Editorial: Free Prescriptions-What's Wrong with this Picture?

It was quite unbelievable when a pharmacy chain recently announced it was going to provide seven different antibiotics free to whoever presented a valid prescription for them for a 14-day supply, with no apparent limit on the number of prescriptions that can be filled. When will we ever learn? You don't enhance patient care, pharmaceutical care, rational drug therapy, and respect for the pharmacy profession by giving away potentially dangerous drugs!

In addition to the obvious potential problems of over-prescribing and overuse of these specific [free] antibiotics, another consideration is that although the antibiotics may be offered free to the "customer," they are not free to the pharmacy and to the pharmacy profession; it all comes at a huge cost. Consider the following:

1. If patients can get antibiotics free, why not other drugs?
2. If pharmacists and pharmacies are making so much money and can afford to give away free drugs, why do we need an increase in the Part D prescription fees?
3. If you are inundated with prescriptions for "free antibiotics" and have prescriptions presented by paying patients, who are you going to take care of first?
4. Are you going to offer "free delivery" with these free prescriptions?
5. If you are charging third-party in the future for these drugs the "usual and customary charge of AWP less X%", is your new cost and fee for these drugs $0.00?
6. If you are a patient in a hospital, can you have your antibiotic ordered at these pharmacies so they are "free"?

In summary, this places community/retail pharmacists in an impossible situation. It appears that we make so much money that we can give some drugs away. However, many pharmacies are closing up because of lack of sufficient reimbursement by third-party payors. Also, it gives the appearance that pharmacists and the pharmacies are the ones charging so much for prescriptions that they can afford to give some away. Not so! It is the pharmaceutical companies that have set the prices so high that pharmacists have to settle for such a small fee that they can't stay in business. Meanwhile, the pharmaceutical companies continue their high-dollar perks to their employees and shareholders.

It will also be interesting to see if these older antibiotics are so effective that many of the newer and more expensive antibiotics will not be prescribed, thus hurting some of the pharmaceutical companies sales of the newer antibiotics. Meanwhile, I am waiting for my local service station to offer free gasoline so they will get my other business for aspirin, toothpaste, etc.

Yes, it is an interesting picture that is being painted!


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

Like surprises? If you answered yes, keep reading, because you may not like this one. Beginning October 1, 2007, prescriptions from Medicaid patients for Class II narcotics can be accepted by pharmacists only if those prescriptions are written on "tamper resistant prescription pads." This is not only a surprise to pharmacists, but it will be a surprise to the physicians whose patients come back to them frustrated because no pharmacy will accept their prescription for refill. Why all this havoc? This was a provision passed along with the emergency spending bill for Iraq to prevent illegal procurement of drugs, as well as a way for the government itself to save some money.

This law poses several concerns, which include:

• The inability of patients to access healthcare
• The number of doctors and pharmacists who are unaware of the law
• The short amount of time available to implement the law
• The lack of a clear-cut definition of a "tamper-resistant prescription pad"
• The lack of instructions on what to do in case of an emergency situation

For more information regarding this matter refer to the links below.
http://www.deseretnews.com/article/content/mobile/0,5223,695194030,00.html
http://www.ncpanet.org/template/tab_content.php?mid=136
http://www.aphanet.org/AM/Template.cfm?Section=Home&CONTENTID=8204&TEMPLATE=/CM/ContentDisplay.cfm

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Reading Material
Need some good reading material for your waiting area? Consider magazines like Good Old Days, Saturday Evening Post, Readers Digest, and many others that your senior patients will enjoy reading. By placing your store label on them, after they have been in your waiting area for a few weeks, drop them off at a senior citizens center so they will continue to work for you.