An open letter to my state’s BOP!

     I thought I would share with you the exact letter I wrote last night with the intentions of sending it to my state’s Board of Pharmacy.   The subject of my letter to them is my concerns over the use of incentives by pharmacies for the specific purpose of attracting new customers by encouraging them to transfer prescriptions from other pharmacies. 

    I have long disliked the practice of transfer coupons or other incentives for several reasons.   I think the constant transferring of a prescription from pharmacy to pharmacy resulting from these promotions is burdensome and creates the potential for errors.  Here is the draft of the letter I will send to my state’s board of pharmacy regarding my concerns.   Feel free to comment on what you think of this letter or the concepts behind my argument against transfer incentives of any kind.   This is the draft I wrote last night word for word in italics which I intent to send to my BOP:

 

Dear BOP Members,

     I write to you today as a concerned licensed pharmacist working in this state. I am a community pharmacist currently working for a grocery store chain. My employer along with many others operating retail pharmacies in this state have made the decision to use various incentive promotions in the attempt to attract new pharmacy customers. Those incentives involve rewarding customers with some kind of monetary gift (typically a gift card) for transferring a prescription to that individual pharmacy. I feel this practice is dangerous, reckless, and not in the best interests of public health.

     Those incentives create the environment where pharmacists are burdened with excessive amounts of prescription transfer processing. Patients are being encouraged to jump from pharmacy to pharmacy simply in the attempt to catch the latest promotion offered by competing drug stores. The potential for error in constantly transmitting this prescription information from one pharmacy to another is very real. I feel that these transfer coupons and other promotions are hindering our ability as pharmacists to provide optimal patient care.

     I recently spent a Saturday shift at work taking phone call after phone call from other pharmacies requesting prescription transfers. During one nine hour shift I gave out at least a dozen prescription transfers. And every single prescription that was transferred out had recently been transferred into our pharmacy from another drug store. It is a revolving door of transferring prescriptions in one month and out the next as patients are chasing deals. Patients would be better served by maintaining all of their prescriptions at one location so their pharmacist has access to that patient’s entire prescription profile when filling a new prescription or recommending an over the counter treatment option.

      I would like to urge the board members to consider a new rule or regulation prohibiting prescription transfer incentives or any other reward intented to encourage customers to transfer prescriptions between pharmacies. We should end this dangerous practice of pharmacy hopping by customers in the name of safety. Lets be proactive in this state and not wait for the potentially severe dispensing error that inevitably will occur if patients continually transfer prescriptions from one pharmacy to another on a routine basis.

      Other states have already taken action to prevent these multiple transfers. Look at the State of Ohio for an example of a recent rules change that was put in place specifically to stop multiple prescription transfers. That state now limits prescription transfers to one per year per prescription.  While I don’t agree with that solution and would favor a ban on the incentives instead I did want to highlight Ohio as an example of another state that took action.  Our state should come up with some regulation that would be beneficial for both practicing pharmacists and patients.  Safety should be priority one!

      I hope you take my concerns to heart. I think having an open forum or questionnaire on the subject of transfer incentives would be an eye opener for the board. There is a real potential for errors related to all of this prescription movement. Fell free to contact me with and questions, concerns, or comments related to this letter.  Thank you for your time.

                                                                         Sincerely,

                                                                         The Redheaded Pharmacist

 

     That is it!  It isn’t the most eloquent piece of prose ever written but I think I made my point.   And that story about the Saturday shift was true.   It actually just happened this past Saturday.   And all of those transfers were prescriptions we had recently transferred in from another pharmacy.  In fact, in many cases the very pharmacy we had called last month to get an individual prescription was the same pharmacy calling back this month to transfer the same prescription away from our store!  

     What do you think?  Is this a letter I should send to my BOP?  I’ve never sent a letter to my state’s BOP like this but I feel they need to be aware of this issue!  Do I have a real point or was this letter a simple byproduct of a frustrated pharmacist after a long Saturday shift on the phone with several pharmacies giving out prescription transfers?   I’d like some feedback from you. 

The Redheaded Pharmacist

14 Comments to “An open letter to my state’s BOP!”

  1. By Peachy, January 17, 2011 @ 10:41 am

    I really like this letter and I do think that it is a problem that the BOP needs to put a stop to. I, too, have problems with a silly promotion that most all big store pharmacys send out to try and gain a few more extra dollars. It is very dangerous to the patients and it will eventually lead to someone dieing from not catching a drug interaction because a patient will be using multiple pharmacys. It has happened at a pharmacy I use to work at were several patients were on coumadin, but the caregiver decided to get the patient’s aspirin at another store because they had a better deal. The state needs to step in and good for you for taking some sort of action.

    -Peachy

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  2. By WrongAid, January 17, 2011 @ 11:36 am

    Love the letter, mostly. Please do not back the idea of solving the problem by limiting refills to once per year. That only adds extra burden to the pharmacy. I feel you should state this action is only a bandaid for the real problem. The ‘incentive’ is the problem, not the transfer itself. You take away the incentive and the transfers stop.

    I reiterate, mandating one transfer only is a bad idea!

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  3. By Pharm_King, January 17, 2011 @ 11:56 am

    I think you’re spot on here. It is definitely worthwhile to send this to your state board; the Ohio board is the perfect example why. Right or wrong with their particular way of dealing with it, I am elated that they ARE dealing with it.

    I, too, work in a retail chain grocery store and decry this practice. It may sound like conspiracy theory, but I truely do feel like large chains are pushing towards reducing the practice of retail pharmacy in their stores to ‘just another commodity’ so that it’s convenient as possible for them to lure more customers into their stores. I’m all for making money, returning dividends to stock holders, and the health of the company I work for, but this is not an avenue I feel should be being pursued by these companies for this purpose.

    From the comments on the Ohio rule, it seems customers (patients) are upset because they’d be losing out on money and they feel they have a ‘right’ to receive . I would hope they could look at it from a health care practitioner’s perspective, however, and realize how much is at stake. Tally up the time you waste driving to all different pharmacies, physicall calling or going in to transfer each time, etc… Not to mention the possibility of error in you or your loved one’s prescription.

    Like anything, there are always the few who ruin it for most — we all have them at our stores — the ones who it almost seems like are making a LIVING off these transfer rewards. But even excluding these outliers, it is still extremely burdensome on our already overworked/understaffed profession.

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  4. By The Redheaded Pharmacist, January 17, 2011 @ 9:58 pm

    I have edited the first draft of my letter to reflect the fact that I do NOT advocate the solution that the Ohio BOP chose to deal with these transfer incentives. I would be supportive of an outright ban on the incentives themselves while still allowing patients to freely transfer prescriptions as often as they wish. There are too many legitimate reasons for prescription transfers to simply attack the problem of incentives by limiting prescription transfers directly. Simply outlaw the incentives and the excessive transfers will go away on their own. Thank you to WrongAid for pointing out that fact. I have highlighed the minor changes to my letter in my post in bold type. Otherwise, it is unchanged and will probably be mailed out tomorrow. I will let you know if/when I hear anything back from my state BOP regarding this letter.

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  5. By pharmiechick, January 17, 2011 @ 10:07 pm

    I practice in New York, where the transfer coupons are not legal. We typically only do transfers for students and patients on vacation. Additionally, in New York, transfers are (supposed to be) for “emergency purposes” only so we can only transfer one refill of each script out at a time, instead of transferring out the entire prescription, and then having to call that pharmacy the next month to get the script back. That seems a little more sensible than limiting a patient to one transfer per drug per year. I’m wondering what patients who travel a lot do? Since we know they don’t often plan ahead! =)

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  6. By Jones, January 18, 2011 @ 12:04 am

    Absolutely send this to your state’s BOP. I’ve been out of the retail practice for awhile now, but remember quite clearly all the issues involved with those transfer coupons. You’ve summarized them well.

    Though I think in your haste to type out your views on Ohio’s response, you made a small error: “I did wanted to highlight…” Fortunately a quick fix before you send this out tomorrow. (Please forgive my nit-picking, I wouldn’t have mentioned it but for the fact that this letter is headed to the BOP.)

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  7. By pharmacy chick, January 18, 2011 @ 12:13 am

    on contraire Red Head, i think its a brilliant piece of prose…send it!

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  8. By The Redheaded Pharmacist, January 18, 2011 @ 12:23 am

    Though I think in your haste to type out your views on Ohio’s response, you made a small error: “I did wanted to highlight…”

    Thanks Jones for catching that but it appears that error was a typo on the blog only that wasn’t found in my letter draft document when I proofread it one last time. I’ve updated my blog post to remove the typo! And yes, it is printed and will be in the mail for tomorrow. I’ll keep everyone posted if/when anything happens. Smile

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  9. By rxkerber, January 18, 2011 @ 2:51 am

    If this works to get your state’s law changed, work on limiting time to fill ER or Urgent Care rxs next. Great letter!

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  10. By Ray Poorbaugh, January 18, 2011 @ 9:38 am

    I already interviewed with drug topics about the ohio law…its a bad law. It gives the chain stores more reason to offer incentives because now once they get the transfer it is stuck there and it screws little old independent. Your solution would be much better…ban any sort of commodity incentive that could be considered to have monetary value. This would end the practice once and for all. Instead of pretending to ‘protect the public’ like Ohio BOP has whilst bending to the lobbyists demands.

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  11. By Joey Mattingly, January 18, 2011 @ 9:57 am

    I love your letter. I too work for a grocery store chain and we are engaging in the largest free grocery offer I have ever seen for a transfer. I brought up my concern to our VP in a pharmacy management meeting and she spent 20 minutes blasting me (considering the coupon offer was her idea I should have expected that). I believe that transferring an Rx is meant to be a convenience and not a marketing tool. I would expect this tactic to be loved by business execs, but it truly disappoints me when healthcare professionals suggest this practice. My only hope is to climb the ladder far enough to provide this perspective.

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  12. By RxBoy, January 18, 2011 @ 10:57 am

    I think the best idea for dealing with this is to follow the example of New York, which is where I work as a tech. I work in a very high volume supermarket pharmacy and we generally only deal with a few transfers per month. Most of them come from people who have become dissatisfied with the original pharmacy or people who recently moved into our area. Once in a while we will also get one from somebody who is on vacation or here for college.

    I think this is a much better solution than Ohio. In that situation there is the possibility that someone could have to go without their medicine for a couple of days if the pharmacy they transferred to is out of it or unable to get it in.

    It’s a tough situation to be in when your job is to put the health and well-being of your patients above everything else and the company you work expects you to put profits and sales first.

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  13. By OHIO GUY, January 18, 2011 @ 10:17 pm

    The Ohio law regarding prescription transfers is simply a result of the chains shooting themselves in the foot. Likely this is the result of an injury to a patient as a result of a missed interation or miscommunication due to multiple tranfers and the use of multiple tranferrs by customers who like deer in headlights follow the ridiculous offers made by many pharmacies, Yes inependents included.

    Luckily pharmacists in Ohio need not deal with these bullhit tactics anymore and can simply defer to Ohio code when Joe Blow requests fills only to be transferred for free gift certificates somewhere else. Our pharmacy now makes it policy not to take incoming tranfers as most sites cannot or will not guarentee the validity of the origin of the prescription.

    I have never said this before but three cheers for the Ohio Board action.

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  14. By Wendy, July 13, 2012 @ 1:45 am

    I will be the one person to disagree. No doubt every comment here is by a pharmacist. By offering incentives, it helps patients with overall costs that are burdensome. There are sales on everything else in the world, yet not on the one thing that 1. has the highest markup of any other good and services, what was it, 3000%? and 2. Is necessary for the quality of a patients life, or sheer survival. There is never a discount on these things because the evil drug companies know they can charge what they want, patients don’t have an alternative, and that’s wrong. This was the tiny little bit of relief.

    It’s the patients responsibility to know what their taking regardless of the pharmacies they use. If they don’t share what their taking with the RPH and something happens, it’s on them. Maybe the solution is to not make mistakes? To be careful when handling transfers? Mistakes can happen either way, and accuracy can occur either way. The only difference is you have some more work, yes. But last time I complained at work for constantly being given more work, nothing happened and they still expected 100% accuracy. Perhaps you could help think of something to help customers if you’re aiding in the removing of this incentive? It’s now gone in my state because of pharmacists complaining of more work. All I see is just a way to help pharmacists, nothing wrong with that, but please replace the incentive with something else to help patients financially, rather than just taking it away.

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