Costco Fixes Customer's Botched Electronic Prescription
If you get your prescriptions filled electronically, always double-check the dosage. Kimberly's prescription was recently screwed up somewhere between the physician filling out the order online and Costco's pharmacist receiving it. Luckily for her, the Costco pharmacist was incredibly helpful and fixed the problem for her, so Kimberly didn't have to waste her copay or deal with the issue on her own. He also explained, however, that the current state of electronic prescriptions is a big mess.
I recently switched doctors because I didn't like the first random doctor I picked after moving to Austin last year. My prescriptions from that doctor had one renewal left on them at the Costco pharmacy. My new doctor said if I had Costco fax him for refills, he'd have them all changed over to him, since he'd done my bloodwork already and determined that those prescriptions were fine to continue.
I phoned Costco and asked them to switch the prescriptions to the new doctor. They said it would be no problem, just to give them a few days to process it. I had planned for that anyway.
So at the end of that week I picked up the prescriptions while shopping at Costco with my family. As usual, I glanced at the list to make sure they were the right drugs. However, what I didn't notice then - and actually didn't notice until three days later when I went to use one - was that one of them was the right drug, wrong dosage. It was the 15mg version but I'm on the 30mg version. Of course, it was the brand-name, no-generic-available one so I'd paid the bigger $30 copay.
I phoned Costco the next morning and explained the problem to the pharmacist. I figured that since I had signed for the pickup and then taken three days to notice the error, that they'd a) tell me it was my new doctor's fault and to call him myself, and b) too bad on the $30. I was wrong! The Costco pharmacist was extremely pleasant and helpful. He could see that they had faxed the request properly to the doctor, but said that the electronic prescription filing system my doctor uses (which is apparently a big national one) is highly prone to errors, and that the doctor had probably clicked on the wrong dosage in a list of choices. The pharmacist went on to say that they have tons of problems with that system, from wrong dosages like this to wrong directions to even the wrong patients with same or similar names. He said the system is set up in a way that makes errors easy.
But instead of telling me to go call my doctor, he said he'd take care of it for me. He said he'd fax the doctor again with a partial record to show that I had been on the 30mg for some time, and that he'd call me when he heard back from the doctor. He said if the doctor wouldn't fix it, then I'd have to deal with them directly, but otherwise he'd take care of everything.
Since moving to the US from Canada 9 years ago, I've become sadly used to having to chase down medical/insurance problems all the time, spending hours on the phone at times just to resolve the most basic billing problems. I can't fully express what it meant to me, even in this small instance, to have someone else say they'd handle it for me.
Happily, the doctor quickly replied to the pharmacist with the right dosage. I brought in the wrong pills and the receipt. They did the exchange at no cost to me at all.
Costco really stepped up to the plate for me on this. They took care of the hassle and the money when they didn't have to do either. It may not have been a particularly dire issue, but it made me a very happy customer. I really shouldn't be surprised, since we've had consistently excellent customer service from all departments at Costco, both here in Austin and when we lived in Las Vegas. Clearly, discount prices doesn't have to mean discount service!
PS to Consumerist readers: if your doctor uses electronic prescription filing, be sure to check everything carefully! And don't count on it being quick; I had to wait 18 hours once before a basic antibiotic prescription made it through the system because of backlog on a busy Monday when lots of prescriptions are sent in to the system.
(Photo: CarbonNYC)
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Comments:
@Cocoa
Sometimes the pills aren't designed to be cut, doubled or altered in any form or fashion due to how the pill is composed. If you cut a pill that has multiple time release layers, you'll recieve the dosage right then due to the surface areas being exposed prematurely.
Same goes for multiple lower dose tablets. If the larger tablet only released a certain amount per hour, the doubing of the dose could be harmful.
@Cocoa Vanilla: Most pharmacy locations can take back partially used or unused perscriptions. In fact, they'd prefer it to you dumping them in the garbage or down the sink since they at least have a disposal system so it doesn't end up in someone's water supply downstream.
I had that happen to me once, but I didn't say anything... because I got the 15mg dose instead of the 5mg, and the pills were scored for cutting into thirds. Cheaper for me!
@Kogenta: That's a good point... they may have disposed of it. Still, I hope it was a time-release pill that couldn't be doubled, otherwise it was a waste of those pills.
@Cocoa Vanilla: They would never dispense the pills to someone else. They wouldn't let a customer walk around with extra pills they weren't prescribed and weren't supposed to get, either. They collected them to dispose of them.
@Kogenta: They most likely did throw them in the trash without any special treatment, though. When I worked as a technician, the only trash we treated specially was paper containing patient info, which we shredded and disposed of in opaque bags that went into the compactor with everything else.
It's nice that this incident made the OP feel all warm and fuzzy inside, but it's the minimum I would expect -- it's what we did for customers at the pharmacies I worked at. On the other hand, I'm routinely mildly appalled at the service I see at the pharmacies I patronize nowadays, so maybe I just didn't realize how special it was.
@Cocoa Vanilla: A pharmacy cannot just redispense returned medication. That just sounds like a lawsuit waitting to happen. All it takes is one person to poison the pills before returning them.
@bluewyvern: Maybe it depends on the company. I used to work in a store with a pharmacy and they have special buckets that any returned meds, expired OTC, etc went into that was shipped back to the central warehouse for disposal. I would imagine that if it were just garbaged, the store would have a problem with dumpster diving if they had an exterior unit.
The fact that these are life-saving or taking medications being handled should not falsely lead us to believe that any more care is taken than your burger order at the drive through. We are all consumers, expected to consume, pay, and shut up. Do you want your xanax or not? Now get outta here!
Costco's customer service is generally really good, it doesn't surprise me too much that they went out of the way to help.
The US healthcare "system" is a nightmare for its users. I'd accepted it as normal until I spent time abroad. You could get a house call at midnight if you really needed it, doctors were available during clinic hours rather than by appointment only - and whatever nominal costs you assumed, you paid in advance by buying a "ticket" at a bill-payment place. There was NEVER any question of receiving a bill after the fact. Doctors practiced medicine without computer systems second guessing every move. It wasn't perfect - certain lab tests had to be done a couple of times to be sure the result was accurate - but it was far more accessible.
He also explained, however, that the current state of electronic prescriptions is a big mess.
Translation: All that porn he downloaded onto his PC at work infected it with malware, and now it won't boot up.
So uh my doctor scribbles on a piece of paper and hands it to me when I need a script. I hand the scribbles to the pharmacy I still have no clue if the prescription I get from the pharmacy is the one that's on the piece of paper. It might be kind of nice to have this done electronically but not if there are as many problems as the OP says.
$30 for a name brand Rx? I want to be on her insurance plan
Always, always, always check the medication you receive from the pharmacy. Check it before you leave. If it's a medicine you're not familiar with, use an online pill finder to make sure you're taking the prescribed medication. I take medication for a chronic condition, and have caught several (human) errors over the years, from the wrong dosage to the wrong pills entirely.
This happened to me, too. My doc in a box filed the wrong medication electronically, and I didn't notice the difference until I got home, since it wasn't the way my doctor described it. I called them and they reimbursed me for the cost of the prescription.
In my case, the front office staff sent the prescription electronically. I wonder if that has something to do with the issues?
I could go on and on about COSTCO's excellent service!
I bought a large bag of lemons last year and the second day I had them 3-4 were rotting. I called and explained that I lived an hour away and wouldn't be getting back there to return them until a week later. They told me to bring them in when I could and explain that 'so-and-so' said I could return them. I did so w/o a problem! I have quite a few stories to tell regarding their excellent service!
I actually had a chance to SEE the electronic system in action a few days ago when the doctor was prescribing something for my wife. You start typing in the name of the drug and then auto complete gives you a list of possible drugs. Once you click on the drug, dosages come up and you click on one of them. It's very easy to click on the wrong one. The doctor should be forced to manually type in the dosage number.
I work in healthcare and have done a lot of work with e-prescribing systems (a Medicare mandate is slowly being phased in requiring doctors to use e-prescribing).
Based on what I've experienced and research I've read, e-prescribing is NOT more prone to errors, as the pharmacist tried to tell the OP. In fact it's WAY more accurate and has resulted in a lot less medication errors in the past few years.
As to where the OP says, "And don't count on it [e-prescribing] being quick; I had to wait 18 hours once before a basic antibiotic prescription made it through the system because of backlog on a busy Monday when lots of prescriptions are sent in to the system."
That sounds like an issue with the pharmacy's computer system, not the eRx system itself (which is a network connecting doctors and pharmacies) and could likely have happened with a phoned-in prescription from the doctor's office too. It sounds like the pharmacy itself had a backlog of prescriptions resulting in the delay, not the eRx network (which is real-time from everything I've read).
@keith4298: If the doctor were to be forced to manually type in the dosage, then you'd get entry errors. I think lots of studies of data entry systems have shown that keyed in data are more prone to errors then menu-selected, though I don't have specific details of this (just going from memory).
@formergr: Nope, they were able to fax it in about 3 minutes and it all went through.
And it's not just Costco...since telling friends about this I'm hearing that other pharmacies in town are also having more problems with errors with the electronic system.
@formergr: But auto-complete is a really silly idea when it comes to drugs. There are too many drugs that start with similar syllables.
Given that doctors were apparently able to write the correct names more often than not on a pad, they presumably should be able to type them in as long as an autocomplete feature doesn't erroneously guess something for them.
However, I could believe that menu selections would also be okay, provided it popped up drug info upon selection and required confirmation so the doctor couldn't click the wrong one on a list.
@Cocoa Vanilla: Costco never re-issues prescription drugs. In fact they took 100% of that loss and returned the drugs to CLS, a company that destroys them in an environmentally responsible method. They keep accurate records to back it up.
Hmm, is it scary to anyone that they took the pills back? I hope they threw them out rather than putting them back in the dispenser. The best course of action for Costco in this case would have been to just give Kimberly another bottle of 15mg pills. Sure, she'd have to take two for a month or whatever, but is that really much of an inconvenience?