Ethical or Unethical

[islander01]

I want to get an opinion from some of you. I work in a retail pharmacy, and I know that the pharmacy is all profit-oriented. I believe that the profit should go to a certain point. I feel that the following situation I will be describing is unethical for the sake of the consumers.

A doctor called in a new script for an OTC product Metronizadole 2%. It is out in the OTC section, and each tube costs about $2 + tax. Because I want the customer to pay the cheapest price, I asked my pharmacist what should I do. Should I process it as a label but charge him/her $2 instead of the normal drug cash price (over $10)? My pharmacist said we should charge him over $10 because we will lose money. He said that lighting costs money, MY and HIS labors cost money, etc etc. IMO, he has a point there...facility and labor cost money. But does it matter that much for the quick recovery of the patient? We as pharmacists or technicians are here to serve people, not taking advantage of them.

What do you guys think? If this case is unethical, can anyone provide me an article that support it?

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[confettiflyer]

That $10 includes the price of the drug plus your professional service fee. By putting work into the product (typing the script, printing the label, etc...), you are adding value to what the patient is receiving and therefore it is ethical to charge $10.

Now...what would I do? I'd point the patient to the aisle with the handwritten directions. Less work for me, I'm getting paid the same wage anyway.

The problem will be when you get a savvy customer who knows that it is OTC and will wonder why you are charging $10 when it is $2 right behind them. Even though it's ethical, try explaining your way out of that one.

So yes, the practice is ethical...but a waste of time when I have a pile of other scripts to process, other pt's waiting, and the risk of alienating the pt. and looking like a crook.

 

[confettiflyer]

And..I guess you can think of it as being analogous to an ATM fee. For $2.50, you save yourself the inconvenience of walking/driving around trying to find your own bank.

For this example, you pay $8 more to save yourself from hunting for a small tube in the store and having to decipher instructions scribbled on a pad from your doctor. You also pay for the pharmacists time in verifying that this, in fact, is what the physician ordered.

 

[JerryPharmD]

Metronidazole is not OTC in any topical formulation and comes in 0.75% and 1% strengths

 

[imperial frog]

We as pharmacists or technicians are here to serve people, not taking advantage of them.

I would tellt he customer that it was an otc product and point them to where it was. However, you should really get it out of your head that we are there to serve the customer and replace it with the fact that we offer a service to the customer...HUGE difference.

 

[OhFear]

Maybe try to explain to the customer the situation, and let them decide? i.e. give them all the information they need to make the best decision for themselves? I know that's a bit idealistic, but I think that would be the most ethical thing to do.

 

[npage148]

It's shady- I will always sell them the cheaper one. Plus i'd rather not input and check a script if I dont have to. Why make more work for youself

I'm guessing the OP meant Miconazole

 

[Old Timer]

I'd like to know where you work. At CVS, the RX price would come out the same as the OTC price.

I personally think it would be unethical to charge the patient $10.00 for something that costs $2.00 without at least offering them the choice.

 

[bananaface]

My comments aren't specific to this case, but if the label directions differ from the OTC directions, you open up the possibility of misuse by not filling it as an Rx and affixing the correct directions. You also miss potential drug interactions by pushing them to OTC unless you are logging OTCs someplace in your system and including those items in the DURs as you fill future prescriptions. My point is, it's not such a simple decision. What is safest is not always what is cheapest.

 

[confettiflyer]

I'd like to know where you work. At CVS, the RX price would come out the same as the OTC price.

I personally think it would be unethical to charge the patient $10.00 for something that costs $2.00 without at least offering them the choice.

Yeah, I work at CVS...I typed up a dummy script for Cetirizine #30 and it came up $18. The OTC package on the shelf is also $18.69, but it happened to be on sale so it was $10 w/coupon. There is a tax savings for the pt, but that usually doesn't amount to much anyway.

 

[Pianopooh]

When my pharmacist notices that the item is OTC, he tells me to tell the patient it is available OTC and they shouldn't pay for version from the pharmacy since it would cost more. I think you should always offer the patient a choice of OTC and see what the patient says. The patient might have tried it and had an allergic reaction or side effect to it, and the version that is carried behind the pharmacy won't give them same reaction/doctor recommends it.

 

[RxWildcat]

like they said before, there is a professional dispensing fee. banana that is a great point that I hadn't consider before, thanks!