Dear YOUR State
Board of Pharmacy,
My name is The
Cynical Pharmacist and I am a licensed, practicing pharmacist in YOUR STATE.
It is my mission today to ask you to outlaw prescription transfer incentives.
While I understand the YOUR STATE Board is not in the business of
regulating company practices, they are in the business of protecting their
State's citizens.
Pharmacy is a
profession. We expect to be treated as healthcare professionals. We expect to
be respected as professionals. If we allow our services to be bartered for
gallons of gas and free gift cards, we are nothing more than cheap hookers, a
profession which does not require a license.
We pharmacists
are not in the position to make these changes to our state laws. You are. You
give us our licenses. You take them away. You write the laws that govern how
pharmacy should be practiced in your state. We listen to you. It is time you
listen to us.
There are several states
that have already outlawed the incentivizing of prescription transfers. This
list includes New York, New Jersey, Oregon, Alabama, Mississippi, New
Hampshire, and Arkansas. Simply put, prescriptions are not commodities to be
traded on the retail market. These are life-altering medications that make a
huge impact on a patient's life.
My concern with
continued acceptance of this practice in YOUR STATE goes deeper than
transfer errors. It goes deeper than the possibility of mistakes. It goes
deeper than missing interactions and therapeutic duplications. It is about
perception. We are the most accessible professional in all of healthcare. We
gladly give away all of our professional services for free. The problem isn't
companies attempting to buy patient loyalty. Studies have shown less than a 20%
retention rate on patients who use coupons and incentives. The problem is lack
of respect that arrives as a side effect with these programs. If we do not
respect ourselves, we simply cannot expect our patients, and even other
healthcare professionals, to respect us. I am starting a
campaign to take my profession back. It starts with your help.
I have broached
this subject directly with my State Board in the past. I have spoken with other
pharmacists who have also contacted their State Boards and had similar results. The Boards' refusals to enter this discussion
often boil down to the following argument: The Board does not exist to regulate
company policy. I have mentioned each of the following situations before and
received the equivalent of a shoulder shrug from those with whom I spoke.
According to these members, the following are simply anecdotal and they have no
proof that these can happen, do happen, and even if they did, the frequency
with which they actually occur.
1. The risk for errors
increases each time a prescription is transferred. The more times you fill it,
delete it, call it in to another pharmacy, and give a verbal order to someone
else, the risk increases. (Think of the telephone game in kindergarten.)
2. Time is wasted on
transfers for coupons that could be spent on any other professional task. Each
time I have to step away to get a transfer or give a transfer for a patient, I
am at risk of speeding through something to catch up. I may miss a drug
interaction. I may dispense an incorrectly filled prescription. The risk that I
may make an error increases.
3. Patients complain
about not being able to shop around or "going South" for the winter.
There are states that only allow single transfers. Simple. If the rules exist,
patients will adjust to them. They will get two prescriptions: one for home and
one for their desert oasis. (Think about how well everyone adjusted to no
refills on Hydrocodone-containing products recently.) Also, with most insurance
plans, the patients' copays are the same at nearly every pharmacy. They
shouldn't need to shop it around.
4. Grown adults use
their elderly parents' medications to make money. This is true. I have seen it
firsthand. Do the parents know? Is that their right? We have people who will
carry folders with their parents' prescription receipts from all the local
pharmacies. Every week they will drive from pharmacy to pharmacy, transferring
CVS to Target, Target to Walgreen's, Walgreen's to Rite Aid, Rite Aid to
Wal-Mart. Next week, they repeat the process. This should not be allowed to
happen. If an error occurs, who will get in trouble? The pharmacies. Who will
pay the price? The elderly parent. Your job as State Board involves looking out
for the health and wellbeing of your citizens.
Patients will complain
states are taking away their rights. I believe they are taking advantage of a
system that never should have existed in the first place. We need to make our
profession more professional. It starts with you. It starts with this law
change. It has to start now. I want my profession back. Please.
I would be happy to
attend a Board meeting to discuss my proposal further.
Thank you for your time
and consideration.
Sincerely,
I have included a link
to Alabama’s law, a state that changed most recently.
“A
pharmacist and a pharmacy should never offer or participate in the offering a
financial award or benefit, not related to competitive retail pricing of any
drug, to induce or encourage any individual to transfer a prescription from one
pharmacy to another.”
Author:
Statutory
Authority:
History:
effective
June 13, 2011. Amended: December 16, 2011; effective January 20, 2012.
Herb
Bobo, R.Ph. Secretary
Code
of Alabama 1975; §34-23-92.
Original
rule filed: May 30, 1990; Effective July 30, 1991; Amended: May 9,
Here
is the verbiage currently proposed in Virginia.
http://townhall.virginia.gov/L/ViewAction.cfm?actionid=4186
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