Friday, August 2, 2013

Sometimes Life Just Isn't Fair...

As a pharmacist I've seen my fair share of patients come and go and pass on.  I'm usually not affected to hear when a customer's relative tells me that they have died.  I usually just feel surprised because one minute your filling their scripts and counting their pills and then they never get counted again.  But I've never felt sadness.  However, one of my patients, Mrs, Happysmile, recently gave me the bad news that she was just told not too long ago.  Apparently, the breast cancer that she beat and survived from more than 10 years ago has reared its disgusting face again and she was found to have metastasis.  This stupid piece of cancer not only metastasized but set up shop in her bladder, spine, and many other places.  When she told me this I felt complete and utter sadness.  My heart sank and felt like I was losing one of my family members.

Mrs. Happysmile is the kindest, most generous, humorous, beautiful customer I have ever dealt with in all my years in pharmacy.  She's followed me from the big chain monster to this small independent and has been loyal to me since my career began.  She's one of the few that would actually remember my birthday when it came up and gave me gifts when Christmas time came around and when I got married.  I don't know how much she knows about what's going on, but in looking at her ultrasound reports and lab tests, it seems like there's not much time left for her.  Mrs. Happysmile, you are in my daily prayers.  I pray you continue to live happy and smile many more days.  You deserve only the best.

Monday, July 1, 2013

Get Your Government Hands Off My Drugs...

This blog is about an article I just read.  Here is the link:

Pharmacies unwilling to take loss on insulin for Medicare patients

Poor Mr. Carr.  He can't get his insulin filled because his insurance is paying the pharmacy less than what it actually costs.  In basic terms, it's like a store buying a shirt from the designer for $50, then selling it to a customer for $10.  It doesn't make business sense to practice that way.  And it's all because the government has it's greedy and stupid little hands on his healthcare.  Don't get me wrong, I am a big supporter for those who are disabled and low income to receive some sort of help for their insurance and healthcare costs, but at least do it the right way. 

According to the article, "Medicare has not raised its payment for insulin under Part B since 2003."  2003!! So they think that in 10 years, the price is going to be the same?  Excuse me, has anyone in Congress gone to a gas station recently, or even a McDonalds or supermarket?  That gas, or Big Mac, or box of cereal cost the same as they did 10 years ago?  That house that you live in costs the same today as it did when you originally signed the ownership papers?  

It's not just the government sponsored programs that have this issue.  The big insurers also do this as well. When I call Caremark to ask them why they are paying me $15 under my cost, they tell me that the pricing schedules and updates run once a month.  I'm sorry, is my pharmacy open only once a month?  No, I open every day and you should update your freaking pricing files everyday so I can make a profit as well, not only you.

"A Medicare spokeswoman said the price is set in federal law — at 95 percent of the average, wholesale price in effect on Oct. 1, 2003. So it requires Congress to change it,".  Great, so this means it will take another 20 years to resolve the issue, in the meantime, Mr. Carr can go into diabetic ketoacidosis and be hospitalized another 50 times and waste more tax money being treated in a hospital.

Maybe the government should open up a pharmacy and provide him with his insulin.  Let them pay $100 dollars to buy it from the manufacturer and then let them get reimbursed $75.  Then we will see how fast they change their policies.

Tuesday, June 18, 2013

Buy Something!!

Yes I know it is difficult to compete with the big chain companies.  Yes I know that they have a store relatively close by.  Yes I know I am taking a risk.

Why is it that people feel the need to come in to the store to say those things to me.  Would you like to know how I can survive and keep helping the community and providing people with better service and improve overall health?  Instead of walking in the store to just ask me what I was thinking opening a pharmacy, maybe you should actually buy something.  Maybe you should transfer your prescriptions to my pharmacy.  I've had to hold my tongue so much because I just want to cuss out those people that don't understand why I would open a business.  Thanks for coming in the critique the place and my decision and buy nothing and leave.  You are a real asset to me.

When I worked at a chain, I was amazed by how much people complain about every little thing.  I once had a customer that had a problem with our service every single time he came in, and for some reason, he came month after month after month to fill his scripts.  I'm not sure the way his brain works, but in my brain, if I get bad service every month and every visit for 3 years, I'm probably going to start looking for a new pharmacy to start getting my prescriptions.

I'm a little biased towards small businesses.  My father owns his own business and was able to put me and my 2 sisters through college with that business.  So even before I started my business, I was always a supporter of the little guy whenever I got the chance.  I have a ton of respect for all those that risked a big chunk of their money to open a store front and not know what the future will hold.

Friday, June 7, 2013

To Compound or Not To Compound...

To compound or not to compound, that is the question.  I've been going over in my head what I can do to attract more customers to my pharmacy.  I keep thinking that I need some kind of hook.  I've tried the whole excellent customer service and family pharmacy angle but the neighborhood I'm in doesn't believe it's worth the extra $5-10 dollars on their copays for using a "non-preferred" pharmacy.  And I don't blame them, a penny here a penny there starts to add up, especially when you take about 6 medications a month.

So I've been contemplating getting into non-sterile compounding.  It seems like a sound idea.  For those that may not know what a compound medication is, it is basically a medication that is specially formulated for the individual which pharmacists create at the store.  It was best described to me by one of my customers, "gourmet pharmacy."  The other thing I thought of getting into was durable medical equipment (DME) like canes, walkers, wheelchairs, etc.  The problem I see with this is that dealing with medicaid is like dealing with an older idiot brother who still thinks he's in high school and takes advantage of you ALL the time.  With the amount of audits and hoops to jump through just to give someone a box of test strips or give a cane, it's just not worth my time and patience.  So I figure I can start compounding.  With no real set prices on custom drugs, the profit potential seems limitless.  And with the majority of insurances not covering them means better margins and less audits.

Hopefully, I'll get some of these people in the door with this because daddy's gotta eat!

Tuesday, May 21, 2013

Screw You Pfizer...

This might be a little late but many of you may or may not know that Viagra will now be sold online in a direct to consumer way.  This is absolutely ridiculous.

First off, they are taking money out of my pocket because according to them they can give it to you cheaper.  How about not making a 30 count bottle cost close to $800 and people won't complain that it's too expensive.  Also, I'm hoping they have licensed pharmacists at the company that will be taking care of the patient counseling, medical history check, etc.  The reason they are doing this is to not help the patient out, but to increase their margin.  I'm sure that those pills can't cost the company more than $2 to make but they still make it incredibly expensive for the consumer.  They have seen a drop in sales because of this, so they decided to cut out the middle man, a basic screw you to pharmacies worldwide.  And the whole story of them not wanting people to buy fake Viagra online is crap.

Why don't they cut out the doctors too and set up a skype session with a Pfizer doctor.  Who needs medical professionals anyway, their years of sacrifice and schooling to learn how to treat potentially dangerous diseases and how dangerous drugs work is all for show.  We all just did that for fun because we were bored, kinda like reading Hunger Games on our free time.

What's scary is that if this is successful and the corporate monsters see their margins rise and their profits soar, what's to stop them from doing the same thing with all their drugs.  What is Pfizer decided to start selling Celebrex on their website, then Lyrica, then Enbrel.  Then when all those go well, the Lilly company will come out and start selling Cialis online.  And the vicious cycle goes on.

I really hope those organizations that are designed to help out pharmacists, specifically retail pharmacists, and the organizations for independent pharmacists are doing something to try to stop this.  This could be the small snowball that eventually leads to an avalanche of problems for all pharmers.

Friday, May 17, 2013

Crackhead Twitter, Oxy Facebook?

There must be some kind of social networking website or iPhone app that all junkies have that they use to communicate to one another.  I swear, they must make a post or something and their alert goes off.

Usually when a person who has a legitimate prescription but they just reek of a junkie, I tell them we don't have those oxycodones in stock.  But once in awhile I like to mix things up and make the junkies feel like it's the luckiest day of their lives and fill them.  The look on their faces when I say yes and that it will be ready in 15 minutes is like watching a kid wake up Christmas morning and seeing that Santa finally came.

And every single time I fill one for them, I get a plethora of others with the same prescription for the next 5-6 days or so.  It's like making a tiny crack in a damn wall, you make one little crack and then the damn bursts and you got meth heads, crack heads, and pill poppers flooding the store.

In a way, they are some of my favorite customers.  First off, they always have a story to tell, either of how they have been to 100 pharmacies or how their roommate stole their last bottle and that is why he his early this month.  And second, I make so much money off of them.  These people will pay anything as long as they get it.  People in chains may not realize this, but that 120 count oxycodone they are dispensing costs the pharmacy about $25-$30, and the AWP is about $175ish, that's a huge profit.

So if there is a Twitter for junkies, I want in.  I would love to read their posts.

Wednesday, May 8, 2013

Urban Outfitters Under Fire For No Good Reason...

So I recently came across this article and news story:

Urban Outfitters Under Fire

This article is about a retail store that is currently selling Rx themed merchandise.  For example they sell a flask with a prescription label that says "Boozemin, Drink as much as you stomach can handle."  They also sell beer can coolers with the outside making it look like a prescription bottle.

And the kicker of the story is that there is a group out there making it their sole purpose to make sure things like this aren't sold.  According to them, they feel these products are promoting drug abuse of prescription medications.  The feel that the tweens that are seeing these things will be compelled to experiment with their parent's medication at home.

Holy moly, are these people serious?  It amazes me how nowadays it is so easy for people to point the finger at someone else and not look in the mirror.  So instead of talking to the parents to make sure they are more careful with their prescriptions are having these parents talk to their own children that the stuff in the amber vials isn't candy.  The group is probably the same ones that believe it's the video game companies fault that someone goes and shoots someone.  And as for the crackhead in the video that didn't like the stuff because it might trigger is addiction again, screw you, it's not my fault you ruined your life at one point and i'm not going to hide potential "triggers" from your view.

Personally, as someone who needs a drink or two after a shift in the pharmacy think these products are hilarious and amazing.  So for all those in that group and people who are on their side, take that collective stick out of your asses and be responsible for your own shit.  Stop blaming other people for problems that can and should be resolved at home by yourself.

BTW, I just bought some beer holders.  Peace.