Letters to the editor: September 4, 2006

September 4, 2006

Regarding your July 10 article on drug counterfeiting, the intent of the drug pedigree law is great, but it comes with a tremendous price to all pharmacies. We no longer have the ability to return any unopened products to the wholesaler beyond seven days. What is one to do when we have to order expensive medications for HIV or cancer patients, for example, then find out after seven days that the patient has expired before the Rx is picked up? Now we are stuck with thousands, maybe tens of thousands, of dollars' worth of medications that are in the same condition as when they were received from the wholesaler.

Regarding your July 10 article on drug counterfeiting, the intent of the drug pedigree law is great, but it comes with a tremendous price to all pharmacies. We no longer have the ability to return any unopened products to the wholesaler beyond seven days. What is one to do when we have to order expensive medications for HIV or cancer patients, for example, then find out after seven days that the patient has expired before the Rx is picked up? Now we are stuck with thousands, maybe tens of thousands, of dollars' worth of medications that are in the same condition as when they were received from the wholesaler.

Let us take it one step further: How many Rxs are left in the will-call bin in most stores (not ours) after one or two weeks? We are talking about full unopened stock, unit-of-use bottles, or creams in original boxes.

Another problem that arises is the ability to borrow a medication from a fellow store. Now you cannot. Why? Because you now must show a pedigree. So the ability to accommodate your customer is now gone! How do we solve this problem? Fairly simply. The pharmacies were not the cause of counterfeiting, so regulate the wholesalers. Increase the penalties against those who violate the law and make sure the punishment really hurts them. A slap on the wrist or a fine will not stop any illegal activity associated with diversion. Please do not punish those of us who operate "clean" businesses. We need to have the ability to return Rx merchandise beyond seven days here in Florida.

Please share your template

Regarding your July 24 article on collaborative practice, what is needed for growth is a template for such agreements. We shouldn't all have to retain a lawyer to generate one of these protocols. There have been some agreements proposed by a few pharmacy academic centers and they should make them available.

My consultation practice is growing and each month more physicians hear about us and want to send patients to us for workup. I'm happy to take these referrals and collaborate on the prescription. I just need a two-page document that both of us (doctors and pharmacists) can sign to delineate our responsibilities. Would anyone like to share his or her agreement as a template?

Mark Burger, Pharm.D.
Health First! Pharmacy
Windsor, Calif.
mark@healthfirstpharmacy.net

What's my line?

I am at that point in life when I find myself in the company of other senior citizens when I am on vacations, bus rides, or ocean cruises. Inevitably the question comes up, "What do you do for a living?" The answer, "pharmacist," is always a mistake. There is an immediate chorus of comments such as, "Why are drugs so expensive?... I can buy drugs in Canada where they only cost 10% of the U.S. price.... I buy all my medicine on the Internet.... How much do you charge for Zocor on my insurance?"

A better answer in this situation is simply to say, "I sell life insurance." This will bring an abrupt end to a conversation that would surely become unpleasant.

Robert A. Musch, R.Ph.
Easton, Md.

Plight of the independent pharmacist

I am a small, one-store independent pharmacy owner, but I have some big questions for our profession. Over the past 20 years or so, isn't it true that the mantra for our business success has been volume, volume, volume? Retail pharmacy accepted lower and lower fees and reimbursement in exchange for the promise of increased volume and efficiencies. This worked marginally for a time and drove most "benches" to bare-bones staff and budgets. Now we are told that in order to survive and remain relevant, we must prove our worth and value with MTM services and other time- and resource-consuming activities. How can these two business models work at the same time? More expense for us, less reimbursement. How do we hang on until reimbursement catches up with reality?