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Problems In The Pharmacy

Problems In The Pharmacy. Dimitry Gotlinsky Western University Managed Care Clerkship ProPharma Pharmaceutical Consultants, Inc. 06/23/06. Working as a Community Pharmacist. Fill and dispense prescriptions High script volume Consult on new prescriptions and OTCs Insurance issues

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Problems In The Pharmacy

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  1. Problems In The Pharmacy Dimitry Gotlinsky Western University Managed Care Clerkship ProPharma Pharmaceutical Consultants, Inc. 06/23/06

  2. Working as a Community Pharmacist • Fill and dispense prescriptions • High script volume • Consult on new prescriptions and OTCs • Insurance issues • Calling doctors for new RXs or new directions • Calling for copies or transferring RXs • Concerned with sale and supply of medicines • Stock control • Dealing with upset or angry customers

  3. Difficult Pharmacist Questions • Why do my medications cost so much? • Do I really need to have this filled? • Why do I have to wait so long, they’re only pills? • Why shouldn’t I get this cheaper from Canada?

  4. Common Causes of Dispensing Errors • Heavy work load • Distractions • Work Area • Use of outdated and incorrect references

  5. Additional Problems • Staff training inadequate • Medicines stolen or lost • Medication given at the wrong time • Wrong dose of right drug administered

  6. Refills • Many patients think: a) have unlimited amount of refills b) can get refills approved right away c) blame the pharmacy for not automatically getting the refill for them • Getting refills or new prescriptions on the weekend • Large volume of refill request per day • Refill to soon

  7. Solution for Refill Problems • Prefilling prescriptions • Giving a prefill without an approval from MD • Giving hold over for couple of days • In case of emergency or during the weekend, contact MD on call • Faxing instead of calling • Reminding the patient to call for more refills ahead of time

  8. Insurance Problems • By far the biggest problem in the pharmacy • Missing or lost drug cards • Deductibles issues • Multiple insurance cards • Prior authorizations • Multiple tier co-pays • Insurance not contracted with the pharmacy • Coverage terminated • TARs (treatment authorization requests)

  9. Solution for Insurance Problems • Not too many options • Give loaners to patients who are waiting for PA • Always have an experience insurance employee on staff • List of direct phone #s for pharmacy help desk

  10. Mail-Order Problems • Rx runs out before mail order arrives • Lost in the mail • Never sent • Rejection from insurance to pick up medication at a community pharmacy • Higher co-pays when picking up at a community pharmacy

  11. Solutions for Mail-Order Problems • Calling insurance to get an approval for a short term supply • Higher co-pays can still be a problem • Sometimes give out for free a 2-3 day supply • In some cases patient just pays out of pocket, and is reimbursed by insurance

  12. Inventory Budget • Each pharmacy has a different inventory budget • Based on the volume of prescriptions • Inventory audits happens every quarter • If over budget must send prescriptions back to manufacturer • 2 weeks out of the year when you can send prescriptions back without a restocking fee • Can not send back anything with <6 months expiration date

  13. Ordering Drugs • Two main sources • AmerisourceBergen & Warehouse • AmerisourceBergen is more expensive • Inventory over budget occurs when employees order from AmerisourceBergen

  14. Solutions Not to Go Over Budget • Check inventory every week, instead of once a month • Proper training from employees on how and where to order from • If over budget occurs, return drugs back to manufacturers during non-penalty period • Cut hours if volume of drugs drops

  15. Called in Prescriptions BY MD • Don’t have full info about the patient • Wrong spelling of the name • Fake prescriptions • High volume of called in prescriptions • Don’t leave DEA or state license # • MDs are difficult to get a hold of for questions

  16. Solutions for Called in Prescriptions • Always get the patients DOB, phone #, and verify the address • Call back MD’s office to verify a prescription • Have MD sign up for electronic prescribing • Write the time of the call, and fill within an hour

  17. Conclusion • Many patients don’t really know what a job of a retail pharmacist entails • People think that pharmacist only count pills and fill prescriptions • Pharmacy has expanded its role within the healthcare delivery system

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