The Pharmacy Chick

Flying the coup in retail

Mutual and Westward? I am calling you out!

Filed under: Uncategorized — pharmacychick at 8:09 am on Tuesday, February 12, 2013

I am a little righteously indignated this morning ( if thats even a word.).  If you are involved in the world of pharmacy you know that drug shortages and back orders are more commonplace than they used to be. I never have an answer for this. We are the USA after all.  This isnt Berzerkistan. Over the last few months Doxycycline has been in ever shorter and shorter supply and eventually I ran out of all Doxy Hyclate 50 and 100mg tabs and caps.  This is pretty huge because we use a lot of that med on a daily basis.

If we have found it at a competitor, we have sent it there, and likewise, they have sent to us if we happened to have scored a bottle.  Last Friday and yesterday we got out first real shipment in: 2 bottles from Mutual Pharmaceuticals and 1 from Westward… $2300 and 2000 apiece for a bottle of 500.   WHAAAAT???  This is a cheap product that used to be under 50 bucks for the 500ct.

Can you say PRICE GOUGING ?

I dare you to respond…any of you in the industry!  I point my finger to your overstuffed shirt, and accuse you of collusion, price fixing, price gouging…whatever. You have no ethics whatsoever.

I havent opened any of these bottles and in my opinion they dont exist. I tried to refill ( and bill) a rx to an insurance for this and when I sent my cost of 139.00 for 60 tabs, it came back with a reimbursement of 5.28.  NOPE. not gonna happen.

I hate you Mutual and Westward.  you are a used kleenex in my mind.


Comment by goose

February 12, 2013 @ 9:52 am

I can solve this mystery for you. I work in a hospital and we store drugs for emergency response to disease type outbreaks that may or may not be acts of terror. We used to have a whole bunch of Tamiflu from the CDC that even was on a skid with an alarm on it!
Right now, on my shelf, I have about 50 bottle of Doxy 100mg caps 500 count from Westward and I’m sure we didn’t pay a dime for it. Also a bunch of bottles of 500 of ciprofloxicin, same deal.
It is all stockpiled for an anthrax outbreak and I’ll be we didn’y pay a dime for it.
I would not be surprised if many shortages were due to the feds stashing away stuff.Imm sure the public will be thrilled to know that after they have to shell out over 400.00 for every 100 tabs…yuk

Comment by goose

February 12, 2013 @ 9:59 am

I constantly get grief from the docs in the hospital about doxy not being available.
Can’t tell them we have all they need down in the pharmacy because they can’t have it.
It will all outdate in about a year and I’ll bet we just throw it away.
In the case of the Tamiflu though, The CDC told us to add a year to the expiration date when it expired and use it anyway if we needed to. That might happen with the doxy and Cipro too.

Comment by Pharmaciststeve

February 12, 2013 @ 10:31 am

IMO.. the issue is that as the insurance industry has pushed the MAC’s down and down.. the generic industry has had to consolidate to try and get economy of scale to be able to sell below the MAC’d price.

We never have this problem with brand names.. because there is adequate gross profit to be able to toss a whole bunch if they go out of date because they misjudged the demand.. Apparently the margins are so small on generics … that it dramatically affect their bottom line.

I would bet your PBM contract states that you must fill a Rx for any product that you have in stock. Regardless of profit/loss..

A couple of complaints from pts to the PBM.. might cause a audit..who is lying? i take it out of inventory! customer cant complain if I dont actually have the drug.

Comment by Loren Pechtel

February 12, 2013 @ 1:49 pm

It’s not just the insurance industry, Medicare/Medicaid shares a good chunk of the blame.

The basic problem is the low reimbursements, though–the profit margins are low enough that it doesn’t make economic sense for the manufacturers to maintain buffer inventory or anything else to ensure supply. Anything glitches and the patients are the ones that suffer.

Comment by Dr. Grumpy

February 12, 2013 @ 5:25 pm

A used kleenex? You are too kind for them.

Comment by drsteverx

February 13, 2013 @ 6:49 am

I got wind of this increase right as it was happening and ordered hundreds of doxycycline capsules from my wholesaler while it was still low. About 20 bucks for 500ct I believe. I was going to buy and sell in futures. My hope was the MACs would get lifted and I could finally make a tidy margin in the process. No dice. That was months ago and MAC increases have been denied. Pretty neat system we have.

Comment by TexasPharmacyChica

February 13, 2013 @ 7:14 am

Tetracycline – we miss you, too.

Our wholesaler gave me a heads up on the price increase and I stocked up (sorry, but we would all do it if we could), but our automated system ordered in a bottle of a different manufacturer – the WAY expensive kind – and the tech had already opened it to use for a prescription by the time I got to check it. I almost cried – we had plenty in stock. Now, it seems we are going through it like crazy!

Also keep in mind that a lot of Dr. Reddy’s products have been recalled due to manufacturing problems at one of their, I believe, four plants in India, so expect more issues.

Comment by ws

February 13, 2013 @ 11:25 am

Try not being about to get potassium, sodium, magnesium, calcium, trace elements, vitamins, lipids, amino acids and everything else that goes into TPNs. Everyday it’s something new. The only thing that we haven’t had problems getting is the dextrose. I said pretty soon we’ll just be giving them sugar water.

Comment by pat

February 15, 2013 @ 8:28 am

there’s another piece to this, re-sellers. when we had issues finding the items WS mentions, seems we could always find it from re-sellers…..for a price. somehow they got a heads up on the upcoming shortages and stockpiled further contributing to the issue. they always had midazolam, etomidate, etc etc. what are you going to do? we paid premium price for these items.

this is a multi-factorial issue, i think, that can have devastating consequences, witness the NECC tragedy. that was partly driven by shortages (and probably in a large part by greed-i hope they “hang”).

Comment by Bubba The Bubster

February 15, 2013 @ 10:15 am

have you tried getting the MAC lifted? I know your are busy and don’t have time to call for coverage much less payment from the PBM, but if you can’t return them it would be worth it to keep from taking a loss

Comment by FM

March 2, 2013 @ 9:57 am

This just happened to me too. In December I had 100mg Doxy 90 day supply filled with Express Scripts for $9.17. February 23, same prescription $417!! Mutual Pharmacy is the drug manufacturer. Can you say furious? Express Scripts didn’t disclose the price on the website – said “price unavailable” and they happily filled it, charging my credit card. Their response was “well it went towards your deductible. . .” I’m done with Express Scripts. It’s just unconscienable to me that there would be that kind of increase and they wouldn’t notify me before happilly filling the Rx. They won’t authorize the return of the drug – I haven’t opened the mailing package, so they would be assured that it wasn’t tampered with. Any ideas on how to get them to take it back??pretty simple actually. RETURN the item. send it back by trackable, certified mail. Initiate a charge back with our credit card, call it “unauthorized use”, as a small business owner, i can tell you pretty much every customer who wanted to rip me off did it by that…because the credit card company will side with the cardholder pretty much every time. And no, I am not saying you want to rip them off, they did the wrong thing. there was no rational reason they shouldnt’ have informed you. We always contact our customers when we see price increases like that!!

Comment by anymousie

March 2, 2013 @ 5:25 pm

@ FM.

It is not legal in most, if not all, states to take back prescription medication once it has left the pharmacy.true, but I think she has a strong case to send it back.

Comment by Dave

August 10, 2013 @ 7:06 am

Same thing recently happened to me. I saw a 425 dollar charge on my credit card and incorrectly assumed that express scripts charged me for my medication for the year. Once I realized that it was a 425 charge for a 90 day supply it was too late for me to stop the charge on my credit card.

I check their website and the same exact medication at a higher dose was only 120 dollars for a 90 day supply. So clearly a mistake must have been made. Nope. I asked for a refund of a difference but even after going through two levels of complaints with Express Scripts and contacting the state of MO about the obvious price gouging I was told that no violations had been committed.

Its pretty obvious when such a large supplier of medication tells you that the price is based on the supply and other factors is clearly screwing you when the same medication anywhere else is just above 100 bucks.

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