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Should you only use one pharmacy?

I recently saw an article posted on KevinMD.com that was written last year or so, it also prompted me to look at other articles similar to this. In the article, a medical student describes the situation where Coumadin is 15 dollars at one pharmacy and 4 dollars at another. You can find it here: http://www.kevinmd.com/blog/2012/07/pharmacies-charge-prices-prescription-drugs.html I feel this article really gives a telling insight into the way many (non-pharmacy) medical professionals feel about pharmacists who dispense medications. The article goes on to discuss the wide differences in the cost of drugs at different pharmacies. For those not in the world of pharmacy, I’m sure it’s an interesting read, and leads the reader to believe that there is no value in getting your prescription at the same pharmacy. I am all for transparency and competition, but I’m going to save that discussion for another day. I believe this article really gives you the sense that dispensing pharmacists provide zero value other than the product they dispense, but I guess that’s the problem when you have been historically attached to the sale of a product. I’m not intending to tear down this writer who wrote the article, but am asking healthcare professionals and pharmacists to look inward and a little deeper at what a pharmacist can and does provide. I believe there is a significant proportion of healthcare providers (non-pharmacy) who feel as if dispensing pharmacists are simply making sure the correct drug and quantity is in the bottle – i.e. just look at the comparison the author used to describe buying a pack of gum to getting your prescription filled. For cash paying patients, when your sole focus is cost, it’s a no brain decision…go buy the Coumadin, Lasix, Zithromax, etc. at the cheapest location. However, let’s dig a little deeper than that. Let’s say Coumadin is cheaper at pharmacy A. Go get your Coumadin there… Now, that same patient gets put on Bactrim – pharmacy B sells this drug at a much cheaper price than pharmacy A. Would pharmacy B know that the patient is on Coumadin and there is a potential for a significant drug interaction? Obviously any computer program designed to help aid in identifying interactions is useless in this case. The pharmacist might know that the patient is on Coumadin, or identify that upon adequate questioning, but I can guarantee you that it is not nearly as likely if the patient received all their prescriptions at one pharmacy. I’ve seen people get hospitalized due to this interaction. Working in healthcare, I understand that nurses, pharmacists(including me), doctors all make mistakes and that a pharmacist is a critical final check before the drug reaches the patient to help prevent hospitalizations, injuries, deaths etc. There is definitely a long way to go in educating the public as well as other healthcare professionals as to what pharmacists know and can do. So is the 15 dollar Coumadin actually cheaper than 4 dollar Coumadin? I will let you decide.

Eric Christianson PharmD, CGP, BCPS

Written By Eric Christianson

December 1, 2013

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