The Pharmacy Chick

Flying the Coop in Retail

$4 prescriptions

Filed under: Uncategorized — pharmacychick at 10:23 pm on Thursday, April 10, 2008

Pharmacy Chick was internet surfing the other day when she came upon a little news item that yet another major pharmacy and grocery chain was joining the ranks of the apostates and offering the $4 prescriptions on “over 300 drugs”. (bear in mind that warfarin 1,2, 2.5,3,4,5,7.5,and 10mg counts as 8 drugs). I wish I could ask WHY?

Pharmacies have never been known for their intelligent decision making. But this one takes the cake. When Walmart ( I can use their name because its widely known) came out with their $4 offering, I bravely hoped that it would be a passing fad. After all, pharmacy amounts to what? 2% of their business? Who cares if they lose money if they can get Mr Joe Six pack to fill his cart while waiting for his $4 loss leader. Target followed later with their own list. Target is a relatively new player in pharmacy. Now its Kroger. I don’t know much about these guys, they aren’t around my neck of the woods. But Pharmacy Chick is hopping on her soap box for a few observations:

95% of my business is already managed by health insurance. These are people whose prices are already fixed and the rate of reimbursement can be called sucky at best. There are a few precious plans that have a fixed generic copay, $10 for example whether its 100 metformin or 2 lorazepam, its 10 bucks. Why are we giving a PBM incentive to cut our reimbursements even more? Ya’ll think they are blind and won’t notice?

The few cash payers that I have left are snatched up by “discount cards”. What the hell is this? Since when can Quickie Lube and Tire offer a card that decides how much I can or cannot charge for my services? Why did we ever accept this from the start? When I used to work for Joe Independent, he refused the cards. “If its not insurance, I’m not takin’ it!” And he didn’t.

Generic medications were the last bastions of profitibility in the pharmacy. If we bought it for $2 and sold it for $22, we made a tidy $20 gross profit, which was still a great deal over the $99 it would have cost the patient for the brand name. I dont care what you say, there isn’t going to be great profit in some of these auxilliary services like vaccines and MTM, they are too labor intensive. It costs a lot of labor to run those services, and in no time, PBM’s will be cutting reimbursements to is for them too. Just wait, you will see. Why are we buying the rope they are hanging us with?

One of my buddies works in a pharmacy that will price match the $4 when asked. He doesn’t get asked very much cuz he works for a discounter that sells stuff pretty cheaply already. The “when asked” part bugs me. If you are gonna do the $4 deal, either do it or don’t, this sliding scale thing bothers me. That means you have to keep track of Ms C who gets her Lisinopril for $4 and Mrs D who gets hers for $12.99. In fact the whole price matching thing gets me going, but that is a blog on its own, suffice to say that Pharmacy Chick thinks that if you are gonna do this $4 nonsense, either jump in or stay out, sticking your toe in only is gonna cause trouble with customers.

Imagine this, cuz I already have: Its a big conference room, BPOP (Biggest PBM On Planet) is having a meeting with all their decision makers. They have, in front of them, the lists of all the $4 prescriptions that all these players are offering. Mr Big in his bigger suit stands up and addresses the group: “Gentlemen, we have a golden opportunity here, these jokers have cut their own throats, and we dont have to do it for them. All we have to do is rake in the profits, because effective at next renewal period, all these meds will be contracted at $3.50. If they can accept $4, they will accept $3.50″ HAHAHA, ” Lets go have lunch, and take the rest of the day off, we didnt’ have to earn it, they just gave it to us.”

Its the beginning of the death of pharmacy, and unfortunately for us, this one can only be classified as “suicide”.

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6 Comments »

369

Comment by CPhT

April 11, 2008 @ 5:06 am

I have to add my 2 cents on your comment about doing $4 for everyone or for no one —

I work for a chain who does not offer $4 generics. However, our supervisors give us discretion as to price matching; they actually encourage it, which I think is utter bullshit.

So, my (former) PIC and I came up with a solution, which I honor to this day — if you’re a regular, who I know by sight, and typically name (which I know most; working 40 hours a week, M-F, and daylight), I will consider seriously giving in on that lisinopril or warfarin that’s costing $12.50 a month on your shitty insurance. If someone walks in off the street, and says “Hey, are you guys doing that $4 generic thing?!” and I’ve never seen them before, I tell them no. Simple as that. We keep a note in the people’s files, and require them to verbally call in their prescriptions, rather than go through our IVR, so that we can make sure that it gets processed correctly. These same people are the ones who constantly send in compliments to my supervisors on our staff, and are happy that, even if their brand name prices are raping them, we’re at least giving them something in return for being a good, regular customer.

370

Comment by Pharmacy Mike

April 11, 2008 @ 6:03 am

My company price matches. I think it’s really freaking stupid. I would refuse, but I’m but a lowly peon.

My company is also a huge grocery store chain, so they only partially care about how well the pharmacy does. They just want to make sure customers stay in the store.

372

Comment by Future Pharmer

April 11, 2008 @ 8:13 am

The Big wigs at our company have declared that we will price match $4 medications at the decision of the pharmacist on duty. One of our RPh’s (new guy) has no problem matching the drugs. Ever other RPh that works for our chain IN THE CITY refuses to price match at all. The only time we edit our prices is for a cash customer who obviously is having a hard time paying for this medication. Ex. If the antibiotic for their kid comes up 17.99 and they only have 16.00 then it costs them 16.00. But we only do this when it is a necessary thing.

When people ask if we price match, we tell them that if they want it for $4 then they can go to the places that advertise it. It’s that simple.

FP

396

Comment by The Ole' Apothecary

April 12, 2008 @ 7:02 pm

The chain that decided to GIVE AWAY (price = $0.00) certain antibiotics takes the devil’s food cake. What they are saying is that pharmacy services have no monetary value, and they are saying this at the moment that pharmacists are supposed to be getting reimbursed for medication therapy management. How many times have I said, on my own blog, that pharmacy is on a collision course with reality?

401

Comment by KrogerRx

April 12, 2008 @ 11:27 pm

We’ve been required to match prices forever, so the $4 plan hasn’t really changed much. I do hate that now we’re advertising that what I do is worth next to nothing. The REALLY crazy part is Kroger feels it can
justify the loss by expecting people to buy other stuff while in the store, but everytime they build a new store they put in a drive-through pharmacy. Hello!?! but I’m just a lowly peon too.

422

Comment by drug dog

April 13, 2008 @ 8:27 pm

All of this goes back to the simple fact that pharmacists gave away the profession to bean counters long ago. Just scan the previous comments. They all do it because their company says to-mostly non pharmacists. They don’t care or stop to consider the impact as long as they get paid on Friday. No other profession has so willingly given it all away. Look at doctors, accountants, dentists, etc…, they don’t allow others to so completely run their careers. We do, and with a smile on our faces. Piss down our backs and tell us its raining, but pay us please. Pharmacists have allowed big retailers to treat the profession like snow tires on sale just to get folks in the store. These pharmacies using the $4 deal are running a false business, likely not able to be self sustaining without thousands of square feet of junk sold out front. I own my business, know what it costs to run a pharmacy and the day I have to work for some pinhead with an mba, I quit.

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