medtipster

All supermarket scenarios aside, Ginger Skinner at the Consumer Reports Health Blog sums up how the app can benefit you:

Bottom line: My Medication Tracker can help you take control of your medication and health history, and will also improve your communication with your doctor. At your next doctor's appointment, bring a printout of your medications and ask your doctor, "Do I really need to take all these medications?" It's likely your doctor is unaware of all the medications you're taking-especially if you're seeing several doctors and specialists. Your doctor may even recommend you stop taking unnecessary or duplicate medications or dosages-which can not only help cut costs, but can also keep you healthy and prevent potential drug interactions.

My Medication Tracker requires a password to access your data, and doesn't report anything back to the Consumer Reports mothership or leave any cookies or hidden tracking software on your computer. Yeah, CR looks out for regular people like that. That's why we like them.

"My Medication Tracker" [Consumer Reports]

The company is accused of aggressively marketing four drugs to doctors for "off-label" uses, or prescribing a medicine for a use for which it hasn't been explicitly tested and approved by the FDA. And by "aggressively marketing" we mean "taking doctors on vacations and feeding lavish meals while handing over huge metaphorical sacks of cash."

In financial filings in January, the company had indicated that it would pay $2.3 billion over allegations it had marketed the pain reliever Bextra and possibly other drugs for medical conditions different than their approved use. The civil settlement announced Wednesday also covered Pfizer's promotions of three other drugs: blockbuster nerve pain and epilepsy treatment Lyrica, schizophrenia medicine Geodon, antibiotic Zyvox and nine other medicines. Pfizer said the agreement with the Justice Department resolves the investigation into promotion of all those drugs, plus several related whistleblower lawsuits.

Under terms of the settlement, Pfizer must pay $1 billion to compensate Medicaid, Medicare, and other federal health care programs. Some of that money will be shared among the states: New York, for example, will receive $66 million, according to the state's attorney general, Andrew Cuomo.

There's nothing wrong with off-label use of medicines, but there's plenty wrong with aggressively marketing medicines to physicians for off-label use.

Pfizer to pay record $2.3B penalty over promotions [Boston]
Pfizer settlement: Be wary of off-label drug use [Consumer Reports Health]

(Photo: wadem)

The first is that the FDA doesn't require Lexapro's makers to statistically back up their claim that Lexapro is more effective than Celexa, which is basically Lexapro's parent. (Forest Laboratories changed the molecular structure of Celexa, which was about to lose its patent protection, in order to create Lexapro in 2002.) In fact, Forest has even used this near-interchangeability to its financial advantage:

The F.D.A. views the two medicines as so interchangeable that the agency recently approved Lexapro's use in depressed adolescents based in part on the results of a study Forest conducted using Celexa.

The second is that sales of Lexapro are on the wane, and correspondingly Forest "has been recently raising the price." But, "Many doctors say they believe that Lexapro is the best antidepressant, so they prescribe the drug despite its cost."

"Document Details Plan to Promote Costly Drug" [New York Times]
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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)

From the NYT:

Like many other people, Ms. Krinsk thought that her prescription information was private. But in fact, prescriptions, and all the information on them - including not only the name and dosage of the drug and the name and address of the doctor, but also the patient's address and Social Security number - are a commodity bought and sold in a murky marketplace, often without the patients' knowledge or permission.

This could apparently change if a little noticed portion of the stimulus bill that bans the sale of health information in most cases is enforced. The NYT says the law also prevents your pharmacy from marketing new drugs to you on behalf of the pharmaceutical company, a practice that is already illegal in California.

Still, the law doesn't prevent companies from selling "anonymous" health data — and it's apparently not that difficult to "reidentify" the users — which is probably what happened to the consumer mentioned above.

So... just make sure not to have any health conditions that you might want to keep to yourself. Ok?

And You Thought a Prescription Was Private [NYT]
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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)

Fuze Slenderize
Advertising for Fuze Slenderize energy drinks was allegedly misleading consumers with claims that the drinks would cause appetite suppression and/or weight loss. (Consumerist was suspicious of Fuze's advertising claims years ago.) If you bought a Slenderize drink between July 16, 2004 and April 6, 2009 (July 16, 2002 and July 15, 2004 in New Jersey) You can claim for fewer than ten bottles without proof of purchase. Fill out the form here. Deadline: July 10, 2009.

T-Moble Early Termination Fees
If you were charged a flat-rate early termination fee instead of a prorated one when canceling your T-Mobile contract between July 23, 1999 and February 19, 2009, you're eligible. However, you're also eligible if you happened to be under a T-Mobile contract with a flat-rate ETF during that period, whether you canceled the contract or not. The claim form is located here. Deadline: September 25, 2009.

450 Prescription Drugs
The suit alleges price-fixing among major pharmaceutical companies, and consumers who paid cash (between 8/1/01 and 1/23/09) or percentage-based co-pays (between 8/1/01 and 3/15/05) for any of 450 name-brand drugs (PDF link) are eligible. Evidence such as receipts or a doctor's letter is recommended, but not required. Get the claim form for your class here. Deadline: July 9, 2009.

Bextra and Celebrex
The suit claims that Bextra (which is now off the market) and Celebrex were marketed in a way that was not consistent with their FDA approval. If you paid cash or a co-pay for Bextra or Celebrex before July 29, 2005, you're eligible to file a claim. Deadline: October 23, 2009

GE Microwaves (warning: site immediately plays video with sound)
A number of GE microwave owners have experienced scary, scary problems with their appliances, including control panel failures, arcing, fires, pet deaths, property damage, and the microwaves turn themselves on for no reason. They are looking for other people who have experienced similar problems and are interested in a class action suit.

(Thanks to Top Class Actions for some of this info, and our lovely readers for the rest!)

(Photo: muffet)

Wikileaks reports that the Web site for the Virginia Prescription Monitoring Program was defaced last week with a message claiming that the database of prescriptions had been bundled into an encrypted, password-protected file.

[...]

Whitley Ryals said the state discovered the intrusion on April 30, after which time it shut down Web site site access to dozens of pages serving the Department of Health Professions. The state also has temporarily discontinued e-mail to and from the department pending the outcome of a security audit, Whitley Ryals said.

Here's the full text of the ransom. Why can't hackers be a bit more elegant and well spoken in a James Bond Villain sort of way?

ATTENTION VIRGINIA

I have your shit! In *my* possession, right now, are 8,257,378 patient records and a total of 35,548,087 prescriptions. Also, I made an encrypted backup and deleted the original. Unfortunately for Virginia, their backups seem to have gone missing, too. Uhoh :(

For $10 million, I will gladly send along the password. You have 7 days to decide. If by the end of 7 days, you decide not to pony up, I'll go ahead and put this baby out on the market and accept the highest bid. Now I don't know what all this shit is worth or who would pay for it, but I'm bettin' someone will. Hell, if I can't move the prescription data at the very least I can find a buyer for the personal data (name,age,address,social security #, driver's license #).

Now I hear tell the Fucking Bunch of Idiots ain't fond of payin out, but I suggest that policy be turned right the fuck around. When you boys get your act together, drop me a line at hackingforprofit@yahoo.com and we can discuss the details such as account number, etc.

Until then, have a wonderful day, I know I will ;)

"Hackers Break Into Virginia Health Professions Database, Demand Ransom" [Washington Post via Slashdot] (Thanks to Chris!)
"Over 8M Virginian patient records held to ransom, 30 Apr 2009" [Wikileaks]
(Goblin statue: tanakawho)

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)

Iron County Deputy Wade Lee says two of the men admitted to being illegal aliens. The driver said he's been delivering prescription drugs for a company called "Nevada Courier" for several months. Lee explains, "He said ‘I was sitting at home and somebody called me and paid me $150 and a tank of gas to drive these medications down here and drop them off.'"

Police say the men are from Las Vegas. They had made a delivery in Mesquite, two in Saint George, and their fourth delivery would have been in Cedar City. Lee says, "I called Wal-Mart and they said yeah they were expecting a delivery and the driver was late."

We called Wal-Mart with some questions. In an email statement, a Wal-Mart spokesperson writes, "This situation is unacceptable to Wal-Mart. We maintain strict standards for courier companies that transport products for us. As this was a situation involving a contractor, your questions would need to be addressed by the courier company or the police."

Iron County Sheriffs say what's frightening here is the safety of Wal-Mart pharmacy customers. Lee says, "You don't know if they opened the box, no tamper seals, nothing... so you never know what you're going to get I guess."

And now you know how Walmart keeps their drug prices so low.

Illegal aliens delivering drugs to Wal-Mart [ABC4]

The program will last through the end of 2009, and is offered every weekday between 11am and 3pm. You can find the nearest clinic on this page. If you need cheap meds, check out Walmart's $4 Prescriptions Program to see if your drug is on their cheap list.

"Walgreen giving free care to jobless and uninsured" [Associated Press] (Thanks to Jesse!)
(Photo: simon_music)

A campaign will hit DC's streets too promoting comparative effectiveness research, which tests what which drugs, devices, and procedures are the most effective and the least risky.

If you're in DC you can get a free copy at Union Station or different Metro stops, or read it online for free.

Also, if you're in DC cruise by Union Station and gawk at two guys dressed in giant pill costumes on exercise machines getting monitored by Consumer Reports testers, representing our rigorous drug research and testing. Hey, laughter is the best medicine, right?

Best Drugs for Less [Consumer Reports Best Buy Drugs]

Kathy says:

I was picking up prescriptions for my 11 year-old son (who had pneumonia) at the Target pharmacy and was given the bag, asked if I had any questions for the pharmacist, I said “no” then paid and turned to leave (it was approximately 9 p.m.).

I looked in the bag before leaving—I was about 5 steps from the pharmacy counter, and I realized I had better ask a question about the odd looking box inside I had never seen before. Since the last time I had given my son nebulizer treatments at home, the medication had changed.

So, I turn and tell the female Target pharmacy employee that I DO in fact have a question about my prescriptions and I noticed the “iron curtain” had been pulled down behind her indicating the closure of the pharmacy. They must have pulled that down fast as I turned to ask the question in mere seconds after leaving the counter. The female then told me to “come back tomorrow at 9 a.m. We are closed.”

I didn’t pay her any mind and proceeded to take the medication out of the sack and proceed with my questions hoping she could answer them. She told me that she didn’t know the answer and repeated to me, “come back or call tomorrow at 9 a.m. I told her that I couldn’t do that as I was heading home to give my son the medication immediately and I couldn’t do that if I wasn’t sure what or how to give it. Well, she didn’t budge or even offer to get the pharmacist from behind the iron curtain. I was pretty much denied access to the pharmacist because it was something like 9:01 p.m.—after official closing time.

Kathy says she complained to the Minnesota Pharmacy Board (they were apparently horrified) and to Target itself. Target's response was to remind her of the closing time of the pharmacy.

It seems like Kathy has the situation well in hand, complaint wise, but she might consider letting Target's CEO know about the incident.

(Photo: imasuperhero )

When the drug program began in 2006, Humana's premiums were among the cheapest. Humana, Mr. Noland said, has provided the most cumulative value for its drug-plan members, saving them an average of $4,900 on drug costs during that time and that the premiums are still in line with rivals.

The drug plans are heavily subsidized by the federal government and are offered through private insurance companies. Insurers will begin advertising their plans Oct. 1, and the six-week enrollment period starts in mid-November.

It's unclear how the price increases will affect the market. Medicare beneficiaries tend to select a plan and stay with it, and the market is highly concentrated.

"Medicare Drug Premium on Rise" [Wall Street Journal]
(Photo: Getty)

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)

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)

No word yet on whether Target and Kroger (who also offer a $4 drug program) will match Walmart's new offer. Midwest grocery store chain Meijer offers some commonly prescribed antibiotics for free with a prescription.

Wal-Mart offers more low-priced drugs [Reuters]
(Photo: Aaron K Smith )

We travel full time, so to get our prescription meds we have used Walgreens, because they transfer prescriptions to any of their stores. In Dec of last year I had a prescription filled (for high blood pressure) at a Walgreens store in Dallas...I noticed that the pills looked different, but thought they must have changed to a generic. When I finished that 90 day supply, I got a refill at a Walgreens in Florida. Now the pills were back to what I'd taken for years...an oval green pill. I had 2 left in the old bottle, white round pills...not what that bottle label said they were suppose to be. Acckk! So now I had taken 3 months of the wrong mystery medicine.

I checked the PDR, no matches...I went to the local Walgreens and they couldn't identify it. Nor could the Poison Control Center. The local Walgreens gave me a phone number for Walgreens Corporate office, which led to another phone number and another, climbing the corporate ladder, finally speaking to the CEOs office (but not the CEO). I couldn't get anybody to understand that this was serious...that the pills needed to be identified, that it was important to know what I had taken, who else might have gotten the wrong med, how had this happened and more importantly what was being done to assure this wasn't still happening.

I tried to explain that if this had been a case of product tampering it would have presented like this...a pill not matching the description on the label. That in a case of product tampering people could have died waiting for their corporation to respond.

It ended up taking Walgreens six weeks to get the pill identified. It was a generic allergy pill that was a Wall Mart brand. There was no explanation of how it got in a Walgreens bottle. No explanation about any of this. And no assurances that they have improved any part of their system.

I wanted Walgreens to tell me what had happened... and what they were doing in the future to deal with this sort of mistake. People faced with this situation should immediately be given access to a person or department who will take this seriously. They should not have to wait SIX WEEKS to have a medication identified. And it should not have taken so much persistent effort on my part. Walgreens should have recognized this as an immediate problem, and responded quickly... with concern for my safety and others. They did not and have not done that.

When patients hit the donut hole, all sorts of bad things can happen. First, switching to generics introduces the risk of new or worse side effects. But some patients—according to a recent AARP study, about 15%—stop taking their prescriptions altogether, or else they rack up huge credit card debts to continue paying for the drugs.

Sometimes a patient can score free samples of the drugs he's taking, but unfortunately the value of these "free" drugs won't count toward his annual overall expenditure, so the patient remains stuck in the donut hole, and has to start paying against it again once the Free Drug Train leaves the station.

The New York Times quotes one study that says 23% of patients could avoid the donut hole if they started with generics at the beginning of the year. But to do this, you have to talk to your doctor about your personal financial situation, which can be difficult. One study found that

four of five [patients] wanted doctors to discuss medication costs, but fewer than one in five doctors did. One in three patients in the study who cut back on their drugs because of cost said they had never asked their doctor for help in reducing expenses.

"Usually I'm a little blind to it if they're in the doughnut hole," Dr. Epperly said, "mainly because they're proud people, and they feel their obligation isn't to share that with the doctor."

the cheapest approach in the short run might be to forgo Part D insurance altogether. Instead, they could simply shop at discount retailers like Wal-Mart, Costco and Target whose pharmacies offer low-cost generics for as little as $4 for a monthly prescription.

"Strategies to Avoid Medicare's Big Hole" [New York Times]
"There Are Alternatives: Insuring to Bridge the Gap or Opting Out" [New York Times]

RLEATED ITEMS
"Find & Compare Plans that Cover Drugs" [Medicare]
"Seniors in Part D donut hole unlikely to have gap coverage" [Managed Healthcare Executive]
"5 Ways to Lower Your Costs During the Coverage Gap" [Medicare]
(Photo: Getty)

Incidentally, Zocor is the cholesterol-lowering drug that recently lost its patent protection, leading to a burst of business for the generic version of simvastatin and a steep drop-off in profits for competitor and market leader Lipitor. (For the record, Lipitor is a third kind of statin, called atorvastatin.) Pfizer, the maker of Lipitor, has been trying hard to persuade consumers to not switch to generic Zocor—maybe now they have a new bit of ammo to use in their argument, at least for those who aren't getting any rest.

"Sleepless? Maybe it's your statin" [Reuters]

RELATED
"Pfizer Launches Campaign To Warn Users Away From Generic Competitor"
(Photo: Getty)

One of strongest claims Pfizer is making is that patients who switch have a higher risk of death, but the in-house study they cite is being criticized by doctors:

But independent researchers say that limitations in the study, which was conducted by Pfizer's own researchers, gives it little predictive power about what will happen to patients who take simvastatin instead of Lipitor. And they say the study is far less important than large clinical trials that have shown simvastatin's effectiveness at reducing cholesterol.

Of course, your doctor will know better than a blog whether you should switch:

For patients with extremely high cholesterol, Lipitor may be a better choice. An 80-milligram daily dose of Lipitor, the top dose, can reduce cholesterol by up to 60 percent, compared with about 50 percent for an 80-milligram dose of simvastatin, also the top dose."

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)

(b) LIMITATIONS- A prescriber may not—

(1) require purchase of contact lenses from the prescriber or from another person as a condition of providing a copy of a prescription under subsection (a)(1) or (a)(2) or verification of a prescription under subsection (a)(2);

(2) require payment in addition to, or as part of, the fee for an eye examination, fitting, and evaluation as a condition of providing a copy of a prescription under subsection (a)(1) or (a)(2) or verification of a prescription under subsection (a)(2)

Fairness to Contact Lens Consumers Act (FCLCA - H.R. 3140) [Eyetopics] (Thanks to Hustler Moneyblog!)
(Photo: Ninjapoodles)

Here's a tip about pharmacies; we all have a minimum price that we charge for prescription drugs. It doesn't matter how cheap the drug is. The drug could cost less than a penny, and we would still charge that minimum fee. At my pharmacy, that fee is $10.99. At most pharmacies, the fee is comparable as well.

We do this for two reasons. One, it's illegal for an insurance company to charge you more than the store price for a prescription drug. Most insurance companies have a $10 copay for generics. So, when you get your 30 hydrocholorthiazide or atenolols, the insurance company can charge you $10.00, even though the actual price of the drug is closer to $2.00. This is because the pharmacy would charge you $10.99, so the insurance company gets away with charging you "less" that what we would charge you.

Secondly, it's done to recoup losses in other areas, like theft, loss, damages, and non-reimbursement. Our friendly way of passing the charges on to you.

So this has two implications. One, most of those $4.00 generics are drugs that actually cost less than $4.00 for a thirty day supply. Two, there's a crafty way to get around the price increase.

First things first: make sure your drug is actually cheap. If you're getting ANYTHING that's a brand name, it's not cheap. Most anti-depressants aren't cheap. A few that are: Generic Xanax, Ativan, and Valium (alprazolam, lorazepam, diazepam). Generic Vicodin. Lower strength lisinopril (and anything that ends with -pril, for the most part.) Hydrochlorothiazide. Levothyroxine. Atenolol.

Then, tell your doctor to write your prescription for 90 or 100 pills at a time, rather than 30. Then, tell your pharmacy that you don't want to file the drug on your insurance. We'll give you the cash price of the drug, and because you're getting so many, you probably won't end up paying the minimum charge. 120 hydrochlorothiazide costs 12.04. 30 costs 10.99, which translates out to a 10.00 copay on mosts insurances.

The best part is, there's nothing illegal about this. You're not committing fraud or being even the slightest bit immoral. You're just beating the system.

We're not sure about the details of these details—do the $5/month premiums pay for largely pointless "limited benefit" plans? What deductibles are being eliminated, exactly?— but it's a step in the right direction.

There are still some valid criticisms. Wal-Mart Watch points out that low wages and long waiting periods (before qualifying for insurance) mean that for a large group of employees, these plans are still unaccessible, and that the new plan is better seen as more of an upgrade for current insurance holders. Too, the cheapest plans have ridiculously high deductibles, which render them fairly useless for low-income families. But others note that it could drive other companies to improve their plans. One benefits consultant says the $4 generics are "game-changing for the industry."

"Health Plan Overhauled at Wal-Mart" [New York Times]

According to the FDA, most brand-name drugs receive patent protection for 20 years, though there is a large lead time between the submission of a patent and the sale of a drug. Most drug companies enjoy their patent protection for only seven years, at which point generic drug makers, who do not need to recoup the cost of development or marketing, step in and offer the same drug for a third of the price.

The Senate Health, Education, Labor and Pensions Committee will mark up the proposal on Wednesday. — CAREY GREENBERG-BERGER

Lawmakers Offer U.S. Plan for Generic Biotech Drugs [Bloomberg]
Write Your Senator
(Photo: e-magic)

Best Buy Drugs

One way to protect yourself is to see if the site caries a seal from Verified Internet Pharmacy Practice Sites (pictured at right), a certification program overseen by the National Association of Boards of Pharmacy.

Drugstore.com, for instance, is a VIPPS member and can offer savings up to 30%. A complete list of VIPPS site is supposed to be found here, but the page is giving a 507 error at the moment. — BEN POPKEN

Save Money on Prescription Drugs by Buying Online [Money via Free Money Finance]

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!)

That's basically what United Health Care had CVS tell Kelly when she went to get a scrip filled. Kelly has taken the meds for three years. Her past two insurance companies covered the prescription without fail.

Now United Health Care has decided the drugs are too pricey, and, "...since a generic is not available, they've decided the best way to prevent paying too much for their clients' medication is to put limits on how many pills they'll pay for per client, per month," she writes.

Kelly needs to take 1.5 pills per day, 45 pills per month. United will only cover 30.

That's not the worst of it.

The pharmacist told her that if the pills are a medical necessity, as they are, she should have her doctor call the insurance company and explain the need for the medicine.

Kelly said to the CVS pill pusher, "An authentic written prescription from a medical doctor is not proof enough of medical necessity but a phone call with no real explanation will make giving me 15 more pills OK?"

The white coat affirmed this was correct. In addition, if United ultimately determines not to cover the 15 pills, the cost would be $50.

This practice seems pretty ridiculous and arbitrary on United Health Care's part but we have to ask, if you're going to switch providers, shouldn't you find out whether they cover the medicine you'll be needing?

Kelly's letter is inside.

Kelly writes:

According to Consumer Reports Drug Companies have several tactics for delaying the release of generic drugs into the marketplace.

Here are a few of them:

• Legal Hassles: The FDA allows any person or company to file a citizen petition challenging generic-drug approval. Drug companies exploit the system by filing frivolous complaints. These complaints delay the approval of the generic and the drug company remains the only game in town. Neener, Neener.

• Bribes: Brand-name drug companies bribe generic-drug companies to stay out of the market. Who wouldn't want to get paid to do nothing?

• The Walmart Technique: Drug companies repackaging their own products and going head-to-head with existing generic manufacturers, muscling them out of the market by reducing profit margins until there is really no point.

This is the sentence where we'd give you advice about what to do, but there really isn't anything. Ha-ha. Drug companies win again.

"Wal-Mart is not discounting generic drugs in general—it offered the $4 price on 291 of the several thousand generic drugs commonly available.

Further, even a casual look at Wal-Mart's initial list revealed just 124 different drugs (later increased to 143).

So where did the 291 come from? One needn't have looked past the letter "A" to see: 12 different variations of the common antibiotic amoxicillin. Many other common drugs appear in multiple dosages, including some already available at other stores for less than $4."

12 flavors of amoxicillin? Doesn't amoxicillin usually cost like 7.99, anyway?

Also, let us remind you of the fact that Kmart already has a $5 a month generic drug plan. Wow, a whole dollar cheaper? Walmart, what will you think of next?

"Kmart stood by its existing plan, which offers a 90-day supply of selected generic drugs for $15. Kmart said its plan covers more than 185 medications and is expanding.

The company said that, while Kmart shoppers will pay $1 more per month for generic prescriptions, they only have to go to the pharmacy once every three months and can save money in gasoline costs for each trip to the store."

Wal-Mart counters, "Whatever, bitch. $4." Target responds, "Yeah, what Wal-Mart said." Then Wal-mart and Target stole Kmart's Hostess Cake and ripped off the head of Kmart's favorite Han Solo action figure. They were not sorry.