New Pharmacist Laws regarding scripts count and max hours

[VA77]

After the news report last year concerning pharmacist missing key interactions, a new bill has been proposed in Illinois concerning pharmacist breaks and maximum scripts. The link is below.

Does anyone have any numbers on input and verification for a pharmacist that they consider safe. It seems everyone has a different opinion of the word "safe". I know that NC has a law that a pharmacist can only verify 150 Rx per shift but most far exceed that number and it only becomes a concern to the BOP if there is an error involved. It kind of reminds me of the highway law in Montana for the speed limit being "safe and prudent" meaning you can do 120mph but if you crash then your in trouble. I know some pharmacist do not want a limit and would verify 1000+ Rx's a day but I'm worried about the legality of it and being sued. If for instance, the average Rx filled in your state is 350 and you are doing 600+ and a patient is injured would they consider the amount of Rxs reckless or ill considered? I know the bottom line is only do what you feel safe doing but management has a different perspective and a clean license is something you never get back plus a clean conscience.

http://www.chicagotribune.com/news/...ractions-flowers-pharmacy-20170207-story.html

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[lord999]

That gets proposed every 5 or so years. The ones that have passed it (TN, NY, KY) immediately rescinded it for inability to enforce.

0 is the correct number for safety. The question has always been, for the pharmacists that you employ, how far can you work them before resignations and lawsuits become more than just the cost of doing business. My personal magic number without assistance or automation (from intake to me personally ringing them out and counseling) is 180 fills/shift with half of them being new scripts requiring entry. Depending on automation and assistance , that can go as high as 650 a shift.

And Montana and North Dakota have that stupid law where part of the interpretation has been even if you are under the speed limit, you can be ticketed for driving above a "safe and prudent" ex post facto limit due to weather conditions. We have had faculty ticketed driving home from UND going under the speed limit, yet exceeding what Fargo's police thought was safe and prudent right at the border of MN.

http://www.drivinglaws.org/resources/traffic-tickets/speed-violations/north-dakota-speeding-laws.htm

MNSCU and UMN have specific policies that will pay for traffic tickets for unsafe driving issued in ND for that reason so long as the driver doesn't exceed the speed limit.

The interesting thing in MN why they are considering a break law is that the US Attorney has been very uneven about enforcing DoL standards in the state with respect to breaks and lunch. I'm pretty sure the worst of the chains are going to need to compromise and change some policies before MN codifies it in MRS (Walmart already has a very well-enforced internal corporate policy for lunches and breaks that pharmacy can even close during a one-man operation due to them losing big in AR a decade ago).

 

[BenJammin]

Sounds like a disaster waiting to happen. 10 prescriptions every hour and no more than 8 hours every day? That would destroy our outpatient pharmacy.

@MountainPharmD gotta get your thoughts on this.

 

[Old Timer]

I can safely and accurately verify as many as 75 scripts per hour

IF

The phone doesn't ring.
My staff asks no questions
I have no patient consultations
I take no doctor calls.
I make no doctor calls
I have no corp required calls or projects.
There are no data entry or production errors
There are no drug interactions
There are no outlier prescriptions, like the Metformn ER 500 twice a week I got today.
There are no insurance rejects to deal with
There are no vaccinations

In other words it's the interruptions that cause the problems and create the stress. The real issue is how much overlap you get. The answer is, NOT enough......

 

[VA77]

I fear that the media will jump on more pharmacists errors and cause the profession to look unorganized or worse incompetent. We have had a hard time regulating ourselves so I think more regulations need to be introduced but tailored to specific environments (retail, hospital, mail order, etc). I just wonder who the martyr is going to be.

 

[VA77]

That gets proposed every 5 or so years. The ones that have passed it (TN, NY, KY) immediately rescinded it for inability to enforce.

0 is the correct number for safety. The question has always been, for the pharmacists that you employ, how far can you work them before resignations and lawsuits become more than just the cost of doing business. My personal magic number without assistance or automation (from intake to me personally ringing them out and counseling) is 180 fills/shift with half of them being new scripts requiring entry. Depending on automation and assistance , that can go as high as 650 a shift.

And Montana and North Dakota have that stupid law where part of the interpretation has been even if you are under the speed limit, you can be ticketed for driving above a "safe and prudent" ex post facto limit due to weather conditions. We have had faculty ticketed driving home from UND going under the speed limit, yet exceeding what Fargo's police thought was safe and prudent right at the border of MN.

http://www.drivinglaws.org/resources/traffic-tickets/speed-violations/north-dakota-speeding-laws.htm

MNSCU and UMN have specific policies that will pay for traffic tickets for unsafe driving issued in ND for that reason so long as the driver doesn't exceed the speed limit.

The interesting thing in MN why they are considering a break law is that the US Attorney has been very uneven about enforcing DoL standards in the state with respect to breaks and lunch. I'm pretty sure the worst of the chains are going to need to compromise and change some policies before MN codifies it in MRS (Walmart already has a very well-enforced internal corporate policy for lunches and breaks that pharmacy can even close during a one-man operation due to them losing big in AR a decade ago).

Lord999
How long do you consider a shift?

 

[steveysmith54]

10 rx per hour would cause a lot of pharmacies to close... average rx profit was around 9 bucks last time that I read... or maybe pharmacies will decline to fill Lasix and atenolol rx bc they need to save their rx count for the truvada and atripla rx haha

 

[lord999]

Lord999
How long do you consider a shift?

8, around 22-25 an hour, and that's with the normal stupid stuff going on and having a standing lunch. I'd be pretty exhausted at the end of the day, but it's doable in Walgreens or a VA outreach. My norm was 500-600 in a 8 hour shift when I was a pharmacist alone with three-four (if cashier counted) techs and a ScriptPro and was paid quite handsomely for it. No one wonders why I went to graduate school and VA as I knew that it would not get any easier and I would not get any younger. That said, I do strongly prefer outpatient if I'm not in the radiopharmaceutical business as they are opposites in terms of workplace expression.

OldTimer and I agree to an extent though 75 new would be more than I could handle in an hour even with help. I could handle 75 fills with good assistance with about half as new scripts competently. However, as OldTimer notes, just one stupid incident can make things go to hell. I actually did not have a problem turning away problem children (I wouldn't make insurance calls for bad cards and I kicked hostile and druggie patients out) even if got me in trouble with corporate. I would though do the wrong prescription calls, but I was notorious in town for getting a problem folder together and then taking it to the Board of Medicine or Osteopathic Examiners if they were repeatedly making the same mistakes.

I'll try that out next week though. I'm acting chief for two weeks in a remarkably broken VA pharmacy, and I intend to serve the line the best I can considering my predecessor basically got all the good techs to quit.

 

[farmadiazepine]

If you want a limit on how many scripts you can verify per hour then you better be ready for a limit on your pay, or a pay decrease.

Pharmacist verifies 60 scripts per hour. Worth $65/hr.

Pharmacist verifies 20 scripts per hour. Worth $20/hr.

I hate when people want a law to decide what a safe or maximum Rx count can be. I can check 100 first time aspirin and multi-vitamin prescriptions in an hour but I can barely check a first time clozapine prescription in 5 minutes.

I also hate when people want a limit without looking for another source of pharmacy income. If there is a limit, how does the pharmacy make money? Then you have to push for provider status and start doing other things to make up for all the lost money.

Check 25 scripts an hour. Be prepared to be the pharmacist, cashier, drop-off, and production pharmacist. Be prepared to be the only one working with no tech.

Also, as someone mentioned earlier, it's not the number of prescriptions, but the distractions like phone calls, drive through, etc which cause stress and errors. In the hospital it is a piece of cake to verify 600 orders without having to answer a phone or help anybody.

 

[Deja]

That gets proposed every 5 or so years. The ones that have passed it (TN, NY, KY) immediately rescinded it for inability to enforce.

0 is the correct number for safety. The question has always been, for the pharmacists that you employ, how far can you work them before resignations and lawsuits become more than just the cost of doing business. My personal magic number without assistance or automation (from intake to me personally ringing them out and counseling) is 180 fills/shift with half of them being new scripts requiring entry. Depending on automation and assistance , that can go as high as 650 a shift.

I know this wasn't the point of this thread, but you are telling me that you can do 180 scripts with 90 as new/drop offs without even a cashier? no freaking way, at that volume, you would be stuck at the cash register half of the time, and then you have to consider the phone calls and other duties.... out of all of the pharmacists I have worked with, I have never seen anyone that maybe capable of doing this and I have met a couple of really efficient pharmacists

as a side note, when I worked at a busy pharmacy that did 5k-6k scripts a week, I sometimes would catch myself not really thinking about what exactly I was checking, I was merely going through the motions and only comparing if the scripts was typed and filled right... that's probably why a lot of the pharmacists would miss interactions too

 

[PharmDBro2017]

I can safely and accurately verify as many as 75 scripts per hour

IF

The phone doesn't ring.
My staff asks no questions
I have no patient consultations
I take no doctor calls.
I make no doctor calls
I have no corp required calls or projects.
There are no data entry or production errors
There are no drug interactions
There are no outlier prescriptions, like the Metformn ER 500 twice a week I got today.
There are no insurance rejects to deal with
There are no vaccinations

In other words it's the interruptions that cause the problems and create the stress. The real issue is how much overlap you get. The answer is, NOT enough......

100% truth.

 

[nextyearrx]

Every month on pharmacy magazines, talk is about adding services for retail pharmacists like MTM, Immunizations. Wish they talk more about stress of pharmacist job and ways to Prevent medication errors.

 

[owlegrad]

Every month on pharmacy magazines, talk is about adding services for retail pharmacists like MTM, Immunizations. Wish they talk more about stress of pharmacist job and ways to Prevent medication errors.

I don't know that I would enjoy reading an article about how stressful the pharmacist job is, I already know all about that. And I don't think there is some new, innovative idea on how to prevent errors (and there are plenty of great CE credits for that if that is an interest of yours), the problem isn't that people don't know how to prevent errors IMO, the problem is that collectively most pharmacists care more about techs working quickly than accurately. It drives me nuts but it is what it is - 'we' pay lip service to the need for accuracy but in the end speed is always the trait valued the highest, to hell with petty things like if the counter is kept clear to minimize the possibility for errors (for instance).

 

[lord999]

I know this wasn't the point of this thread, but you are telling me that you can do 180 scripts with 90 as new/drop offs without even a cashier? no freaking way, at that volume, you would be stuck at the cash register half of the time, and then you have to consider the phone calls and other duties.... out of all of the pharmacists I have worked with, I have never seen anyone that maybe capable of doing this and I have met a couple of really efficient pharmacists

as a side note, when I worked at a busy pharmacy that did 5k-6k scripts a week, I sometimes would catch myself not really thinking about what exactly I was checking, I was merely going through the motions and only comparing if the scripts was typed and filled right... that's probably why a lot of the pharmacists would miss interactions too

Exactly, it's doable, but not quite safely doable as unless you're focused enough, you'll do stupid things.

Not bragging, the reason I actually know that number is that I was forced exactly into that circumstance several times in my career (completely alone, no cashier) and counted afterwards what was done. It can be done, it's not pleasant, and I'm falling over exhausted afterwards. But as an outer limit, yes, I actually am that efficient under Intercom Plus before all the stupid stuff about script scanning and such have been. The system now forces you to be slower than the pace we used to work at. And yes, cash and counsel would be the majority of the time (more than half), but it doesn't take much to fill and punch through scripts if you are extremely efficient. You bet I had to get a good system and stick to it, but yeah, it's at the limit of my ability. Overnights at 3rd and Hell and Litchfield and Indian School (when it was the westernmost 24 hour Walgreens) consistently averaged between 120/150 in the solo part of the shift back in the day. I am not superhuman, but I learned under much worse circumstances that the spoiled generation did. The only thing I did not do is learn on a typewriter. The fastest and most accurate script typers I knew were all IBM Selectric users who routinely typed 120 wpm at secretarial accuracy. Those guys and gals, I bow to as their environment was worse than mine. The old pharmacist who trained most of us in that generation, Paul Tauscher (may God rest his soul), used to throw bottles at us saying that "if you're walking, you're not working (fast enough)" and meant it.

Although what's funny when we do competitions between the faculty and students in terms of how fast their are with their Abbott Trays, the faculty still have an edge over the students (most students don't even count past 30 anymore and weigh everything). That said, it isn't about efficiency as much as risking the numbers. Different era, different requirements. It is far safer to practice (and I don't think most students would tolerate how unsafe my practice habits are as my experience basically sheds and risks a lot more than them). I'm slower now than I used to be, but that was a reality that I planned for.

 

[MountainPharmD]

Sounds like a disaster waiting to happen. 10 prescriptions every hour and no more than 8 hours every day? That would destroy our outpatient pharmacy.

@MountainPharmD gotta get your thoughts on this.

The problem is the disconnect between the corporate pharmacy middle managers who set the hours and the pharmacist filling and checking the prescriptions. This law further complicates things by getting more people involved that are even further disconnected from the process.

In my opinion there are too many variables to pass a law that specifies you can only fill X number of prescriptions in X number of hours.

10 RX's an hour? Really? Okay as long as I get reimbursed at least $100 above my cost on each prescription!

 

[BidingMyTime]

I think this proposed law was written by someone who has ZERO knowledge of pharmacy practice. First, it doesn't even distinguish between hospital and retail pharmacies, so yeah, does she really expect hospital patients to suffer or die because the pharmacist has already filled the 10/hr quota? Second, 10/hr is ridiculous and non-nonsensical, as farmadiazapine mentioned, there is a big difference between different prescriptions--clozapine compared zithromax, warfarin compared to a lactated ringer's, etc. 10/hr would make for an extremely boring workday, even if they were all heavy duty RX's.

Check 25 scripts an hour. Be prepared to be the pharmacist, cashier, drop-off, and production pharmacist. Be prepared to be the only one working with no tech.

Actually this same proposed law mandates that there must always be a tech on duty with the pharmacist.

Talk about BORING. 10 prescription/hr *with* a technician? Does this legislator think pharmacists are still compounding every prescription by hand?

Also, as someone mentioned earlier, it's not the number of prescriptions, but the distractions like phone calls, drive through, etc which cause stress and errors. In the hospital it is a piece of cake to verify 600 orders without having to answer a phone or help anybody.

This, it's the unplanned distractions that are the biggest problem.

 

[ldiot]

I fear that the media will jump on more pharmacists errors and cause the profession to look unorganized or worse incompetent. We have had a hard time regulating ourselves so I think more regulations need to be introduced but tailored to specific environments (retail, hospital, mail order, etc). I just wonder who the martyr is going to be.

Also some stupid regulations need to be slashed. For example... why do techs have to waste time folding eScripts and putting them in order when you have an electronic copy. Might not sound significant but when I was in retail working drop off it was more than a minor annoyance when you are typing hundreds of scripts a day. Make it so a pharmacy can switch a maintenance drug to 90 days if the patient is on it. Tech has to waste 15 minutes dealing the the patient and another 15 minutes on the phone trying to fix it. Regulations like this kind of stuff waste time at no benefit to anyone. Removing some of this BS would lower the workload, even if only slightly, and in theory lower workload = less errors. Putting limits on scripts/hr or tech to pharmacist ratio also seems a bit excessive but since it would increase pharmacists hours I wouldn't really complain.

 

[lane one]

IL pharmacists live like kings, CVS drops the hammer in every other state to make up the revenue. Then, closes IL pharmacies as soon as they can get our of their leases. Everyone gets screwed.

 

[Wickett]

Also some stupid regulations need to be slashed. For example... why do techs have to waste time folding eScripts and putting them in order when you have an electronic copy. Might not sound significant but when I was in retail working drop off it was more than a minor annoyance when you are typing hundreds of scripts a day. Make it so a pharmacy can switch a maintenance drug to 90 days if the patient is on it. Tech has to waste 15 minutes dealing the the patient and another 15 minutes on the phone trying to fix it. Regulations like this kind of stuff waste time at no benefit to anyone. Removing some of this BS would lower the workload, even if only slightly, and in theory lower workload = less errors. Putting limits on scripts/hr or tech to pharmacist ratio also seems a bit excessive but since it would increase pharmacists hours I wouldn't really complain.

My company did away with printing off and filing eRxs. It's amazing how much small changes like that lighten the general workload.

 

[BidingMyTime]

My company did away with printing off and filing eRxs. It's amazing how much small changes like that lighten the general workload.

I think it's state law that dictates whether or not e-rx's have to be saved (in IL they do for control's, but not for non-control's.)

 

[VA77]

I'm surprised at how many pharmacists are willing to play fast a loose with their license. Might as well verify 1 Rx every second...what the hell could happen. Oh yeah, someone gets hurt or dies and your license gets yanked and you really will be working for McDonald's.

 

[ldiot]

I'm surprised at how many pharmacists are willing to play fast a loose with their license. Might as well verify 1 Rx every second...what the hell could happen. Oh yeah, someone gets hurt or dies and your license gets yanked and you really will be working for McDonald's.

Its not so much a problem with how many scripts you verify per hour, it's the fact that the pharmacist ends up doing tech work which increases their total workload and results in them changing tasks more often and having more distractions. Even on the most busy days I don't think many pharmacists end up verifying more than 40 scripts/hour, the real question is how much other work did they have to do in addition to verifying? Rather than putting arbitrary limits on how many scripts you can verify how about we have adequate tech help? It's cheaper and likely has a greater impact anyways. It's just not realistic to have two pharmacists on duty in every retail pharmacy. What do you think?

 

[wagrxm2000]

I'm surprised at how many pharmacists are willing to play fast a loose with their license. Might as well verify 1 Rx every second...what the hell could happen. Oh yeah, someone gets hurt or dies and your license gets yanked and you really will be working for McDonald's.

That's what insurance is for. You could have verified 5 scripts by the time you read this.

 

[Sine Cura]

This is just an optimization problem. 1 Rx/second is not good. Neither is 1 Rx every 5 minutes.

 

[zelman]

It's just not realistic to have two pharmacists on duty in every retail pharmacy.

Why not?

 

[Wickett]

Why not?

With reimbursement where it is, a lot of pharmacies are having a tough time as it is to make any profit. A rule like this would just shut down more smaller volume/non big chain retail pharmacies that are already struggling to stay open. The only places that would stay open would be places pumping out big script counts.

 

[ldiot]

Why not?

It's easy to crucify companies like CVS when they make billions a year but people don't realize that the profit margin is actually pretty thin... only a few percent actually. For every dollar of revenue CVS as a company walks away with like 3 cents. Doubling their greatest expense would obviously put them under. They can't really cut pharmacist pay either when the demand would be doubling in that scenario. Profit margins would have to double, good luck.

 

[owlegrad]

It's easy to crucify companies like CVS when they make billions a year but people don't realize that the profit margin is actually pretty thin... only a few percent actually. For every dollar of revenue CVS as a company walks away with like 3 cents. Doubling their greatest expense would obviously put them under. They can't really cut pharmacist pay either when the demand would be doubling in that scenario. Profit margins would have to double, good luck.

*blink*. So CVS would go from a Fortune 50 company to bankrupt if they had two pharmacists on staff at all times? Sure....

 

[zelman]

With reimbursement where it is, a lot of pharmacies are having a tough time as it is to make any profit. A rule like this would just shut down more smaller volume/non big chain retail pharmacies that are already struggling to stay open. The only places that would stay open would be places pumping out big script counts.

You really think most pharmacies are profiting less than six figures annually?

 

[ldiot]

You really think most pharmacies are profiting less than six figures annually?

CVS has what... 8,000 stores? 100k profit each would be 8 billion dollars... CVS made 6 billion last year and that even includes Caremark, specialty, and all the other crap they do. If every store added a full time equivalent they would be losing billions a year just by being open. This isn't some kind of speculation it's very simple math lol.

 

[ldiot]

*blink*. So CVS would go from a Fortune 50 company to bankrupt if they had two pharmacists on staff at all times? Sure....

If they added an extra 40 pharmacist hours to every store yes they would.

 

[trailerpark]

I know I spend a majority of my time doing tech work to keep things moving. If I didn't every day would be a disaster. It amazes me how many techs can't play monkey see monkey do and just accurately type a rx from a picture of it. Having to send things back is the biggest waste of time but how can you convince a tech to read what they type before submitting it...


Sent from my iPhone using SDN mobile app

 

[wagrxm2000]

If they added an extra 40 pharmacist hours to every store yes they would.

Everyone says our pay is going to go down someday, if this happened it most definitely would be split in half.

 

[gwarm01]

If they added an extra 40 pharmacist hours to every store yes they would.

I don't know the numbers.. but how many pharmacist hours did they have 10 years ago? And how has reimbursement gone down? Seems crazy that it would hurt them that much, but it's hard to say without knowing the math.

 

[ldiot]

Everyone says our pay is going to go down someday, if this happened it most definitely would be split in half.

The problem is the demand for pharmacists would pretty much double if they did this, so how could they drastically reduce pay if they can't even fill the job openings?

 

[Wickett]

You really think most pharmacies are profiting less than six figures annually?

I never said most...I am talking about any pharmacy that isn't part of the few big retail giants. I do the weekly reports/am a pharmacy manager at a grocer. I can definitely tell you the numbers aren't pretty for non high volume places right now (and I'm not just talking of places barely doing 100/day). If you aren't pushing big script counts like a busy CVS, then no. You have no idea how ****ty reimbursements have become in the last 18 months.

 

[Wickett]

I don't know the numbers.. but how many pharmacist hours did they have 10 years ago? And how has reimbursement gone down? Seems crazy that it would hurt them that much, but it's hard to say without knowing the math.

Insurance companies have just stopped paying. I look at the numbers as a manager and have access to spread sheets from several years back. I see point blank where I have higher gross sales than the same month 1-2 years prior, but current gross profit ends up being almost half what it was due to companies not paying. It's brutal right now unless you're high volume.

 

[PharFromNormal]

Insurance companies have just stopped paying. I look at the numbers as a manager, and have access to spread sheets from several years back. I see point blank where I have higher gross sales than the same month 1-2 years prior, but current gross profit ends up being almost half what it was due to companies not paying. It's brutal right now unless you're high volume.

You sir get a gold star for understanding rising gross sales does not mean rising gross profit. One of the major chains I forget if it was cvs or wags said recently on an analyst call, due to the cost structure of operating a pharmacy the most profitable prescription filled is the last one. On an incremental unit basis you make more per script then the previous one affirming that yes there is a breakeven point on volume and high volume stores are the ones that do very well.

 

[PharFromNormal]

I don't know the numbers.. but how many pharmacist hours did they have 10 years ago? And how has reimbursement gone down? Seems crazy that it would hurt them that much, but it's hard to say without knowing the math.

Drug acquisition prices have increased higher than inflation rates. Which on a revenue basis increases top line sales. Reimbursement as a %age of benchmarked acquisition prices has decreased constantly. Add to the fact that now many are giving up even more % to drive (or keep) volume in their pharmacies.

Very simple example:
Let's say 2 years ago you could get a drug on your shelf for $15 and when dispensed the pharmacy would get $20. That's $5 for the pharmacy to pay their employees and bills and keep the rest as profit. Now let's go to today and say that same drug costs $20 but the pharmacy is now only getting $22.50. That's $2.50 to pay their employees and bills keep the rest as profit. If you want the same profitability (or if your stockholders are actually demanding profit growth) your employees need to start getting awfully more efficient because many are struggling to keep up with the current environment. And this talk about mandating extra operating costs... lol good luck to any independent owner out there.

 

[rxdawg21]

Drug acquisition prices have increased higher than inflation rates. Which on a revenue basis increases top line sales. Reimbursement as a %age of benchmarked acquisition prices has decreased constantly. Add to the fact that now many are giving up even more % to drive (or keep) volume in their pharmacies.

Very simple example:
Let's say 2 years ago you could get a drug on your shelf for $15 and when dispensed the pharmacy would get $20. That's $5 for the pharmacy to pay their employees and bills and keep the rest as profit. Now let's go to today and say that same drug costs $20 but the pharmacy is now only getting $22.50. That's $2.50 to pay their employees and bills keep the rest as profit. If you want the same profitability (or if your stockholders are actually demanding profit growth) your employees need to start getting awfully more efficient because many are struggling to keep up with the current environment. And this talk about mandating extra operating costs... lol good luck to any independent owner out there.

Does your gross profit include the rebate you get from your supplier. That is a quite substantial figure and is typically given out quarterly. Easily 5 digits for a 100-200 a day store

 

[Wickett]

Does your gross profit include the rebate you get from your supplier. That is a quite substantial figure and is typically given out quarterly. Easily 5 digits for a 100-200 a day store

Mine personally already include rebates. I also see the same declining trend in gross profits and overall net profit/loss in quarterly reports.

 

[ldiot]

Drug acquisition prices have increased higher than inflation rates. Which on a revenue basis increases top line sales. Reimbursement as a %age of benchmarked acquisition prices has decreased constantly. Add to the fact that now many are giving up even more % to drive (or keep) volume in their pharmacies.

Very simple example:
Let's say 2 years ago you could get a drug on your shelf for $15 and when dispensed the pharmacy would get $20. That's $5 for the pharmacy to pay their employees and bills and keep the rest as profit. Now let's go to today and say that same drug costs $20 but the pharmacy is now only getting $22.50. That's $2.50 to pay their employees and bills keep the rest as profit. If you want the same profitability (or if your stockholders are actually demanding profit growth) your employees need to start getting awfully more efficient because many are struggling to keep up with the current environment. And this talk about mandating extra operating costs... lol good luck to any independent owner out there.

This is a lot more concerning to me than the projected oversupply of pharmacists. There is a lot of talk about passing laws allowing us to import drugs. Do you think it's possible that these lower priced drugs would increase margins for retail?

 

[VA77]

This is a lot more concerning to me than the projected oversupply of pharmacists. There is a lot of talk about passing laws allowing us to import drugs. Do you think it's possible that these lower priced drugs would increase margins for retail?

Uhh..we are already importing drugs from "FDA inspected facilities".

However, I am glad to see some agreement between the chains and independent pharmacists on here that reimbursement rates are more of a danger than oversupply of schools and pharmacists. PBM's are the greatest threat to your paycheck!

 

[ldiot]

Uhh..we are already importing drugs from "FDA inspected facilities".

However, I am glad to see some agreement between the chains and independent pharmacists on here that reimbursement rates are more of a danger than oversupply of schools and pharmacists. PBM's are the greatest threat to your paycheck!

There was some bill proposed to import drugs from Canada. I'm not sure if it would even have a relevant effect or why Canada would want to sell us their drugs in the first place (seeing as they probably have usage caps) but that's what I had in mind. Many of our drugs are produced overseas in FDA inspected facilities; that I realize.

From what I gather the reason drug prices are so much more expensive here is that individual health plans don't have near the negotiating power as entire countries. So we are essentially subsidizing the healthcare of other countries in terms of research and development. I'm not in favor of the government mandating drug prices nor am I in favor of a single payer healthcare system, but if you rule out those two options there's not a simple solution. Am I even correct in assuming that lower drug prices would increase margins and net profit for pharmacies despite lowering revenue? That I really don't know.

 

[CountBy5s]

[ Even on the most busy days I don't think many pharmacists end up verifying more than 40 scripts/hour, ]

We do more than 40 on an average day. Some days as high as 60 or 70/hour. With one pharmacist at a time and 2 techs and a cashier. We are still pressured to go faster and get more done with our time. The question is how is this possible?

 

[Sine Cura]

Let's say your store does 550 a day in 13 hours. That is 42/hour over 13 hours but you can peak at 60-70/hour depending on the time of day.