1) ReadyFill is a voluntary opt-in program for maintenance medications to be refilled when you're about to run out. Nearly every pharmacy has something like it, CVS took it company wide in the middle of last year. It's a fine idea in theory.

2) You receive a call when it's ready (which is actually three days after it's filled in the case of ReadyFill prescriptions since they're filled slightly ahead of time). If any filled prescription is not picked up, a reminder call is made on day three and day seven. Most people like this.

3) There are also two other types of calls that happen. There are robo-calls that supposedly remind people that medication is due to be refilled. This sucks because the pharmacy has no idea who is getting robocalled, and this person will usually call the store up and talk to a confused technician who can only guess at what you might need refilled. These calls are also apparently misinterpreted that the medication is ready, which it's actually not so sometimes people come in expecting to pick it up and are upset when the pharmacy has no idea what they're looking for.

4) The second type is store-generated calls about refill reminders. The criteria used to be that a maintenance medication had to be coming up due for refill and there also had to be at least one medication that was overdue. Earlier this year they added a category of just overdue medications. In high volume stores, this can be over 100 people that have to be called. Every single employee hates these. They're incredibly stupid because people generally stop taking a medication for a good reason, but we're supposed to ask people if they want to refill it. One store once called a customer that had died. Oops.

5) Okay, back to ReadyFill. What happened at the start of this year is one of the internal performance metrics for each store became the percentage of prescriptions enrolled and filled by the ReadyFill program. Since this (officially referred to as the Execution Scorecard) actually affects things like pharmacist (and upper management, natch) bonuses, a few stores took it upon themselves to automatically enroll *everything* that they could possibly enroll in this program, regardless of whether the customer wanted it or not and of course without their knowledge. I know this happens beacuse my father fills his medications at a store different from the one I work at and when he tried to refill his drugs over the phone the automated system told him it was already finished. He didn't seem to mind it but I know there are customers who are going to be livid over this, and it's just to satisfy an internal metric. Oh, and the refill reminder calls in #4 are also part of store execution, which is the only reason stores bother with them even though they're hated.

I approached my district manager with the fact that the store was auto-enrolling prescriptions, which I felt could be an issue down the line. He didn't care because as soon as they started doing that, they started making the number needed to satisfy the metric.

Please, please, please, if you are annoyed with the phone calls or were enrolled in ReadyFill without your knowledge, take it to corporate, not the store. It's a pipe dream, but if enough people call and say that they're pissed off by what they view as "world class customer service programs," (really it's "sneaky ways we fill your prescription and hope to collect insurance payment plus your copay") maybe they'll cut back some. I would even go as far as to threaten to take all your business to another pharmacy if the calls continue.

PREVIOUSLY: "Why Is CVS Automatically Refilling My Prescriptions?"
(Photo: bubble dumpster)

Rite Aid had its own similar natural remedy, Germ Defense, which was sold and marketed in its stores alongside Airborne. The FTC went ahead and charged Rite Aid with false advertising, and now Germ Defense customers are entitled to refunds.

The manufacturer of Germ Defense, Improvita, has also been charged with false advertising. If you bought Germ Defense tablets or lozenges, you're eligible for a refund of the value of up to six packages of the supplement. From the FTC's press release:

Like Airborne Health, Inc., which settled deceptive advertising charges with the FTC last
year for marketing its effervescent tablets as a cold prevention and treatment remedy, Rite Aid will settle similar charges for selling a purported cold-and-flu remedy under its private label. Rite Aid will pay $500,000 for consumer redress under the agreed-upon final order. The company is required to post a refund notice, along with postage-pre-paid refund request forms, in a clear and conspicuous location in the cold-and-flu aisle at each of its stores for 60 days beginning on October 1, 2009. Consumers will have until December 31, 2009 to submit refund requests for up to six packages of Germ Defense.

Also under the settlement agreement, Rite Aid may not claim that any Rite-Aid-label version of Airborne, or any Rite-Aid-label food, drug, or dietary supplement can reduce the risk of or prevent colds or flu, reduce the severity or duration of colds, or boost the immune system unless the claims are truthful, not misleading, and substantiated by competent and reliable scientific evidence.

Rite Aid and Improvita marketed several flavors of Germ Defense lozenges and tablets as
dietary supplements that contained vitamins C and E, zinc, and echinacea. They claimed the products could reduce the risk of or prevent colds and flu; protect against or fight germs; reduce the severity or duration of a cold; protect against colds and flu in crowded places; and boost the immune system, according to the complaints. The FTC charged that there is inadequate evidence to support these claims.

If you're eligible, make sure to wander by your nearest Rite Aid and pick up those forms in October. And be wary of the health claims made about any supplement that aren't backed by actual, like, science.

Rite Aid to Pay $500,000 in Consumer Refunds to Settle FTC Charges of False and Deceptive Advertising [FTC] (Thanks, Mary!)

(Photo: el_en_houston)

We have also shared with all of our pharmacy departments that this is an unacceptable practice and should not be repeated. At Sam's Club we always have the health and welfare of our customers and members in mind with everything we do and we deeply regret that this incident occurred.

You can read the full response over at Salisbury News.

(Note: Joe says Sam's Club gave him permission to publish the email, so you can ignore the "privileged and confidential" warning at the bottom of it.)

(Photo: Joe Albero/Salisbury News)

It took three calls from CVS' automated reminder service for me to realize what was going on: CVS Pharmacy was refilling our prescriptions without our asking for them to be refilled, and then their automated dialer was calling us to notify us that we had a prescription waiting. Nobody in my family requested to have a prescription refilled, yet three times CVS called us to tell us to come and pick up our prescription.

Bill is not impressed by this service, which CVS calls "Ready Fill" and which is intended as a convenience both for the customer and the pharmacy. He writes,

When my wife went in to our local Washington, DC CVS to ask about this she was told 1) a lot of people are complaining about CVS' auto-notification system, 2) there's nothing they can do about the robo-caller since it's a system that the company, not this store, initiated, and 3) the doctor wrote these prescriptions with instructions that they be automatically refilled. Say what? Our doctor did no such thing – he didn't write the prescriptions with instructions that they automatically be refilled every 30 days. (One of the medicines was a seasonal allergy medication that obviously wouldn't be refilled in the winter.)

We couldn't find much information about Ready Fill on the CVS website, but this post on a student doctor forum suggests that it's opt-in, but that a lot of times the program isn't sufficiently explained to the customer when he opts in. (We imagine it's also possible that some CVS pharmacies opt in their customers automatically, but we hope that's not the case.) There are also problems with unwanted refills when a prescription changes. Here's the forum post:

If a patient has a monthly prescription that has refills, s/he is eligible for readyfill. This means that in our system we will automatically fill the prescription without us having to call the patient or the patient having to call us to ask for a refill. Basically a few days before the patients prescription runs out, our computer will tell us to fill the rx so all the patient has to do is come in and pick it up. Readyfill is meant to help people who sometimes don't call in their refills till the last minute or people who sometimes just forget to call their refill in.

But truthfully readyfill, from what i have noticed, brings up more problems than it solves. I get a lot of people who say they want readyfill but 1 month later they're angry/confused as to why they are getting an automated call about a prescription being ready that they never called in. Also if there is a dosage change, or a prescription is no longer being taken, or a patient has changed pharmacies, someone has to notify us to take it off or that rx will still be on readyfill and we'll get the angry/confused calls.

So here's the deal: if you get your drugs at CVS and don't want the Ready Fill experience, pay them a visit and ask to have it removed/turned off. If you like the convenience of not having to remember to get your prescriptions refilled, don't forget to contact them if the prescription changes before you're out of refills. And if they won't or can't turn it off and you don't want it, take your prescriptions somewhere else.

(Photo: Lee Nachtigal)

The pharmacist on duty at CVS tells me they got a call from CVS Corporate, instructing them to bill only Medicare B (B pays 80% for imunosuppressants) and to "not" bill secondary insurer N.J.P.A.A.D. (New Jersey Pharmaceutical Assistance to the Aged and Disabled), but to bill me instead. $296.47 for 1 month supply of Prograf.

The pharmacist said it is because P.A.A.D. has never paid their portion for the 21 months I've been on the medication.

I asked for a rejection printout and she told me they couldn't do it because it will come out "APPROVED!!!" No name of who called. No printout. Just some ghost at CVS corporate.

To me, it's a problem between CVS and N.J.P.A.A.D. Part of my kidney transplant evaluation was to prove that I could get my anti-rejection meds paid for. I know of people with full time jobs and what they thought was "good" insurance, get denied transplant surgery even though they had a donor only because they couldn't get the meds paid for!

He wrote back this morning with an update:

P.A.A.D. tells me that CVS has been billing the entire amount instead of the 20%. P.A.A.D. will email CVS corporate and clear things right up! LOL I have 4 days of anti-rejection meds to hold me over.

(Photo: strangelv)

The group Change to Win released a report Thursday claiming that 58 percent of 310 CVS stores surveyed in nine U.S. markets this spring were selling at least some expired products, including at least a third of CVS' 31 stores in Fairfield County, the only Connecticut region included.

The group released a broader report on CVS in December, taking aim at the chain for its pricing, store location decisions and unequal access to condoms from store to store, among other things.

CVS complains that Change to Win is picking on them because they won't let workers unionize. They might be right, but we don't really care. It's a distraction from the real issue: CVS is still selling expired products.

CVS Stores Criticized In Report By Labor Group 'Change To Win' [The Hartford Courant]
PREVIOUSLY: NY AG Will Take Legal Action Against CVS & Rite Aid For Selling Expired Milk, Baby Formula
(Photo: pixeljones)

He wrote, in part:

I don't know how many people are affected by this, but I bet quite a few. I'm certainly annoyed by it. I've been taking Prozac for years. I remember how nice it was the day it went generic (fluoxetine hcl) and my prescription drug insurance cost went way down. It's been generic for a long time now.

United Health Care has a three tiered prescription drug program. Tier 1 for generics (the cheapest, was $8 now $10 for 30 days supply), Tier 2 for name brand ($25) and Tier 3 for optional stuff like Viagra ($40). That was how it used to be defined anyway. Now it seems they can put any drug in any tier they want. As of last August my generic Prozac went from Tier 1 to Tier 2. I asked them why and they just said that sometimes drugs change tiers.

As many people take this, I'm surprised there hasn't been more of a backlash. I used to have 2 generic Tier1 prescriptions and one name brand Tier 2 (Lipitor), for a total of $41 per month. (8+8+25). Now I have two Tier 2 and one Tier 1 for a total of $60 per month (10+25+25).

It just makes me mad that they are so greedy.

We don't normally have time to answer every question on the tipline, but I had some extra time that day. So I wrote B. back, telling him about the $4 generics program at Wal-Mart, Target, and some other stores. I remembered seeing fluoxetine on the list, and behold, there it was. I advised him to fill his prescription at Wal-Mart without using his insurance card.

A few weeks later, he wrote back:

I just want to thank you for your reply. I was not aware of the deals available at Wal-Mart on fluoxetine and triamterene/HCTZ, both of which I use. Now, instead of paying $33.99/month for these two items thru my United Health Care prescription drug plan, I can pay $20 every 3 months by not using any insurance at all! It turns out that even though the fluoxetine is a $25 Tier 2 UHC drug, Walgreens "only charges $23.99 for it because that's how much they sell it for". So they save me $1.01 and think I should thank them.

I've been thinking about it since, though. It's been a few years since I've filled a prescription with an insurance card. I remember Target charging me just the $4 generic cost instead of my $10 co-pay, I wasn't sure whether Wal-Mart and other stores had this policy, and even whether it was still done that way, so I advised him not to use his insurance.

Have you switched to a store that carries $4 generics since stores started this policy?

(Photo: jm3)

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)

I am stunned by what happened to me with Walgreens. I moved to a new town and needed a prescription and decided to go to Walgreens. I was pretty unfamiliar with the process for having a prescription filled and I received excellent service from the pharmacist. They answered all my questions and made sure I understood the precautions with taking the prescription.

That was all well and good but today, about a month later, I got something in the mail from Walgreens. It was a HAND-WRITTEN card written and signed directly by the pharmacy manager. It said "Thank you for choosing Walgreens for your recent prescription. We hope you will continue to use Walgreens for all your pharmacy needs." She included her card and a Walgreens magnet. I was extremely impressed with this nice gesture and I absolutely will use Walgreens in the future for my prescription needs.

We don't want to bring you down from your up-with-people high, but pharmacists pretty much have to explain how to take the drugs, Mike. However, the hand-written note is a really nice touch.

(Photo: freddthompson)

Pattie says:

Today I picked up my medication from CVS Pharmacy, it's something I've taken for a couple years now so I'm familiar with what the pills are supposed to look like. When I got home with the bottle of pills and went to take one, I found that they looked all wrong. My pills are blue oval pills and rather large. These pills were small round gold pills. It's written on the bottle what they are supposed to look like, and the bottle said, "blue oblong tablets." I have never noticed this description before but I now see (looking at old empty bottles) this has been on there for some time. I wonder how many other people don't read the description.

I returned to the pharmacy with the bottle of pills and the pharmacists seemed confused but not concerned or terribly apologetic. They did say they were sorry, but that did not explain to me how this happened. What if I couldn't see? I'd have taken these mystery pills and who knows what could have happened to me. Don't pharmacies have double check policies to make absolutely certain that what is in the bottle is the proper medication? How often does this happen?

It's hard to actually know how often this happens — because pharmacies are not required to report errors to any regulating agency.

A 2007 20/20 investigation found that "in more than one in five cases, chain pharmacies made some type of error in filling their prescriptions," which, of course, is totally terrifying.

ABC says that none of the errors that they found were as severe as yours, (they were never given the wrong medicine) but their report apparently saved someone's life. A mom saw the investigation and checked her son's meds — only to find out that he'd been on the wrong pills for three weeks.

Ramirez said she filled her son's prescription for a drug called Tegretol-XR, which was prescribed to treat her son's mental health problems, on March 15 at her local Walgreens. But her child's condition worsened, and his doctor told her to increase the dosage.

It was not until a friend suggested she view the recent ABC News "20/20" report on pharmacy errors on The Blotter on ABCNews.com that Ms. Ramirez thought to double-check the prescription.

To her horror, instead of Tegretol-XR, Walgreens had given her Toprol XL used to treat high blood pressure in adults.

Apparently, had this gone on for much longer, it might have been fatal.

So pharmacy errors happen. Drugs sound the same, doctors scribble, and pharmacists don't have magical bad handwriting deciphering powers. They're also human beings who make mistakes.

Consumer Reports Health has some tips for preventing pharmacy errors from harming you or your family. Check them out.

Prevent drug mix-ups [CR Health]
Results of the ABC News '20/20' Undercover Pharmacy Investigation [ABC News]
New Pharmacy Error Found at Walgreens [ABC News]
(Photo:Spidra Webster)

Nearly all of Houston has no power and most has no water. Even though my upstairs ceiling caved in, my manager at Walgreens said "you're scheduled to work and are expected to be here."

That's the message that he had left. When i called the store back to let them know there's no way in hell that I'm showing up, I luckily spoke to my friend Ms. Curtis, an assistant manager. I told her the situation and she then told me her situation. On Saturday, Mr Hudson, the store manager, called her to tell her that she needed to be there at the store on Sunday. She told him that she couldn't get out of her driveway due to a massive tree that was now in her driveway.

Mr. Hudson's response was, "You don't have a neighbor with a chainsaw ?" Ms. Curtis is a little person. She's a dwarf. 3' something tall, and he suggests to her to borrow a chainsaw to move a tree from her driveway so that she can come to work during a natural disaster.

I see no point in our store being open because we were out of all the supplies that could be useful to anyone on Thursday night.

So if you need 3 for 1 pantyhose packs, electric nose-hair trimmers, bouncy balls, or singing Hallmark Christmas houses, come on down to Walgreens in Houston, TX. Their automatically-opening doors stand ready, awaiting your patronage.

(Photo: cycle60)

His response was "Whatever, somebody needs to come deal with this because I'm about to go off..."

"You're about to 'Go off?', I asked him."Do you really think that's the best thing to say to a paying customer?"

And at this point, with his back turned to me, the young man muttered "Fucking AIDS freak."

Read J's full story of how it got to this point, and CVS' meager response, below.

Here's J's full email, for those of you who want a more detailed story:

In what has been one of the most horrifying experiences of my entire life, I have had a dreadful recent encounter at my local CVS. Ironically one of the other worst customer-service related mishaps I've ever had was at a CVS as well, though not the same one...

I was in my local CVS in Philadelphia getting my partner's prescription filled. We are a gay male couple and my partner is HIV+. The medication, Atripla, is HIV related. We are both currently on a medicaid-related health insurance plan, a situation that is new to us and directly related to his current health issues.

I had in hand a coupon from the local paper that awarded me a $20 gift card if I transferred a prescription to CVS. I had actually used the coupon the day before for another prescription, as it says you can do use it multiple times (just not on the same day.)

On this particular day they were having a very hard time getting through to the other pharmacy to put the transfer through. The staff was also particularly snide and unpleasant; more so than usual, at any rate.

After the fiasco of getting the actual transfer put through, when the young man attempted to ring me up and process my coupon, something went wrong in the computer. Another employee came by to try and figure things out, and they determined that the coupon was not acceptable for those with Medicaid.

I got a little agitated because they weren't being particularly polite about it, and I tried to explain that I wasn't specifically on Medicaid proper, but on a related plan. I also pointed out that I had just used the same coupon the day before. They then called over another young man who was apparently a manager. His actual position in the store is still up for debate; he appeared to be a front-of-store manager who was doing some work in the pharmacy area.

He walked into the situation with an extremely aggressive attitude. He wouldn't allow me to actually SAY anything or discuss the situation with him, and it was clear he was taking an "I know what I'm talking about, I know what you're up to, and I'm going to nip this in the bud" kind of stance with the whole thing. I was getting impatient, embarassed and frustrated. The whole of the staff back there were just glaring at me, and I was extremely perturbed.

My inclination in these situations, which seem to happen more frequently these days, is to try and be rational and direct without being rude. I said to this young man "You know what? I don't think you're handling this very well or being very polite, and I'd like to speak to someone else about this."

His response was "Whatever, somebody needs to come deal with this because I'm about to go off..."

"You're about to 'Go off?', I asked him (probably exacerbating the situation, I admit.) "Do you really think that's the best thing to say to a paying customer?"

And at this point, with his back turned to me, the young man muttered "Fucking AIDS freak."

I have to be honest with you: I'm 30 years old, and in all of my adult life - with all of the bigotry and hatred I have encountered in various forms and situations - this was the absolute most shocking and flabbergasting thing that has ever happened to me.

It was one of those situations where I was so stunned and slack-jawed that I had no real faculties to handle the situation. It's the kind of anger that silences you while your body tenses up and you try to control the shaking that's coming from the inside out.

By this point a woman, the manager of the pharmacy, had approached me and asked - stone faced - if she could help. I told her that if her employees felt comfortable speaking to customers they way they just did, and in her presence, that I didn't think she COULD help because obviously they felt doing so was okay. I asked her to void my prescription transfer and I left.

When I got home I immediately called a different CVS location and asked for a number to call to file a complaint. I called a local "headquarters" number and left a complaint on a voicemail for a district manager. I also called the general 800 number for CVS and left a complain with the customer service person. I was told the general manager of the store, Anthony, was on vacation until Monday.

On Monday, Anthony did call me back. Our conversation was brief and typical of what I expected. I was told that he would investigate the situation, and that if what I described did, in fact, happen, it would be dealt with. But that basically he couldn't promise anything other than that if I ever came into the store again and something similar happened, I should ask to speak to him directly.

I can tell you now that nothing really came of the situation. The young man still works at that CVS, and I have done my best to simply not go there anymore. As it is located only 2 bocks from my apartment, and is the only 24-hour estalishment in the area, I do still go occasionally, hating myself every step of the way.

I don't know what I expected CVS to do. I suppose - and I say this laughingly - an apologetic gift card might have been nice. But the real point is, is there any real resolution to a situation like this? Other than having the guy on video or audio tape, he's obviously going to deny that it happened, and his co-worker chums - presuming they heard what he said (as that one part is probably the only "fireable" part of his lousy customer service) - didn't seem the types inclined to get involved.

There's no real great way to wrap up this report. I guess the great lesson is, people can still be complete douchebags, and sometimes there's nothing you can do about it.

J, you may want to try writing a complaint letter and mailing it to the executive headquarters in Rhode Island—here's a list of their executives. (We looked for executive phone numbers and email addresses in their SEC filings, but couldn't find any.) Some people will never stop being complete douchebags, but it's likely your complaint never made it past the district manager, and since it wasn't adequately resolved at that level, you should take it higher.

(Photo: Getty)

Here’s how it works: Many health insurers contract with PBMs to administer their drug plans. Among other functions, the PBMs negotiate lower drug prices with pharmacies. But some PBMs, under a practice allowed by Medicare, then charge a higher price to health insurers and, ultimately, both the government and patients. Though the opaque practice is common in the private insurance market, Medicare currently has a proposal to curb it, because the agency is worried the tactic, by inflating patients’ drug costs, is speeding their pace toward the “doughnut hole” coverage gap.

The differences between what the PBMs pay pharmacies and what they charge the plans can range from a few dollars to well over $100. In one case, a Medicare patient filled a prescription for a 90-day supply, or 270 pills, of the generic antinausea medication prochlorperazine. The difference between what the PBM, Express Scripts, paid the pharmacy and the price that showed up on the patient’s explanation of benefits was $146.53.

Well, that seems high. The PBM told the WSJ that mark-ups over $100 are rare, and that the money is used to help " fund programs that drive patients away from branded drugs and toward generics that ultimately still cost less."

Generics Are Cheap, but They Could Be Cheaper [WSJ Health Blog]
(Photo: Daquella Manera )

The article says,

The most common, widely publicized conflicts have involved pharmacists who refuse to fill prescriptions for birth control pills, morning-after pills and other forms of contraception. They say they believe that such methods can cause what amounts to an abortion and that the contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes. The result has been confrontations that have left women traumatized and resulted in pharmacists being fired, fined or reprimanded.

In response, some pharmacists have stopped carrying the products or have opened pharmacies that do not stock any.

"This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable," said Karen Brauer, president of Pharmacists for Life International, which promotes a pharmacist's right to refuse to fill such prescriptions. The group's Web site lists seven pharmacies around the country that have signed a pledge to follow "pro-life" guidelines, but Brauer said there are many others.

"It's just the tip of the iceberg," she said. "And there's new ones happening all the time."

Virginia does not have any laws or regulations that would prohibit a pro-life pharmacy, and is not considering adopting any, according to the Virginia Board of Pharmacy.

Critics also worry that women might unsuspectingly seek contraceptives at such a store and be humiliated, or that women needing the morning-after pill, which is most effective when used quickly, may waste precious time.

"Rape victims could end up in a pharmacy not understanding this pharmacy will not meet their needs," said Marcia Greenberger of the National Women's Law Center. "We've seen an alarming development of pharmacists over the last several years refusing to fill prescriptions, and sometimes even taking the prescription from the woman and refusing to give it back to her so she can fill it in another pharmacy."

Everyone has their own personal beliefs regarding human reproduction. However, when it is your job to provide health services to the public, we don't understand how those beliefs are more important than the customers'.

'Pro-Life' Drugstores Market Beliefs [Washington Post]
(Photo: Getty)

CBS explains the scheme,

To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs. But it doesn't bother to set price-ceilings on rarely-used versions.

Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.

The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each. Walgreens figured it could pocket millions by switching patients from tablets to capsules.

The article also says,

By gaming the system, Walgreens managed to change over almost all Medicaid customers from cheap generic Zantac tablets to pricy capsules.

In Florida alone, it cost taxpayers an extra $1.2 million the first year.

And the pill-switching went on for several years nationwide, including other prescriptions: generic Prozac (fluoxetine) for depression, and generic Eldepryl (selegiline) for Parkinson's.

Walgreens denies wrongdoing and declined to be interviewed. But they recently agreed to pay back the government more than $35 million.

And they're not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more. The whole pill-flipping episode proves just how imperfect some drugstore chains can be.

Whether Walgreens' pharmacists are secretly mocking you, or just being so incompetent that they prescribe a drug that causes a miscarriage, it seems they can do nothing right. Hopefully, this little multi-million dollar fiasco they've created will be a catalyst for change at the woeful pharmacy, but we won't hold our breath.

Walgreens Accused Of Scamming Taxpayers [CBS]
(Photo: Okasan1)

The report’s findings track with similar studies by the federal Drug Enforcement Administration, which has found that roughly seven million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants.

The Florida report analyzed 168,900 deaths statewide. Cocaine, heroin and all methamphetamines caused 989 deaths, it found, while legal opioids — strong painkillers in brand-name drugs like Vicodin and OxyContin — caused 2,328.

Drugs with benzodiazepine, mainly depressants like Valium and Xanax, led to 743 deaths. Alcohol was the most commonly occurring drug, appearing in the bodies of 4,179 of the dead and judged the cause of death of 466 — fewer than cocaine (843) but more than methamphetamine (25) and marijuana (0).

The study also found that while the number of people who died with heroin in their bodies increased 14 percent in 2007, to 110, deaths related to the opioid oxycodone increased 36 percent, to 1,253.

Florida doesn't track prescription drug purchases like other states, making life mindlessly easy for prescription drug addicts.

The lesson here is throw-out unused prescriptions, and be suspicious if your Xanax-munching friend keeps talking up impromptu trips to Disney World.

Legal Drugs Kill Far More Than Illegal, Florida Says [NYT]

Frank writes,

The other day I went to pick up my prescriptions at my local CVS #1323 in Cressona Pa. The weather outside was about 97 and very humid. I looked forward to going inside in hopes of cooling down a little bit.

I got inside the mall which was nice and cool. When I got into CVS I was hit with nothing but heat. As I made my way back to the pharmacy I could swear it was getting hotter and hotter.

I got to the pharmacy counter and noticed all the employees had thier usual labcoat attire off and they were sweaty. I took a glance at the digital thermometer they had there and couldn't believe my eyes. The thermometer said it was almost 93 in there!!! 93!!

That brought some questions to mind which I relayed to the pharmacy staff. How are all the medications stored back there still good after being kept in those kind of temps? How long exactly has the AC been broken and why hasn't it been fixed yet?

I didn't get many answers. The only thing I got was the following, "The AC has been broken for over a year and a half now. CVS is too cheap to buy an air conditioning system. It is like this every year and they don't care!!" That was told to me by a sweaty employee, which brings another question to mind. How safe is it exactly to have human sweat dripping on the overheated medication they are dispensing?

After seeing that and losing about 10 lbs in the process from sweating, I asked to have my prescription transferred to another pharmacy. I hope this little bit of info comes in handy. I am sure others around my area would like to know how their meds are stored and what the people have to work in that are handling their meds.

We doubt the sweat is that dangerous, but it's certainly gross to imagine a big fat salty drop of brow sweat falling into a pill bottle right as the cap's being screwed on.

(Photo: Getty)

Ok, so we had an "accident" with our condom. We decided before it was too late to purchase the famous PlanB at a local CVS pharmacy. When we got there the pharmacist requested a "state issued I.D.". My friend is visiting so she does not have a state-issued I.D. so she showed her Colombian citizenship ID that clearly shows her date of birth as well as her picture and signature. The pharmacist did not even look at it and rejected it because it was not a US-issued I.D.

So I told her, "What if someone is here illegally and is raped? Would that mean they don't have the right to buy Plan B?" She kept saying "It's the law." I got really mad and told her that was absurd. Then I told her that I had a state-issued I.D. and she said that it could only be purchased by the person who is going to take it, which basically means it can only be sold to women.

So we went back home and I searched online for information about purchasing Plan B, and I found on the FDA's website that as long as you are over 18, you can buy it, no matter if you are a male or a female.

I printed this information and headed back to the pharmacy. I confronted the pharmacist and told her that the law protects me as a consumer and that I had the right to buy the pill. She did not even look at the information I had printed and kept saying "It's the law."

We ended up buying it from another CVS pharmacy in the area. The pharmacist there was very polite. At the beginning she did not know that the law allows ANYONE over 18 to purchase it but she did not have a problem verifying her age with a foreign-issued ID.

Please publish this story. People need to know their rights. Thank you Consumerist!

We sympathize with you both. It sounds like this CVS pharmacist put you through a lot of trouble for no good reason because according to the FDA's website, a man or woman can purchase Plan B if they are 18 or older and does not mention the exclusion of foreign identification. From the FDA's website:

7a. How can I purchase over-the-counter Plan B?

In order to purchase Plan B over-the-counter, personal identification showing proof of age (18) is required. Plan B will be available behind the counter at the pharmacy in order to manage both prescription (17 years and under) and OTC (18 years and over) dispensing. This means Plan B will not be sold at gas stations or convenience stores, where other OTC products are routinely available.

7b. Can men purchase Plan B? (added 12/14/2006)

Yes. Plan B OTC is approved to allow OTC availability of Plan B for consumers 18 years and older. Plan B remains available by prescription only for women 17 years and younger.

We're happy to hear that the second CVS store accepted the foreign ID, even though neither store was aware that it could be legally purchased by a man of legal age. You should talk to the head pharmacists at both stores and inform them of the FDA's rules regarding Plan B. Also contact the store managers and let them know that the pharmacy is not operating within the FDA's guidelines. If that doesn't help then keep moving up the chain of command until the problem is acknowledged and corrected. You could also file a complaint with the California State Board of Pharmacy. It might sound like a lot of trouble but doing so will help ensure that others won't have to endure similar headaches.
(Photo: Getty)

CVS wrote in asking that we forward their contact info to Rachael. We did.

Rachael writes:

Ok, so I emailed Mike, the director of public relations at CVS back after he wrote to you requesting to get into contact with me. I let him know that I was emailing because I was at work and could not make a personal call until around 6PM. He immediately wrote back and arranged for a Customer Service Supervisor call me after 6.

Sure enough, approximately 6:30, I received a call from them. Unfortunately, I don't recall the young lady's name but she was actually very pleasant. She said that they appreciated my candid post on The Consumerist and that they were happy I was so honest. I couldn't help but think that all these people read where I said "Fuck you CVS" and I kind of felt bad. I told her this and she said not to worry - that nobody took offense and they probably would have responded in much the same manner given a similar experience.

I was surprised that they read The Consumerist and she mentioned that they have several customer service reps browsing various similar blogs as well.

We chatted briefly about my experiences in the store and she asked if I'd had other problems. I told her that getting a prescription is no problem and purchasing things off of the shelf is not a problem (other than the painfully long lines) but the only problem is honestly when you try to get some help (getting razor blades or photos).

She said that the district manager was notified of the issue and that the store manager was as well and that they would be taking care of it. She also informed me that they would honor the 15 cents per print photos and that they were mailing me a CVS giftcard to make up for the frustration.

So all's well that ends well. They were very helpful and gave me a couple telephone numbers and email addresses to address any future concerns.

I must say I'm surprised - albeit pleasantly. I didn't think a big faceless corporation like CVS would care what I thought about two poor experiences I had in their store. Now there are going to be those saying that they bought me off, but I don't think so. I was there Tuesday to pick up a prescription and had no problems. It was a service issue with a store I frequent and I would have continued shopping there (just not for photos or blades lol). But in any case, I'm happy, they are happy and it's all over for now.

Perhaps this weekend I will try again for the photos....

Thanks Consumerist.

Hey, kudos to CVS. Don't feel guilty about complaining Rachael, anything that makes access to razor blades at CVS even a little bit easier is considered a service to your fellow man.

(Photo:Vince Brown (attila))

I wanted to tell you of a good resolution I had at the Seattle, Rainier Ave. Rite Aid pharmacy in Seattle, WA.

First, little background. I have Celiac Disease. It's an immune response to wheat, specifically the wheat protein gluten. This is an issue for prescriptions because some medications use wheat products to bind the pills. Even a spec of gluten can make a celiac sick for a few days. It's not a terribly rare condition because 1 in 130 people in the USA have it.

I went to go get a prescription filled at the closest pharmacy, which was the Rite Aid on Ranier Ave, in Seattle, WA. As I was filling out paperwork to get in their system, I told them I had celiac disease, and could they double check to make sure my medication was gluten free. This is a pretty run of the mill request. I have been a nurse since 1998, and I have had to call in this kind of prescription before I even knew I had celiac disease myself. It's a very basic.

The gal at the counter had to have me repeat myself multiple times, which is okay, it was early morning. However, she still doesn't even understand my request, and starts asking the pharmacist if this medication has "glubellium". The pharmacist looks annoyed, and says he doesn't know. I put on the brakes, and tell her that I can't get that medication then, because I can't have gluten in me. The pharmacist just shrugs, and the gal takes my filled out paperwork and starts putting me in the computer, ignoring me.

I ask again, that there has to be a way to check. Celiac is not that unusual a condition. They continue to show me the bottle, and say there isn't any way to check. Then, the gal asks to help the folks behind me, ignoring the fact that I can't even get the medication if I can't be sure it's gluten free. The pharmacist starts filling my prescription, and I am exasperated.

I tell them don't fill the prescription because if they can't tell me if it's gluten free, I don't want it. The pharmacist looks really irritated by now, and says, "I suppose I could call the manufacturer. That could take a few days." I just start walking out, and tell him I will go to a pharmacy that can deal with celiac disease. There are places that know if there is wheat products in my meds.

I then go home, and call the Kelley-Ross Pharmacy in downtown Seattle. They are flabbergasted that a pharmacist would not look this up for me, and laugh at the Rite Aid guy. Needless to say, I go get my prescription filled down there. They even show me the medication insert to make sure it all looks safe. The nice insert that accompanies most medications, and shows all the inactive ingredients. (When I work in facilities as a floor nurse, often those insert papers come attached on bulk meds we get, so I knew they existed, while at Rite Aid.)

When I get home I write an angry but polite email, containing pretty much what I wrote here.

Flash forward to today.

I just got a call from Billy who is the pharmacy district manager for Seattle. He wanted to contact me to make sure I knew that not being able to tell if a medication was gluten free, is not acceptable. They have a Clinical Service Line, that contains that information, as well as all sorts of other stuff. He was especially hard on the pharmacist for not wanting to even initially look it up. He said he thought only "blind stupidity" could be the reason this happened. The pharmacist in question is out for vacation, but he is going to talk to him when he comes back in. Billy agreed this is a pretty common request, and over all seemed stunned that his pharmacist could have done this.

He was also very cool, and said he understands that I get my medications elsewhere now, but if I ever decided to come back, they will be able to handle gluten free medication. He also talked about some of the PDA supported software that you can use to check the gluten free status of meds and foods.

Overall, I am very happy at this. Billy didn't make any excuses, and took credit for the situation. The pharmacist involved will be retrained, so the next celiac that comes in won't have to deal with what I did. That's the kind of apology, that makes me think I will keep shopping at Rite Aid, although my meds are still set up at Kelley-Ross. My husband still has his medications at Rite Aid, and I am no longer in any big hurry to change that.

It made me very happy to know that the corporation does care that its customers are taken care of.

He also shared some advice with the customer on how she can be better prepared to deal with similar situations in the future—so if she runs into another couple of ignorant pharmacy employees, she can answer her own questions about gluten. And finally, he invited her back. Result: he may not get her business in the future, but he effectively cauterized the wound, and can be certain she won't bad-mouth Rite Aid to other potential customers.

Maybe it's too expensive to train employees to have that much emotional intelligence, but it would be nice if businesses would at least screen for that natural ability in customer-facing new hires.

What do you think—still not enough? Or did Billy handle this the right way?

RELATED
"Dancing Deer Apologizes For Blondie-Encrusted Metal Spear"
(Photo: Getty)

Several trade and professional groups support the idea, including the National Community Pharmacists Association and the National Association of Chain Drug Stores. The FDA points out that pharmacists have the necessary training to educate consumers about how to use certain drugs, and that a BTC category would help people without health insurance gain access to certain medications.

The one huge down-side we can see to this: big pharma will start targeting pharmacists with freebies and samples to pass out to customers—we can imagine going to get a BTC drug in 2009 and being met by a pharmacist wearing more pieces of "Ask Me About [Drug Name]" flair than Jennifer Aniston's nemesis at Chotchkie's.

"FDA explores behind-the-counter drug sales" [Reuters]

RELATED
"US FDA Considering 'Behind-The-Counter' Drug Status" [CNN Money]
(Photo: Getty)

We're glad. Controlling fungus should be affordable enough for everyone. Lamisil used to cost $337.

Also getting a price chop: a fertility drug and two forms of birth control, a move that the NYT says is meant to lure young women into the store. You can now pick up your reproduction related drugs for $9 a month. Other big box stores have similar programs if you're not into Walmart. Kmart has a $15 (for a 90 day supply) program. Meijer offers free antibiotics.

The only drawback to Walmart's cheap generics? Controlling your deep urges to buy Walmart's other products. Huge jar of Vlasic pickles... your siren song is impossible to resist.

Wal-Mart Adds Drugs to $4 Program [NYT]
(Photo:Ms. Jessica)

The Plastic Bag Reduction Ordinance, written by Supervisor Ross Mirkarimi and Co., sponsored by six other supervisors, gives major supermarket chains with more than $2 million in annual sales six months to make the switch to biodegradable bags. Pharmacies and retailers with at least five locations have one year. Violators face fines of up to $500.

If you don't live in San Francisco and want to do your part, don't throw your bags away. Most stores even offer a negligible discount to consumers who reuse their bags. — CAREY GREENBERG-BERGER

Paper Instead of Plastic for San Francisco [Canyon News]
(Photo: Zainub)

Simply type your first and last name into the online form, and it creates a printable card usable at many major chains and independent pharmacies. There's a field for email address but you can type NONE if you don't want email updates.

Go here to see which drugs, and how much, you can save on.

At the bottom of the printable page are computer codes and instructions for using the card with various pharmacies.

We thought this was too good to be true but we checked around and it seems legit, despite how janky the page looks. The card is sponsored by the non-profit United Networks of America and has been covered in USAToday, Self, and other reputable publications. Can't see a catch yet, but let us know if you see one. — BEN POPKEN

Free Drug Card [Official Site] (Thanks to Jason!)

Guess which one represents which party...

She writes, "What I don't want is the blank stares, the curt answers, the reluctance to answer simple pharmaceutical questions about side effects and such, and I certainly don't want to be kept waiting as my prescription languishes on a shelf because two pharmacy staff members can't decide which brand of mayonnaise is better in a bowl of potato salad."

She just wants to walk in, get her scrip, pay for it and walk out. Is that so hard? Apparently, yes. Since sending the letter in January and receiving no reply, she now drives "many miles" out of her way to CVS.

Her letter, inside.

January 20, 2006

Walgreens
David Bernauer
200 Wilmot Road
Deerfield, IL 60015

Dear Mr. Bemauer:

I am writing to express my deep dissatisfaction with the customer service I have received at multiple Walgreens locations in both northern Minnesota and around the Twin Cities area. I have been getting my prescriptions filled exclusively at Walgreens for over ten years. At this point I'm not sure if the convenience of a nationwide pharmacy network is worth the problems that I've had, which I will now enlighten you with.

Without fail, Walgreens has some of the worst customer service on a regular basis that I've ever experienced. It doesn't seem to make any difference which store I visit, I'm always greeted with the same rudeness, ignorance, and unapologetic apathy from both pharmacy staff and the regular retail employees and managers. The retail employees' attitude I can understand. I've been there. I worked in retail for many years. I remember being an underpaid teenage retail worker and I have reached a point where I fully expect to be treated poorly from these people. The pharmacy staff, on the other hand, surprises me. For a bunch of diplomaed professionals, they sure are a cranky lot.

I don't know if they're underpaid, overworked, or if this attitude has trickled down from the corporate level. Frankly, I don't care. All I want to do is walk in, get my prescription refill (which I have already submitted via wallgreens.com), pay for it, and walk out. What I don't want is the blank stares, the curt answers, the reluctance to answer simple pharmaceutical questions about side effects and such, and I certainly don't want to be kept waiting as my prescription languishes on a shelf because two pharmacy staff members can't decide which brand of mayonnaise is better in a bowl of potato salad.

I can honestly say that to this day I have not once had a good customer experience at a Walgreens store. Why do I keep going? Laziness, I suppose. Perhaps it's a sort of self-flagellation. Maybe somehow I've been conditioned to accept this behavior over time.

Sincerely,
[PikaPikaChick]

C.C.: Jeff Rein, President and COO

—-

Note that this letter was sent in January. Haven't heard a peep out of anyone at Walgreens since then. I, like JPac, have been happily driving many miles out of my way to get to a CVS and their almost ludicrously good customer service."

Oh, but he has a voice, and he sent us a great little rant about Walgreen's pharmacies. The opening line is just killer:

So I and my parents go into Walgreen's for some prescriptions and overhear the pharmacists talking about how their customers are all B*tches, and how they wish the people would just die...

That's certainly the sort of attitude you want to see people parcelling out medication, isn't it? By comparison, JPac thinks the CVS employees are effusively delightful, the model of excellent service.

His email, after the jump:

So I and my parents go into Walgreen's for some prescriptions and overhear the pharmacists talking about how their customers are all B*tches, and how they wish the people would just die... Now you can still get your medication but they would rather see you die than provide you with something I like to call customer service. When I walk up to the counter to give them my prescription slip they are more than happy to take my slip, pretend they can read the writing on the slip and say okay, it will be ready in 30 minutes or whatever. so it makes it all that much more fun when you go back 30 minutes later and find out they still haven't found the time to fill my prescription let alone anyone else's who is standing in line... sure it could be that they just totally suck at estimating time, or from what I have been overhearing the pharmacists in the background cursing all of humanity, they just want a break, or have way too many prescriptions to fill, or way to few pharmacists. And the story is no better with their automated phone system, even if you give them a day, they would rather ignore the phone refill system entirely than give you your prescription than actually fill them for when you need them.

Now it could just be the only problem Walgreen's has is rude pharmacists, but its not. now if you try to find some employee in the store to help you find some items in the store.. you might as well buy a lottery ticket, you have a better chance of winning the lottery than finding an employee anywhere to help you, and you better avoid the pharmacists even if they aren't busy they will basically just tell you to go to Hades. Usually at the Walgreen's in my area there are only 3 employees you can see, the 2 pharmacists and the poor person massively overwhelmed at the cash register, all who would rather you go away than ask them for any sort of customer service.

However there is a completely different story when I head over to my local CVS pharmacy, I quite literally have never seen better customer service, its like an ACE hardware store, there are always employees wandering the Isles checking to see if you could use some help or even advice, something I never find in any Walgreen's that I have ever been. The pharmacists are incredibly nice too, they will make sure you have everything you could possibly need, and won't hesitate to help you with anything you need, even if its not prescription related. The people at the cash registers are friendly too and when they ask you if you were able to find everything you were looking for they mean it. If you tell them there was something you could not find, they will go out of their way to help you and see if that item/items are in the store or recommend places where you could find what you are looking for. I have switched all my prescriptions over to my local CVS Pharmacy, what they say about customer care in the commercials they have on TV is 100% true, they really do have superior customer service.

In conclusion I say
Walgreen's you suck!!!
CVS Pharmacy You Rule!

Thank you.
John aka JPAC

(Thanks for listening to my little rant consumerist, I just had to get this off my chest)