Online pharmacy fined, barred from filling prescriptions for Iowa patients

The Iowa Board of Pharmacy has fined an online pharmacy $10,000 and temporarily barred it from filling prescriptions for Iowa patients.

In June 2022, the board charged Mint Pharmacy and Skin Clinic of Florida with dispensing prescription drugs solely on the basis of an Internet questionnaire; failing to provide counseling before a prescription order is delivered to a patient; failing to include on the label for a compounded drug all of the required elements; failing to comply with pharmacy standards when compounding nonsterile preparations; and failing to meet all inspection regulations and other requirements for the practice of pharmacy.

The board alleged that in April 2021, a state compliance officer purchased tretinoin cream – a product often used to treat acne — from Mint through the company’s website. To obtain the cream, the officer submitted an online questionnaire along with a photo of a baby doll. Board records give no explanation as to why such a photo was sent to the company, but it may have been to test the level of scrutiny given to patient photos.

One month later, a compliance officer purchased through Mint’s website a compounded product consisting of horny goat weed tadalafil, a drug used to treat erectile dysfunction.

In both instances, the board claims, the compliance officer was not contacted by the prescriber after submission of the online questionnaire and had no interaction at all with the prescriber.

The company’s compounding records indicate the tadalafil powder used to compound the drug in March 2021 had expired in January 2021, according to the board.

In resolving the allegations, the board and the company agreed to a settlement that calls for Mint’s nonresident pharmacy license to be placed on probation indefinitely and for the company to pay a civil penalty of $10,000.

Mint has also agreed that it shall not ship any prescriptions into Iowa until it receives written confirmation from the board that it has demonstrated, through an on-site inspection performed by a board representative, full compliance with Iowa statutes and rules.

Mint has also agreed to reimburse the board for the costs associated with each inspection, up to a maximum of $5,000 per inspection. The company must also submit to the board a periodic report listing all prescriptions shipped to Iowa patients and any disciplinary action taken against the company by other boards or entities. The report must also include any complaints pertaining to quality of care or products that are tied to Iowa patients.

In other recent actions, the Board of Pharmacy:

— Issued a warning to the CVS Pharmacy located at 2303 Merle Hay Road in Des Moines and fined the store $2,500. The board charged the store with unethical conduct and alleged that in November 2021, it had dispensed a new antibiotic prescription for a pediatric patient and attempted to have a pharmacy technician – rather than a licensed pharmacist, as required – provide the mandatory customer counseling. Investigators later determined the pharmacist at the store had directed technicians to provide the counseling on multiple occasions in violation of Iowa law.

— Issued a warning to pharmacist Natasha Konfrst of western Iowa and fined her $1,000 for engaging in unethical conduct and for knowingly advising another person to unlawfully practice pharmacy. Konfrst was accused of directing pharmacy technicians to provide customer counseling in violation of Iowa law.

— Issued a warning to dentist Michael Bierie of Dubuque and fined him $1,000 for issuing prescriptions for controlled substances while his Controlled Substances Act registration was expired sometime in either 2021 or 2022. The board alleged it had previously disciplined Bierie for the same issue. The Iowa Dental Board has never taken any disciplinary action against Bierie, according to state records.

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