Ethical Question

goldensmomOctober 26, 2006

This may be a little off the topic but don't know where else to post. Will try to be short...getting the same Rx from a store for years paying 20.00 w/insurance. Recently this drug changed to generic & was told by manager of store that even though the cost is 138.00 they have agreed with pharmaceutical co. that they will sell it at 10.00 w/insurance. New pharmacist is hired (but still has same manager)and told me my insurance denied payment & no longer could give me the same Rx and started to replace it with a much cheaper one which caused me many complications. At the time I didn't question what she was telling me. So discussed this with her which ended in a VERY HEATED argument & by giving me this Rx at 10.00 the store was losing money but gave me the original Rx and said "it was a gift as she didn't charge it to my insurance co." Thought that was strange so checked with my insurance and she did charge them. Also insurance never denied paying as she stated so discussed with manager and he once again stated that they most certainly have an agreement with the pharmaceutical co even though they do lose money. Went to pick it up again yesterday and now she ignores me completely even when I say excuse me can I pick up my Rx she will pick up the phone and call someone to look busy. When she finally did give it to me after 30 minutes on the phone she threw it at me. My dilemna is that this is the only store that has this policy vs me paying a whole lot more else where. She acts like she is the one losing money & its my fault. As this is not a privately owned store but a nationwide chain I hesitate to report her as who knows what she would do in retaliation. Why should I go elsewhere to avoid her and pay alot more when they agreed to this policy? Any suggestions?

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agnespuffin

My feeling is that you aren't the only one that has problems with this woman. And I am betting that she won't be there long if there have been other complaints. So, if you think that you need to talk to the manager more, don't hesitate. Otherwise, just be patient.

Document any correspondence that you have with the insurance company. With the recent changes with Medicare and Medicaiid coverage, insurance companies don't always know what is going on either. The entire business is in a turmoil.

A lot of insurance companies are insisting on generic drugs unless they have a letter from the doctor stating that generics do not work for you.

    Bookmark   October 26, 2006 at 1:25PM
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marie26

I had a problem with one of the techs at a pharmacy. He was snooty and just not professional. Since, unfortunately, dd needs many medications each month, I figured that they wouldn't want to lose our business. So, I complained to the store manager. Now, this person is personable. We shouldn't have to accept being treated terribly. We are, after all, the ones who keep the pharmacies in business.

    Bookmark   October 26, 2006 at 5:07PM
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Vickey__MN

Complain, nicely, objectively, but complain. Objective is facts, subjective is your interpretation of things. She gave me a funny look...versus..she looked at me, and stuck out her tongue. What is "funny look", questionable, Looked at me and stuck out her tongue, no question.

On XX date I went in to pick up medicine. State here as you did, do not mention attitude (attitude is subjective, not objective). Turn this into the Store Manage, with copies to corporate headquarters. (keep a copy for yourself). If it happens again, DO IT AGAIN. Guess what enough complaint means action. Again, nicely, objectively.

Vickey-MN

    Bookmark   October 26, 2006 at 7:01PM
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Meghane

I'm a bit confused. Does your insurance not cover the generic but does cover the brand name Rx? If so, have your doctor write a prescription for the brand name Rx only, especially since you were having complications with the generic. You have the right to get the Rx that doesn't cause adverse effects. Then you have to pay only the co-pay of $20 as before.

If that doesn't work, I would call the manager over again, and have him explain the agreement with the pharm company directly to the pharmacist while you are present. That way you know she is getting the message from her manager and you are there to verify that it happened. She won't have a choice but to give you the correct co-pay without an arguement.

    Bookmark   October 26, 2006 at 7:08PM
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goldensmom

Thanks everyone for your responses. Meghane ... I thought it sounded confusing. I was paying $20 Zocor then it went generic (Simvastatin) so I started paying $10. She decided on her own to change my Rx to Lovastatin which is weaker and not as effective as Simvastatin but very very cheap $ wise. At the time she told me my doctor approved this which I didn't understand but decided to try the Lovastatin anyway. When I found out the doctor didn't do this along with saying the insurance denied payment that is when we had a heated argument and I complained and when I say manager I mean the manager of the pharmacy. The day I picked up my Rx for Simvastatin he wasn't there as they don't work together and now it seems she is there more than he is. Elsewhere I would have to pay at least 65.00 for this but hey as the manager told me this is the agreement that was made stupid as it is it was made. I just don't get why she should care if the store is losing money on this particular presciption. I have to go pick up a Rx today so I'm hoping he will be there and not her. Wish me luck .... :-)

    Bookmark   October 27, 2006 at 9:15AM
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agnespuffin

Let us know how this come out. I may be mistaken, but I think that a pharmacy MUST give what the doctor prescribes. They can refuse to fill it, or they can give the equivilant generic, but they can't change it to another medication. They are prevented from giving customers something that isn't prescibed. It may vary from state to state, but that's my understanding. If your doctor doesn't want you to have a generic, then he has to state Brand Name Only on the prescription.

Some insurance companies are beginning to refuse to pay for anything except generics if they are available. Perhaps your company is one of them.

We have a medicare pharmacy coverage that will pay only for generic unless the generic does not work, but it has to be tried for a while.

    Bookmark   October 27, 2006 at 11:21AM
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Meghane

It is a bit odd that the pharmacist cares so much, unless she is paid on commission or is getting kick-backs from the pharmaceutical company. Could also be miffed that if either of the are true, she's losing more money with the deal the manager made. Tough tooties for her though. She doesn't have the right to treat you that way.
I do wish you luck with this. Sounds like a mess :(

    Bookmark   October 28, 2006 at 2:08PM
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goldensmom

Well I picked up my Rx and and the manager was there instead of her. I very tactfully explained the situation and he just once again stated that the agreement was made with the pharmaceutical company and that was that. I asked if maybe he could talk to her about the situation and he said that she was a good pharmacist and does her job well. I agree 100% with you meghane....could be commission and/or kickbacks but the manager didn't make the deal the store chain did. Maybe the difference in the way I am treated between the two is that the manager is much older and wiser than she is so since I feel I am between a rock and a hard place I am going to just bite the bullit every month, pay my $10 when I pick it up and walk out with a smile knowing I'm getting a great deal for however long this agreement lasts :-).

    Bookmark   October 28, 2006 at 3:30PM
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Meghane

Glad you had a more pleasant experience this time around. Being a good pharmacist doesn't mean crap if she's chasing away all the good customers. I've heard that for every one person who complains, 10 simply don't return, but they do tell their friends who will also think twice about using that particular pharmacy etc. So this "good" pharmacist could be costing the store a LOT of money. Hopefully others have complained and the problem will be resolved. In any case, glad you're getting the medication for the correct price.

    Bookmark   October 29, 2006 at 5:54PM
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