So I got some hatemail in response to this entry

They may be corporate assholes, but at least they hold nobel intent.

Nobel intent would be charging a fair price for /all/ generics. Not $4 for amoxicillin yet $40 for a month supply of lisinopril or HCTZ.

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.

Actually inappropriate use of antibiotics kill people (MRSA? VRE? VRSA?). Maintenance drugs that cost pennies will save more lives than all of the antibiotics combined. Why aren’t they giving all those away for free?
You’re right, no company /has/ to give this type of break however it looks really, really good for business if they do. Plus guess what, if you transfer all of your drugs there for 2 or so drugs at $4, you get to pay 10x what an independent charges for the remaining 5 of your Rx’s. Bait-and-switch. Bend over and grab your ankles. They are making up for the loss somewhere.

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).

Nah, myself and all the other pharmacists will be out of business at that point. We’ll determine that the cost of our schooling outweighs our income and we’ll just all do something else that makes money. Then as the pharmacies start to dwindle, the ones remaining can charge whatever the fuck they want or just refuse to serve you. Then what? You’ll just bitch that pharmacists are a bunch of greedy bastards because they don’t wish to work for free to fill your trade name Coreg for $1.50 profit.
Oh, I dont drive a porsche. I think fancy cars is just pissing money away. I prefer to spend all my money paying taxes so welfare folk don’t have to work and for this website so you’ll have something to bitch about at work.

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 think money is on wall street? I should of opened a PBM and started raping the system a long time ago, however anally raping the sick and poor isn’t really my cup of tea. Maybe to you wall street types its okay.

You’re a self-loathing narcissist; get over yourself.

You’re just a retarded douche who has totally made an ass of himself in front of a few hundred pharmacists.

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.

Zofran is pennies now. Its generic, so yes, I will be Rx’ing myself some Zofran because it costs about the same a Phenegran and doesn’t have all the sedation side effects. My pharmacy however does not have a $4 menu because we charge a fair price for /all/ medications, not cheap out over a few to draw people in to rape them on the other ones. Fair prices and good service, like all pharmacies should be.
Plus what does my post have to do about anything that you are ranting about? Did you even read my post? Let me recap because I know I used some big words.
My rant was about these pharmacies giving away free/$4 generics away setting a precedent to the insurance companies to cut our reimbursements due to the fact that if we can get by selling things for $4, then obviously their reimbursements are way too high. They are fucking it up for the rest of us who cannot afford to sell medications for $4. Its a marketing scam and its going to draw the opinion of all the major PBM’s to make that AWP-30%+1.50 sound like a wet dream.
Wait to see how many pharmacies are left when the PBM’s make all the reimbursements $4/rx, and next time read my damn post before flaunting your ignorance.

Oh-boy! A response from an Express Scripts Reject!

As an employee of Express Scripts, I just thought I would drop you a line and let you know to fuck off. You pharmacies bitch like shit about this but when there’s drugs out there your being reimbursed SUBSTANTIALLY over cost do you call us and complain? I didn’t think so, not as if any of you fuckers are taking a loss on a day to day basis.

So, a Call Center dropout somehow knows what our cost is to fill prescriptions? What is your definition of “SUBSTANTIALLY” over cost? Is $5 over cost? How do you know how much we get medications for? You think that if we were being reimbursed over a ‘fair’ price we would call and bitch? We call and bitch because:

Sorry for the lapse. Work, death in family, long needed vacation, life, etc. I’m not dead.

who r u if u worked for WAG THEY WOULD HAVE FIRED U A LONG TIME AGO. I know
this will not make it to your blog because your are a plant .give me a
break . if you are a chain pharmacist you wopuld not know some of the stuff
you are blogging about like profit margins and such. so own up and tell us
who you really work for

I am a plant? What the hell?
You’re right, if I were a chain pharmacist I would not know about profit margins and other stuff like that. I work for an independent pharmacy (thats a pharmacy not owned by a big company, but a family/single person) so I have to know about profit margins, how much ExpressScripts is boning me, and what a ‘good’ reimbursement is. I’ve said it a bazillion times in the past, you just had to take 2 seconds and look for yourself. Now you look like an idiot in front of everyone. Good job.

I swear, sometimes this website just writes itself. I wrote this a while ago, but you guys have already picked out all the choice material in the comments by the time i got around to post it. 🙁

I have been in medical sales for my entire career, ten of those as a drug rep. I am a professional woman, I dress professionally, and hopefully I bring decent information to the doctors and pharmacists that I call on.

“Decent” information would include unbiased information.. So you bring propaganda, because you have a desired outcome the moment you walk in the front door..

Drug reps are not prostitutes, nor have I ever “sucked anyone’s….” to get business. I have never been out on a date with a doctor. I seperate business from my personal life.

Oh jeezus. Wear a net over your head so maybe you’ll understand one of my many jokes.
Did you really think that I thought drug reps were out giving doctors blowjobs and lapdances? Seriously, it was a metaphor, a figure of speech to mean that they were selling themselves and preforming “favors” in the way of pens and free dinner/goodies in return for something, in this case writing for the product that you are pushing. It was a creative and descriptive way to say “bribe” or “kickback”. Its not really prostitution, because the doctors aren’t paying YOU for your services, its the other way around, so its like reverse prostitution, prostitution^-1, or noitutitsorp (thats prostitution backwards).
Now if my made-up example was correct, and there were drug reps out giving blowjobs in return for writing for their product, then I’m in the wrong damn profession. 😉

Two things are going on here and I know that you are just going to slam me but I will say it anyway. Normally I find your blog funny, as I do have a sense of humor. I too think that the industry as a whole needs some repair.

True, and I’m glad you have a sense of humor. I do too, and if you think I treat drug reps in my store like I rag on them on here you are mistaken. I dont care what they have to say, but i’ve never crumpled up a business card and thrown it at them screaming. I just smile and nod as I’m up to my neck in Rx’s and answering the phone. As they are reciting their little speech about how wonderful the next $400 wonder drug is, I say “oh really?” and an occational “uh huh, wow!”. But to be honest I dont really have time to sit there and grill them.

But maybe, just maybe, you have interviewed for a position as a drug rep, and you just don’t cut it? So you are disgruntled? There is alot more to being a rep than throwing out pens, ect. I will put my knowledge of the 4 drugs that I sell up against any MD or Pharm any day of the week.

Oh, yeah… I couldn’t make it as a drug rep so I decided to be a pharmacist instead. You know, because I am incapable of knowing 4 drugs yet somehow capable of knowing all of the major classes, the disease states, the mechanism of action, and everything else that goes into being a pharmacist. Head, meet desk.
You can put your knowledge of the whole 4 drugs you know against my knowledge of not only those same drugs, but the treatment plans for what they treat, their mechanism of action, what patient population you can and cannot use (based upon how its cleared), AND who covers them.
Dont compare your knowledge of 4 whole drugs against an MD and think you’re some hot-shit or something. Anyone can walk circles around them in pharmacotherapy-land much like MD’s can run circles around me quoting excerpts from ‘Harrisons’ and diagnosing Wierdo-McButtfuck-Syndrome. So I’ll say this: Maybe YOU tried to become a pharmacist and couldnt cut it so became a drug rep instead.

You and the docs have to somewhat know the PDR

PDR?!?! HAAAAAAAAAAA HAAAAAAAAAAAAAAAAAAaaaa……. *gasp* HAAAAAAAAAAAAAAAAAAAAAAAAAAAAA*snort*AAAAAAAAAAAAAAAAAA HAAAAAAAAAAA!!! PDR!!!! Oh fuck! Somewhat?!! HAAAAAAAAAAAA HAAAAAA!!
That quote right there just completely blew your whole argument right out of the water. The PDR is shit. Any pharmacist who uses the PDR needs to be publicly drug out into the parking lot and shot. Pharmacists use books that manufacturers dont PAY MONEY to have put in there. We use Facts & Comparisons, Lexicomp, or any other REAL pharmacy reference (Remingtons for the hard core old timers out there! Go big green book!). We pay big dollars for our reference books. We also use pubmed to get journal articles (you know, those pieces of paper you give to doctors in the nice binders printed on glossy paper with the big words and weird looking graphs on them). Pharmacists use unbiased sources and draw their own conclusions using the available data, its what doctors should be doing as well.

, we have to know our products.

You dont know your product, you recite what the mothership has brainwashed you with. Did you take pharmacology? No. Did you go to college to learn about therapeutics and treatment standards? No. You got the pharmacy cliff-note version of “here is what you need to know”. Memorizing numbers and figures and fancy acronyms for studies that spell out things like SHIELD and stuff.

Or maybe, you are a fat,ugly nerdy type with no personality, and a good looking woman ( drug rep or not ) will not give you the time of day?

Well you are a poo-poo-head dummy butthole. I’m taking my wagon and going home because you called me names!
Actually I (and im sure most of the people on here) wish that no drug rep would give us the time of day. And how can you say with a straight face that I have no personality! Look at what I write on here! I have talent!

Because your anger towards women in general comes out loudly.

Because every comment about drug-reps I make involves women? Hate to tell you, but most MD’s that actually listen to your bullshit are men. Plain and simple. For some reason the women doctors around here dont really care what you have to say and I get far less DAW-1’s and your silly drug-rep stamps from the women then I do from the men. Plus most if not all of the female drug reps (and I see a ton of them) are really hot. I can talk about the male drug reps giving.. uh.. lapdances? to the female doctors? yeeaah.. with his low cut pants?… uhhh.. suuuuure…. doesnt really have the same effect, sorry.
But you’re right. I hate women. I’m only engaged to one, and work with a whole staff of them for 9 hours a day. Does it count if I beat them with my belt? What if I make them worship me and call me “Your royal angryness” (that sorta has a nice ring to it)… “A new Rx on line 3 your royal angryness!”… “Yes your royal angryness, I shall get you the tramadol 50 and count thee 60 of them”… “Your royal angryness, there is a woman here who says her vico-dans were flush down the privy. What shall we do with her sir?”…
Give me a break, seriously.

Normally I laugh at your blog, but your anger has taken a dark turn towards people who are just like you, trying to make a living in an increasingly difficult world run by insurance companies.

Ever think that maybe the company you work for is part of the problem and not the solution? Wonder why insurance is so damn high now days? You think the insurance companies like your little speeches to change everyone from a product that costs them $5 to one that costs them $200? I realize you are making a living selling something, but its just that, selling something. You are a salesmen, not a consultant but a salesman. Quit acting like you are a consultant to a doctor/pharmacist (or part of the treatment “Team”) and start acting like the commercials I see on TV.

And one more thing, as you rail against people and their habits or addictions. Alcohol is an addiction too…you just are able to buy it in any store..so when you talk about your drinking in relation to the people that you despise with addictions to rx-meds, perhaps you need to look in the mirror?

If I give a liquor store owner both barrels because I drank my whole bottle of scotch in 3 days when it was supposed to last a month even though the directions say “1 glass at bedtime” then yeah, I expect to be bitched about. I don’t rail on them for being addicts, I rail on them for being so dense and oblivious to the stupidity they inflict upon the world then giving me both barrels thinking its all MY fault. Am I out selling my booze that I got for FREE on the state dime? Do I lie and make up stories to the liquor store man so I can buy another bottle?

Later TAP.

Thats TAP(tm) (I know the angriest is watching). Are you really a drug rep? Or is someone playing a joke on me. Seriously, for someone who has been a drug rep for “10 years” i expected something a bit more.. uh.. realistic?

Ah, I love it when I get hate mail from other pharmacists. After reading this over, I mostly agree with him/her (surprisingly). Though I dont think CVS wants this persons name attached to what he/she wrote.

1) You don’t have the staff to handle the load from mail order pharmacies
if they disappeared tomorrow.

You meaning me personally? No, you have me there god dammit. If every mail order place closed and they all came to /my/ store, then I guess I’d be up shit creek without a paddle. So would you. Thats sorta like saying “If someone drove a car through your front room, you’d be upset”. Pretty much a big “Duh” there.

2) I get one of my meds via mail-order, because I got tired of paying 3
copays when I could do 1 instead. I’m not an idiot for doing this.

Then don’t bitch when your patients jump ship and do it to you. Of course I see that you take gifts from drug-reps, so that says something. At least you had the common sense to throw out the DAW-1 forms when the Coreg vultures came circling pushing Coreg ER. I did the same thing too, but I didn’t get any loot from them. Actually I told them they were a bunch of liars for pushing Coreg just months before, but suddenly going against all they told me once the generic came out for $5 per 100. Amazing how all those studies just aren’t worth dick if the drug company that paid for them isn’t making a $100+ profit from each Rx that I fill. Thank you Mylan for making generic Coreg so inexpensive.
Working in a pharmacy Im surprised you even have to pay copays for your medication. Even I dont have to pay the $25 copay on my medication. 🙂

3) You bitch and moan about “kickbacks”. Sounds to me like you’re a whiney
independent pharmacist pissed off because you don’t have the economies of
scale that a mail order house does. (And neither do the big chains,
incidentally.) Since you’re throwing out some pretty serious accusations,
you should offer some sort of proof. But since you’re full of shit on this
particular point, you can’t. Go ahead, though, I’ll wait to see what you
come up with.

Usually I get a few bitches a month about my Clomid + Medicaid rant. About every other one is written by a complete idiot. You make the call as to which one this is.

Are you stupid? Welfare and Medicaid are NOT the same. We’re not bums. WQe
work. Medicaid is to help those who cant afford the high costs of
insurance. So you’re saying someione who is dissabled and on ssi or welfare
or medicaid is a bum?? Get your facts straight dummy. And you shouldnt be a
pharmacist.

Oh yay! Where should I start:

One (1), uno, a single person had a complaint about my Nurse vs NA/MA rant.

I am a 17 year old girl in my senior year of high school. Im in the miami
valley career tech center. This is my second year in the MVCTC. I am taking
allied health. I have always wanted to be a nurse as far back as i can
remember. My program has already went on clinicals and everything and we
are trying our best to learn everything as quick as possible. I think that
NA’s and MA’s should be able to call themselves some what of a nurse
because after all thats what we are going to school to be is a nurse. I
also dont think people should run their mouths about people who call
themselves nurses because its none of anyones buisness so leave it alone.
Our teachers that teach us here are all very good RN’s that know what they
are doing!!!!!!!! SO STOP YOUR SHIT AND GET OVER IT!!!!!!!!!!!!

Ah, to be young again. Honey, you’re going to find out later on in life that if you call yourself something that you are not, especially in the medical field, you are going to get in a whole pot of deep hot shit. Comparing your education to someone with a BS degree in nursing is really insulting to those who actually went to college for 4+ years to get an RN. Names and titles are reserved for those who actually earn that title. See, the ‘A’ in your title stands for ASSISTANT. Therefore you are a Nursing ASSISTANT not a NURSE. You can call yourself an NA or a MA until the cows come home, just don’t call yourself a nurse. In fact, you don’t even call yourself a ‘woman’, but a ‘girl’. Afraid someone is going to call you out that you are in fact a girl and not a ‘woman’?
And yes, It is my business to know exactly who I am talking to on the phone, because you may not realize this now, but when I ask you a question, and you guess an answer (because you are not an RN, and you think its okay to just guess) and someone dies, its my ass, not yours. I’m not saying that you all are a bunch of idiots, but my pharmacy techs don’t run around calling themselves Pharmacists, so you shouldn’t call yourselves a nurse. See what your RN teachers think about that.
Now what you should be worried about is the influx of angry nurses who are going to chew your ass a new one when they read this post. Of course its best to have this happen on the internet than in front of everyone in a hospital where they can see you cry.
I’m going to enjoy this. Nurses, you know what to do! Get your friends in on this. Lets make something she can print out and hand to her teachers who think its okay that they call themselves nurses.