Mail Order Pharmacy

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A Legal Drug Dealer
15+ Year Member
Jun 10, 2004
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Until recently we have been seeing a rise number of mail order phamacies or internet phamacies. does anyone work in any of those areas? if you do, how do you go about consulting patients who might have a problem with Rx that is mailed ordered in?

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I live here in Vegas, about 1 block away from Medco Health's large mail order warehouse. In my time here, I've met floater pharmacists who've worked at that facility. What they tell me is that pharmacists who work there work in different areas. Some work in the "call center", answering customer health questions. That's where the consultation comes in, along with the printed literature. Others work on dispensing, but a lot of the dispensing is automated. Here's a listing of job duties from their website that pertain to this Las Vegas location:

Call Center Pharmacies
Columbus, OH; Dublin, OH; Dallas, TX; Las Vegas, NV; Tampa, FL
Call center pharmacists hold positions with roles/responsibilites in two major areas: Customer Service and Managed Care.

Customer Service
Pharmacists' responsiblities include the handling of all inbound calls. These calls are primarily focused on drug information and patient counseling/education. In addition, all call center pharmacists:

* Handle patient questions and issues with respect to drug therapy and drug information
* Contact and discuss drug therapy with physicians

Managed Care
Pharmacists' responsibilities are primarily focused on the provision of clinical information related to Medco Health's vast array of programs and services. Managed Care pharmacists will:

* Provide patient counseling focused on behavior modification, including diet and exercise/wellness or prevention to improve outcomes associated with drug therapy and compliance
* Assess barriers that prohibit patients from maximizing drug regimens
* Keep accurate and detailed records of all communications with patients so that success or failure of methods can be assessed and studied
* Maintain effective communication with other health-care professionals

Automated Prescription Dispensing Centers
Las Vegas, NV; Willingboro, NJ
Automated dispensing pharmacists benefit from a high-tech, state-of-the-art environment ? including robotics for prescription dispensing ? allowing them instead to perform a strategic role in quality assurance, testing and operating efficiencies. At present, our Las Vegas pharmacy dispenses over 700,000 prescriptions weekly; the Willingboro, NJ pharmacy opened in September 2001 and will dispense 1,000,000 prescriptions weekly when running at full capacity.

It's actually not that easy to get a job there (although I know a recent graduate from my school who may end up working in the call center).
I work at Express-Scripts, Inc., which is about the third largest mail order facility. Pharmacists consult via phone and provide other functions everything from our pharmacy, to verifying scripts, to doctor calls for clarification. Everything is like retail but separated into different areas. Needless to say, i won't work mail order unless I am 50 or 60 and wanting a change, or need extra money. haha

But they do help give patients cheaper meds and push generics...
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Merck has a funny little quirk in which they mail a letter to the doctor stating they will be switching Medicine A to Medicine B unless the doctor disapproves the change. The physician is given a certain number of days to protest the change, otherwise the medicine will be changed to a Merck product. Merck was verbally warned by the Oklahoma State Board of Pharmacy about 5 years ago for this practice, and ceased for a while. However, while doing a FP rotation in April the doctor handed me a letter and asked what I thought - Merck was at it again. The first time it happens on a patient of mine I will be filing a formal complaint with the Board of Pharmacy for prosecution.

In Oklahoma, a pharmacy cannot fill for generic unless the patient or doctor approves the change, and the change has to be "confirmatory" - in other words, a sign is not posted stating that all meds will be filled in generic unless you tell the pharmacist not to use generic. (Eckerds and Walgreens got in trouble for this).
I used to work at Diabetic and Respiratory Supply of USA (I think they've since changed their name to Chronic Care Solutions) in Clearwater, FL (Tampa area). Medco's just across the bay in Tampa.

They are growing, and have gone from dispensing insulin and nebulizers to a fully stocked pharmacy and have expanded beyond diabetic and respiratory supplies to include ostomy (and some others. Forgive me, it's been a while since I worked there. :) )

Anyway, I felt the mechanics of it from a tech's point of view were similar to that of retail, only instead of having screaming customers in your ear, you have screaming customers in your ear. :laugh: This is not to say that all customers are angry or screamers, so I hope my point in referring to that scenario is understood. The techs duties involved ordering meds, customer service, inputting prescriptions (I would put in the scripts for patients using an insurance card like FL Medicaid, Express Scripts, PCS, etc.), filling prescriptions, calling for refills, running reports, packing the patients medications into boxes after they were checked, etc. The pharmacists mainly called for new Rxs, answered any patient questions regarding medication, and checked the medications that the techs filled, which was an all day process. Other than that, one or two pharmacists had involvings in managerial duties, but that's it.

For me, it was an experience that I'm glad I had, but it wasn't for me. I love working in a hospital. :) Hope this helps.