i am supposed to be studying but instead i am reading this (hehe)
Q. I’d like to renew a subscription.
A. It actually sounds better when you say “I need to get some pills”.
Q. Why does it take so long to get my prescription?
A. Because we hate you so much.
Q. I brought you the prescription. Can’t you just give it to me now?
A. Because the reason it’s a prescription medication is because the FDA decided it’s too complicated or dangerous for members of the public like you to use it without supervision.
Q. But you have the eyedrops right there in your hand. Why can’t I just buy them?
A. Because they’re prescription-only. Also, we hate you so much.
Q. Do you hate everybody so much?
A. Mostly the people who have no idea of or appreciation for what we’re doing, and ask nasty questions like “it takes you twenty minutes to put my cream in a bag?”
Q. So what are you actually doing back there that takes 20 minutes?
A. Finding your drug on the shelf, making sure we have enough to fill your prescription, checking that it’s a legal prescription, checking that it makes sense for the indication and patient, typing the prescription into the computer’s dispensing software, counting the pills/tabs and labeling the vial, checking the typed-in information against the hard copy of the prescription, logging out the narcotics and checking the drug against your profile to make sure there’s no drug or disease interactions and judging, if there are, whether any of them are clinically significant. Possibly also calling the insurance and/or the prescriber. That’s for your prescription. Meanwhile, we’re answering the phone to take new scripts from doctors, refill requests and general queries from patients, checking the patient and prescriber voicemail, counseling other patients, faxing for other people’s refills, and calling doctors about scripts that didn’t make sense. In any downtime, we’re ordering new inventory, selling pseudoephedrine, returning unpurchased prescriptions to stock, calling people to make sure they know they have orders to pick up or maybe unpacking the drugs we ordered yesterday.
Q. I thought pharmacists are just pill-counters.
A. That is one of the best ways to ensure that your prescription takes several hours to process.
Q. Ok, but it’s a refill!
A. And there are ten people in front of you. If you had called a day ahead and used our automated system to request refills, you would not have to wait.
Q. But I did.
A. Calling after we have closed for the evening and coming in 15 minutes after we open the next morning does not count. Have a seat.
Q. Can I tell you what my prescription says and then give you the hard copy when I come pick it up?
Q. Can I fax you a copy of my prescription?
A. No. You are probably not a licensed prescriber, and if you are, you should not be calling in your own prescription. We need the hard copy, or you can give your prescriber’s office our phone or fax number.
Q. But I did!
A. And did you just leave the office? Calling in prescriptions is not the top priority for most medical offices. Also, if you are handing me a hard copy as you say this, they did not call it in. I promise.
Q. There’s a problem? With my prescription? Written by my doctor?
A. We are contacting your doctor to get this sorted out. Please stop dialing your doctor’s office and put your cell phone away. I am sorry I extended you the courtesy of telling you what’s going on.
Q. This is my first time here. Do you need my insurance card?
A. Only if you want us to bill them.
Q. I gave you my card! What do you mean I don’t have coverage?
A. Not the medical, dental or vision insurance card. The prescription coverage card.
Q. But my insurance-
A. Screw your insurance. Srsly.
Q. There’s a problem? With my insurance?
A. Please put your cell phone away. We are contacting your insurance company to get this sorted out. I am sorry I extended you the courtesy of telling you what’s going on.
Q. Is this covered on my insurance?
A. I have no idea, and absolutely no way of knowing because there’s dozens of carriers with a hundred bajillion different plans. Ask your insurance company, or your benefits coordinator.
Q. But I pay a bajillion dollars a month for coverage!
A. Your insurance company doesn’t cover this drug. I’m slightly sorry that you have to pay out of pocket for your skin-bleaching cream or SEXYTIMES tablets, but it’s not my fault and I can’t change it; it’s part of your contractual agreement with your insurance company.
Q. My prescriber wrote for three months’ supply.
A. Your insurance only allows us to bill them for a 30-day supply at a time. See you next month.
Q. I’m taking my hard copy to a different pharmacy, then.
A. Have fun discovering the same issue there.
Q. OMGWHY?
A. Most insurance companies that limit retail-pharmacy fills to 30 days’ supply have an in-house mail-order pharmacy that they want you to use for meds you’re going to be on long-term. You will probably have to get your prescriber to call or fax in a new prescription written for a 90-day supply to the mail-order pharmacy, and their number is probably in your insurance enrollment packet.
Q. Why doesn’t my $Drugstore discount card work on prescriptions?
A. Assuming have insurance your co-pay is part of the contractual agreement between you and your insurance provider, which you consented to when you signed your insurance enrollment papers. For everyone else, the reason it doesn’t work is that $Drugstore set up their discount cards to not apply to prescriptions.
Q. Can I get it in generic?
A. Sometimes. Some medications are still under patent and are only available in brand. When permitted by the prescriber, we substitute a generic equivalent whenever possible.
Q. Can I get it in brand?
A. Sometimes. For medications still under patent, you can only get brand. For many others, you can get brand at a ridiculous price premium. We would actually prefer that you get generic because our margins are better.
Q. But brand-name is better, right?
A. No. In the US, generics manufacturers must submit evidence documenting their product’s bioequivalence to the brand product in order to be “AB rated” and automatically substitutable. Many times the prescriber writes for the generic name, meaning that we do not have to use a product bioequivalent to the brand product anyway.
Q. My medication looks different!
A. I told you this when you picked it up. Our supplier automatically substitutes the least expensive generic when we order, so sometimes they send us a different generic.
And while it’s good that you actually looked at your medication, it would probably also behoove you to look at the sticker saying “generic substitution made” or “this is the same medication but size or colour may differ due to a new manufacturer.” You know, the one that’s on the vial, next to the warning about your pee turning colours.
Q. My medication has the wrong name!
A. The generic came out. FFS, it’s five dollars now, and your doctor wrote the prescription so we could substitute. You’re bloody welcome for us saving you money.
Q. What is my co-pay going to be?
A. Unless it’s printed on your card, I have absolutely no way of knowing until I bill them. ABSOLUTELY NO WAY. Q. WHYYYYYYYYYY is it so expensive?
A.
- You don’t have insurance; the drug is just expensive.
- You do have insurance
- Your insurance doesn’t cover it
- Your insurance covers it, but your insurance also sucks
- You’re on seven different medications and have to pay ten bucks for each one
- You’re paying a hundred dollars for something that’s $2700 a month, so count your blessings
- oh yeah, we hate you.
Q. How can a generic drug be expensive?
A. Not every drug market has fierce enough competition to drive drug prices down to pennies per tab. Sometimes drug companies have agreements with insurance companies to set preferences for a certain brand-name drug, so InsCo and therefore you get a discount on it. Often the first generic in a field will be only slightly less expensive than the brand product, because that slight difference will be enough to tip purchasing patterns in its favour for now. Some of the older generics in the field have also gone through changes in the manufacturing process that makes them much easier and cheaper to produce now than they were right after they came off patent. Also, drug forms that come in a device, like an inhaler of some sort, will always be more expensive than tablets, because you’re paying for the device.
Birth control is an especially heinous example where every generic seems to have become its own brand, so that rather than “monophasic birth control, 28-day cycle, 0.2/100 ethinyl estradiol/levonorgestrel”, you get Barr and Watson and everyone else putting out their own branded version of a monophasic 28-day EE/LNG cycle-pack in its own flowery package with its own flowery name and a differently shaped punch-out card. All the generics cost about the same, regardless of formulation-about $35-45/month retail- and all the brand-name formulations (yes, the ones that the family planning clinic gave you for free) are $50/month or up.
Q. I do so have refills! It says on the bottle!
Q. Um, I have a standing prescription for such-and-such; I’m supposed to take it for the rest of my life.
A. Prescriptions eventually expire. We can fax your doctor for a refill for most medications.
Q. How about my OxyContin?
A. No. Schedule II controlled substance prescriptions cannot be faxed. Bring us the new hard copy. Also, no, we will not order it for you or start getting it ready until you bring the hard copy in.
Q. Hehe. What do you do with the expired Ritalin?
A. We have to fill out a controlled substance transfer form (mandated by the DEA) and turn it over to an agency that destroys it-usually our supplier. My nose is not a DEA-licensed drug handler, so quit snickering.
Q. How can you not have this in stock?
A. It’s very old/very new/very expensive/very rarely requested. Drugs are expensive, so we only keep a huge inventory for drugs that move quickly. Also, we hate you so much.
Q. My narcotics fell in the toilet?
A. That sounds pretty rough. You should be more careful next time.
Q. Can’t you do anything about it?
A. I am not physically capable of reassembling dissolved tablets. Sorry.
Q. No, I mean can’t you give me more?
A. Only if I call the doctor and she decides you’re not a drug-seeking schmuck, and it’s also not a schedule II controlled substance. If you are seriously in pain you need to tell your prescriber and not me, and you also need to quit taking so many of those so you don’t kill your liver with all the acetaminophen.
Q. This is the third time this has happened! I’m going to talk to your manager!
A. Perhaps you should also replace your toilet.
Q. Hey! I need to drop off a prescription!
A. Some people would take the shutters being closed and the lights being off as a sign that we are closed. But not you, you plucky little pony.
Q. But you’re there!
A. We are not processing prescriptions currently because I am clocked out and wish to go home and kick off my sensible shoes. I can fill it tomorrow.
Q. But-
A. Perhaps because it’s so urgent you could have taken your 6-week old crumpled prescription into a pharmacy earlier in the day. Have a good evening