Well, maybe not, but I have been linked from the Wall Street Journal Health Blog (and its requisite copyblog). The article is about Medicaid’s new requirement that all prescriptions must be written on tamper-resistant pads beginning in October, something that will undoubtedly cause headaches in the last 3 months of this year.
The WSJ Health Blog is a great resource for health professionals. It’s a great honor to be linked from it.
It’s nice to be able to send a script to an independent pharmacy for one. Usually, we’re transferring them from the independents.
This afternoon, someone called asking for the price of 40 capsules of Vancocin 125mg capsules ($615). They didn’t ask if we had them, so I just figured it was another pharmacy price-matching–that is, until they brought the script in four hours later. Of course, we didn’t have it.
Pt.: But I called earlier!
Me: Yes, but you only asked how much it was. I didn’t know you were coming in for it.
Pt.: Well, can you call another pharmacy? I have to start taking it in less than an hour.
So, I, being the nice person that I am, pulled out my list of other pharmacies, and started calling all the pharmacies up and down the highway. After the fifth call, the pharmacist started calling from the other extension, too. At the same time, I found it at an independent pharmacy that is close by (but whose price is $725) and the pharmacist found it at another one of our pharmacies which is further away (by a considerable distance.
The patient thought it over for a second, then decided to go our other store since we were cheaper. Since he was in a rush to get it, we offered (again, out of the goodness of our hearts) to get his info at our store and then transfer the script to the other store. So, we had him fill out a profile, and he whips out an insurance card.
Me: Sir, you didn’t say you have insurance. You can just go the closer pharmacy; it will cost the same there as here.
Pt.: But, I have a percentage copay (actually called coinsurance).
Me: Yes, but it’s a percentage of the Maximum Allowable Cost (MAC, a dreaded acronym in pharmacy, almost as bad as IRS).
So, we sent the patient down the road instead of across town. And it felt good to be able to help out an independent pharmacy. (Plus, I’m sure they were anxious to get that Vancocin out of their inventory.)
If one more person tells me this week how long they’re willing to wait for their prescription to be filled, I’m think I’m going to explode. Some examples:
Me: Okay, that will be about 20 minutes. (no joke, that’s our usual wait time)
Pt.: Well, do you think it will really take 20 minutes?
Me: Yes, I do. (thinking) No, I’m just going to make you wait that long for the heck of it. It really only takes about 30 seconds.
and:
Me: About 15 or 20 minutes. (this was the day before the 4th of July)
Pt.: (in a thick New Yoa(r)k accent): I’d really appreciate it if it was 15 minutes. I have a plane to catch at National in 90 minutes.
Me: I’ll do my best. (thinking): Good luck. I hope you get put on standby. Now your script will take 21 minutes, just out of spite.
Pt.: Well, you’d better.
and finally, when we were really busy:
Me: Just to let you know, it’ll be about 30 minutes.
Pt.: What?! Can’t you get it done any faster?
Me: Not with five people ahead of you sir.
Pt.: Well fine! I’ll just take it down the street to XYZ Pharmacy.
Me: Fine. Here’s your script back. (thinking) Great! One more annoying patient I don’t have to fill a z-pack for, especially since happen to know XYZ’s wait time right now is 45 minutes.
A word to the wise: Making your pharmacy tech (or pharmacist) angry is just as stupid as doing the same to your waiter. Just be glad I have too high a standard of ethics to switch your antibiotic for an erectile dysfunction pill. Goodbye bronchitis, hello four-hour erection!
Sarafem is the biggest rip-off I’ve ever seen. We had a patient bring in a script for Sarafem 20mg, 1 capsule daily, for a 3 month supply. Of course, we didn’t have it, so I told here we would have to order it.
What I knew about Sarafem was limited; I knew it was for postpartum depression, and that it was essentially an antidepressant. What I didn’t know was that it’s the exact same thing as Prozac (fluoxetine), which is available as a generic for literally 1/10 the copay (for this patient anyway.) The patient’s copay for 3 months of Sarafem is $120 whereas her copay on 3 months of fluoxetine is $12.
On the other side of things, we got a promotional fax (which I usually throw away) for Neupro, the new Parkinson’s patch. We have one patient (Mrs. Nicelady, if you’ve been reading this blog for a while) who can only afford her Parkinson’s meds during the catastrophic coverage of her medicare plan, which is usually just the last 2 months or so of the year. So, I priced Neupro for her, and even during the coverage gap, it’s under $100 a month for the lowest strength, which is much less than her normal $600 a month. Plus, since it’s new, her doctor can get a ton of samples to give her when she can’t afford it.
It’s nice to see a new drug that doesn’t cost an arm and a leg (relatively speaking, of course.)
In my pharmacy we are (or at least I am) very superstitious about the dreaded “S” word–no, not that one; “slow.”
Well, today being the day before a holiday, the pharmacist had the (mistaken) impression that today would be, umm, s**w, since everybody should be travelling out of the area. I told her not to say that word, and she just said I was being superstitious.
Around 10am, a “nurse” called in a script for Vicodin ES, #30, 1-2 twice daily. All in all, not a weird script, except for the following:
So, the pharmacist called the ER, and the nurse who answered quickly said, “Well, we don’t even have a nurse by that name.”
RPh: Well, I need to speak with the doctor to confirm that it really is fake.
RN: Dr Soandso is busy right now.
Rph: Well, I’m sure Dr. Soandso would like to know if someone is calling fake scripts in under his name.
RN: Ok, I see your point.
Well, the doctor confirmed that it was fake as well, so we called security, who then called the police. A really nice policeman came and took a report of what had happened. He waited in our back area where he couldn’t be seen for about half an hour before deciding to leave his cell number (something he said he doesn’t give out to just anyone) with instructions to call if she came.
I said as he was leaving, “Of course, she’ll be here in ten minutes.” (and of course, I was right; an early-20-something very-pregnant woman wearing daisy dukes, a tank-top, and flip-flops came strutting in.)
To stall her, we had her fill out a new patient profile. “We haven’t filled anything for you since 2005 (which was true) so we need to update your information (which was pure baloney). Meanwhile, the pharmacist got on the phone and called the officer.
As the “patient” finished filling out the profile, a different officer came in behind her and yelled at her to drop her backpack. He then proceeded to cuff her and lead her to the bench by the bath room. Evidently he loosened his grip just enough, because she decided to make a run for it; not easy to do when you’re very pregnant and wearing flip flops, not to mention hand cuffs behind your back.
By this point, the first officer had come in, the assistant managers on duty came back to the pharmacy, and half the employees were wondering what was going on. We also had one patient waiting for about an hour in the store while this was going on; thankfully she was nice, and it was an otherwise sl…er…not not not busy day. (Hopefully that will keep me from jinxing myself for the next time I work.)
I was sent to make copies of the “script” that she called in and the profile she filled out. When I came back, one officer was asking her name (“I don’t have one,” being her response; gotta love stupid criminals) while the other officer pulled out 4-5 prescription bottles and half a dozen presumably fake scripts from her back pack.
When it was all over, I turned to the pharmacist and said, “See, I told you not to say the “s” word. It gets us in trouble every time. (of course, I meant we’d get a lot of scripts, not a nearly nude pregnant girl running from the police.)”
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Hope everyone has a happy 4th.
