Are you prepared to help when someone far from home has lost their prescription medications?
Tourists, vacationers, business travelers, and anyone who has wandered far from home have all experienced it: no matter how well planned a trip, one or more prescription medications or other medical need was left at home or was lost along the way. These unlucky itinerants then call in or go to the nearest pharmacy asking for help with their problem.
While this scenario happens occasionally at every pharmacy, those pharmacies located in resorts or seaside destinations, or places that see a lot of business travelers encounter them every day-- and sometimes even more often.
How do these pharmacies cope with problems that may take time, counseling, and a lot of phone calls to iron out?
When it comes to dealing with the prescription needs of travelers, there may be no match for Turner Drugs in Celebration, FL. Located just outside Disney World in Orlando, the pharmacy has a division specifically set up to handle the needs of people who come to visit the Disney theme parks.
“Disney came to us 30 something years ago and wanted someone to help their guests’ needs,” said Larry Turner, RPh, who owns the pharmacy with his brothers, Jack and Ken. “Disney bends over backwards in every way to please their guests,” he said. Disney had decided that it needed a pharmacy for the prescription and nonprescription needs of its guests and chose Turner Drugs.
To keep theme park guests as worry free as possible, Turner Drugs Tourist Prescription Service pulls out all the stops, according to Turner. It is open 12 to 14 hours a day, 365 days a year, and carries almost every product a person needs, from baby needs to water and soft drinks. If someone staying at the Disney theme parks needs any nonprescription item that Turner does not carry, a Turner employee will go to another store to buy it. Everything is then delivered to the vacationer’s hotel for a fee. Disney employees (called “cast members”) either call Turner Drugs or tell the guests that they can do so.
The division of Turner Drugs that works with Disney guests usually has four employees working the phones and contacting doctors and pharmacies all over the country, Larry Turner said. Another division of Turner Drugs is a community and compounding pharmacy for the people who live in the area.
In contrast to the continual comings and goings of tourists in Orlando, Sunshine Family Pharmacy, located on the Outer Banks in Duck, NC, tends to see a weekly surge in vacationer needs. On the Outer Banks, there are a huge number of houses and condos that usually rent for a week or two, generally from Saturday to Saturday, creating a large influx of people each weekend.
“The busiest time for us is Monday and Tuesday,” said Tom McGrady, PharmD, owner of Sunshine. “Vacationers often don’t realize that they don’t have their stuff with them until Monday.” Although the busiest time of year on the Outer Banks is from May through September, there are some tourists here all year long, he added.
McGrady works with a staff of certified pharmacy technicians and pharmacy students. They are trained to understand that making calls to doctors to arrange for prescriptions is primary, he noted. “That is our bread and butter. That is what we do,” he said. “We’ve called everywhere from Alaska to Hawaii to the Florida Keys.” The staff also makes many phone calls to insurance companies to arrange for coverage for emergency refills, he added.
For Myra Pascua, PharmD, the Walgreens in the financial district of San Francisco dealt with the needs of many tourists, but also for a lot of people traveling for business when she worked there. Pascua is now Manager at the Walgreens at the University of California at San Francisco Medical Center. “At our Financial District store, about 10% of patients are out-of-town visitors. Of those, the great majority were already Walgreens customers in their hometowns. That means they are in our system and we have the records we need to fill their prescriptions,” she said.
There were also many international travelers who sometimes present the pharmacy with unique difficulties, Pascua added. “For example, they might take drugs not available in this country. They may not speak English. Or, insurance coverage might be a concern.” She noted that she has access to pharmacists on the Walgreens team who speak other languages, and that she pitches in when needed since she speaks Tagalog, spoken in the Philippines.
Patients from overseas who need prescriptions drugs that are not available in the United States must get a new prescription from a US doctor, both Pascua and McGrady said. Pascua has a partnership with an urgent care provider near her pharmacy where tourists can get an appointment. McGrady has a doctor onsite in his pharmacy or sends foreign vacationers to an urgent care center.
Turner noted that he has very seldom had a problem dealing with a traveler’s hometown pharmacy or doctor. “Pharmacists are a pretty reasonable group of people,” he said. “They are always accommodating.” He added that he has a very good relationship with the chain pharmacies in the area and if he does not have a certain prescription product, he sends the customer to another pharmacy for it. However, often Disney will send a cast member to pick up the medication in that situation, he added.
Prescriptions for controlled substances can be an issue, however, both Turner and McGrady said. “I can transfer someone’s prescription for Ambien down here, but refills cannot be transferred back,” McGrady said. Different states have different laws governing transfer of controlled substances, which he says he has had to learn.
Florida has made it easy for pharmacists to deal with the prescription needs of visitors, which is helpful when dealing with controlled substances, but other states’ rules may not be, Turner noted. Transfers and new emergency prescriptions are allowed in Florida for class III, IV, or V drugs and can be filled if no previous abuse is shown, he said. “If a visiting patient produces a class II for maintenance of chronic pain for instance, we must make a call to the prescriber's office to validate and evaluate the needs of the patient.”
For Turner, one memorable case of travelers in need concerned a family of four. Going against all the usual travel advice, they put their medications in their checked luggage, which the airline lost. Among the four of them, they needed 22 or 23 different medications. “We had to call doctors and pharmacies to get all the information,” he said. “We were able to get all that set up.”
One case for McGrady stands out. An organ transplant patient came into his pharmacy carrying a badly battered backpack. The pack, with all his medications in it, had been in a luggage carrier on top of his car. The carrier had opened up on the causeway leading on to the Outer Banks. The backpack landed on the road and was run over by a truck. The man had stopped traffic to pick up as many of the pills and vials that he could from the roadside and brought it all to Sunshine, where the staff dug through everything and found enough whole pills to last the man a day. His doctors then overnighted all his prescriptions down and Sunshine was able to fill everything by the next day.
Valerie DeBendette is Managing Editor of Drug Topics.