3 ms·

It seems like every time I have to deal with a pharmacy, I am continually blown away. It's a uniquely terrible experience, more akin to the DMV than a retail st

by brbsix 10y ago

It seems like every time I have to deal with a pharmacy, I am continually blown away. It's a uniquely terrible experience, more akin to the DMV than a retail store.

arethuza 10y ago
Out of interest (I'm not from the US) - how can a pharmacy be bad - every time I go to one it's a case of handing across a prescription, waiting a few minutes and then getting the drugs/whatever.
- brbsix 10y ago
  They won't have a medication in stock, they can only partially fill it (requiring you to forfeit the rest), you have to bring in a physical prescription (it cannot be called or faxed in), they say the wait time is 1 hour and it ends up being days, they have to call the doctor, pickup requires a pharmacist consult but no pharmacist is presently available, their computers (and thus insurance billing) are down therefore only cash is accepted. I could go on.
  - arethuza 10y ago
    Only time I can remember having to wait more than about 15 minutes (and that was in an eye hospital for apparently drugs that were rare and expensive) was for rabies vaccine and even then the pharmacy delivered it to the GP for them to store it before we had paid (NB we don't normally pay for prescriptions here, things like rabies vaccine are done "private").
- Spooky23 10y ago
  Insurance craziness. CVS is becoming a classic horizontally integrated monopoly for drug distribution (benefit management, wholesale distribution and retail) so it's getting much worse in recent years. For normal drugs they have "step up" process for new drugs so they won't pay for a 90 day script without you first getting two 30 day scripts. They make more money via co-payments on 30 days so shockingly, they fuck this up all of the time to make more money. In my case, I am on a blood pressure med that went generic. So the script changed to the generic... Which triggered the 30 day "step up" for the same drug. I lost alot of weight and had the generic script changed to a different dosage... Again, back to the 30 day "step up". My insurance penalizes you for short term scripts for maintenance medication, so I get to pay $50 each for two 30-day scripts vs. $25 for a 90 day. My wife was different, "speciality" drugs, which include stuff like type-1 diabetes and fertility meds require that you use the insurance company's pharmacy and jump through more hoops. My co-worker has a daughter with type-1 diabetes. He's a "type A" PM and actually has developed a project plan with about 100 documented steps to ensure that her medications are delivered on time. He did that after he daughter had to be admitted to the hospital when they ran out of drugs -- which cost the other insurance coverage $25k or more, so it's not saving money. It's all about delaying expenses over some reporting period and maximizing revenue. Nickel and diming co-pays is how they make a profit with a huge employer like mine with lots of bargaining power. Delaying issuance of speciality drugs is also a profit center, as they are paid a commission/incentive for "controlling" costs in a given quarter/year.
  - matt_wulfeck 10y ago
    Honest question, is it possible to get these prescriptions filled from mail-order or international pharmacies? It seems there's a demand for reliable, no-bs medication delivery from outside of the system.
    - mcculley 10y ago
      I would be surprised if there aren't obstacles to importing drugs that require a prescription.
      - hiram112 10y ago
        There are. It is mostly illegal to import drugs from overseas. There used to be 90 day exemptions that did in fact lead to many older Americans creating tour groups with the express purpose of crossing into either Canada or Mexico to purchase 90 days worth of drugs. Big pharma lobbied to end this practice and it appears to be in a bit of a gray zone. When it comes to visa workers, we know that the rallying cry is 'severe shortage of skilled workers'. The analog talking point for drug imports is 'safety - think of poor grandma ordering some blood pressure meds and instead getting fakes or worse'. We can't allow imports and it's for your own good, citizen. It is absolutely illegal for a wholesaler to import drugs for resale, though. This would essentially destroy big pharma's monopoly overnight, and it is absurd that this is rarely discussed. American consumers essentially subsidize the cost of medicine for the rest of the world (similar to military protection), and it is a large reason we spend more per capita with worse health than every other peer. Interestingly, Trump is one of the few candidates that has ever pledged allow imports and cut off the pharma industry embargo. See point #7 on his page's plan for health care reform. Hillary's plan says vague things like 'more affordable health care for all working families' with no description of how this will be accomplished.
    - Spooky23 10y ago
      Yes, absolutely. But the insurance won't pay for those. Many self-employed folks import drugs from Canada. For awhile, local governments in my area were doing it as well.

by brbsix 10y ago

It seems like every time I have to deal with a pharmacy, I am continually blown away. It's a uniquely terrible experience, more akin to the DMV than a retail store.

arethuza 10y ago

Out of interest (I'm not from the US) - how can a pharmacy be bad - every time I go to one it's a case of handing across a prescription, waiting a few minutes and then getting the drugs/whatever.

brbsix 10y ago
They won't have a medication in stock, they can only partially fill it (requiring you to forfeit the rest), you have to bring in a physical prescription (it cannot be called or faxed in), they say the wait time is 1 hour and it ends up being days, they have to call the doctor, pickup requires a pharmacist consult but no pharmacist is presently available, their computers (and thus insurance billing) are down therefore only cash is accepted. I could go on.
- arethuza 10y ago
  Only time I can remember having to wait more than about 15 minutes (and that was in an eye hospital for apparently drugs that were rare and expensive) was for rabies vaccine and even then the pharmacy delivered it to the GP for them to store it before we had paid (NB we don't normally pay for prescriptions here, things like rabies vaccine are done "private").
Spooky23 10y ago
Insurance craziness. CVS is becoming a classic horizontally integrated monopoly for drug distribution (benefit management, wholesale distribution and retail) so it's getting much worse in recent years. For normal drugs they have "step up" process for new drugs so they won't pay for a 90 day script without you first getting two 30 day scripts. They make more money via co-payments on 30 days so shockingly, they fuck this up all of the time to make more money. In my case, I am on a blood pressure med that went generic. So the script changed to the generic... Which triggered the 30 day "step up" for the same drug. I lost alot of weight and had the generic script changed to a different dosage... Again, back to the 30 day "step up". My insurance penalizes you for short term scripts for maintenance medication, so I get to pay $50 each for two 30-day scripts vs. $25 for a 90 day. My wife was different, "speciality" drugs, which include stuff like type-1 diabetes and fertility meds require that you use the insurance company's pharmacy and jump through more hoops. My co-worker has a daughter with type-1 diabetes. He's a "type A" PM and actually has developed a project plan with about 100 documented steps to ensure that her medications are delivered on time. He did that after he daughter had to be admitted to the hospital when they ran out of drugs -- which cost the other insurance coverage $25k or more, so it's not saving money. It's all about delaying expenses over some reporting period and maximizing revenue. Nickel and diming co-pays is how they make a profit with a huge employer like mine with lots of bargaining power. Delaying issuance of speciality drugs is also a profit center, as they are paid a commission/incentive for "controlling" costs in a given quarter/year.
- matt_wulfeck 10y ago
  Honest question, is it possible to get these prescriptions filled from mail-order or international pharmacies? It seems there's a demand for reliable, no-bs medication delivery from outside of the system.
  - mcculley 10y ago
    I would be surprised if there aren't obstacles to importing drugs that require a prescription.
    - hiram112 10y ago
      There are. It is mostly illegal to import drugs from overseas. There used to be 90 day exemptions that did in fact lead to many older Americans creating tour groups with the express purpose of crossing into either Canada or Mexico to purchase 90 days worth of drugs. Big pharma lobbied to end this practice and it appears to be in a bit of a gray zone. When it comes to visa workers, we know that the rallying cry is 'severe shortage of skilled workers'. The analog talking point for drug imports is 'safety - think of poor grandma ordering some blood pressure meds and instead getting fakes or worse'. We can't allow imports and it's for your own good, citizen. It is absolutely illegal for a wholesaler to import drugs for resale, though. This would essentially destroy big pharma's monopoly overnight, and it is absurd that this is rarely discussed. American consumers essentially subsidize the cost of medicine for the rest of the world (similar to military protection), and it is a large reason we spend more per capita with worse health than every other peer. Interestingly, Trump is one of the few candidates that has ever pledged allow imports and cut off the pharma industry embargo. See point #7 on his page's plan for health care reform. Hillary's plan says vague things like 'more affordable health care for all working families' with no description of how this will be accomplished.
  - Spooky23 10y ago
    Yes, absolutely. But the insurance won't pay for those. Many self-employed folks import drugs from Canada. For awhile, local governments in my area were doing it as well.