Pharmacist here. It’s not our fault as much as you think. Basically, the insurance companies invented something called “Pharmacy Benefits Managers” who basically act as a middleman between you and your doctor on what you can get, and how much they will reimburse the pharmacy if you do.
If your doctor says you need atorvastatin, but your PBM says they only want to pay for simvastatin, you can either get your doctor to pay for simvastatin, or pay for atorvastatin yourself with a discount card. The cost for a generic med like that is probably about your copay anyways, so no big loss to you to skip the headache.
Surprisingly, they invented fees for pharmacies! If you choose the route to get your doctor to change you to simvastatin, we get the privilege of managing that for you, and once we finally reach your doctor and make the change, they will give us maybe $10 to fill it for you! Plus you have a $10 copay, so there is some money… But of course we have to source the med. It probably costs us like $12 for this example, maybe less maybe more, depending on the manufacturer. So if we do all of this then it seems like we made $8, but SURPRISE, your PBM charged us a fee for utilizing them. It might be $6. It might be more if we don’t meet certain criteria, like percentage of diabetic patients on statins.
So okay we have our nice $2 to pay for shipping your med to the oharmacy, renting our location, and filling it (I think it’s less than half that on average, I just don’t know the actual figures) with our staff. It should come as no surprise that we have very limited options on manufacturers now.
You might say “well at least the PBM fought to make my meds cheaper in the end” but no! They now get to say to your insurance company “okay we managed getting your patient another month of lower cholesterol, please pay us $100 for our efforts”. So, indirectly, you paid an extra $100 on this whole thing through your insurance premiums. Not sure on if this part is true I just heard it as a rumor.
But wait there’s more! The insurance company actually owns the PBM all along! They paid themselves to offer themselves this service for you!
So anyways I’m getting out of retail pharmacy. Thanks for coming to my ted talk.
I didn’t need to get this upset before 8am. I don’t even take medications, but this is the exact type of nonsense that gets my blood boiling. That there’s anyone between a patient and their doctor (or perhaps a patient and a pharmacist) is just screaming for some forced changes.
Another meme I cannot relate to because I have the privilege of not living in america
Yeah, my pharmacy texts me to confirm I want a refill, then I go pick it up. One extra confirmation text and wait a couple days if there are no more refills
To be fair, this is generally my experience in the US as well. However, I do recognize that the insurance I get through my union is very good.
Americans just don’t get that brand name medications are exactly the same as generic ones either 😅
The fun part is the generics aren’t always the exact same medication! In most cases it is a 1:1 between name brand and generic but there’s always edgecases, whether due to allergies or quality control or sometimes the recipe differences actually impact the potence and performance of the medication
Not all of them are though my wife can only take the name brand of cimbalta because the generic fucks with her body
With prescriptions, it is not about what the customer wants, it is about what brands the insurance wants to cover (and getting a doctor that does not write a brand specific prescription). If an insurance company only covers a weird brand of a common (but expensive) medicine, the customer either has to hunt for a pharmacy that has it in stock, wait for their local pharmacy to order it (in either case delaying when the insurance company has to pay for it), or buy the in-stock brand without any insurance coverage. The insurance can still claim they cover the drug while paying less for it.
At one point, I was on a medicine that had a very high co-pay for the brand name and would not cover the generic. It was so high that it was cheaper for me to buy the generic uninsured instead of paying the co-pay.
The active ingredients are exactly the same. The inactive ingredients may differ and there may be some slight differences in bioavailability that for most people are not significant. There is no reason that the vast majority of people can’t take a generic equivalent of a branded medication. That said, there are sometimes exceptions that need to be considered on a cases-by-case basis. Anyone who says “I can’t take generic medications” is full of shit.
Source: I am a licensed pharmacist.
There is no reason that the vast majority of people can’t take a generic equivalent
There’s no reason why ANYONE can’t take generics. Over here (UK) its extremely unusual to be prescribed a brand. And we’re all absolutely fine.
The difference? Pharmas can’t advertise their products to the general public. Nobody falls for the marketing guff and nobody makes up reasons to need branded medication.
My daughter has an anaphylactic reaction to an inactive ingredient that is present in some generic products but not others. We have to be very aware of what company makes the generics she takes to make sure exactly what they contain. That’s why I say most people can take them and not everyone. Some medications will harm her more than help because of an inactive ingredient.
Surely thats a problem with ALL medications then? Not just generics?
Possibly. There are branded products that she is allergic to and she’s not allergic to the generic, but it tends to be the generics using the ingredient she can’t have.
My point is that the generalizations are MOSTLY true, but there can be exceptions. People who discount all generics out of hand are usually just blowhards.
Ok…but generics are not always compounded for delivery like the original brand, I.e. slow release, enteric coatings, dose size, different fillers.
But a licensed pharmacist should know that.
I don’t know if you are in the US, but AB-rated generic equivalents are determined to have a release profile that is within an acceptable range of variance from the reference product to still be considered equivalent. I’m not saying that all diltiazem products are equivalent because obviously Cardizem injection is not the same as Cardizem CD is not the same as Cardizem LA is not the same as Cardizem regular tablet. What I’m saying is that Cardizem CD 240 mg capsules and all of the AB rated equivalents a pharmacy would substitute for it may have some subtle differences, but in general they don’t matter clinically for patients.
Haha was thinking the same thing. Minor issues here for certain medication availabilities at times but nothing that would make this meme relatable to many people!
Pharmacists deal with drug shortages worldwide.
I live in America take boat loads of meds cause I’m post transplant and don’t have these issues, I think OP needs a new pharmacy
Yup. In the uk, you pay the same charge for each prescription you pick up, whatever it is (or you get an annual flat fee pass if you get more than one a month). So if the pharmacy only found an expensive version, that’s a them problem, not a me problem.
Anyone have that I’m too European for this image handy?
I am too Indian for this, even though we have a strange habit of copying the shitty parts of the US and ditching the actually functioning parts.
Oh, is Walgreen’s your pharmacy too?
America: Land of the Free, Home of the decreasing average lifespan because people can’t get access to routine medications that are affordable in most other countries.
RFK Jr.: You need meds? What’re you gay?
he just dips in methyelene blue, suntans till his skin is more burnt than a rotisserie chicken and hopped on roids at 70. fun fact the bear incident was just 11years prior.
Nothing a few hours on a tanning bed won’t fix.
PrFK Jr
I had this bullshit happen in Florida at a Walgreens…I had a doctor put a prescription for me…we had worked together for a good while and finally found a script that works for me. Walgreens tells me they dont carry it, except I’ve had it filled in the past at that location.
Then this way over stepping mother fucker starts trying to diagnose me and then had the audacity to say, “have your doctor call us and we can see if we can work something out.”
Bitch what the fuck do you think the PRESCRIPTION is, that IS the communication between the pharmacy and the doctor, last time I went to Walgreens
I commented without reading what everyone else had to say, and the first words I typed were, “Is Walgreen’s your pharmacy too?”
What would piss me off is that they would constantly blow up my phone telling me to come get my script, it’s ready. Then I get to the pharmacy, and nothing is ready and I have to stand around awkwardly while I wait for them to fill it.
The final straw was I go in person to request a refill 5 days before I am out of meds. “Oh we haven’t gotten the shipment yet? Come back tomorrow.” So I go back the next day, and the next until I am finally out of meds and they still don’t have it in. Like, bitch, I have been filling this RX here for 2 years, do you mother fuckers not understand how to inventory?
After my last refill was up I had my Dr. start sending my scripts to Hannaford. It’s further away, but when they call me for my RX it’s ready for me when I go to pick it up.
To personify a bit, if I came across Walgreen’s dying in the street, I would step the fuck over their body and keep walking.
Walgreens is just generally the worst pharmacy in the country. I’m convinced they intentionally create delays in picking up the prescriptions that are supposedly already ready to get you to buy more stuff in the store part, plus the store portion is always so chronically understaffed good luck being able to buy anything. Oh and now everything is locked up so you can’t even pull stuff off the shelves to attempt to buy anything. And then they wonder why profits keep going down…
Walgreens once gave me the wrong prescription, which I didn’t notice until after I already taken some. It was some weird drug for schizophrenics or something like that and it totally fucked me up to the point I had to take off work for the day. Instead of apologizing or trying to make the situation right the Walgreens pharmacist was a total asshole to me and tried to blame me for what happened, they acted like I had stolen someone else prescription instead of them fucking up and poisoning me.
I’m currently stuck in prior authorization hell and used the last dose of my med yesterday. Ugh. I hate this fucking country.
Might be a long shot, but depending on the med, might want to ask your doctor’s office if they have sample supplies of the med to hold you over until they get the prior auth approved.
Generally a good suggestion but having your mental health depend on a controlled substance is a fresh kind of hell. Anyone know how Spain’s health care system is for trans folks on testosterone? I can get citizenship in an EU country and a couple of people I know moved to Madrid last year and I think this situation has convinced me to move even if I’ve forgotten most of the Spanish I once knew.
I did pitch a fit and managed to get it filled today but I never want to deal with this shit again, it’s been life-alteringly awful previous times.
medications for mental illnesses are controlled so the insurance/hmo adds extra laborious steps to get it. pre-authorization or must have in-person doctors appts,etc. its not as fast i need this cream for skin/fungal asap. my insurance in the west requires pre-authorization, plus probably other requirements before refills. they are also more resistant Rx to more pricey drugs too.
i currently unable to get topicals for my skin condition because i have a hard time scheduling appoints since i had to use new insurance around my work schedule, which one of “problem solvers” have denied me of changing it. oh yea certain drugs like controlled substances, your insurance people adds extra step to even get it.
I had to set an annual reminder to call insurance to get that sorted out because the pharmacy doesn’t know why they rejected it and after a year my ADHD would forget that prior auth was a thing. So good of the insurance company to decide they need to interfere once a year with the medication I have been taking for over a decade!
Doctor: for condition A use med B in C manner.
Pharmacist: Oh no, what is he nuts? Never use med B for condition A as it contains flixadidlian cortemolezeum which will react badly to manner C. No you’ll need med D.
i mean occasionally the pharmacist is right.
Yeah that’s the pharmacist’s job
yeah, now most of the time the pharmacist is too busy to actually do their job. what people get angry about is when they do it.
Oh I’m glad when they do it. But I also find it a little concerning that your doctor is supposed to be the one who knows everything and then it turns out they sometimes seem to talking out if their ass (or that’s what it looks like at the very least, I’m sure there’s more nuance to it).
sometimes it’s frustrating when the pharmacist is rechecking your work and insisting that the interactions (that you have verified are not a problem via taking the drug for twenty years) are going to be a problem if you accidentally take the drug once. occasionally the patient does know more.
I have found that going to literally any other pharmacy besides walgreens or cvs is a significant improvement in competence and convenience.
CVS and Walgreens pharmacies are staffed like dollar generals. They can’t handle the load but they won’t hire more pharmacists.
I had a small pharmacy I loved I had to give up on when I got a new job and they weren’t in network. I was not going to CVS or Walgreens.
So I went to the hospital pharmacy that is in network. Can’t imagine that’s any cheaper but whatever insurance.
Exactly this! I’ve been going to a local independent pharmacy chain for years and it is a light-years better experience than either of the national chains
I’m pretty limited as to who my insurance covers, so I can’t go to any of the independent pharmacies near me. I’ve been going to the kroger and it’s great, they’ve never once had an issue with my insurance and typically order refills / reach out to my dr for a new script before I even realize I’m low.
My in-laws have the same problem so I’ll get to experience how bad Walgreens is when they ask me to pick up their prescriptions
I’ve had exactly one prescription done at CVS (because I could get my med for like 60% of the cost there) because they managed to be out of stock on my med on month two. Immediately switched back and haven’t had a problem
me scrambling every month to get adhd meds in nyc:
first time? 🫠Hell, in Kansas I can finally get there scripts sent to the store but I have to talk to someone to get it filled. If they have it in stock. No, their checking isn’t always reliable. No, I can’t call two days earlier than the hard 28 limit on getting it refilled. I must call no more than 28 days ahead of time.
Also to call and speak to someone I have to spend 2 minutes telling the automated phone system that no, I can’t do it on the website and listen to their hours and all the other shit they put in the way of speaking to a human being.
Are you going to Walgreens? If so, entering 771 as soon as you hear something will take you straight to a human.
Yeah, I’ll give that a try next time.
meanwhile, you can get an ounce of meth online for like $200
Lemme guess… Adderall?
It’s far easier to buy crack online without getting caught than getting your legit Adderall script
And to make matters worse there’s some sketchy shit going on with reformulation to reduce euphoria 🙄 I’m so mad that I started taking medication because it changed my life and now I’m unstable due to this shit.
I didn’t know about the reformulation thing — is it Adderall that’s affected? I’m not personally on Adderall, but I like to be aware of the overall landscape of ADHD meds due to having many friends with ADHD (and also being a nerd)
If i recall, and someone correct me if im wrong, back in August the ratio of active ingredient allowed to filler allowed went from 2:1 to 1:1 for adderall.
Yeah, the reformulation cut the effectiveness nearly in half for me. I went from stable on the same script for 2 years to suddenly being emotionally agitated all the time, constant headaches, and 0 symptom relief. It took 8 months to figure out, but my provider and I finally landed on using a different manufacturer and nearly double the dose of what i had before to almost get me back to my original stable state.
Ugh yeah, and it’s so often based on these ideas like “too many people have adhd” or these worries of addicts. I’m sympathetic to addicts and the misdiagnosed, but at the end of the day, I have a medical condition that requires prescription strength stimulants in order for me to contribute to society and not cause accidental damage to myself and others. No choices were made to cause this other than when two people with adhd decided to have kids.
This whole limited supply thing comes from the drug enforcement agency, cops, not from the fda who are public health officials. Hell a lot of the hoops I have to jump through come from a government more afraid of damage done to those actively seeking this medicine who don’t need it than the damage done if I can’t consistently get the medicine I need in order to hold down a job, drive safely (or walk safely where cars may be), and not forget to pay my bills, do my laundry, and take dinner off the stove when it’s done.
Also the “see a psychiatrist every 3 months” thing is kinda funny because well managed adhd should be pretty consistent. Once it’s good annual checkups should be fine to just check you don’t need to change dose or drug due to tolerance.
I hate the three month appointment requirement. My psych is already overbooked as is and 9 times out of 10 our calls end up being a quick 10 minute check in followed by a 450.00 charge to insurance with 150 uncovered. The alternative is to see a primary care doctor, but they often require a drug test with every visit and its a 50-50 shot they wont try to mess with a script ive had for years.
Blaming pharmacists for things they have no control over, nice. Biggest brain
If you are in the US and have a Costco membership, try getting your prescriptions without entering in your insurance. They will put you in the Costco Member Prescription Program. My pills were 75% cheaper. Also this works if you don’t have insurance.
Yeah, they refuse to enroll anyone locally if you don’t have insurance. I tried.
https://www.inhousepharmacy.vu/
https://www.alldaychemist.com/Some old school sites that allow ordering of certain rx medicines without an rx. You can’t order scheduled substances like opioids, but they have a lot of common prescription medications.
I tagged you at some point with “knows his shit” and youve yet to disappoint.
Please. Knows HER shit! :D
The tag has been updated, haha
