The controls, carried out by the Guardia di Finanza, refer to alendronate and similar active ingredients. Only in Catania is there a wall-to-wall situation, but the problem affects the whole of Sicily.
Mauro Miserendino – Wednesday, 25 February 2015 – Doctor33
In addition to evaluating the strike, the Italian Doctors Union is verifying the illegitimacy profiles of the work of the Asp 3 health company in Catania after the latter communicated to a few hundred family doctors that it had reported them to the Court of Auditors for prescriptions inappropriate for osteoporosis.
The controls, carried out by the Guardia di Finanza, refer to alendronate and similar active ingredients. The national secretary Smi Pina Onotri in a press release speaks of "witch hunts" and investigations "Italian-style: costly and useless". Only in Catania is there a wall-to-wall situation, but the problem affects the whole of Sicily, as SMI regional secretary Paolo Francesco Carollo explains.
«The prescriptive criteria of the alendronate in Sicily are different from the rest of Italy; in June 2002 a resolution by the then councilor Ettore Cittadini allowed densitometry only in cases of hypogonadism, menopause before 45 years or "chemical", prolonged treatments with antiepileptics and anticoagulants, previous femur fractures or in 1st degree relatives, people very underweight (Body Mass Index less than 19), severe endocrinopathies.
This resolution has never been modified, neither in 2009 when note 79 of the Aifa National Medicines Agency intervened, nor in 2011 when the note was revised. The Aifa note in turn indicates densitometry as a necessary condition for prescribing alendronate in a variety of patients. Of course, the drug can also be prescribed to patients for whom densitometry is allowed in Sicily (women in early menopause, or subjects with previous fractures or those of their parents/siblings) but outside of the cases mentioned, if in the rest of Italy the The exam can be practiced, not in Sicily, and the alendronate is either prescribed without verification or it is not prescribed.
Hence the inappropriateness found, which should be evaluated in the light of the hierarchy of sources, Aifa decree against regional resolution, and which in the other Sicilian Asp is overcome by activating the channels of the agreement, primarily the update ". In Catania, however, the Asp recognizes an alleged tax damage. Smi wrote to the Councilor for Health Borsellino to ask for diriment rules; for the union, however, the Asp decision contravenes the national convention.
«An office for the coordination of district activities pursuant to article 25, paragraph 4 is responsible for monitoring the prescriptive activity of the mmg - says Carollo - and there is a procedure in article 27 to contest any irregularities in an internal hearing within the ASL. Furthermore, according to another regional decree, this time from 2007, the checks on the prescribing activity cannot go back to drugs dispensed more than 180 days prior to the activation of the check.
Therefore - assuming a maximum time of 60 days between prescription and dispensing of alendronate - if the control started now, it shouldn't have started with recipes from 2011 but with prescriptions from 240 days ago, May 2014. Therefore, the Local Health Authority's decision to prosecute doctors must be revoked".
