Posts filed under: Tales from the Counter

Tales from the Counter

Real stories of clinical interventions made by pharmacies.

We serve a patient with severe mental disabilities living in a group home. He has full time staff assisting him with his medications. Our pharmacy provides the patient’s medications packaged to meet the rules and regulations for this type of residential care facility. These packaged medications are delivered in monthly installments. The prescription drug plan......
Continue Reading →
In a modern pharmacy, specialized systems and software assist the pharmacist in identifying potentially important issues important to patients. It is important to recognize that while these aids are invaluable, they also require sound clinical judgement and an underlying knowledge of the disease states and pharmacotherapy involved. I would like to share an example in......
Continue Reading →
I recently had a discussion with an angry patient. At the center of the interaction was the allowable day supply of one of his diabetic medications. The patient was questioning why I was only able to give them 7 vials of insulin instead of the 8 vials they wanted. To me, the answer is simple:......
Continue Reading →
Recently, pharmacies failing to address significant drug interactions has made national headlines. But while the pharmacists that failed to address these interaction are certainly at fault, to some degree we all share in the fault. Today’s healthcare world is regularly pushing providers to do more for less. The payor and the patient both want low cost, and with respect to pharmaceuticals,......
Continue Reading →
Darrel Huff’s How to Lie With Statistics is an excellent overview of using mathematics and statistics mislead things that may not actually be true. At the beginning of his book, Huff starts with a quote popularized by Mark Twain and attributed to British Prime Minister Benjamin Disraeli: There are three kinds of lies: lies, damned lies, and statistics. The art of statistical malfeasance is regularly......
Continue Reading →
Recently I received an after-hours call from a rehabilitation facility. One of my patients was recovering from surgery and they were out of one of her medications.  Normally, a call like this would be a routine delivery and the story would end here. Instead, this call transformed in my latest adventure in Tales from the Counter.......
Continue Reading →
This week’s tales from the counter deals with the high risk medication Zolpidem. The other day, I received a call from a patient concerned with their copay for zolpidem. The patient’s copay increased to over $90 for a 2 month supply. This was up by 200% compared to the previous refill, and she had concerns about being able......
Continue Reading →
Okay, maybe it seems that I am obsessed with writing about the 90-day supply. I have long maintained that our ability to care for a patient is directly correlated with the frequency we see them. Only seeing a patient every 90 days is often not frequent enough to enable quality care. But today, I hope, even strong......
Continue Reading →
One of the more interesting and important findings from a pilot we recently participated in was the financial impact pharmacy can have on a payor’s total health spend. Spoiler alert: it can be very significant. But teasing out exactly what a pharmacy is doing to decrease health spend is difficult, and one of the only ways to do......
Continue Reading →
I am seeing more and more drugs that are being moved from traditional retail status, meaning that you can get them from your local pharmacy, to specialty-drug status, available only from a designated pharmacy. According to Specialty Pharmacy Times: specialty drugs or pharmaceuticals usually require specialty handling, administration, unique inventory management, a high level of patient monitoring,......
Continue Reading →