The Pharmacy Chick

Flying the coup in retail

Everything is $4..according to….

Filed under: Uncategorized — pharmacychick at 9:35 pm on Saturday, October 1, 2011

Mr. I-know-more-than-you comes in and brings me a script for Lipitor 20mg.  Before I can pick the rx up from the counter he states emphatically that “My doctor told me this is only $4″.  Since I am quite familiar with Pfizer’s $4 lipitor cards, I ask him for the card to which he stares at me as if I had just spoken Swahili or something. ” its only $4 if you have enrolled in the manufacturer’s loyalty program.  check lipitor(dot) com to see if you qualify,( I quickly run a claim) otherwise its $xx.xx copay in your insurance”.  Either he didn’t believe me or I was still speaking in some tongue he was not familiar with. ” But my Dr said it was only $4″. here we go again..the circular conversation…

A un-insured mom brings me a worn script for Adderall 20 that I can tell has already been to a couple of pharmacies based on the stuff written on it. Anytime I get one of these I know I am to prepare for a headache. Surely she is not going to tell me why she has already been to pharmacy #1 and #2..but I will find out myself soon enough.  ” this is on your $4 list? right?”  Um no, not only do we not HAVE a $4 list, but we do not price match prescription drugs that are out of stock elsewhere. And since Adderall generic just took a 4-5x price increase get ready for some REALLY bad news.

Big Box pharmacy has this on their $4 list, you price match right? Since the iron-man poster at the store front does indeed say that, I can’t exactly argue that point. But the script says fluoxetine 20mg  #90, 3qd.  ” You get 30 capsules for $4, not 90.. you can have 90 for their price of $10.”  she told me I was a rip-off.

But lastly, but certainly not leastly…the booby prize goes to the finely dressed gent with the gold pinkie ring who asked ” do you have a $4 flu shot?’  I wanted to hand him a tissue and a bottle of hand sanitizer.


Comment by ChaCha

October 2, 2011 @ 1:19 pm

I keep thinking about doing relief in retail but these posts make me reconsider….smart man ( or woman)….

Comment by mb

October 2, 2011 @ 4:22 pm

Working for a certain big box store with a $4 list, I can tell you it is also alot of headaches for us. Everyone seems to think that all generics are $4 if the doctor rights on the script (30 day supply) regardless that I don’t think your taking a once a day drug 4 times a day at 3 tabs a dose. People get so pissy when you tell them to read the fine print and it says per X# of tablets, not the fictitious days supply. I also would love to snark to the people that demand their advair/lipitor/ect for $4 because “the doctor told me it was only $4!” with “well, you can pay us $4 for it if the doctor wants to give us their credit card to charge the remaining amount to them”.

Comment by another pharmacist

October 3, 2011 @ 6:29 am

I remember a patient coming into my place of employment, asking if I had a drug in stock and telling me that he had been all over the area trying to find his medication. It was a Saturday, and he had the gall to complain that our price was $2.00 more than the price Wal-Mart would have charged if they had the drug. I will never understand why he thought I should price match an item that a competitor doesn’t have? It wasn’t as if our price was out of line, or as if he was going to be a long term customer.Ive had this happen quite a bit, and my long-since-quit tech came up with the perfect retort. ” If they dont have the drug, they aren’t exactly our competition are they?”

Comment by Frantic Pharmacist

October 3, 2011 @ 8:38 am

I love it when someone else tells the customer how much their prescription is going to cost. Yeah, it’s wearing me down — being told how much it should cost and how long it should take.
P.S. Love your technician’s retort. I’ll have to remember that one!

Comment by Alex

October 3, 2011 @ 9:21 am

A $4 flu shot? You must be kidding.I wish…

Comment by smartTech

October 3, 2011 @ 5:49 pm

The $4 list is the bane of my existance. Being an independant pharmacy, we cant even buy somethings for that let alone let it out the door for that cost.

Comment by JS

October 3, 2011 @ 7:24 pm

How about a $4 shingles vaccine? J/K! Hope all is well with you, PC. How are the Pups?all three are happily shedding fur like the the trees are shedding leaves right now!

Comment by PharmGamerKid

October 3, 2011 @ 10:45 pm

the other day, we have someone walk away when they found out their copay for the flu shot would be $1 and not $0 wtf o_O

@JS, zomg, $4 shingles vaccine? ppl will be lining up for it especially since every doctors seem to push it on everyone >60yo nowadays.

Comment by ADHDammit

October 4, 2011 @ 4:16 am

Dear PharmChick,
I am writing you for advice. I, too, have a script for 20 mg. Adderall which has been to a couple of pharmacies.

One pharmacist wouldn’t fill it, because he felt the dose was too high. Believe it or not, this caused no consternation whatsoever for me. Pharmacists don’t fill orders they don’t feel comfortable filling, and that’s it. It inconvenienced me by 20 minutes, but in general, I think this kind of thinking is a good thing, because it keeps patients safer.

What irritates me is that there is NOT ONE single pharmacy that has enough to fill a sixty count 20 milligram script (dropped off three days before I was due, as I was expecting some kind of road block.

For the record, I am a thirty two year old college educated male with no criminal record, a polite demeanor, and a healthy respect for Pharmacists as the experts on anything you put in your body that’s not food or someone else’s body part. I pay cash, can’t afford insurance, but I make it work, cough up the $200 a month for the psychiatrist, who is worth it, and the meds, who are worth it, because it’s the only way to manage a condition that besieges me at every interval that time bloody advances.

Please tell me why this is happening, this “backorder” bollocks that happens like clockwork. I know giving speed to people who routinely lose their keys, wallet, time-management, dignity and self-respect is controversial, to say the least. i’d consider any restraint exercised in telling me why life is so hard, from anyone who reads this as compassion, and what else I could do to make my situation better, so feel free to skip that part.

This is what i’m saying: to me, ADD not being a death sentence is sort of a novelty. I’ve held down a sixty hour a week job taking care of my two elderly uncles. I fix their meals, bathe them, wipe their behinds and change their diapers, get to work at home, read 1500 pages a day, keep them out of a nursing home, and have finally gotten into a groove where I feel maybe not completely fucked for life in the long run. It is grueling, exhausting, wonderful, miraculous, terrifying, and sometimes hell on toast. And I will stipulate that I am the luckiest person alive, since two twenties twice a day of Magic Adderall has been the fulcrum with which I have been able to turn my life from shit to shine.

EXCEPT THAT I CAN’T GET MY MEDS ON TIME!!! Why is this? Every month?? It’s not the pharmacy, they’re like, the best, kindest most hardworking, under appreciated people. I never bitch at them, a paste a smile on when I have to wait, and I thank them profusely, play by the rules, and try not to cause them too much grief.

But somebody has to have screwed up, and I’d love it if you could speculate as to whom I should address an ornery, yet well written and tastefully vulgar letter. Thanks for your time, and feel free to edit out the curse words… All is ask is that you use $&@:;%*#^ type stand-ins, as I feel that fake curse words could potentially diminish the vitriolic qualities of my rant.

Since my boyfriend has dumped me (for not returning phone calls and being late and exhausted for ‘quality time,’) I am sure that you can sympathize with my lack of interest in bending over for anybody else, namely whoever dropped the ball on this ‘backorder’ lunacy.

-hanging on by a thread in Georgia.Get some more thread because you may be hanging for a while. The bad news is that from what I understand its the DEA that is controlling how much product hits the market ( tho they deny its the reason) so you can write your well vulgared letter to them but I suspect it will fall on the desk of some underling secretary who will never forward it on. the DEA is big and powerful and answers to no one. The good news is that you have some options. Adderall (the generic of which raised its prices by 3x of late) is not the only game in town. There are lots of other amphetamine options for the ADD inclined. You may want to consider using some of the other amphetamines until the generic adderall (mixed amphetamine salts from a single source)returns to stable stock. You may even ask if the 10mg tabs are in stock. Adderall 20 mg # 60 can be subbed by adderall 10mg # 120 without any problem in most states. Many pharmacists are wary about making any changes to a CII drug but According to the DEA, the only things that CANNOT be changed on a CII is the DRUG ENTITY, ( strength can be changed with a phone call), the PATIENT NAME, and the DATE WRITTEN. Weve made that change several times to accomodate this shortage.

Comment by JS

October 4, 2011 @ 8:07 am

Pharmgamerkid~ I was totally kidding and going along with the idiocy of people. My dad’s MD has been pushing it for two years (he’s 63). His BCBS plan will pay for it if his MD does it ($30 co pay), if he goes ANYWHERE else it’s covered under his out of network benefits; which have a $14,000 deductible. Our PCP can only give in office shots for HMO patients. So, he either needs to “dig deep” and pay for it, or hope he doesn’t get shingles. Sure would like to see the statistics, risk factors, etc., and see where he falls; as in does he really need this?if you cannot afford it, dont digg too deep, people have survived in generations before us without the vaccine so dont forego rent or groceries. The stats are as follows: 1 in 3 adults over the 60 will contract shingles…thats a little over 30%. the older one gets however the more difficult it becomes to get OVER shingles and the occurrence of the neuropathy afterwards (that in many cases never goes away) raises significantly as one ages. This can be debilitating in some cases and may be life changing…in a bad way. The vaccine does not guarantee that you will never get shingles, it reduces your likelyhood by 50 percent or so. but if you DO get shingles, the case will be less severe and the likelyhood of the painful neuropathy is drastically reduced. Hang on and see what Obamacare will be…supposedly all vaccines are to be covered. we will see what the final product will be, and Medicare D ( which your dad will be eligible for shortly) DOES cover the vaccine at some kind of copay depending on the plan.

Comment by JS

October 4, 2011 @ 4:55 pm

Thanks, PC. The issue is that his MD can only give it to him if he had an HMO (they order it for those patients only, no exceptions or he would make one). So, he has a plan that will cover it, but only if an MD gives it to him. But his MD is working within a group who won’t allow him to give it to him, because he has a BCBS PPO. His PCP is strongly suggesting he gets the vaccine and is making nothing by encouraging it. I am just wondering if he has any of the risk factors or are there no risk factors and it’s simply a crap shoot for those 30ish%? On another note, it sounds like you and Mr. PC are doing a lot of vacuuming to accommodate the “mess” left by hairy doggies. I know you love every minute of it, though. Are the three you have now yours or rescue and yours?

Comment by JustADoc

October 4, 2011 @ 5:08 pm

For doctor’s offices for Medicaid kids it’s not even a $4 flu shot. It is a completely free flu shot in some circumstances. And I don’t mean free for the kid and parent. I mean free for the state/Medicaid as well.
If I see a kid for their well-child check and give them 2 shots, then the 3rd thru x shots are free. We get paid exactly $0.00 for giving the shot. Of course we get to keep the liability.

Comment by Jade

October 4, 2011 @ 7:47 pm

Shots for kids with Medicaid insurance are free through the State Health Department in this part of the country. But, I don’t imagine every state has one since various cuts are being made in state governments.

My office is across the hall from the county shot place and I noticed a sign on the door earlier this year about a new rule. It seemed to me that it said that if patients had any sort of private insurance at all they couldn’t be vaccinated through there, only if they only had Medicaid insurance.

If the children were insured through Medicaid they get a free shot at the health department, but if they had other insurance they had to obtain the necessary immunizations from someone other that the free supply at the health department.

Also, I thought a signed standard VIS form took care of liability in administering vaccines.

Comment by ADHDammit

October 4, 2011 @ 8:24 pm

THANK YOU! That was exactly what I wanted to know, and I appreciate not just what you said, but how you said it. That, ladies and gentleman, is what classy is.


I didn’t know they could sub!

Comment by JustADoc

October 5, 2011 @ 5:44 am

Signing the VIS does transfer liability for the vaccine itself to the government. It does not transfer liability for the shot. Admitedly that is low, but it is not zero.

And the nurse doesn’t work for free.

And yes, I could send all of my Medicaid children to the Health Dpt for their shots there. I am sure that 100% of them would actually be taken there to get their vaccines.

Comment by PharmacyJim

October 9, 2011 @ 1:34 pm


Concerning CII’s, my state’s Board of Pharmacy has interpreted the DEA rule to mean NO changes, even by phone, of drug name, strength, dosage form, or quantity. So we send them back to the prescriber for a new Rx.

As for the $4 flu shot, I don’t expect that. But I do expect with the big box stores or grocery chains having an abundance of vaccine, we will see it advertised at $9 or something similar. I hope I’m wrong, but that is what I expect. After all, we don’t have anything else to do, lol.thankfully we have never seen a 9.00 flu shot anywhere around here.

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