The Pharmacy Technician Blog

We’ve seen the number of oxy/roxy calls go down a bit, but they’re being replaced. Instead, the same people (or at least the same ‘type’ of people) are asking for Percocet or Dilaudid.

I guess they’re starting to get the picture. We’re being told from our supplier (and anyone else in the know that we can get information from) that this shortage is expected to continue for several months, possibly toward the end of the year.

In any case, we’re handling it the same way - ’sorry, no gots.’

The clerk came back with the blue slip in her hands and snickered “I don’t know, she said something about her Afghanistan drops,” and walked away laughing. We all waited to see what the pharmacist would discover in the customers profile.

Yes, sure enough, the customer requested a refill for her Afghanistan drops. Eye drops, that is. Or Alphagan, depending on how you would like to pronounce it.

We all laughed. That one has to go in our ever-growing list of fumbled medication names. Techs and pharmacists have enough trouble pronouncing brand names and generic names for medications, and customers understandably have a harder time. But it’s always fun to hear what some customers can come up with.

Here’s something I can’t explain - Topiramate recently came available as the generic for Topamax. The cost of it is very low. But why?

Usually, when a new generic becomes available, the price is only slightly less than the brand, let’s say 10%. The reason is because the brand still has some ‘price protection.’ And then about six months later, the price of the generic will go way down, possibly aslow as to 10% or 20% of the cost of the brand, which may or may not go down in price at all.

But as soon as Topiramate was available to us, the price was already at that very low cost. What happened to the six months of price protection? Did our supplier not have it available during that period? Unlikely, we usually have things available immediately, especially a fairly common drug like Topamax/Topiramate.

Was there some litigation regarding the release date or cost of the generic vs the brand? Most likely. But why does this happen to some drugs and not others?

I know very little about drug patents and pricing with respect to generics. The problem is, no one else seems to know anything either. Not the pharmacists I speak to or even company reps - when pressed, even they don’t know why these things happen.

I could easily go off on a rant about drug pricing, but all I’m talking about here is consistency, which the drug industry does not have. For the drug manufacturers and insurance companies, it’s all about money and nothing else.

The calls come every day. 10, 15, 20. They’re looking for Oxycodone. They always say the same things - they’ve been calling all over the place and no one seems to have it.

It’s been many weeks since the problem started, but people don’t want to accept it. Which, of course, makes us believe that most of these calls are exactly the people that don’t really need the Oxycodone. They just want it. Or are selling it. Which is most likely the point of this apparent shortage of Oxycodone.

Sometimes they even show up in person, bringing in the prescription with them. 9 times out of 10 we can identify them as they walk in the door. “No gots” we say to ourselves. They’re almost always the same type - young guys in their 20’s who could probably handle pain ok, yet don’t seem to be struggling with any. But they do have a prescription for a couple of hundred Oxycodone. Sorry, no gots.

Here are a few mispronunciations for relatively common medications :

Coudamin = Coumadin
Fonisopril = Fosinopril
Panatol = Patanol
Fenofexadine = Fexofenadine

All of these are understandable and believable. If you’re not in the business, who can tell the difference?

But how about Splenda? A customer asked for a refill of Splenda. They meant Plendil. That one’s pretty good, I think.

We noticed something unusual today. We found Lotrel labelled capsules in a bottle of the Lotrel generic - Amlodipine/Benazepril. It wasn’t just an accident on our part (ie someone returning capsules to the wrong bottle), but rather they were from a sealed bottle from the manufacturer. Furthermore, other bottles had them as well.

Now, if you’ve studied the concept of Misbranding, you would certainly come to the conclusion that this is such a case. Someone thinks this is legal, as the company that manufactured it did this intentionally. In most cases there would be no harm in it, but in the next few posts I’m going to give my case as to why this has to be illegal.

Now we start to see the flip side of the Donut Hole.

We’ve gotten through the end of the year, explaining how the Donut Hole works for hundreds of customers (who will forget when later this year their regular monthly prescriptions suddenly skyrocket again …) and seeing that many were taking less of their medications to save money or foregoing them altogether.

And now we are presented with a new problem.

Many of these people expect their once affordable monthly copays to come back when they suddenly realize … they haven’t!  “What!” they say, “my copay should be $5, I’m out of the Donut Hole!”

But … “It’s a new year, do you have a deductible” we ask. “Well, yeah…”

Well, there you go. We can’t entirely blame the insurance companies. Presumably, these customers knew about the deductible, right? Sure, about as well as they understood the Donut Hole. When it comes to health insurance it’s Caveat Emptor.

Of course, people interested in becoming a pharmacy technician wonder what the salary is. Well, there’s good news and bad news.

Here’s the bad news - the salary of a pharmacy technician is not great. It’s comparable to other service-level jobs, which of course depends on where you live.

But here’s the good news - the pharmacy technician salary stands to rise in the future, and faster than other jobs. Why?

1. The pressures put on pharmacists have been growing for years and their roles will continue to grow and change. That means that the demand for techs will grow. Pharmacist salaries have been one of the fastest growers of any professions and that too will continue, with techs also seeing a commensurate rise.

2. Increasing standards for pharmacy techs will increase pay. States continue to add pharmacy technician standards like certification, licensing or required training programs. This will have the longer-term effect of raising pay.

3. Anything in the medical/healthcare field will be growing anyway. Use of medications and prescription drugs is expected to increase dramatically and consistently for the foreseeable future. Pharmacists are already in short supply, and pharmacy technicians will be in demand for years to come.

Here’s some more good news - the benefits aren’t too bad. Just to use myself as an example - I get paid vacations (2 weeks this year), health insurance, a 401k, a few paid sick days, and a store discount. I don’t have dental or vision coverage with my insurance, however. I also don’t have prescription coverage, but I get a pharmacy discount of just above cost for any medications. And this is with a small independent pharmacy, larger retail chains have even better benefits.

There are also other environments than retail for pharmacy technicians. Hospitals, closed-door pharmacy, laboratory, assisted living facility and military pharmacies may all have equal or better benefit packages and pay.

It is a good time to break into the field as it is growing and before the competition gets fierce. Some sources have already put pharmacy technicians as one of the fastest growing professions. It is a relatively easy field to get into (right now anyway) with decent pay and benefits (although not spectacular) and prospects for the future are excellent with many possible career paths beginning as a pharmacy technician.

I started working as a pharmacy technician in April. After I had been there a few months, I started hearing this phrase ‘the donut hole.’ Being a fan of donuts (and donut holes) I remember asking “what is this donut hole and how do I get in it,” seeing as how it sounded like a good place to be for me.

Of course, the realities of the ‘donut hole’ are nothing at all very tasty. It is the gap in Medicaid coverage when the copays for medications skyrocket. When a patient accumulates enough costs, they come out the other side of the ‘donut hole’ into what is called ‘catastrophic’ coverage, and their copays go way down.

The problem is, too many people get into the donut hole and simply can’t afford the copays for the medications they have been taking all year. When they can’t afford it, they don’t take it.

Some people know about the ‘gap’ as it is also less colorfully called, and hit it earlier in the year and look forward to getting to the other side. But, the vast majority of people A) don’t even know what the donut hole is and B) can’t afford medications when they get there and C) won’t get to the other side before the year ends and they can start over.

Sound crazy? It is. I see older people everyday say “I can’t afford that,” refuse their (often important) more expensive medications and just take the cheaper ones.

Let me say that again - people can’t afford to pay for the increased copay of their medication and go without until either they get to the other side of the gap or the end of the year. The government got hold of a decent program to help people pay for medications and completely mangled it. The ‘donut hole’ is one of the worst inventions I have ever seen.