Wednesday, February 27, 2013

I Think if I See One More Prescription for Tylenol, I'm Gonna Lose it

More and more, I feel like I am spending a TON of time filling prescriptions for over-the-counter medications. (For the non-pharmacist reader, many of these are covered under medical assistance plans -- and as such, need to be processed just like a prescription medication, with all the same procedures, record-keeping, etc.)    Now, this is not going to be a swipe against the "moochers" -- and believe me, I struggle with this, because I believe that the majority of people on assistance do NOT abuse it.   But even fellow pharmacists who've been doing this a long time are beginning to wonder how long we can keep it up.  Additionally, many of our customers on state assistance are immigrants (some might even say refugees) from other countries.   Now, if a child enters this country and immediately comes down with leukemia, I'd like to think we're not going to stand there and let him die.  We are better than that.  But how obligated are we are to cover prescriptions for (and to stock people's medicine cabinets with) things like Tylenol?   And hydrocortisone cream,  and every form of vitamin, Miralax, Compound W, Colace, saline nasal spray, simethicone,  Sudafed, Claritin, Eucerin, ibuprofen, calcium, iron, aspirin, Benadryl, Maalox, Milk of Magnesia,  Lotrimin cream,  Robitussin, artificial tears,  and many MANY others -- all things that most of us purchase on our own.

Inexpensive products..... BIG EXPENSIVE HEALTH CARE machinery behind them.  I think about it now every time I wade through those quality-assurance double checks of my saline nasal spray prescriptions.

We routinely have people bring us prescriptions for OTC's from a hospital emergency room.  We all know the cost of an emergency room visit,  and this is utter INSANITY.    There needs to be a way for people to get advice on minor health issues, (ask your pharmacist, maybe?)  and then be given a recommendation on what to go out and BUY for it.  To be sure, there are lots of very expensive drugs and medical procedures out there that the average person cannot afford on their own.   Tums is not one of them.

Monday, February 18, 2013

The Prescription Abuse Game

I've only worked about half my career in retail pharmacy (started in hospital) so I always thought of myself as a neophyte when it came to fake prescriptions, phony call-ins and other forms of drug diversion.  I'm sure I've been fooled more than once.  I'm not sure how many occurrences most pharmacists would say they have in a typical week, but I seem to have encountered a cluster.

We had one guy come in -- never filled with us before and wanted to pay cash for his Percocet prescription ( I wasn't too familiar with the doctor, either.)  Of course even for me this was a red flag
and a check of the state's monitoring website revealed a long string of Percocet prescriptions, some filled literally right on top of each other.  The most recent was 4 days earlier for an even larger quantity.
Sent him away and he was not a happy camper.  I don't really care what he's doing with it,  probably selling it, but it's irritating as hell and a waste of my time.  I contacted the doctor's office, sent them a copy of the State information, and never heard anything back.

I've also encountered a string of 'lost' prescriptions claims -- 'lost' on vacation, 'accidentally' threw it away, lost my purse, etc. etc. etc.   I wish every prescriber would make it clear from the outset that they will not replace lost or stolen prescriptions without a police report.  I can't believe how accommodating some of these doctors are.

Also recently became aware of someone calling in her own prescriptions -- she was pretty good but it never sounded completely right to me and I am mad at myself and the rest of our staff that no one thought to take the time to verify it.

I guess it's just irritating to be played for a fool.  We're hammered with the principles of customer service and being nice to everyone and I feel like these drug seekers are probably laughing all the way out the door.  I know this isn't news to any experienced retail pharmacist out there, but just had to get it off my chest.

Saturday, February 16, 2013

Pharmacy PRO

There's a commercial on TV for National Car Rental that features the "Business Pro" -- the frequent and experienced business traveler who can breeze through the airport -- going "shoeless and metal-free in seconds."  In the endless procession of people we wait on at the pharmacy every day, I have come to truly appreciate the Pharmacy Pro.  I'll give people a pass for their first couple of visits (maybe) but after that, well ----  these are the true marks of you,  the Pharmacy Pro:

1. You hand me your prescription insurance card with the prescription, or in the case of an e-prescription, when you check in.  Each and every time.  Even if you've been to the pharmacy 40,000 times before.  It's the newest and most current card. It's not your dental or medical card.  If the prescription's for a family member, you give me their card, not yours. I already love you for that.

2. You are acutely aware of your surroundings.  If the place is going crazy and there are lots of people waiting, you say "I'll stop back later."  If you know you have multiple prescriptions, you do the same regardless.  I love you for that.

3.  You are aware, at least generally, of what your doctor has sent us.  If there are things you don't need filled, but just kept on file, you tell me up front.  I love you for that.

4.  If you want a refill of something, as well as having your new prescription filled, you tell me immediately.  You do not wait until we are ringing up the prescription before saying, "Oh, and I also need some test strips" and expect to just stand there and wait.

5.  While waiting for your prescription, if you are paying by check, you have your checkbook out and you have already filled out the entire check except for the amount.  I love you for that.

6.  You are an active participant in this process.  You look over what you are receiving and verify that what is there is what you're after.  Not when you get to your car, not when you get home, not 3 days later when you tell me you 'never got' something.

Here's to you, Pharmacy Pro.