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Amazon opens online pharmacy
- Thread starter Taka
- Start date
CVS pharmacists always look stressed. It's pretty much working retail with an advanced degree. I feel bad for the Pharmacy techs too.
If you have low cost maintenance medications that aren't controlled, I can see this being more convenient. If you don't, I'm not entirely optimistic. I'm also not optimistic about how they'll handle emergency contingencies. If you lose some pills down the drain, or are about to go on vacation, you might be fucked.
Can't you just go to a pharmacy in that case? The way I see it, you submit a prescription, they offer you a price which fluctuates according to market dynamics, you have X amount of time to confirm the order, and if you don't like the price you can just buy it elsewhere.
If you think you can get what you need faster and/or cheaper, I don't see why you wouldn't go there. You're not "locked" into Amazon. I sometimes buy stuff on Amazon, sometimes I just google the item and Google shows me a price comparison of a bunch of stores and I can find the same thing for less (like currently with my Renos, I bought some parts for my shower from Amazon, some Home Depot, some Wayfair).
People don't seem to realize how soul-sucking retail pharmacy can be. Especially at CVS where they are 100% more concerned about numbers than care. You're timed on how quickly you can get things out. You're "encouraged" to meet a certain number of flu shots per period. When I used to work at Walgreens, if you said you were waiting on a script, the time we get to fill it is 15 minutes. Even so, sometimes there are delays because the insurance is having trouble. Then it's up to us to call your insurance and get that sorted out. Now while we're doing that, you have people coming to pick up their meds or check out their sodas. You have people calling to get scripts filled or doctors calling scripts in. You have people coming by to drop off their scripts and what do you know, they say they want to "wait" while leaving the pharmacy. So you're supposed to get theirs out in 15 minutes too. Oh and don't forget that drive thru that constantly has people coming.
The average person has no idea what goes on behind the counter. It's retail, plain and simple. Everyone here agrees that retail is horrible. Retail pharmacy is no different. Well I mean except you could kill someone if you make a mistake. Or if you don't do your due diligence to make sure every script is legitimate or on time. All within that super generous 15 minute waiting period right?
The average person has no idea what goes on behind the counter. It's retail, plain and simple. Everyone here agrees that retail is horrible. Retail pharmacy is no different. Well I mean except you could kill someone if you make a mistake. Or if you don't do your due diligence to make sure every script is legitimate or on time. All within that super generous 15 minute waiting period right?
Thankfully I have a great local pharmacy that fills things while you wait (5 mins). If I didn't, I'd probably give this a shot because the Walgreens and especially CVS are ridiculous with both their time to fill and lines.
Well, it's not all doom and gloom, even though my post made it sound like that. The job market sucks for a lot of careers right now, so a lot of my complaints can be generalized. I think if you're passionate about pharmacy and you make an effort to build good connections in school, you have a fulfilling career. In a sense, it is similar to law school: if it's your passion and you have the grades and connections to get into a solid school, then by all means go for it. Just go in with your eyes open to the realities of the career. You can still make a difference, but you will may have to do that within the bullshit framework of a large corporation, assuming you work in a retail pharmacy.
Canada is a bit different. Traditionally, salaries have been much lower in Canada, especially when you account for the exchange rate. However, work conditions have been better. It is hard to make generalizations, though, because salary, work conditions, and the ability to focus on patient care, varies between and within provinces and states. If you want to get retail work in a smaller city or town, the hours and money are still good ($45 -$50/hour, 40 hours/week for a new grad in rural prairie towns), but if you're looking for work in Toronto or Vancouver, the story is quite different ($30 - 35/hour, 28 - 32 hours per week). Your friends also likely graduate before all schools switched to Doctor of Pharmacy programs (PharmDs). As soon as the switch was made, colleges jacked up tuitions from ~8k/year to ~20k/year. Students really don't get many benefits from this -- instead of doing ~4 months practicum in their final year, they do ~8 months practicum. And, frankly, during those internships, students are working as assets to the hospitals, pharmacies, etc. that they are in, yet they are paying full tuition to their colleges.
Pharmacists in Canada also have, in general, more autonomy and opportunities to make patient interventions (prescribe, vaccinations, order lab tests, offer emergency supplies of medications, etc) than those in the States, which should in theory make for a more fulfilling career, even if remuneration stagnates or declines (as it has been doing). But again, this is a generalization and will break down depending on which locations you are comparing. In some States, retail pharmacists have a very narrow scope of practices, while others are much broader (ex: New Mexico). This is true within Canada as well. For instance, in Alberta Pharmacists can prescribe for schedule 1 drugs (all drugs excluding narcotics and controlled substances), which means your retail pharmacist could in theory take a more active role in managing chronic health conditions. Other provinces allow pharmacists to prescribe for schedule 1 drugs when they have a formal relationship with a doctor. For instance, a group of pharmacists may work at a kidney clinic alongside a nephrologist. Pharmacists at the clinic can prescribe, modify medications, and help manage patients' chronic disease without the doctor being present. Other provinces, like Ontario, limit their pharmacists to a narrower scope of practice -- pharmacists in Ontario cannot even make a therapeutic substitution for a schedule 1 drug.
The reason I said that these abilities make for a more fulfilling career in theory is that in practice they are time consuming and offer minimal remuneration. As an example, consider a pharmacist who conducts a medication review with an elderly patient. The purpose of these reviews are to interview the patient about his or her medications and determine which ones the patient is taking (you would be surprised how many patients are not taking a medication they are prescribed or take it differently than is optimal), whether they're actually working, whether they are necessary (ex: tons of people started taking baby aspirin in the late 90s/early 2000s as primary prevention for heart attack/stroke but don't probably shouldn't be taking it anymore), side effects, , etc. This is a valuable service because many patients end up on a laundry list of medications from multiple doctors and often can discontinue or switch medications or be educated on how to better use their medication/medical device. anyway, doing an interview with the patient could take 30 - 60 minutes and the provincial government pays $60 for this service. The reality is, every prescription that pharmacists fills, the provincial government pays $11.60 (this varies between provinces but is generally around $10 in Canada). Now, which service do you think a corporation is going to value more? The answer is obvious: fill more prescriptions. It's a numbers game.
A lot of the problems that pharmacy has been facing in the States are emerging in Canada as well. Like the US, there has been a large increase in the number of pharmacists in Canada. Around a decade ago, there were approximately 20k pharmacists in Canada. There are now 30k. Part of this is due to increasing enrollment. I'm working from memory right now, so the exact years may be incorrect, but in 2008 there were around 800 - 900 new graduates per year. Now, there are 1300 per year. However, the main reason for the increase has been that changes to immigration resulted in large numbers of international pharmacy graduates immigrating to Canada. Ostensibly, the rationale for increasing the number of seats in programs was a pharmacist shortage in the early 2000s that was projected to worse in the coming decades. Unfortunately, we didn't foresee the impact technology would have on improving efficiency in pharmacies, nor did we consider the growing commercialization of pharmacy by large corporations.
I'm not an expert on this, so take everything I say with a grain of salt. Quite frankly, the job market sucks for nearly every occupation nowadays, so many of these criticisms could apply to other careers as well. I'll cut the rambling off here.
This might depend on the state since laws can vary. Some places only allow you to transfer a prescription once, so if you had it transferred from Walgreens to Amazon, you are now locked in until you can get a new Rx written. Navigating these waters can be a legal an regulatory nightmare at times.
If your prescription has already been processed by your insurance and filled by Amazon, then no. What would need to happen is that Amazon considers your request for an emergency fill legitimate, and then communicate that to your insurance who would then eat the cost for extra medication. After this, Amazon would still have to mail it to you. If you tried to transfer the prescription to another pharmacy, they are going to be blocked from filling it by the outstanding claim, and tell you to go right back to Amazon to hash it out.
To prevent you from trying to illegitimately fill controlled substances. Pharmacy hopping is a huge red flag. If it's a controlled substance, it is locked at whatever pharmacy your prescriber sends it to in many states.
I see, but what if it's drugs that don't have a high risk of abuse, why does it still apply in such cases?
Also, isn't this a tech issue? You would send the prescription to multiple places, but the purchasing should trigger a notification considering the purchase complete, preventing multiple purchases. If that was resolved, I don't see how this regulation would still be needed?
Yep. Let's just consider this another reason why we should join the modern world and implement universal healthcare. You are dealing with a system where your prescriptions can get locked to a single location, and your provider is unlikely to write a new one early due to rampant drug abuse and crackdowns on pill mills. You won't know what your co-pay is until they run a claim, because it is your insurance and not the pharmacy that sets this. You can't really shop around for cash prices either, because in many cases PBMs do not allow individual pharmacies to advertise their cash price because it might undercut them.
Blah, even talking about retail pharmacy gives me stress. That's why the poster earlier in this thread complaining about a 20 minute wait got under my skin. The pharmacist may have been stuck on the phone trying to get someone's life saving medication approved by their insurance, while also doing their best to keep things afloat, and we have someone standing at the counter with his arms crossed demanding we drop everything to give them a flu shot NOW.
One of many reasons why I refuse to work retail pharmacy.
It's just a super complicated issue. You would have to get every pharmacy in every state to use a unified system that can communicate this in real time. You would probably need to get providers in on it too so they can see if their patient already has a prescription for what they are writing. The system would also need to reconcile the difference in state laws, especially for something like Amazon that might be filling remotely.
Let's consider this yet another reason why we should join the modern world and implement universal healthcare. Maybe then we could at least set standards federally (and I wouldn't need a new license if I decided to move states).
If a drug isn't a scheduled drug, then it's likely not locked and you can transfer freely.
And what you're asking is for every pharmacy in America to be clued into the same system in order to flag a prescription at the outset, for Walgreens and CVS and Kroger et. al. to have access to everyone else's medical records within their native systems, which is a logistical and legal nightmare. There are websites we can go to check beforehand if you're trying to fill a scheduled drug illegitimately, but that's separate from what we use to process a prescription.
The protocol in my state and workplace is that I need either an electronic prescription from a doctor, or for you to bring in a legitimate paper prescription and your driver's license. After I check the website to see if you're a responsible patient, and that the prescription isn't dated for later, then we can fill it.
However, if you're calling around asking if you can get 120 oxy filled, and are reluctant to bring it in, especially if you're a patient the pharmacist doesn't know you, you will be denied. No one wants to risk their license on a druggie.
As a former pharmacy tech, the above post is spot on. Don't forget to add dealing with all the people addicted to prescription medication and explaining to them why they can't get a refill on a controlled medicine with 30 day supply they just filled 5 days ago.
You joke, but this is the logical progression
Amazon want to do healthcare
Also this. In a good day, everything goes smoothly and I can actually fill your shit in a timely manner. If the insurance fucks up, or the phone doesn't stop ringing, or someone wants to argue with me for whatever reason, or if it's just busy, the wait time is guaranteed to grow. And of course, people don't know processes, protocols, and law, so they think we're trying to spite them or are incompetent.
Well then it seems pharmacists should purchase the drugs on a competitive market. So they might lock in your prescription, but they would have to send a purchase request on a platform that seeks the lowest price available. Same as things are done with the stock market when you send a purchase request at an open current-market price. If a pharmacist doesn't want to, they would lose business as people chose others who will unless they make up for it through other means.
Seems like this is the approach Amazon will take.
And like I said before, the locality of a pharmacist is only relevant if you need to be in direct contact with them, and in that case it is the transportation costs that should be covered. Otherwise, it should be online, to increase access.
I'm by no means an expert on anti-trust laws, but I'm not sure that being too good at too many different things is grounds for anti-trust action, is it?
I know that GE, which was for a long time the largest company in the US, has divisions in sectors as diverse as power, aviation, healthcare, insurance, renewable energy, and others.
Pharmacies are usually locked into a contract with a regional distributor as well, so you get the price that McKesson or Cardinal is charging you. Half the times the damn drug is on backorder anyway, so you have no choice but to order whatever NDC becomes available regardless of the price.
Then you fill the prescription, run it through the patient's insurance, they have to pay you a $30 co-pay. Out of that $30, $29 actually goes to the pharmacy benefits manager contracted by the insurer and the pharmacy gets $1. Sometimes you actually lose money on the prescription. It's a real racket.
Did you know that Medicare is actually forbidden from negotiating drug prices with the pharmaceutical companies as well? The US government has no ability to leverage it's weight and get competitive prices.
The bottom line is I think we need to nationalize this and toss out the private sector entirely. It has done nothing but jack up prices, deny people healthcare, and created a labyrinth of laws, regulations, contracts, and red tape.
For all those talking about saving money based on amazon's buying power are you using insurance? My insurance has price tiers for covered drugs with flat co-pays for anything that isn't a specialty drug. Are you folks paying percentages not set prices ? Regardless CVS and Walgreens are giants in their own right so they are getting the best pricing.
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This is on the cards in the UK as well. Heard a few rumours of them wanting to buy one of the online pharmacies such as Pharmacy2U.
They can't replace community pharmacies, and even tell you that when it's urgent, go to one of them. No pharmacist for advice, can't get a flu jab. Stick to community pharmacy, if they have a good team, they're so much better.
They can't replace community pharmacies, and even tell you that when it's urgent, go to one of them. No pharmacist for advice, can't get a flu jab. Stick to community pharmacy, if they have a good team, they're so much better.
It's almost like there's literally hundreds of people who also have to be serviced at the same time...
Giving a flu shot means the pharmacist can't do any of their other duties for a minute, which can very quickly back up literally everything else.
I fully expect Amazon to buy AMC next year and rebrand it Amazon Movie Cinemas