Letters: January 2013

January 14, 2013

Readers discuss what rights pharmacists can expect and drug disposal options.

What about pharmacists’ rights?

I read the October issue and have never been left with such a bitter taste in my mouth after reading a pharmacy publication.

Starting with Frederick Mayer’s “Patient Bill of Rights for Prescription Drugs,” nowhere mentioned are the pharmacists’ rights, starting with the right to set the prices for providing all of the services that Mr. Mayer asserts should be rights of the patient. Yes, they are good ideals, but the reimbursement we’re seeing for medications is no longer enough to even cover the cost of dispensing the meds, let alone provide a bunch of ‘extras’.

Right after that was David Stanley’s “Feeling Like a Real Pharmacist.”  I’m glad he had that experience, but really, should the lady who was ‘beyond embarrassed’ have expected that advice for free? What he provided to her had real value, as well as providing him with a sense of professional pride-yet it was provided for free which only promotes the idea that a pharmacist’s advice has no value. Make an appointment with a doctor or lawyer and you expect to pay. Contact a pharmacist for advise that can have major repercussions on your life and a request for payment is unexpected and offensive.

Finally, I made it through the rest of the magazine and at the end was Ned Milenkovich’s “Pharmacy Cooperative Settles Price Fixing Charges.” Just the memory of reading that one gives me a hopeless feeling for the profession. We all know who is fixing the prices. Why is it that when a group of pharmacists get together to demand true negotiation and fair reimbursement, they’re demonized and tagged with the label of causing “higher prices for Puerto Rico’s healthcare consumers”? Did the FTC consider the pharmacy’s costs in reaching their conclusion, or just take the PBM’s word for it that because its right to set the prices was challenged that somebody else was acting illegally?  In any case, for the FTC to allow the merger of Express Scripts and Medco, and then turn around and accuse ANY pharmacy of price fixing is beyond belief and sends a clear message that anyone who claims to lower prices for the consumer is automatically right, anything that raises prices is wrong, and that open and fair negotiation between two parties is unnecessary.

So go ahead. Throw a burden of extra patient ‘rights’ at us. Don’t allow us to charge a fee for expert advice. Give the PBMs clear permission to merge as much as they want, force or badger our patients to use the pharmacies that they own, and tell us how much we’ll be paid for our products and expertise. What you’ll be left with is mail order and big box service where Mr. Mayer’s rights are irrelevant and Mr. Stanley’s services no longer exist.

Steve Burney, PharmD
Columbus, NC

Drug-disposal options

After reading your article, “First-in-nation drug-disposal mandate aims to protect patients,” [November] which I found very informative, it came to mind the time back in the ‘90s that I wrote to Drug Topics
after a similar call for safe disposal that so much concern was being paid to the left-over drugs and none to the drugs excreted in the urine or feces. If you look at most package inserts, you will see that any particular drug is excreted either unchanged or only slightly changed in the urine or feces. This is probably the actual source of 80% of the contamination of  waterways. In my opinion, for leftover drugs, the coffee ground method is actually very good because here in Massachusetts all the trash is incinerated.

Mike Saija, RPh, CIP
Sharon, MA

Your November article, “First-in-nation drug-disposal mandate aims to protect patients,” notes the “lack of options for disposal of unwanted or expired medications.” Since its launch in 2010, the National Community Pharmacists Association’s Dispose My Meds program has collected more than 50 tons of unused or expired medications. Drop offs of non-narcotic prescription drugs are accepted every business day at some 1,600 participating pharmacies. Their locations can be found at NCPA’s companion consumer website, www.disposemymeds.org.  Pharmacies that wish to participate should visit the NCPA website, www.ncpanet.org.

Donnie Calhoun, RPh, NCPA president
Anniston, AL

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