Special order Generic manufacturers for patients..

[strp]

Advertisement - Members don't see this ad

I'm a new manager at my dream store within a grocery store chain. We do about 800 a week and are growing at about a 10% rate. The managers before me were not the most business savvy individuals and have set a precedent in special ordering Ndc's for patients. The patient base is very friendly but some of them are very particular on what brand they get. For example we have 7 ndc's on the shelf for amphetamine salts 30mg!!! I think it is getting out of control and some prescriptions we are taking big losses on just to appease the patient. I'm little worried about causing too many waves and losing loyal customers, but I feel like we need to cut down on our inventory costs and could improve our margins just carried our preferred manufacture. Any guidance on the best way to approach this situation would be appreciated! Also another component to this situation is, my lead tech that has been there along time has this concept engrained in her and just views it as providing excellent customer service. Should I keep the peace or make wholesale changes starting the first of the year?

 

[imcallingcorp]

I'm a new manager at my dream store within a grocery store chain. We do about 800 a week and are growing at about a 10% rate. The managers before me were not the most business savvy individuals and have set a precedent in special ordering Ndc's for patients. The patient base is very friendly but some of them are very particular on what brand they get. For example we have 7 ndc's on the shelf for amphetamine salts 30mg!!! I think it is getting out of control and some prescriptions we are taking big losses on just to appease the patient. I'm little worried about causing too many waves and losing loyal customers, but I feel like we need to cut down on our inventory costs and could improve our margins just carried our preferred manufacture. Any guidance on the best way to approach this situation would be appreciated! Also another component to this situation is, my lead tech that has been there along time has this concept engrained in her and just views it as providing excellent customer service. Should I keep the peace or make wholesale changes starting the first of the year?

honestly I think you should ask your superior what they want. pick one of these drugs you take a hit on and be like I tried to talk to patient about it they refuse to and said thy would have to change pharnacies be like what should we do. let that answer be your guidance on this issue. cuz believe me if you try to push this issue some patient will complain and it will end up you talkin to your superior anyways.

 

[npage148]

You do 800 a week but have 7+ patients in adderall 30?

I don't have any good answer that's not gonna result in epic whining

 

[Abby Atwood]

At my store we saw specific manufacturer requests on controlled substances as a potential issue because of the risk that patients are asking for a recognizable ndc in order to get a better resale value. Even for patients we trusted, we had a strict no special order policy for controlled substances. It’s a safety issue in addition to being a financial issue. If you are selling at a loss, it’s not a problem if they choose to take their business elsewhere. Give patients plenty of advance notice (at least a month) and let them know what manufacture and ndc they are currently taking if they don’t already know. Odds are they are going to shop around, find out that no one will special order, and give the new ndc a try.

 

[imcallingcorp]

At my store we saw specific manufacturer requests on controlled substances as a potential issue because of the risk that patients are asking for a recognizable ndc in order to get a better resale value. Even for patients we trusted, we had a strict no special order policy for controlled substances. It’s a safety issue in addition to being a financial issue. If you are selling at a loss, it’s not a problem if they choose to take their business elsewhere. Give patients plenty of advance notice (at least a month) and let them know what manufacture and ndc they are currently taking if they don’t already know. Odds are they are going to shop around, find out that no one will special order, and give the new ndc a try.

ita very often not a controlled substance. patient who wants the generic theyve had for last 5 years doesnt know and doesnt care that it now costs twice as much as your reimbursement. and even though its a joke my old company policy was to try to convince them to switch but never turn them away need be. its all about gttin through the day boss says lose money on rx sure why not

 

[moose10]

I have a handful of people who are picky about non-control generics. Mostly birth control products and the weird ones with multiple NDCs (diltiazem, nifedipine, verapamil). I would put a hard no on special ordering specific C2s for anyone lol. The only time I will go out of my own way to ensure the same NDC is for anti-seizure meds. Other than that a change of manufacturer notice and 2-3 min conversation will get most patients on board with any change.

 

[wagrxm2000]

Not a single patient that we order a specific manufacture for. There is no point.

 

[RxPreceptor]

Do your job as an RPh to explain to the customer there is no significant difference between manufacturers; I even go so far as to point out and show the person some brands that are literally identical (just repackaged versions) of the brand (I.e plaquenil and hydroxyxhloroquine/Prasco)

Sounds like your tech and previous RPh had waaaay too much time and resources to cater to every customer whim (sounds like a bunch of old folks fearful of the slightest notion of change). You should definitely have some way of knowing/documenting patients who (keyword) NEED a certain mfr due to idiosyncratic reactions and/or being narrow TI drugs. Unfortunately, some peoples' insurance at least in my area provide a zero copay for certain MFRs (cough Pfizer); try to find out if this is the case too (medically necessary my ass, more like financially necessary; is a mockery of the meaning of DAW-1...rant off)

 

[owlegrad]

I agree with getting your regional boss involved as ultimately they will get involved anyway. Just ask them what they want you to do and then do that.

 

[npage148]

You should definitely have some way of knowing/documenting patients who (keyword) NEED a certain mfr due to idiosyncratic reactions and/or being narrow TI drugs

Narrow ti drugs don't justify not switching brands. If they are ab rated they are getting switched.

If you go down the road that fda bioequivelence is not good enough for these drugs then the whole system explodes becaue generic bioequivelence uses the exact same guidence that brands must use to show bioequivelence when switching up pieces of their manufacturing process.

 

[RxPreceptor]

Agreed/Clarification with npage184, narrow TIs don't require specific mfrs but it is worth mentioning to the patient as a variable affecting blood levels (may or may not be enough to knock someone out of range or have a significant impact on outcome).

 

[strp]

Thanks for all the good recommendations. We will see how it goes, taking to my director about it will be my first approach.