I’ve about had enough with my local large chain pharmacy. Although I was introduced to pharmacies at my local town store growing up in Michigan (where I worked for 3 years as a teenager), I’ve preferred the big chain stores since I moved to NYC. Sure, there have been problems with this chain in the past, be it getting the Rx transferred to another store or consistently not having my Rx in stock (the same one I take monthly and come to you for every time), but the smaller pharmacies here scare me. This is especially so after counseling Medicare beneficiaries on Part D; some small pharmacies were running scams and totally screwing people over. At least with a chain store there seems to be mostly legal operations.
Recently though, I have been questioning my choice in pharmacies. This relates to the one prescription I do take on a regular basis, birth control. I’ve been on BC for about 10 years now. I started taking it because my periods were out of control; sometimes up to 3 months long and very painful. When I first got on the pill, I had to play around a bit to find the one that fit me well. The particular pill that was the winner was Estrostep FE. I’ve been using this pill steadily for about 7 years now.
About 5-6 months ago I went to pick up my prescription at the aforementioned chain store, and discovered that the pack they sold me was not my estrostep. It was the generic, which the pharmacy took the liberty of switching me to without my approval or even my knowledge. I spoke with my gynecologist at my next appointment. She seemed quite satisfied that I was taking the generic, as it was the same and less expensive (she was well aware that I did not have health insurance). I didn’t make anything of it because the generic didn’t really seem to make a difference (I was experiencing abdominal pain but we attributed that to my IC) and I was saving $10 each month (I cannot believe the generic still costs $55!).
Now, fast forward to last month. I went in to get my Rx refilled only to hear that they were out of my pills (again!). When I went back in, I picked up my Rx only to discover when I got home that it was, again, a different brand. I took them instead of going back, because a) I didn’t want to deal with it and b) I had already pushed back taking the pills a week (not to worry, no chances of getting pregnant currently). Whether it was due to the week I missed or this new brand, I had a horrible month of spotting and cramping. So, this month when I went in to refill the prescription, I specifically asked for the past rx. Here is a run-down of that conversation:
Insensitive Chain Store Pharmacist (ICSP): How can I help you?
Me: I would like to get my prescription refilled. They gave me brand x instead of brand y last time and I’m not sure why, but I would like brand y this time.
ICSP: So you want brand y?
Me: Yes, I did not like brand x. Is brand x also a generic for Estrostep?
ICSP: Yes it is. (types on computer). Okay, you do not have any refills on brand y…
Me: Why is that?
ICSP: (completing ignoring my question) …and we don’t carry it anymore.
Me: Can you order it?
ICSP: Yes, but not today I already put in the order today. You will have to call tomorrow and have them order it.
Me: So I can have them order brand y?
ICSP: Yes, but you don’t have anymore refills. You can have your doctor call in a new Rx.
Me: Wait, I’m confused here. The prescription was written in April, for 12 refills. It’s August.
ICSP: (looks into computer) You had it switched to this brand x, you have refills on that. Would you like me to fill that for you?
Me: No. I would like brand y. Why was the Rx switched?
ICSP: You didn’t request the switch?
Me: No, it was done without my knowledge.
ICSP: Well, you can call here tomorrow and explain the situation then.
Me: If they put in the order for brand y tomorrow, when will it get in?
ICSP: Friday
I left annoyed but contemplating my next step. Would I call the next day? I was leaving for Michigan right after work on Friday so would not be able to pick up the Rx before I left (and was to start the pills on Saturday – I did not want to miss another week). Also the price of brand x was pretty much the same as brand y. So, I didn’t call the next day. I didn’t want to deal with another pharmacist who talked in circles and didn’t want to do anything for me. I went back the next day, got brand x filled and am giving it another try. Who knows if the problems were caused by the new brand or by the pause in taking the pill?
Now I am not brand loyal in any respect (this is coming from someone who works for a pharmaceutical company). I have been under the impression that generics are really the same as name brands (with the exception of inactive ingredients). While this seems to be true, after researching this it seems that it’s not necessarily the case when it comes to
oral contraceptives. Furthermore, it alarms me that pharmacists are just changing to/between generics without the knowledge of the consumer. I know that, in most states, the pharmacist is supposed to fill a Rx with the generic if the MD doesn’t write
DAW. But if you’re used to taking one thing and get home with another, it’s confusing. This doesn’t seem to be illegal, but I think it’s definitely unethical. Sure, generics are cheaper and in most cases people (and insurance co’s) probably would prefer them, but it’s seems so underhanded to make a switch without the patient’s knowledge. Apparently, this has been a problem with young women on
BC in Canada.
Mostly, I think I am just annoyed with the cold, unfriendly customer service of these large chain pharmacies. Okay, I give you that it is in NYC, which is busy and wouldn't know what customer service is if it hit the whole city over the head. But, what are people to do in these situations? The pharmacist gave me some answers eventually but seemed unwilling to actually do anything other than the simplest thing he could do. This is the problem with US Healthcare being a market-driven commodity. If you rely on customer service to deliver much needed care, you're going to inevitably lose quality of care. No doubt the pharmacies are thinking about profits over helping people in any real sort of way.
