Expired antitumor drugs in QSUNT/ Risking continuation of treatments for cancer patients

2026-02-05 11:09:00, Denoncim CNA

Expired antitumor drugs in QSUNT/ Risking continuation of treatments for cancer

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The Supreme State Audit has discovered numerous problems in the management of antitumor drugs at the "Mother Teresa" University Hospital Center.

According to the report of the "2025 thematic audit on the availability of drugs for the treatment of tumor diseases", many drugs have expired, but are still listed in the electronic inventory system of the Central Pharmacy, artificially increasing the state of drugs and jeopardizing the continuation of treatments for patients with tumor diseases.

Among other things, the report provides examples of specific cases of expired medications.

It is emphasized that: 19 vials of Ifosfamide 1 g and 602 vials of Methotrexate in two dosage forms: Solution for injection and infusion x 500 mg (in 10ml or 20ml) with 372 vials and Solution for injection x 50 mg / 2 ml with 230 vials, despite having expired, are still in the Pentaho system, posing a risk of keeping expired stocks in the system and artificially increasing the state of drugs in the system, despite the provisions of Article 4 of the supply contracts. For the drug Ifosfamide 1 g, from 28.08.2024 to 01.05.2025 the progressive state is 19 units in the DMM. Despite the fact that the state is presented as 19 units, verification in the system resulted in the result that this quantity belongs to lot L01AA06 with no. serial number 28E8 and expiration date 28.02.2019.

So, practically the actual situation in the DMM as of 28.08.2024 has been 0 (zero). Also, for Methotrexate, in two dosage forms, the audit evidences a total of 602 vials that have expired: 372 500 mg vials and 230 50 mg/2 ml vials.

The Supreme State Audit Office emphasizes that the stock of expired medicines is not just statistical information, but indicates gaps in inventory management.

"Even if expired drugs cannot be used by operators in the discharge process, their presence in stock brings negative consequences, artificially increasing the situation and slowing down the efficient circulation of drugs. This situation can cause shortages of drugs necessary for treatment, directly affecting the service to patients," the SAI report highlights.

The report also highlights weaknesses in contracts and management.

"The supplier company cannot have information about whether the supplied drugs have been used or not and whether their expiration date is approaching. Under these conditions, it remains the duty of QSUNT to notify the supplier company of the withdrawal of these drugs, where the notification must be made within the contract period," the report emphasizes.

The audit also reveals that the budget allocated for medicines is insufficient, increasing the risk of drug shortages and interruption of therapies.

According to the HSE, the budget allocated to the health sector, namely for medicines, is underfunded, which brings the risk of a shortage of medicines and consequently the continuation of therapies in accordance with disease treatment protocols.

The SAI recommends that the Director General of the QSUNT take measures to establish a working group to verify all drugs used in the treatment of tumor diseases that are found to be expired, with the aim of identifying those responsible for non-compliance with contracts and destroying the quantities of expired drugs.

The audit suggests improving procedures for 24-month drug planning and notifying suppliers of drugs approaching expiration to ensure replacement with valid drugs.

The Albanian Supreme Audit Office (ALSH) underlines that poor management of antitumor drugs and the lack of effective mechanisms for the withdrawal of expired drugs directly endangers the lives of cancer patients, creating a critical situation in the QSUNT that requires urgent measures./ CNA