The Pharmacy Chick

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”.

Tags: competitors, national news, pharmacy life, prices, ranting | |

He came in and handed me the script. I knew what was coming. “Brand only” Okee fine, I have no issue with that. It what always happens next that drives me to distraction. Its the bitching about the price that he does. I can fill the way they want it–brand for $200+ for a 90 day supply of Norvasc or I can do $15.00 for the generic, same manufacturer.

“No, generic doesn’t work”. Then fork over the $200.00+.

You cannot have it both ways. Every time we have this conversation, its the same. They complain about how much medicine costs and every time I offer the generic. Every time they decline. This time they thought they would trump me. “Maybe we should fill our prescriptions someplace else” they said. “Ok, I’ll buy you lunch if they are any less there for the same thing”.

They are still here…and still buying brand. I am thinking they aren’t as awash in cash as they used to be because they never used to whine. Now its all they do. I can fix it. They just won’t let me.

Tags: competitors, prices, rambling | |

I had to laugh today. If you read blogs, The Angry Pharmacist www.theangrypharmacist.com wrote a blog about doing other people’s work, specifically regarding people who bring issues to HIM that really belong to the mail order pharmacy (read: competitor) from whence it came. Its rather colorful, if you know what I mean.

She approached me with a paper bag that she emptied on my counter. It contained a lancing device and a box of lancets. I knew her as the chauffeur for a family member who filled prescriptions at my store regularly. In fact, I believed that the stuff she deposited on my counter was for this family member. She didn’t know how to remove the lance from this device. It had been the lancing device for her brother and he had used the same lancet (!?!?) for years. Oh gag, I really didnt’ need to know that. He gifted it to her for some reason and she wanted to remove the old lancet and replace it with her own. She presented me the box of lancets. I flipped it over. It had a pharmacy label from Big Box Pharmacy up the street. All I said was “You got this at Big Box??”. I immediately thought of TAP’s blog. Her pregnant pause said it all. “yes”, she said.

I pulled the old lancet cartridge out, showed her how to put the new one in and sent her on her way. She was happy and I knew I had fodder for another blog post. Here’s hoping she replaces that lancet more than once per decade.

TAP, I tip my cap to you. Pharmacy Chick understands.

Tags: competitors, customers, ranting | |