I have honestly no idea where else to put this, so since it happened in a drugstore, it's going here.
I get a call this afternoon from a certain PBM (Pharmacy Benefit Manager). Won't name it outright since I still have hopes of going back to work for the pharmacy chain that owns it, one of these days, but let's just say that it's affiliated with the Chain of Very-large Stores. Note that I work in an independent pharmacy within a grocery in a very insular village, and we get very few customers from outside the village.
Them: "I have a client here who's looking to fill a prescription for Timoptic-XE, and they're having trouble finding a store who has it. Do you have that in stock?"
(Timoptic-XE is a beta-blocker for opthalmic use, for treating glaucoma. The generic came out a few years ago. The "XE" means it's a gel-forming solution, typically used at bedtime for longer action, but not usually in the daytime because it can blur the vision.)
Me: "Brand-name Timoptic XE, or generic timolol GFS?"
Them: "They're looking for the brand name."
Me: (checks wholesaler's website) "I don't have it in stock, but my wholesaler does, and I can get it in tomorrow. How much do they need?" (note: it comes in 2.5ml and 5ml sizes)
Them: "They need three 5ml tubes for a 90 day supply. We've authorized it for a vacation supply. It won't go through for that, you'll have to call us for the override when you fill it."
(Well thanks for the heads up, but this is beginning to look like it's going to be a pain in the neck.)
Me: "I suppose I can do that."
(Suddenly, I get an inkling. Something occurs to me to check...)
Me: "Wait, though. How much is the reimbursement for that?"
Them: "I can run it through on their plan and see what comes back. Hold a moment please... OK, the reimbursement is $315.27." (OK, I don't remember the exact amount, but it was in that range.)
Me: (checks price) "Well, since my cost for three tubes of the brand-name product is $455.82, I don't think I'll be ordering that. Sorry."
Them: "OK, thanks for your assistance. Have a nice day."
Yup, you read correctly. They actually expected me to fill this transfer prescription, for a patient who isn't even a customer of ours, and who moreover will require me to call them and wait on hold for them to put the vacation override through for him, and take a loss of over a hundred dollars on the transaction.
Not. Happening.
I get a call this afternoon from a certain PBM (Pharmacy Benefit Manager). Won't name it outright since I still have hopes of going back to work for the pharmacy chain that owns it, one of these days, but let's just say that it's affiliated with the Chain of Very-large Stores. Note that I work in an independent pharmacy within a grocery in a very insular village, and we get very few customers from outside the village.
Them: "I have a client here who's looking to fill a prescription for Timoptic-XE, and they're having trouble finding a store who has it. Do you have that in stock?"
(Timoptic-XE is a beta-blocker for opthalmic use, for treating glaucoma. The generic came out a few years ago. The "XE" means it's a gel-forming solution, typically used at bedtime for longer action, but not usually in the daytime because it can blur the vision.)
Me: "Brand-name Timoptic XE, or generic timolol GFS?"
Them: "They're looking for the brand name."
Me: (checks wholesaler's website) "I don't have it in stock, but my wholesaler does, and I can get it in tomorrow. How much do they need?" (note: it comes in 2.5ml and 5ml sizes)
Them: "They need three 5ml tubes for a 90 day supply. We've authorized it for a vacation supply. It won't go through for that, you'll have to call us for the override when you fill it."
(Well thanks for the heads up, but this is beginning to look like it's going to be a pain in the neck.)
Me: "I suppose I can do that."
(Suddenly, I get an inkling. Something occurs to me to check...)
Me: "Wait, though. How much is the reimbursement for that?"
Them: "I can run it through on their plan and see what comes back. Hold a moment please... OK, the reimbursement is $315.27." (OK, I don't remember the exact amount, but it was in that range.)
Me: (checks price) "Well, since my cost for three tubes of the brand-name product is $455.82, I don't think I'll be ordering that. Sorry."
Them: "OK, thanks for your assistance. Have a nice day."
Yup, you read correctly. They actually expected me to fill this transfer prescription, for a patient who isn't even a customer of ours, and who moreover will require me to call them and wait on hold for them to put the vacation override through for him, and take a loss of over a hundred dollars on the transaction.
Not. Happening.
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