Pharmacist here. It’s not our fault as much as you think. Basically, the insurance companies invented something called “Pharmacy Benefits Managers” who basically act as a middleman between you and your doctor on what you can get, and how much they will reimburse the pharmacy if you do.
If your doctor says you need atorvastatin, but your PBM says they only want to pay for simvastatin, you can either get your doctor to pay for simvastatin, or pay for atorvastatin yourself with a discount card. The cost for a generic med like that is probably about your copay anyways, so no big loss to you to skip the headache.
Surprisingly, they invented fees for pharmacies! If you choose the route to get your doctor to change you to simvastatin, we get the privilege of managing that for you, and once we finally reach your doctor and make the change, they will give us maybe $10 to fill it for you! Plus you have a $10 copay, so there is some money… But of course we have to source the med. It probably costs us like $12 for this example, maybe less maybe more, depending on the manufacturer. So if we do all of this then it seems like we made $8, but SURPRISE, your PBM charged us a fee for utilizing them. It might be $6. It might be more if we don’t meet certain criteria, like percentage of diabetic patients on statins.
So okay we have our nice $2 to pay for shipping your med to the oharmacy, renting our location, and filling it (I think it’s less than half that on average, I just don’t know the actual figures) with our staff. It should come as no surprise that we have very limited options on manufacturers now.
You might say “well at least the PBM fought to make my meds cheaper in the end” but no! They now get to say to your insurance company “okay we managed getting your patient another month of lower cholesterol, please pay us $100 for our efforts”. So, indirectly, you paid an extra $100 on this whole thing through your insurance premiums. Not sure on if this part is true I just heard it as a rumor.
But wait there’s more! The insurance company actually owns the PBM all along! They paid themselves to offer themselves this service for you!
So anyways I’m getting out of retail pharmacy. Thanks for coming to my ted talk.
I didn’t need to get this upset before 8am. I don’t even take medications, but this is the exact type of nonsense that gets my blood boiling. That there’s anyone between a patient and their doctor (or perhaps a patient and a pharmacist) is just screaming for some forced changes.
Anyone have that I’m too European for this image handy?
I am too Indian for this, even though we have a strange habit of copying the shitty parts of the US and ditching the actually functioning parts.
America: Land of the Free, Home of the decreasing average lifespan because people can’t get access to routine medications that are affordable in most other countries.
I had this bullshit happen in Florida at a Walgreens…I had a doctor put a prescription for me…we had worked together for a good while and finally found a script that works for me. Walgreens tells me they dont carry it, except I’ve had it filled in the past at that location.
Then this way over stepping mother fucker starts trying to diagnose me and then had the audacity to say, “have your doctor call us and we can see if we can work something out.”
Bitch what the fuck do you think the PRESCRIPTION is, that IS the communication between the pharmacy and the doctor, last time I went to Walgreens
Walgreens is just generally the worst pharmacy in the country. I’m convinced they intentionally create delays in picking up the prescriptions that are supposedly already ready to get you to buy more stuff in the store part, plus the store portion is always so chronically understaffed good luck being able to buy anything. Oh and now everything is locked up so you can’t even pull stuff off the shelves to attempt to buy anything. And then they wonder why profits keep going down…
Walgreens once gave me the wrong prescription, which I didn’t notice until after I already taken some. It was some weird drug for schizophrenics or something like that and it totally fucked me up to the point I had to take off work for the day. Instead of apologizing or trying to make the situation right the Walgreens pharmacist was a total asshole to me and tried to blame me for what happened, they acted like I had stolen someone else prescription instead of them fucking up and poisoning me.
I commented without reading what everyone else had to say, and the first words I typed were, “Is Walgreen’s your pharmacy too?”
What would piss me off is that they would constantly blow up my phone telling me to come get my script, it’s ready. Then I get to the pharmacy, and nothing is ready and I have to stand around awkwardly while I wait for them to fill it.
The final straw was I go in person to request a refill 5 days before I am out of meds. “Oh we haven’t gotten the shipment yet? Come back tomorrow.” So I go back the next day, and the next until I am finally out of meds and they still don’t have it in. Like, bitch, I have been filling this RX here for 2 years, do you mother fuckers not understand how to inventory?
After my last refill was up I had my Dr. start sending my scripts to Hannaford. It’s further away, but when they call me for my RX it’s ready for me when I go to pick it up.
To personify a bit, if I came across Walgreen’s dying in the street, I would step the fuck over their body and keep walking.
Oh, is Walgreen’s your pharmacy too?
the thing that annoys me is they don’t care that you have a chronic condition. it’s not going to change. i’m going to need this med for the rest of my life.
but they need my doctor to re-up the prescription every 6 months all the same
They do care if you have a chronic condition. If you do, they can charge you as much as they want.
This is because the doctor is supposed to be monitoring the condition and adjusting to a better med if one exists.
I have found that going to literally any other pharmacy besides walgreens or cvs is a significant improvement in competence and convenience.
CVS and Walgreens pharmacies are staffed like dollar generals. They can’t handle the load but they won’t hire more pharmacists.
I had a small pharmacy I loved I had to give up on when I got a new job and they weren’t in network. I was not going to CVS or Walgreens.
So I went to the hospital pharmacy that is in network. Can’t imagine that’s any cheaper but whatever insurance.
I’ve had exactly one prescription done at CVS (because I could get my med for like 60% of the cost there) because they managed to be out of stock on my med on month two. Immediately switched back and haven’t had a problem
Exactly this! I’ve been going to a local independent pharmacy chain for years and it is a light-years better experience than either of the national chains
I’m pretty limited as to who my insurance covers, so I can’t go to any of the independent pharmacies near me. I’ve been going to the kroger and it’s great, they’ve never once had an issue with my insurance and typically order refills / reach out to my dr for a new script before I even realize I’m low.
My in-laws have the same problem so I’ll get to experience how bad Walgreens is when they ask me to pick up their prescriptions
You forgot the pharmacist who thinks they know more than your doctor and has the gall to opine on your prescription.
Dude.
MDs fuck up prescriptions all the time. You want this.
Yeah pharmacists often know a lot more about drugs than doctors, and they get to focus their whole career on getting good at just that
But thats like their main point. Pharmacist do know a lot about drugs. It’s important to know about negative drug interactions and a pharmacist is more likely to catch it since they most likely know all the drugs you are taking. Your GP might not know about the drugs your psychiatrist gave you or that off-label drug your dermatologist gave you because people are horrible at knowing what drugs they are on and for what purpose.
Fair enough. All I really mean is “idgaf some random pharmacist is opposed to stimulants.”
Honestly I’ve always been surprised how much education is required to be a pharmacist when all they do is put pills into a bottle (obeying whatever the doctor wrote on your prescription) and pass it to you through the window. Then imagine going through all the years of University to get a master’s degree to work in the back of a CVS.
Seriously? They source the drugs, in the correct dosage, or they have to compound a drug, they have to know what other drugs you are on for conflicts that could kill you. They also teach you how to take the drugs correctly.
Why do people who have no fucking clue make comments?
As an outsider to the field it seems ridiculuous that being a doctor does not include this bit of knowledge. If a pharmacist is expected to do all this and able to override an MD (who can get the prescription wrong)… seems like a circus to me.
A pharmacist is much more qualified to give you that information than a fucking Doctor. The pharmacist instructions are for the exact drug in you hand, when you get the drug.
There are a lot of bad prescriptions to be honest. The amount of people who are prescribed both Adderall and large fills of benzos is too damn high.
don’t forget all those opiods the MDs told us were non-addictive.
That was a shame. Because now we have gone the opposite direction and they are massively under prescribed to who need it.
They aren’t even that addictive. Look up addiction rates for people prescribed them legitimately. But saying they were non addictive is obviously fucked up… Pharma reps were literally gaslighting doctors into thinking that they just weren’t prescribing enough and that’s why their patients were having pain, after 12 hours. Definitely not withdrawal symptoms
And the pharmacists helped that… How? Exactly?
Doctor: for condition A use med B in C manner.
Pharmacist: Oh no, what is he nuts? Never use med B for condition A as it contains flixadidlian cortemolezeum which will react badly to manner C. No you’ll need med D.
i mean occasionally the pharmacist is right.
Yeah that’s the pharmacist’s job
yeah, now most of the time the pharmacist is too busy to actually do their job. what people get angry about is when they do it.
Oh I’m glad when they do it. But I also find it a little concerning that your doctor is supposed to be the one who knows everything and then it turns out they sometimes seem to talking out if their ass (or that’s what it looks like at the very least, I’m sure there’s more nuance to it).
sometimes it’s frustrating when the pharmacist is rechecking your work and insisting that the interactions (that you have verified are not a problem via taking the drug for twenty years) are going to be a problem if you accidentally take the drug once. occasionally the patient does know more.
Lemme guess… Adderall?
It’s far easier to buy crack online without getting caught than getting your legit Adderall script
Ugh yeah, and it’s so often based on these ideas like “too many people have adhd” or these worries of addicts. I’m sympathetic to addicts and the misdiagnosed, but at the end of the day, I have a medical condition that requires prescription strength stimulants in order for me to contribute to society and not cause accidental damage to myself and others. No choices were made to cause this other than when two people with adhd decided to have kids.
This whole limited supply thing comes from the drug enforcement agency, cops, not from the fda who are public health officials. Hell a lot of the hoops I have to jump through come from a government more afraid of damage done to those actively seeking this medicine who don’t need it than the damage done if I can’t consistently get the medicine I need in order to hold down a job, drive safely (or walk safely where cars may be), and not forget to pay my bills, do my laundry, and take dinner off the stove when it’s done.
Also the “see a psychiatrist every 3 months” thing is kinda funny because well managed adhd should be pretty consistent. Once it’s good annual checkups should be fine to just check you don’t need to change dose or drug due to tolerance.
I hate the three month appointment requirement. My psych is already overbooked as is and 9 times out of 10 our calls end up being a quick 10 minute check in followed by a 450.00 charge to insurance with 150 uncovered. The alternative is to see a primary care doctor, but they often require a drug test with every visit and its a 50-50 shot they wont try to mess with a script ive had for years.
And to make matters worse there’s some sketchy shit going on with reformulation to reduce euphoria 🙄 I’m so mad that I started taking medication because it changed my life and now I’m unstable due to this shit.
I didn’t know about the reformulation thing — is it Adderall that’s affected? I’m not personally on Adderall, but I like to be aware of the overall landscape of ADHD meds due to having many friends with ADHD (and also being a nerd)
If i recall, and someone correct me if im wrong, back in August the ratio of active ingredient allowed to filler allowed went from 2:1 to 1:1 for adderall.
Yeah, the reformulation cut the effectiveness nearly in half for me. I went from stable on the same script for 2 years to suddenly being emotionally agitated all the time, constant headaches, and 0 symptom relief. It took 8 months to figure out, but my provider and I finally landed on using a different manufacturer and nearly double the dose of what i had before to almost get me back to my original stable state.
They learned from all of the mechanics, plumbers, construction crews and electricians. While most of the rest of the world goes broke these folks will do okay. I once called a company to look at a window that needed replacing and the first thing he said when he walked up is “Your shingles are starting to curl”. I went with another company who was more reputable, charged me fairly, and did good work. It’s tough out there.
But are you sure your shingles aren’t starting to curl? Maybe the other one just didn’t have a shingles guy so they don’t give a fuck about your curled shingles
Clearly he put a curling iron to his shingles for that fancy curled shingle look. Why would he want that fixed?
https://www.inhousepharmacy.vu/
https://www.alldaychemist.com/Some old school sites that allow ordering of certain rx medicines without an rx. You can’t order scheduled substances like opioids, but they have a lot of common prescription medications.
I tagged you at some point with “knows his shit” and youve yet to disappoint.
Please. Knows HER shit! :D
The tag has been updated, haha
Blaming pharmacists for things they have no control over, nice. Biggest brain
contrast this me picking up my dog’s prescription meds: “ah, shit, that was his last pill!” <calls vet office> “hey, could I get a refill of gabapentin and vetmedin? Let’s toss in some canned food. Sure, I can swing by after work. Thanks!”
From my point of view, the difference is there’s no insurance involved, so I pay out of pocket and no one has to deal with insurance companies. (pet insurance exists, but I’ve done the math and it doesn’t make financial or logistical sense for me.)
I do like my human pharmacy, but all my human meds are generic and not super controlled or abusable. I gave up on ADHD meds.
there’s no insurance involved
Oh, don’t worry they’re working on fixing that little “problem” won’t be long before veterinary care is as horrible as human health care is. Already have people around me signing up for that shit and raving about how it gives them peace of mind. Morons aren’t doing anything but feeding the enshittification.
i mean they’re probably at a banfield clinic paying through the nose already
