, which develops security analytics technology.
“In addition, if distribution plans are found and downloaded, cybercriminals might become criminals in the physical world by tracking down and stealing shipments to sell,” Daughney added.
Daughney pointed to the usefulness of analytics in alerting systems to signs of trouble.
“Behavioral analytics tools … can be utilized to learn regular user behavior on the network and identify any anomalous activity, such as unusual access to sensitive research, production information or even distribution plans. Security analytics can also detect if this information is being exported to suspicious locations or IP addresses and immediately alert security teams,” he said.
The U.S. Food and Drug Administration is also using advanced analytics to flag fraudulent and unauthorized medical products during the COVID-19 pandemic as its “Operation Quack Hack” has reviewed thousands of websites, social media posts and online marketplace listings over the past year.
Ultimately, say experts, vaccine diversion – as with all medication theft – is a patient safety issue.
“The health of the global population and global economy depend on how well we can safeguard the vaccine supply and distribution chain to get enough people inoculated against COVID-19,” said Daughney.
“That’s the number one reason we’re working so hard on this,” agreed Knight. He noted that his company has teamed up with federal agencies to create a database, healthcarediversion.org, aimed at building transparency around medication diversion in general.
“There’s really big risks,” Knight continued. “This is happening surprisingly often.”