Voices-Letters to the Editor
BOPs don't protect pharmacists
In Jill Sande's letter (Been there, left that, May 2013, Drug Topics, page 3), she remarked how the collective state boards of pharmacy have allowed us to be treated as non-professionals. Sande may be misinformed as to the function of the various pharmacy state boards. In my experience, which now spans 49 years, the functions of the boards are two-fold. The main function is to protect the public from us, the pharmacist, with the related function of extracting money from us to accomplish this.
I've have never known of a board of pharmacy acting as a protector. In fact, I have actually known boards to turn pharmacists over to other authorities for punitive measures (after they had extracted their own pound of flesh).
Sande should stay away from chain pharmacies unless she wants to work as a highly paid automaton in some of the most unpleasant conditions existing today. No chain pharmacist that I've ever talked to believes that he/she controls anything in their practice, taking orders from a high-school educated store manager to being castigated for not meeting the prescription numbers quota for your shift.
Drury H. Bynum, RPh, MBA, FASCP
Merritt’s ‘classless attack’
PCMA CEO Mark Merritt’s letter (A word from PCMA, June 2013, Drug Topics, page 11) was a sad and classless attack on every pharmacist who serves his clients. We work very hard to insure that patients receive the best care possible. Comparing us to fast food was a real low blow.
Mr. Merritt your organization is much like the mafia. You skim off your take of the healthcare budget while providing no actual benefit. You then force pharmacies to accept horrible take-it-or-leave-it proposals. When you mandate mail order, and they fail to deliver as promised, we are the one’s that take care of your sick customers. But unless it’s a spreadsheet number, you could care less.
You letter shows how little you think of pharmacists. I sleep well because I know I have made a positive difference to my customers. How can you sleep at night?
Tim Melin, pharmacist
Pharmacy tobacco bans ineffective
Regarding Jim Ober’s article [“Why do drugstores sell products that kill?” May 2013], first of all, I do not condone tobacco use. My mother died of throat and lung cancer from a smoking habit. She chose to smoke, so she suffered the consequences.
I am an independent pharmacy owner with a store located in Boston, where the sale of tobacco products in pharmacies has been banned. This ban only makes customers cross the street to buy [cigarettes] at the liquor store. The ban is totally ineffective in stopping people from smoking.
People will smoke no matter where they have to go to get them. If the city of Boston really wanted to be serious about the tobacco issue they would ban it from all stores, not just pharmacies. The city still gets it tax dollars. It is all about the money, not the feigned rhetoric of helping people stop using tobacco products. We should be wary of any government that can ban legal products.
Why Rx prices continue to rise
On March 31, 2010, at the age of 80, I closed my independent pharmacy. My professional life coincided with the growth of Medicaid, employer provided-prescription insurance, and PBMs. I also witnessed the introduction of computers and their constant modifications. All of these innovations were supposed to lower the cost of pharmacy operation and improve patient care.
Coincidental with these developments was a meteoric rise in prescription costs. Surely, I am not the only person to connect these two phenomena. Computers do indeed contribute to efficiency, but they are not without cost. Hardware and maintenance are expensive. Then, there is the monthly cost of software service. Employee training adds more cost.
Government agencies, insurance companies, and PBMs routinely discover the need for another report, which must be incorporated into the program. These items are not free. They are costs borne by the pharmacy and must be added to the cost of each prescription. Add to all these expenses the time required of the pharmacy staff to satisfy these requirements and one can gain some understanding of the exponential rise in prescription costs.
Insurance companies do not operate at a loss. They never pay out more in benefits than the premiums they take in. PBMs do not offer their services free of charge. If the revenues of insurance companies, PBMs, and other agencies involved in processing pharmacy claims were combined; and that amount subtracted from the total cost of prescriptions, one would see the reason for the increases in prescription cost.
Patient health and welfare is no longer the primary focus. How to squeeze more revenue out of the patient and more profit out of the process is the goal.
Matrin E Cloessner, Jr.
Nothing wrong with rewarding success
In (To each according to his needs, May 2013, Drug Topics, page 3) Mike Saija wrote: "I have a very wealthy customer who owns a large business. His copays are ZERO because he owns the company, but his employees have regular copays. Is this right or fair?"
The response is yes, it is entirely right and fair. The employer has taken risks to build a profitable business and is entitled to the efforts of his success, which in this case includes no copay on his prescriptions. His employees [should] be grateful to have a job with a prescription plan with regular copays.
Without the employer, the employees would not have any work and, thus, no prescription plan at all. If the employees are unhappy, they can always seek employment elsewhere or start their own businesses so that they too could have no copay. Yes, it is entirely right and fair to reward success.
Kenneth W. Dietel, RPh, MBA
Effectiveness of sunscreen spray products YTD
I think it is negligent that [“Here comes the sun,” June 2013] states that "While at the beach or the pool, parents can ensure their children's safety from the harmful effects with SPF 70 for Kids Continuous Mist Sunscreen." As a pharmacy journal you should be aware that the FDA has made recommendations to avoid sunscreen sprays.
For sunscreen spray products, the FDA has requested additional data to establish effectiveness and to determine whether they present a safety concern if inhaled unintentionally. These requests arose because sprays are applied differently from other sunscreen dosage forms, such as lotions and sticks. Thus, as a pediatric pharmacist, all pharmacists should be aware that this product WILL not ensure children's safety.
Beth Deen PharmD BCNSP
Cook Childrens Medical Center
Fort Worth. TX.
Independents are a dying breed
(Put your money where your mouth is, David Stanley, RPh, June 2013, Drug Topics, page 18) resonated with me! I worked in the corporate pharmacy world off and on all my career, but I was never happier than when I was doing relief work for independent pharmacies through my own agency.
About 14 years ago, I moved from northern California to Washington state. The job with Long's in California was more than tolerable, but the mind-set in the same (recently purchased) chain in Washington was ridiculous. The manager went out of his way to make my day harder, and when I tried to get help higher up, it was more of the same. I hated going to work and just decided one day, as you did, that enough was enough.
I went out to find myself a full-time job working relief at the independents in the area. Much to my surprise, there were VERY few independents left. It took me a long time to put together a schedule for myself, but I did. But then, the stores I was working for started dropping like flies. Through the unfair insurance reimbursements and loss leader competition, they just couldn't make it. It is so sad to see that happening to the entrepreneurial part of pharmacy that I love so much.
As you can see by my signature, I became a realtor several years ago and am loving that, even though I still work in pharmacy a couple of days a week.
I wish you SO much luck in your new venture! I hope it works out well for you. There is nothing like the relationships that one can develop in an independent pharmacy. It's all about helping people in the end, isn't it?
Laura Fletcher, RPh
Mount Vernon, WA.