What's up with new pharmacy rules on non-narcotic scripts?

[Chrish]

BTW, when are pharmacists going to get the authority to write scripts for tamiflu?

I'm sick and tired of entire families asking me for it -- would much rather turf that to you, at least you can make some money off it whereas I can't

Not sure if you are a troll or a genuine poster.

Why would you refuse easy money? See those patients for less than 5 minutes and write Tamiflu / Zpak. That’s what urgent care in the town does.

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[JustFillIt]

Nonsense, I'm going to call BS on this. I'm not getting any kickbacks from these stores.

Says you....

 

[APN-59 rph]

And explain to me again why anyone would spend five...maybe six years in Pharmacy college....

 

[Bubba98]

BTW, when are pharmacists going to get the authority to write scripts for tamiflu?

I'm sick and tired of entire families asking me for it -- would much rather turf that to you, at least you can make some money off it whereas I can't

I have heard rumor it is going OTC. Safe but not effective. What is your biggest source of revenue? Comm

And explain to me again why anyone would spend five...maybe six years in Pharmacy college....

Cuz you get paid 60/hr

 

[Xarelto-10]

Multiple pharmacies have come out stating that they can't accept scripts that include designators like "drops" or "spray" and instead have to be converted to "milligrams"

Also they can't accept scripts for designations like "bottle" or "tube" and have to have an exact milligram or gram designation.

So when I write for a prescription steroid cream for eczema, I can't just write "tube" I have to look up how many grams are in each tube. Apparently 4 years of a pharmacy education isn't enough to decide what tube size to use and pharmacists have to be spoon fed the exact gram/mg dose.

BS like this is exactly why the healthcare field is going to hell -- these rules have ZERO improvement on patient care and instead put up stupid roadblocks that don't need to be there.

I kind of understand your frustration with the micromanagement of insurance companies. But I can assure you perhaps most pharmacists hate it as much as you do.

The problem is systemic and only can be fixed if whoever came up with this could consider everyone involved and how best to go about it. But like most of our healthcare is- these decisions are random and not well integrated and result in frustration for all involved.

And I’m sure pharmacies have to play by the rules so they can be paid for the r services as much as you do for your services.

one easy fix I can think of is for you to work with your local pharmacies by providing blanket authority to be able to fix your scripts so they can bill it correctly and notify you of their action.

 

[Rainbowdash]

Sorry, Dr Socrates, it is not the pharmacies. It is those darn insurance companies that audit us. In general, cheap drugs, such as tac, are not being audited. But on more pricey creams: clobetasol, lotrisone, dovonex, elidel, protopic, etc--we need not only the size, but the amt of ftu's per day. . .very annoying for everyone involved.

 

[BenJammin]

BS like this is exactly why the healthcare field is going to hell -- these rules have ZERO improvement on patient care and instead put up stupid roadblocks that don't need to be there.

Are you kidding me? You think we're doing this for ****s and giggles? If your prescription doesn't conform with the rules of the PBM then pharmacies risk recoupment of the claim. Imagine it the other way around. I didn't type up a discharge prescription properly into the computer so the insurance is going to take back everything they paid you for surgery. That $400,000 open heart surgery you performed? Chargeback. You get paid nothing.

 

[sfachine]

BTW, when are pharmacists going to get the authority to write scripts for tamiflu?

I'm sick and tired of entire families asking me for it -- would much rather turf that to you, at least you can make some money off it whereas I can't

Did you tell them the drug is almost worthless?But so are the flu shots, especially in the older population

 

[rxkrafted]

Doesn't matter if I know how it's supplied it only matters what is in stock.

Here's a typical conversation I have after sending in elidel 1% cream 30g tube:

Pharmacist: We dont have the 30g tube
Me: What do you have?
Pharmacist: 60g
Me: Ok then use that one
Pharmacist: I can't do that without a new script
Me: Seriously, you can't change to a size you have in stock?
Pharmacist: Nope, I don't have the authority to do that.
Me: You are an EXPERT on medications, with a doctoral degree in pharmacy, and you don't have the authority to change the tube size?
Pharmacist: Nope, I need a new script
Me: LOL

That's just dumb. If anything, they could just document it and write it as a telephone order but really waste of time. I feel like you are encountering new grads who weren't trained properly or too scared to use logic.

 

[owlegrad]

I have heard rumor it is going OTC.

Seems like a pretty safe bet: Tamiflu Set to Switch to OTC Status

 

[JustFillIt]

That's just dumb. If anything, they could just document it and write it as a telephone order but really waste of time. I feel like you are encountering new grads who weren't trained properly or too scared to use logic.

Either this or the story is fabricated, exaggerated, or otherwise just made up.. Be careful not to blame, or belittle, your peers before someone on the outside.

These days you can never trust a “story” that is told by someone if it involves discussing who is right/wrong. You can almost certainly assume that it has been spun in a way that favors the one telling the story.

 

[Wickett]

Either this or the story is fabricated, exaggerated, or otherwise just made up.. Be careful not to blame, or belittle, your peers before someone on the outside.

These days you can never trust a “story” that is told by someone if it involves discussing who is right/wrong. You can almost certainly assume that it has been spun in a way that favors the one telling the story.

Yea I dont get it....if the prescriber said to use the 60, you document the change on the original rx, or scrap the old one if you want and do it like a call in script. I find it hard to believe it went how OP claims.

 

[rxkrafted]

Either this or the story is fabricated, exaggerated, or otherwise just made up.. Be careful not to blame, or belittle, your peers before someone on the outside.

These days you can never trust a “story” that is told by someone if it involves discussing who is right/wrong. You can almost certainly assume that it has been spun in a way that favors the one telling the story.

I'm not saying I trust the story but if this is how it went down, that's my opinion about it. It's not completely absurd... I've seen similar instances like this happen before with both pharmacists and interns.

 

[MilknCheerios]

BTW, when are pharmacists going to get the authority to write scripts for tamiflu?

I'm sick and tired of entire families asking me for it -- would much rather turf that to you, at least you can make some money off it whereas I can't

Soon, I hope. I, too, am tired of nurses hurriedly leaving voicemails of 8 family members, cousins, and uncles, etc. who have been in contact with the one person that has the flu. If I could do these RXs "per protocol," I wouldn't have to bother any docs about dosing or weight, and just input the RXs for the family members when they come in. I can do narcan and vaccines per protocol... what's to say tamiflu isn't too far in the future?

 

[zelman]

Nonsense, I'm going to call BS on this. I'm not getting any kickbacks from these stores.

It’s called “steering” and is illegal in many states. E.g. Section 13:39-3.10 - Steering prohibited, N.J. Admin. Code § 13:39-3.10 | Casetext

 

[Old Timer]

It’s called “steering” and is illegal in many states. E.g. Section 13:39-3.10 - Steering prohibited, N.J. Admin. Code § 13:39-3.10 | Casetext

You are misreading the statute. You are leaving out the part:

It shall be unlawful for a pharmacist to enter into an arrangement ​

This is the pharmacy act and applies to the pharmacist. Any doctor is free to recommend any pharmacy. It is unlawful for the pharmacist to enter into an arrangement with the Doctor

 

[zelman]

You are misreading the statute. You are leaving out the part:

It shall be unlawful for a pharmacist to enter into an arrangement ​

This is the pharmacy act and applies to the pharmacist. Any doctor is free to recommend any pharmacy. It is unlawful for the pharmacist to enter into an arrangement with the Doctor

with a health care practitioner who is licensed to issue prescriptions, or any institution, facility, or entity that provides health care services

I advise you to count the number of people required to dance the tango.

 

[JustFillIt]

I think we can agree that it’s just not a good idea.

 

[Old Timer]

with a health care practitioner who is licensed to issue prescriptions, or any institution, facility, or entity that provides health care services

I advise you to count the number of people required to dance the tango.

No, your understanding is faulty. This is just a list of people the pharmacist is not allowed to deal with. It has no bearing on the doctor, None, whatsoever. The Pharmacy Act does not apply to him, It applies to the pharmacist. Unlawful for the pharmacist. Doctors recommend other doctors all of the time. They are free to recommend pharmacies and medical supply stores as well. There is a difference between a recommendation and forcing the patient to go to a specific pharmacy. You are dead wrong. Get one of your lawyrer friends to read it over