Lets face it, if you work in community pharmacy these days you are probably dealing with transfer coupons. The ridiculous practice of enticing patients to transfer prescriptions from one pharmacy to another for a financial incentive such as a $25 gift card is commonplace now. Everyone is on board with the idea in this new age of cut-throat competition in the attempt at landing new pharmacy customers. But now the practice has gotten the largest drugstore chain in the United States in trouble.
According to this article on the United States Department of Justice website, the retail pharmacy chain Walgreens has paid a settlement of $7.9 million dollars to the federal government and the states involved in this case. Walgreens was accused of violating the False Claims Act by directing people with government healthcare and prescription plans towards their pharmacies by offering $25 transfer coupons.
In this case, the government alleged that Walgreens employees would repeatedly ignore restrictions prohibiting patients with government insurance plans from getting the transfer coupon incentive being offered by the retail giant. Those transfer coupons or any financial incentives given to patients with government plans are in violation of federal law.
The allegations were brought to the attention of the federal government by two separate whistleblowers. One was a former Walgreens pharmacy technician and the other an independent pharmacist. The two whistleblowers will allegedly get over $1 million dollars for their efforts to bring the problem to the attention of the government.
But more interesting to me is the comments in the DOJ article from some of the attorneys involved in this settlement case. Acting Assistant Attorney General for the Civil Division of the Department of Justice Stuart F. Delery was quoted as saying “This case represents the government’s strong commitment to pursuing improper practices in the retail pharmacy industry that have the effect of manipulating patient decisions.”
U.S. Attorney for the Eastern District of Michigan Barbara McQuade added “Continuity with a pharmacist is important to detect problems with dosages and drug interactions. Patients should make decisions based on legitimate health care needs, not on inducements like gift cards.” I couldn’t have said it better myself!
Now I know what some of you will say. Every pharmacy chain offering transfer coupons is guilty of the same illegal practice to some extent. Employees can forget the restrictions or they are directed by management to give the gift card anyway to appease a grumpy customer. I can also hear the grumblings about how $7.9 million, while a large sum of money, is but a drop in the bucket for a company the size of Walgreens.
It is true that Walgreens may not feel too much financial pain from handing over almost $8 million to the government. But this is a lesson for Walgreens and the rest of community pharmacy- the government is on watch. And if they know about a problem like illegal transfer coupons being offered to patients with government insurance plans, they will take action. And companies may ignore employees who complain about the transfer coupon practice, but having to pay the federal and state governments millions in fines will get their attention.
As to the criticism that “everyone is doing it” I will only say the fact that this practice is commonplace doesn’t make it right. I would also point out that anyone working at any of these other pharmacy chains is welcome to file a complaint with the government themselves regarding the illegal offering of transfer coupons. Who knows, you too could end up with a thank you and a large check from the government!
But the real point and reason why I am sharing this story with you today is the fact that while some attorneys seem to understand the principals of patient rights and the dangers of pharmacy hopping, the state board of pharmacies seem to ignore the transfer coupon phenomenon and the resulting fall out and increased risk of errors inherent when patients move their prescriptions around constantly. Why is that?
Most state boards will deny that transfer coupons put patients at risk or increase the likelihood of a prescription error or misadventure such as a missed drug-drug interaction. But those attorneys are right, continuity of care for pharmacy customers is important. I just can’t understand why pharmacy board members don’t also realize the dangers behind the practice. The lawyers seem to get it.
The reality of community pharmacy is that pharmacists and technicians are now working under extreme conditions that are already conducive of producing above average error rates. The last thing the industry and employees working in these pharmacies need is the added strain and potential for errors that come with offering transfer coupons to patients. Transfer coupons are simply a bad idea even when they don’t violate federal law.
I think what bothers me the most about transfer coupon promotions is the fact that they don’t even accomplish what they’re designed to do. You create a culture of “what do I get?” from pharmacy customers and you also get patients that will simply fill a prescription transfer once and then sprint to the next chain who offers them the same promotional deal as your pharmacy. In the end, you create this revolving door of pharmacy patients. It also creates several times the normal amount of work involved in filling one prescription.
I’m glad that this Walgreens case ended in a large government settlement. Maybe some of the other pharmacy chains will hear this news and realize that these transfer coupons just aren’t worth it? Maybe they will realize this type of promotion is dangerous? Hey, a pharmacist can dream can’t he?
The Redheaded Pharmacist