Why don't pharmacies fill my tylenol prescription?

[WVUPharm2007]

Got to be honest. Y'all were kind of unnecessarily harsh to OP. Lmao.

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[mrbrklyn]

Got to be honest. Y'all were kind of unnecessarily harsh to OP. Lmao.

Not really. Pharmacist need to get paid for services, and the question is presumptuous.

 

[mrbrklyn]

Quite frankly if you are getting lot of scripts for OTC items, it’s a good idea to fill them as a script and switch it to cash if not covered by the insurance (they aren’t that expensive anyways).

We don’t get a lot of Tylenol but we do get a lot of Zyrtec, Vit C, Aspirin, Zinc, Claritin, Allegra etc. and we order 100 count bottles for these to fill them as prescription. I have yet to have anyone argue about the cash price.

Also, if you don’t fill aspirin as a script and simply put it on hold without notifying the patient, they may not even purchase it OTC. This can result in negative consequences if they are supposed to take it as a blood thinner. So, best practice is to simply fill it as a script.

It cost about 17 dollars to fill a prescription before any profit. Everyone in the profession needs to get an essential understanding of medical economics.

 

[mrbrklyn]

Quite frankly if you are getting lot of scripts for OTC items, it’s a good idea to fill them as a script and switch it to cash if not covered by the insurance (they aren’t that expensive anyways).

We don’t get a lot of Tylenol but we do get a lot of Zyrtec, Vit C, Aspirin, Zinc, Claritin, Allegra etc. and we order 100 count bottles for these to fill them as prescription. I have yet to have anyone argue about the cash price.

Also, if you don’t fill aspirin as a script and simply put it on hold without notifying the patient, they may not even purchase it OTC. This can result in negative consequences if they are supposed to take it as a blood thinner. So, best practice is to simply fill it as a script.

You base your best practice declaration based on what? I've been doing this over 40 years, from the Military, to Hospital to retail. the BEST practice, is to do what is profitable and to talk to your patients, and to adhere to the requirements of the PBM is possible.. This Dentist is supposed to give a medication and treatment summery to the patient. That is a CMS standard. It also is supposed to have available translations on it. Nobody is supposed to walk out of his office ignorant of what proper postop treatment is. The Pharmacy is not to blame for every insurance problem and the providers ignorance of the healthcare plan. Let him bring this matter up with the PBM if he thinks they are hindering proper treatment, which is what they do. But how does the patient walk out of the office withoput knowing they need to pick up a bottle of acetamenophen if he feels it is necessary?

Aside from that, it is just not true. OTCs are filled in NYC ALL THE TIME, usually at a loss to the Pharmacy. We do it out of courtesy and we do take it right out of our pockets. So let him do the same instead of playing pass the professional responsibility to the PharmD.

 

[mrbrklyn]

BTW - the claim that using Ibuprofen and acetamenophen together is bogus... people need to learn to read the studies... for example:

Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial

Acetaminophen is often used with a non-steriodal anti-inflammatory drug for acute pain. Hitherto, these drugs have had to be given separately, typically at different time intervals. Maxigesic[®] tablets combine acetaminophen and ibuprofen in ...

www.ncbi.nlm.nih.gov

Although all four secondary endpoints favour the combination treatment (Table 3), only the global pain rating reached statistical significance. More participants experienced ‘nil’ or ‘mild’ pain with the combination (68.4%) than with either other group; this difference was significant for acetaminophen (37.5%; P=0.008), but not for ibuprofen (54.3%; P=0.263).

They just wash over this point and discuss things that don't matter to the patient... like areas under the curves...

The best treatment for dental pain remains, generally, NSIAD... and better to start them before treatment unless one has contrary medical conditions.

 

[WorthlessOxygen]

I have yet to have anyone argue about the cash price.

Interesting. This is a daily argument for me

 

[JustFillIt]

Haha - someone necroed the “Dr. Synergy” thread! Wonder if this guy is still out there getting his undies in a wad over OTC products….

Gosh - this thread feels like it was forever ago, but it was just 1 year…. So much has happened in just 1 year..

 

[Chrish]

It cost about 17 dollars to fill a prescription before any profit. Everyone in the profession needs to get an essential understanding of medical economics.

Based on? Highest profit margin comes from generic ie. $4 and $10 prescriptions. It probably costs 50 cents for 30 metformin 500 mg tabs which we sell for $4 which equates to 800% profit.

 

[Chrish]

Interesting. This is a daily argument for me

We literally fill dozens of Claritin, Zyrtec, Allegra and occasional aspirin each day and tell patients if their insurance didn’t cover. If they want us to put it back, fine we will use it anyways for someone else. I have yet see someone going home and telling me they want to return their OTC drug.

 

[Xenophylia]

I sense a lot of pent up rage being released in this thread....LOL

 

[mentos]

I have yet to have anyone argue about the cash price.

You are lucky. When I worked retail, we'd waste so much time filling OTCs by hand, only to return them 14 days later because none of the Medicaid patients wanted to pay anything for them. Waste of time and resources for everyone involved.

 

[Old Timer]

Probably because you can't just 'make up' a price at chain pharmacies. They would end up paying something like $5 for 12 tablets via the pharmacy filling them since it's not covered. They can get a 100 ct bottle for 1.99 or something like that, so why waste the time?

At my chain pharmacy the 12 tablets would come out less than a $1.00 Pharmacists are too overworked to actually care if the patient has all of their medicines.

 

[mrbrklyn]

Based on? Highest profit margin comes from generic

Based on the FACTS as produced by proper auditing and accounting practices as published repeatedly.

 

[mrbrklyn]

Based on? Highest profit margin comes from generic ie. $4 and $10 prescriptions.

Um - NO. You really don't understand how Pharmacy works and you DON'T get $4 a prescription for generics, which is substantially below break even. We get 17 cents, and 34 cents etc. So please don't make up false economic statements based on vaporware assessments. 3.5 dollars is the MINIMUM manpower cost just for filling the prescription. That doesn't include storage, legal overhead, accounting, insurance processing, auditing costs, electricity, A/C, durable goods expenses, software costs and supports, etc etc etc . Just please don't make things up.

 

[mrbrklyn]

Haha - someone necroed the “Dr. Synergy” thread! Wonder if this guy is still out there getting his undies in a wad over OTC products….

Gosh - this thread feels like it was forever ago, but it was just 1 year…. So much has happened in just 1 year..

It came up on an internet search when I was looking up something else.

 

[Chrish]

Based on the FACTS as produced by proper auditing and accounting practices as published repeatedly.

Ok.

 

[CetiAlphaFive]

Thank you for helping me understand what the problem is.
Tylenol must be pretty cheap though, no? 20 tabs can't be more than a couple dollars?

The Tylenol is cheap.
The payroll for a pharmacist and a few technicians, the bottle, the labels, the monthly fees for the computer system, the rent, the electricity bill, the license, the GPO, the Point of Sale System, the phone bill all add up.

The annoyance and time waste for overworked and understaffed pharmacy staff because someone in your office can't be bothered to print a decent set of instructions is the real issue here.
¯\_(ツ)_/¯

 

[CetiAlphaFive]

A big part of wanting it to be filled at the pharmacy is that every time the patient takes it, they have those instructions right there. Discharge instructions get lost with great frequency and then you either end up with patients taking how many ever Tylenol they feel like (which is often wildly dangerous amounts) or calling your office repeatedly for clarifications on the instructions. A great number of patients in my area have a reading comprehension in the 6th to 8th grade range and low levels of health literacy, so making sure they have clear instructions that they can understand is critical to safe and effective care

LOL at you thinking patients read pharmacy labels.

 

[MyDogAteMySuboxone]

Multiple reasons:

1. pharmacy may not have an OTC bottle with the quantity you sent over... it's annoying to have an open OTC Tylenol on the shelf with 8 tablets left in it that no one will EVER dispense because the front store doesn't have the same manufacturer of Tylenol that was dispensed anymore and the bottle is now open so no one will ever buy it

2. Half the time, if it's not covered by insurance, the patient doesn't want the medication anyway. So if we get a bunch of scripts for OTC products, sometimes we have to waste time filling a bunch of scripts just for the patient to not get them anyway

3. A lot of retail chains are extremely understaffed. If we see a bunch of OTC scripts coming in that we know the patient will likely ask us to just put back, we often just put the Rx on hold, and put a sticky note with the patient's name, pull the OTC product from the shelf, and rubber band it to their Rx prescription (e.g. say, the oxycodone).

This way, the patient can get the Tylenol if they want but it avoids problem #1 and problem #2