Shooting ourselves in the foot, $4 at a time

Say you are an insurance company, and you are looking at reimbursement rates to give to your participating pharmacies. You settle on something thats totally short-cutting the pharmacy (like cost + $2.50). All is well because the pharmacies don’t really have much of a choice.
Then lo and behold some fuckers at Publix are giving away antibiotics for free. Then you see Walmart and other douchebag chains giving away Rx’s for $4/month. Obviously they are sending the message that we can afford to give shit away for free/below cost because we obviously are making too much money filling other things.
To Publix and the $4/month chains: Thanks for shitting in our beds. In an attempt to drum up business under the false pretense of “helping people” you have shit on the rest of us who don’t have multi-million dollar corporate offices to float bouncing paychecks. You are fucking up the profession of pharmacy far more than you will ever gain. Don’t you see that the insurance companies see this shit? Don’t you think that you are publically lighting your cuban cigars with fresh $100’s and blowing the smoke in the faces of those who hold our business (reimbursement) in their hands? You are ruining it for the rest of us. You are giving those rat fucker insurance companies enough ammo to cut their reimbursements even more to us. You are shitting on the little guys and turning our own profession against itself for your own selfish corporate greed.
So yeah, if you are so gung-ho to give away shit for free or below cost, then why dont you pharmacists there work for free or below cost. I’m tired of having to hear people bitch about $4/month drugs and free antibiotics due to fuckers in our own profession. Way to go guys, way to go, you’ll need those free antibiotics when the insurance companies get their heads out of their asses and bend us over.

Comments #

Comment by DrRx on 2007-10-24 13:49:08 -0700 #

This statement goes right back to what I have mentioned in a previous message…. Unfortunately, Pharmacists have to ‘wake-up’ as a profession and realize that the days of making all of your money off of MARGINS is OVER. When Wal-Mart can afford such a ‘Loss Leader’ as giving away free drugs because it brings the grandmas into the store to buy $100 dollars of other worthless shit, then that’s your wake-up call. We all need to drive home the idea that we’ve been ‘giving away’ our knowledge for too long (while everyone else is making money off of theirs!)…. Fight those legislators and starting making $$$ off of your cognitive services!

Comment by hiptocode on 2007-10-24 16:39:52 -0700 #

well crap . . . now every idiot that tried to keep of antibiotics for the sniffles because couldn’t afford unnecessary medication can create their very own drug-resistant-bacteria.

Comment by enrico on 2007-10-24 17:32:36 -0700 #

I can’t comment on the profit margins since pharmacy sales are not my area, but making abx EASIER for people to get is WRONG WRONG WRONG. People are crapping in their pants about MRSA–nobody’s bringing up VRE and other multi-drug (including vanco) strains that just aren’t “in the community” yet. YET.
Of course, if most doctors had any balls whatsoever when Timmy’s mom insists that he get an abx for his cold, they’d either show them the door or ONLY write for ampicillin. Give away the stuff that’s already multi-resistant in the wild, but free flouroquinolones? Free TMP/SMX? People, TMP/SMX is one of the last, cheap defenses against CA-MRSA. When linezolid becomes the standard of care, we’ll see how many $4 rxs are available. Idiots.

Comment by AngryNatalie on 2007-10-24 19:24:35 -0700 #

well my big beef with the whole Publix (or as i like to say Pube-lix) is not the profit margin its the whole fact that people can get ANTIBIOTICS for FREE…WHENEVER THEY WANT. there’s no limit to refills, as long as you show up at some point with a prescription…that you can then fill whenever you want. and they say we have a problem with antibiotic resistance now? yeah sure, lets just give ’em out for free with no need to see a doctor first to see if you actually have an infection. and who’s to say that what you were sick for the first time is what you’re sick with the next time(s) and who’s to say that new bug (if it is actually an infection) will be suceptable to old antibiotic.
ughhh the whole thing just pisses the hell out of me.

Comment by Gary on 2007-10-24 21:32:32 -0700 #

I have to agree with enrico there…when zyvox becomes the standard…lol
At any rate I was reading this article in the paper and I forget which pharmacy it is but they are floating like 2.5 bil…

Comment by Pharmgirl on 2007-10-25 04:18:54 -0700 #

Amen, amen, amen, and A-FREAKIN-MEN!!! How about I had a store manager come up to me and say, “Why didn’t our marketing people think of that(giving away abx)?” I said, “UHH, b/c I think it’s stupid. We ARE NOT FREE CLINIC!!!” Also, we give AWESOME service. From what I’ve heard Wal-mart doesn’t b/c they’re not staffed fully. So why do I have to give great customer service AND $4.00 rx of free abx. These people want their cake with a cherry on top AND give it to me in the ass all the while I’m supposed to bend over and say, “Please give me more, thank you and have a great day.” It should be 1 or the other. I go to Jiffy Lube to get my oil changed b/c it’s quick and they do a great job, but it costs more money. I don’t go to wal-mart b/c it take FOREVER, but it’s cheap. I don’t ask them to match the wal-mart price. I don’t mean to bash wal-mart, I’m just giving an example. OR how about the pt that drops off their rx, we fill it on their insur, go to ring it up and they say, “Oh, it’s not $4 bucks?” UM DID YOU ASK ME TO MATCH WAL-MART WHEN YOU DROPPED IT OFF??!?!?!?! HELL NO, I AM NOT A FREAKIN MIND READER, THEY DIDN’T TEACH US TO READ MINDS IN PHARMACY SCHOOL!!!!!!!!!! UGH!!!!IDIOTS!!!

Comment by Trusted.MD Network on 2007-10-25 07:27:19 -0700 #

$4 drugs killing local pharmacies?

You bet it is, says The Angry Pharmacist in his typically salty manner.

Comment by joejrx on 2007-10-25 08:41:32 -0700 #

Address
Publix Super Markets Corporate Office
ATTN: Consumer Relations
PO Box 407
Lakeland, FL 33802-0407

Comment by John Roman Rph on 2007-10-25 12:27:23 -0700 #

In my opinion the bottom line is these chains have recognized the obvious; pharmacy is no longer profitable. The pharmacy is just a give away to drive foot traffic.
As far as DrRx … “cognitive services ” please don’t make me laugh. Why would anyone pay you for something you are already doing and have always been doing for free? Fight those legislators ? With what money ? Esrx , aetna , medco their petty change purse is bigger than than the total bank accounts of pharmacy legislative groups put together.
Do you know how much money you could save “community doesnt care Rx” over the course of just 1 year on a 12 med review if you changed just half of the rx’s to generic. Thousands ( several thousands ) . What do they give us ? $30 , lol. Fuck off. Ill get more satisfaction seeing them pay for the brand shit.

Comment by IL PS-2 on 2007-10-25 12:56:33 -0700 #

Pube Lix….. Haha

Comment by Wal Mart Pharmacist on 2007-10-25 13:51:43 -0700 #

I’m a pharmacist at Wal Mart. (Here it comes.)
I enjoy your blog a great deal, because we come across the same thing in retail every day, and it’s nice for someone to actually put their thoughts on the record.
I thought that it was a bit over the top of you though to so blatantly point at the pharmacists of Wal Mart and blame us.
We didn’t come up with the $4.00 list, and I certainly don’t enjoy people going out of their way to get prescriptions changed so that they can get something off the list when what they already are prescribed works perfectly fine for them. I don’t enjoy people asking why some of the prescriptions are $9.00 instead of the promised $4.00 (I work in Pennsylvania.).
So, tell me then, with all the flaws of the program, why would you take it out on the lower rung? Once again, that’s mass marketing to get business, yes. Did we pharmacists have anything to do with it to tell us we’re shitting on our hard work? No. Our job isn’t any less easy than yours at a private owned company than it is working at Wal Mart every day.
You should really take that into consideration next time.

Comment by Alex on 2007-10-25 14:25:35 -0700 #

I’ve heard about supermakret pharmacy other than Publix giving out free antibiotics also. That’s even more messed up than Walmart’s $4 generic program in my opinion (ABX resistance.. etc).
I’m just sad that our profession is no longer considered as a profession that can be utilized as a core business but a mere tool for attracting customers. They could have easily given out steaks at no charge or sell large deluxe pizza for $4 to attract customers without affecting the pharmacy.
The public expects free consultations from pharmacists at their convenience. Now, these giant pharmacies will eventually make the public to expect medications at no charge also. Sigh…

Comment by Martin S. on 2007-10-26 08:25:39 -0700 #

I agree with the problems associated with too many antibiotics. Lets not forget if some of you RPhs at these chains don’t wake up your bosses those 6 figure salaries you are currently making are going to vanish. Maybe not until the RPh shortage is over-but when it happens and they can hire someone desperate to work, to pay off school loans, for 20-30 grand less, your ass is gone. See current UAW contracts and don’t think your companies think any better of your degree than GM and Ford do of their employees. Remember-you are really just a very costly business expense. No matter how professional we are as a profession, to a large diversified corp. we are just an expense. You would be replaced by techs today if the company could legally get away with it. One Rph responsible for multiple locations-supervison by computer. In doubt? look at multiple PAs & sites working under one Dr. If we as RPhs don’t reign in what our employers are doing then we ARE shitting in our own bed. It occurs to me that when we are a scarce asset that is when we have the potintial to change how chains and PBMs conduct the business of pharmacy.

Comment by Gravelpit on 2007-10-26 10:07:30 -0700 #

GRRRR…VICO-DANS….
again 90 tablets at 3 times a day = 30 day supply….asking for it 1 week early…..says in same sentence….”I am totally out, and I take them less than the doctor wants me too.” Honest-can’t make this stuff up…and they continue on how the doctor says they can take as much as they want–well do you take more or less-WHICH ON IS IT??…HELLO do you here yourself talk !!!GRRRR…not on the subject, just had to vent…..GRRRR…..

Comment by Brandon on 2007-10-26 12:39:05 -0700 #

With myself working at wal-mart RX, I see some of the horrors that come in.
I’m against the entire $4 program! Unfortunately though, we (meaning the entire pharmacy division) had no choice in the matter. It was the CEO of the company. Blah at him!
I know our pharmacy manager says for every 30 tablets of generix mobic we sell, we lose $64!!!
Our cost for just 30 tabs is about $67.
There are some drugs we can do for really dirt cheap. HCTZ is the main one that comes to mind. $90 tabs isn’t $12. more like $10.70.
And then we have to put up with assholes that come in and want their “generic medicine” on the list. Such as Xanax, Diovan, or Lortab/”vicodan”

Comment by Sara on 2007-10-26 18:14:04 -0700 #

yes.. LOVE $4 generics!! Even though they had to cut technician hours, screw the pharmacists even more, take out $100,000 life insurance policies on their older workers, not give their workers good coverage, so that makes MORE medicaid patients.. and all the while I have people with $5, yes! $5 co-pays wanting us to Price Match good ol’ Wally World.. because well, it’s a dollar cheaper.
And since CVS likes to kiss ass, we price match. So people with $10 co-pays can get all sniffy and DEMAND price matches.
Fuck ’em.. I’m done!

Comment by Cathy Lane RPh on 2007-10-27 10:45:15 -0700 #

Off the cuff, mebbe a reason for national health insurance? Drug costs to consumers in some cases are outrageously expensive, but in others dirt cheap. Pharmacists whose salaries (or hourly wages) that depend on drug cost reimbursement don’t have guarantees if their pay depends on insurance reimbursement, yet as consumers we can see that someone without insurance, or choosing to pay cash gets ripped. Yet manufacturers (and distributors) are suspect in what they’re receiving in the way of kickbacks. Folks that make the ultimate decisions (i.e. government officials, insurance companies–perceived, physicians, upper pharmacy mgmt–and, sometimes in the chains, it’s not a PHARMACIST!) etc.) give themselves unfair advantages. Drugs, health, food, it’s all necessary, and it’s BIG business–why do Canadian physicians emigrate to US? Enter the pharmacist that is supposed to have unbiased advice to the ultimate consumer…and, do we as a profession do that? Where are our ethics? Why do we feel guilty as a profession about the ‘white coat’?

Comment by Daryl on 2007-10-27 15:56:21 -0700 #

OK I hate to throw in a positive twist here because I prefer the negativity myself but…
What if these $4 lists actually caught the eye of the major drug co’s and they decided that they need to lower their prices in order to get their product on the $4 list. Let’s say someone like WalMart decided it would no longer carry Lipitor unless they were able to buy it so it could be sold $4/30. I wonder if Pfizer would take notice. Would they step in so as to prevent patients from requesting their docs prescribe lovastatin because it’s on the list?
Could this be the spark that finally makes medications affordable for all of us? It’s a strectch but just something to ponder.
Now back to the negative. It does makes my blood boil when I hear a customer walk up to the counter, with a handful of scripts, and ask “Are any of these on your $4 plan? How long will it take to fill?

Comment by canadian_pill on 2007-10-27 16:39:29 -0700 #

Let me be blunt, simple and to the point: i have ZERO respect for anyone who works at the WalMarts and Costcos of the world.
for a year, i worked as a relief pharmacist in order to make money and have a flexible schedule until my own 100% independent pharmacy opened. i REFUSED to belittle my profession by working at a dump like WalMart.
when i heard about the free antibiotics and the other gimmicks being offered in the US and A (I luckily live in Canada), i placed calls and sent emails to the head offices of all of the US companies to tell them i am against the degradation of a valuable health care profession.
for those at WalMart et al. who say “but i have no choice!”, i call you on your bullshit. you are 95% incorrect, since you CHOSE to get a job at a cost-cutting unprofessional dump like WalMart and you CONTINUE to choose to work for a place like Walmart.
I say “95%” to blame since, before i opened my own pharmacy and i worked relief, i spent 1 year doing recruitment and retention for a Canadian chain. I had a rule of thumb: don’t even waste your time with a WalMart pharmacist. clearly they are missing clinical skills and the know-how to work in a real pharmacy.

Comment by DrRx on 2007-10-27 21:36:26 -0700 #

*\*Message to John Roman**
OK… you just supported my comment with your statement about getting paid $30 to do the med review (a ‘cognitive service’)…call it whatever the hell you want, but $30 versus $0.02 on the dispensing of ‘drug X’ to a patient…. Clearly, I’m on the side of the cognitive fee for service…… Also, you say, “who will pay for the legislation?” Who pays for it when the doctors go to capital hill to fight an insurance company? The Physician organizations!!! (ever hear of the AMA?). Pharmacists have those too… they just need to get as many ‘non-apathetic’ pharmacist members to actually build the ‘coffers’ to do these things… Read the latest “DRUG TOPICS” magazine… You’ll see what I mean… There’s an article in there about the Pharmacist’s plight…

Comment by Kim on 2007-10-28 09:01:41 -0700 #

Okay, I have NEVER had to stand up for myself on TAP, but as an employee of Publix- I am going to say something.
To Enrico: Ampicillin is one of the drugs on our free antibiotic list. And one of the least prescribed out of all of them. So that’s the doctor’s problem- not ours.
And to say we should all take a stand against these ridiculous corporate schemes that “get in more customers”? I think that’s a noble idea, but I am a tech making $9.50 an hour. Where the hell else am I supposed to go? I mean, really. Same with all the Pharmacists who have just started earning stock or putting money into their 401(k). You make it seem so easy to just sever ties to a company that SORT OF cares about its employees and gives pretty nice benefits. Additionally, like the Wal-Mart Rph, we don’t enjoy these new programs corporate rolls out for us. We see people coming in with 2 RXs- one for Cipro and one for Vicodin. They ALWAYS ALWAYS ALWAYS say “I fill at Wal-Mart (or CVS or whatever) because your Vicodin is too expensive {Note: they never ask how much it costs; our Vicodin price is actually cheaper than CVS but whatever}, but give me the free antibiotic.” Do you REALLY think we’re making a crapload of money off of this thing? We’re LOSING money. So indeed, the profession is not only hurting, but the individual Pharmacies are hurting too.
-Kim.
PS-AngryNatalie, we only give out a 14-day supply at a time. They can’t come in every single day and get more Septra. And if you talk to any Pharmacist who works for Publix, they will say the same thing about antibiotic-resistant strains of bacteria- that we’re making it worse, not better. But does corporate ask the Pharmacists before they do this? Does corporate send out memos to the top prescribing doctors in the area and ask them to stop giving out so much freaking Cipro? NO. I really think placing the blame on the Pharmacists is very unfair here.

Comment by RXJOE on 2007-10-28 09:35:51 -0700 #

This message is for Brandon. Just so you know how much you get misled working at Large Chains, I own an independent pharmacy and I buy Miloxicam 15mg by Mylan for $4.34 for a bottle of 100 tabs. That’s me with ONE pharmacy, and not the buying power of Wal-Mart, who is probably paying about 2 bucks for it. Stop believing everything you’re told and start thinking for yourself!

Comment by Shalom (R.Ph.) on 2007-10-28 09:48:43 -0700 #

To Sara: I also work for CVS, although no longer full time (I’m at an independent now), and when this $4 bull$#!7 started, we were informed from On High that we wouldn’t be matching Wally World on those: did that change, or is your district different from mine?
We do have their current list in RXNet, though, so that when a customer comes in and claims that $DRUG is only $4 there, we can pull the list and say no it’s not. Did exactly that the other day, damn it felt good.
ObArrgh: Customers on Medicaid HMOs who get prescriptions for Tylenol liquid called in for every damn member of their family. That’s bad enough, but then they bitch because it’s generic and the kids don’t like the taste. It’s fscking free, dammit, take it or go bother some other pharmacist. “But $PHARMACY always gives us the brand, they say just go take one off the shelf!” Why don’t you go there then. They’ve been around twenty years, they can afford to take a loss dispensing brand name Tylenol for lower reimbursement than the stuff costs us. We can’t.
I have just now put up a sign at my counter. “1. All prescriptions for over-the-counter items (Tylenol, Motrin, and the like) will be filled with the generic equivalent (acetaminophen, ibuprofen, etc.) No exceptions will be made; brand name items, if desired, must be purchased for cash.
2. State law prohibits returning medicine to stock once it has been dispensed. For this reason, no returns will be accepted on any prescription item, except in case of dispensing error. Dispensing error does *not* include doctors calling in the wrong medicine, changes in therapy, excessive copay, disagreeable taste, or similar situations. If a prescription was filled correctly and in good faith, you must decide whether or not you want it before leaving the store, or in case of a delivery, before the driver leaves your house. ” Hopefully that will stop this bovine excrement.

Comment by life post residency on 2007-10-28 23:48:11 -0700 #

Cathy stole my thunder here. But it’s rather contradictory that this rant is calling for increased professionalism of pharmacy to prevent its financial demise while your previous one was relentlessly beating down some faculty attempts at instilling some… So how would you “professionalize” us then?

Comment by ReeRee on 2007-10-29 09:01:29 -0700 #

Hey TAP, I love your blog! And, it is so good to hear what others have to say/think about the Free Abx Program Pube-lix is doing. I am a pharm-tech for Pube-lix and here’s what I’ve got to say…
I FUCKING HATE IT! And I’m not the only Pube-lix pharm employee that feels this way. No one even knew that this was coming! We just opened one monday morning and right there was the message “Hey we are going to be doing this program, blah blah. Oh and by the way, it starts now, today!” That was some shit. It’s bringing in customers you dont want. They only want it because it says “FREE” and they are extremely rude because they dont want to wait for it, they think we have it ready to just hand out. They get attitudes when you ask them to fill out a patient information form because you have never filled for them before. Another thing that pisses me off is when they have other prescriptions to fill and they only want you to fill “the free one” and especially when the RX was written 3 months ago!! We also have to deal with a whole lot of stupidness such as people thinking you can just get it without a Rx because its free, they think we are just hanging out at the counter just handing it out like candy. Halloween night ought to be interesting. I can see it now, “Oh it’s candy. You’re not giving any abx?” They dont even want any counseling, they just grab and go, the rude fuckers.

Comment by rph3664 on 2007-10-29 12:28:02 -0700 #

I work at a hospital, and in recent weeks have been working on the med/surg floors.
Another disturbing aspect of this is that doctors are deciding what meds the patients will take upon discharge based on the $4 list, NOT on what’s really best for the patient, because, um, that’s the way it is.
grrrrrrr
This is one reason why 100,000 people die every year from prescription drug use. (or whatever the number actually is)

Comment by …… on 2007-10-29 13:20:28 -0700 #

Hello Angry Pharmacist,
I want to play a game. Thus far through your…. leisurley life, you have taken more for granted then some obtain in a lifetime.
You have let your work destroy your innerself, resorting to booze and scotch to warm you up. You see, I believe you are like many of your so called patients… dead. Dead on the inside.
It is my belief you long to be re-united with your true family, so tell me, dear Angry Pharmacist… how much blood will you shed, to stay alive?
Let the games begin.

Comment by DownonthePharm on 2007-10-29 15:38:03 -0700 #

My professor was lecturing about psychotropic meds in class today and presented us with this article. The class got a kick out of it, i thought you might like it.
http://www.cmaj.ca/cgi/content/full/163/12/1557

Comment by John Roman on 2007-10-30 11:01:22 -0700 #

**Message to DrRx**
DrRx, Let me just make it clear my heart is in the same place as you. Im 33yo and have been running my own indy for 9 years ( yes I opened it right out of school with some money borrowed from dad ) . Anyway , about the war with insurance companies … the war is over. We lost. Right now the shoot out is between them and big pharma. Both with equal lobby cash.
As far as the cognitive services .. like I said they are a smoke screen devised to yet make the pmb richer due to your hard work. They are paying you pennies for them to make dollars. Im curious do you know of any company that will allow you to do a monthly review for every patient ? Almost like making then come back for a Physician office visit. Even then $30 isn’t enough we should be getting more like 65-70. $30 is what waiters and lap dancers make for fucking around.
The Physician organizations!!! (ever hear of the AMA?) — The ama is a joke. One of my best friends runs an internal med practice. Docs are getting ass ramed worse than us. The lawyers ( aka legislators aka insurance companies) make sure they make just enough to pay those huge malpractice premiums and then reap the 33% on litigation.

Comment by onourown on 2007-10-30 11:38:40 -0700 #

I have been a pharmacist for 13 years. I have worked for independants, grocery store chains, and big-box mass merchandiser chains…full-time, part-time, and temporary, depending on my stage of life at the time. I am opening up my own pharmacy in 3 weeks with a business partner. I am a woman with 2 young kids (wanting to work 3 days a week max) and my partner is a semi-retired 60ish pharmacist who had his own store for 20+ years, and wants to work 3 days/week. Together we hope to stay out of the chains…have a real window to look out at and see daylight instead of being closed in a huge windowless concrete box all day…be closed at 6pm thru the week…be closed sundays and holidays…treat our customers with respect and demand the same back…and maybe make some money while creating an asset (the business) so that we can eventually get a buy-out from a chain, or sell to a jr partner, or retain partial ownership status later while moving away from earned income. We may be crazy, but we think there are many possible combinations out there just like us….women pharmacists who want to see their kids grow up…I mean, actually SEE it happen, and BE THERE…not in a big box while paying for a nanny or sitter. And all the old men that are killing themselves trying to make it 6 days a week single-handedly in your independant store….why not partner up with eachother?!?! GET AWAY FROM THE CHAINS…BEAT THEM AT THEIR OWN GAME!!

Comment by Heather on 2007-10-30 12:53:07 -0700 #

doctors are deciding what meds the patients will take upon discharge based on the $4 list, NOT on what’s really best for the patient, because, um, that’s the way it is.
What’s better for the patient–a $4 drug they can afford to go purchase and take as prescribed, or a $400 drug they can’t afford (or refuse) to purchase? “What’s really best for the patient” isn’t necessarily the latest/greatest thing the rep was pimping this week.

Comment by -Aaron- on 2007-10-30 13:41:39 -0700 #

rph3664,
Why not send people home on the cheaper medication? People need to get off their holier than thou attitude and be practical. If it’s me and a company is going to offer something that works the same way for a lot cheaper… sign me up for the $4 one every time. I know it’s hard when you’re making good money to put yourself in other people’s shoes, but for some people the only way they can pay for their meds is through Patient Assistance Programs or a $4 plan. I say, good for the Dr’s to consider more than what a drug rep told them, it’s as if they actually care about their patient, go figure. At least with the $4 list it costs them something. Try spending hours helping people fill out applications for free meds and getting no reimbursement for it.
Don’t be too good.
PS- I doubt people are dying because they got sent home on a $4 med… lets not be so dramatic.

Comment by DrRx on 2007-10-31 20:30:08 -0700 #

*\*Message to John Roman**
We are in the same age group (sort of…I’m 2 years older). Never had the desire to be an independant because I knew this shit would come down. What I was referring to with the AMA can be much better explained then I can put it, by reading that Drug Topics article I mentioned before. It describes a history of how the AMA and other physician organizations got docs and nurses recognized as healthcare professionals back in the early part of the century…something pharmacy groups are just now trying to play catch up on. The idea of the reimbursement for DTM is something that I hope will become a clinic-type situation where you would see a multiple patients, but pharmacists keep having to get past regulatory hurtles that PAs and CRNPs, etc…all got free passes on because they made the right moves early. Of all of the healthcare professionals out there (ourselves most definitely included), which of them would you want prescribing and managing your drug therapy!?! The folks with 1 semester of pharmacy and armed with all of the knowledge that the biased salesrep gives them, or the pharmacist, with years of pharmacology and drug chemistry who knows the reps are full of shit and can understand what drug reactions are significant and which aren’t….etc…etc…

Comment by Borgey-RPh on 2007-11-04 06:57:24 -0800 #

I have taken to calling Wal-mart the “evil empire.”
The $4 and free antibiotics plans are not only bad for trying to get reimbursement rates up, but it teaches the public that our services are not worth anything. Why will people ever pay for cognitive services if places like this give the services plus price of the drug away?
People already think that pharmacists, technicians, doctors, nurses, etc. should provide services for free because for some reason people think that health care is a right. Ha!
Yes, because you ate too many twinkies and developed diabetes, I should now help you for free and give you your medications dirt cheap. They actually think this.
There is no self-responsibility for your health anymore.
*****
And I think that is terrible that physicians are prescribing off the $4 list.
To Heather and Aaron and the other folks that say “well it is better that they can get something they can afford rather than something too expensive that they can’t.”
Well, here is what might happen:
Physician prescribes cipro because it is on the $4 list for pneumonia. Cipro doesn’t cover the bacteria present (too much resistance to streptococcus pneumoniae) – patient needed Levaquin (not on the list). Patient comes back to hospital with WORSE pneumonia infection. Treated in hospital (more $$$) not with Levaquin but with a more expensive IV antibiotic since Cipro in the same class was used. While in hospital, patient contracts MRSA – IV vank (more $$$).
So in the end, because the physician prescribed off the $4 list, patient ends up spending more on subtherapeutically treated pneumonia. Now, obviously this doesn’t ALWAYS happen, but certainly could. It is dangerous prescribing this way. Many times it may end up costing the patient (or the state) more in the end due to subtherapeutic therapy.

Comment by Isabell on 2007-11-04 18:57:06 -0800 #

I work at another one of the retail pharmacies that jumped on the $4 generic train. We hate it, but corporate thought it was a wonderful idea.
Every day I get people coming in with 25 RXs wanting to know which ones are on the list.
Is Zegrid?
No, that’s a brand name, the $4 generic drug list is only for generic drugs.
What about Effexor?
No, that’s a brand name, the $4 generic drug list is only for generic drugs.
What about…you get the picture.
The only silver lining for me is that as of today (11/04/07) we no longer accept competitor coupons! Take that CVS and your $30 gift card coupon with a 6 month expiration!

Comment by christhelinuxguy on 2007-11-07 10:43:47 -0800 #

They may be corporate assholes, but at least they hold nobel intent.
People are dying; antibiotics save lives. No company *has* to give this type of break to anyone since the parasitical lobbyists from healthcare industry have penetrated both aisles of Congress. Yet they do.
Get over it.
And when a universal coverage system hits, get over it too. You may have to put your new Porsche up for sale and switch to a Honda (get a hybrid and you can save the environment and maybe someone’s health, all that the same time).
If you wanted to make money, you should have went to work on Wall St not a place where reimbursements have been dwindling for years. Did you think that was going to change?
You’re a self-loathing narcissist; get over yourself.
N.B. I have been reading other comments on here and it’s somewhat nauseating. I think, instead of rx’ing myself Zofran 8mg tid I’ll go with Phenergan 25mg q4-6h off the $4 menu. Where’s your pharmacy.

Comment by joejrx on 2007-11-08 12:40:21 -0800 #

See quote from Randy Heiser, R.Ph. at Giant Eagle:
Giant Eagle expands generic drug discounts
Thursday, November 08, 2007
By Teresa F. Lindeman, Pittsburgh Post-Gazette
Giant Eagle has added more medicines to a year-old program offering a month’s supply of certain generic drugs for $4 in a move that officials say makes their list of low-cost prescriptions the longest in the country.
With more than 400 drugs now included, the O’Hara grocer appears to have topped the expanded offering announced by discount retailer Wal-Mart in late September. That plan covers about 360 products.
“We felt that it was important in our markets to be seen as a leader,” said Randy Heiser, Giant Eagle’s vice president of pharmacy. The company, which also is trying to improve its pricing image, paired the generic drug expansion with price cuts on more than 275 items in its health and beauty department.
By the way, Randy’s address is :101 Kappa Dr
Pittsburgh, PA 15238-2833
Let him know how you like his approach to leading the market.

Comment by Misha Soup on 2007-11-09 00:52:28 -0800 #

I agree with Isabell. Coupons and $4. Great way to revitalize the profession.

Comment by Andrew on 2008-02-15 10:56:33 -0800 #

Has anyone else had any experiences with patients going to these places, getting their prescriptions filled for next to nothing, and then going back for a refill and getting told that their medication was no longer covered? I’m looking to talk to someone about this – please email [email protected] if you have!

Comment by J.P. on 2008-03-11 07:04:19 -0700 #

I would like to know if my independent pharmacy brothers and sisters would be intersted in paying a small monthly subscription fee to be able to post their drug specials on a widley promoted website.
This site will allow individuals and physicians/healthcare providers to search a database based on zip codes to find cheap generic alternatives offered by you so that they do not only go to Wal Mart or one of the other large national chains promoting these cheap drugs all over the news and TV.

Comment by Deanna on 2010-03-04 20:01:24 -0800 #

You idiots!!! Walmart is not losing any money on $4 generics…walmart just has good buyers with the drug manufacturers. Walmart is such a huge corporation, that drug companies see that they will sell more drugs by lowering their cost to Walmart so they can sell them at $4. Give me a break, Walmart isn’t going to lose money on anything, they are smarter than that.
SHAME on the doctors who will prescribe antibiotics to a patient just because the patient can get it for $4. Use your head people…doctors who value their license won’t do that.
Seems to me that everyone is just pissed off because walmart is doing so well in business.

Comment by K.Rph on 2011-02-21 20:59:59 -0800 #

Well, well, well. What do we have here? A bunch of angry pharmacists who are surprised and upset at what’s happened to OUR profession. Giving away drugs, giving away consultation services, working 12-14 hour days, weekends, nights, holidays. No lunch break, no bathroom breaks (forced to wear diapers at work). Treated like dirt by insurance companies, drug companies, physicians, nurses, physicians’ office staff, store managers, pharmacy district managers, customers, drug addicts, store janitors, kids and insects.
Am I surprised? No. We’ve been putting up with this as long as I can remember and keeps getting worse and worse each year. Why you ask? Because we allowed it to happen. Plain and simple. Once again. WE ALLOWED IT TO HAPPEN. We just couldn’t say no. We just had to work for that chain for a guaranteed 25, 30, 35, 40, 50 bucks an hour because it sounded sooo sweet. But that means for that money they own your body, mind, soul and license.
Unions? Bahhhhhhhh you said. Who needs them? Guess what, bra, there’s no job/profession on the entire planet that needed unions more than we did. We busted our tails to make boocoo profits for the man thinking we were getting a great deal as well. Maybe in the short term, it was a great deal. Can you say it still is?
Since the man made more and more money off our hard work for decades, he’s now rich and controls the Boards of Pharmacy. Guess what? That was the final nail in our coffin. Now if you quit or even go to the bathroom, the man’s got someone who speaks Swahili and nary a word of English with the exact same license you have standing right behind you waiting to put that white coat on and serve the man.
Good job folks. Well done! We’ve been making our bed (coffin) for decades. Now we get to lie in it for eternity.

Comment by I hatemyjob on 2011-02-24 20:34:09 -0800 #

Totally agree, we let everything happen ourselves. But can we do anything? No I do not think so because we all have student loan, mortgage, child support, or even alimony and BTW the Bmer, or lexus we got after we were licenced. We all need that $/hr paid. If there is another chance,I really mean that, I am going to medical school or even DO school. At least I can get paid to sale my knowledge, and I actually tell people I am a “doctor”, MD or DO that is, not the doctor from “doctor of pharmacy” that no one would call us doctor except in pharmacy school. As for foreign pharmacy graduate, do not worry, they can even get an internship now because no chain store would spend money for visa sponsorship. It is our own, just see how many new pharmacy schools have been built. There are so many floaters waiting in line to take our job, sorry I have to say that, but it is true. Can we do anything about? God helps me.

Comment by BrandyDW on 2014-01-13 02:02:18 -0800 #

I’ve been reading your entries from the beginning (I just found your site a few months ago), and I’ve been slowly going through it while I have free time. I’m just a tech, but I love your posts. Anyway with this post I’m starting to think you live in the south east of the United States… Florida maybe. There are only 5 states that Publix are in so… I can also say that one of the pharmacists I work with has referenced you before – saying when he first started he was all naive and now he’s starting to become more like “the angry pharmacist” I just find it funny. 🙂