One little temporary shortage of a prescription drug. . .

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First the caveat: I have no evidence to believe this incident had anything to do with Y2K. However--I do believe it has everything to do with the JIT (Just in Time) delivery system adopted by virtually all businesses--including pharmacies--in this country.

I phoned in three prescription refills on Sunday and picked them up last night. Of the crucial medication I take for diabetes, there was only a 10-day supply. Actually, because my good doctor has doubled my scrip to allow me to stockpile some medication, to the pharmacist it would have looked like a five-day supply. I usually get a month of tablets at a time, as permitted by my medical insurance.

I called the pharmacist for an explanation of the shortage. Oh, we owe you another hundred tablets, she said. There should have been another bag with your name on it. She checked, and there was. On the day I called it in, she had only the equivalent of a five-day supply of vital diabetes medicine for me; more was delivered the next day. It being the eighth of the month when I called it in, I doubt the shortage was due to first-of-the-month-income-checks rush. And, besides, shouldn't the JIT system allow for that and have replacements in less than a week?

I didn't ask the pharmacist any more questions. With the insurance company policy of limiting prescription buying to a month at a time, I don't want to draw attention to myself!

I may be just lucky, but this partial filling of a prescription has never happened to me before. It certainly gave me a jolt. If I miss one of my twice daily tablets, I feel it within about two hours. I don't know, but can give an educated guess that without that medication I would be calling for the paramedics within 24 hours. Or somebody would; I might well be incapable by that time.

It could be that people are beginning to stash a little medication, just as I am. Or it might be the normal operation of JIT. But I have to consider: what if--there's always a what if, isn't there?--what if another Fran had blown through here on Monday (that proverbial three-day storm), preventing another delivery for several days--or a week? (It IS hurricane season.) Cuts it a bit too close, I think.

Talk to your doctor NOW, get your prescription doubled, let the system adjust now, rather than in December. . .

Carlos--I know you come on line later, hope you see this--let me know what you think.

-- Old Git (anon@spamproblems.com), August 11, 1999

Answers

My wife is a pharmacist for CVS, and stories like this are commonly heard from her. 1) She cannot increase the in-store stocking levels of drugs - all orders are made by the computer and she is not allowed to change that. She CAN make orders from the 'jobber' - they usually get there the next day or two later, but she is limited in how much of that she can do. If she does it much (it costs the company more than the regular delivery), she gets bitched at by management, and her year-end bonus goes down.

The bean-counters in mgt want as small of an inventory at at time, so as to maximize profits, and if it inconvienences the customer, so what. Her inventory is 33% smaller than last year (and she owes customers ALL the time), yet her business is up 49%. GO figure. If a customer complains to mgt that she doesn't have the drug he needs, SHE gets a complaint noted on her quarterly evaluation report, and SHE gets bitched at, yet it's the COMPANY's fault she didn't have the medicine to give the customer.

It's no wonder that pharmacists are retiring faster than they graduate from school, and no wonder why 9 of 10 surveyed pharmacists said that if they had it all to do over again, they'd never have chosen pharmacy as a career. Don't even get me started about the idiot insurance companies. :)

-- Bill (billclo@msgbox.com), August 11, 1999.


Bill

< The system you described is running the world. It has gotten so far out of hand, it can't be changed. Everyone involved has to follow the rules for their survival. There might be a few who try to change the rules, and everyone sees what little that accomplishes so no one does anything anymore.

-- Carol (glear@usa.net), August 11, 1999.


Old Git,

I have experienced the 'partial fillings' that you have for many years now. The medicine that I take has no 'generic' form and therefore I am limited to the 30 day rule. For the past twenty-eight years, I have dutifully gone to the pharmacy and waited in line for life giving medicine. I stand in line for a half hour only to find that they 'owe' me some pills. This means that I have to come back at another time and stand in line for another thirty minutes. I spend any where from six to ten hours per year standing in line! Multiply that by twenty-eight years! That's 280 hours of standing in line!

BTW, it seems that 8 out of ten times, I am owed medicine. Lord only knows how much they 'owe' me. I've given up over time!

I called my insurance company in regards to the '30 day rule'. They suggested that I write a letter of appeal. Afterall, the medicine that I am requesting is one that I have to take for the rest of my life. There is mucho money being spent in administrative time not to mention my own time aquiring the medicine. Time is not cheap! (Nor is my medicine!)

Grace

-- Carolyn Grace (grace17@pacbell.net), August 11, 1999.


Having had this experience at CVS for four years, I wrote them a blasting letter, including the fact that their lines are so long and their pharmacists so overworked...and telling me they knew management didn't care about them. I switched to Rite Aid for immediate needs, such as an antibiotic, now that I work for a firm where my health drug plan enables me to order three months at a time by mail, and it has been a revolution in time-saving and knowing my meds are there for me. But again, these will be refilled in November, and that will not allow me to ask for another extra three months' meds, unless the pharmaceutical provider will permit it, due to Y2K expectations. It takes air fare to travel to the border of Mexico. Ideas, anyone?

-- Elaine Seavey (Gods1sheep@aol.com), August 11, 1999.

Bill is correct about the inventory. We had the same difficulty when I was interning. You would owe people if you ran low. The most difficult time was during the inventory time of the year. They lower the inventory just before counting it and compare that with the totals sales. They will want the inventory to turn over several times a year. That way you do not waste money by having expensive product sitting on the shelf.

On the good note, my company is now doing the y2k build up. By the end of the year, there will be several months of product completed and ready to be distributed. If the other Pharmaceutical companies are not doing the same and glitches hit the raw material distribution system, we will have a very good year 2000. If you need it Advil, Anacin, Robatussin, Centrum vitamins(and many, many, more), they will be available after January 2000.

Have a good day

-- Ned P Zimmer (ned@nednet.com), August 11, 1999.



Old Git, I too have had both pharmacies I used to deal with owe me part of the prescription refill. I used to go to a small corner pharmacy most of the time and sometimes at CVS. But for the past year or so we've switched to Blue Cross Personal Choice med. insurance, and we get to use Medco mail order pharmacy. I can't tell you how much better it is! I was very skeptical of mail order pharmacies before I tried this one. I have courteous and speedy pharmacist help/info over an 800 number at anytime. They say to allow 2 weeks for delivery but it has always arrived within one week so far. Because it's a mail order pharmacy, my doctor is allowd to write for up to a 3 months' suply of meds.

I have a child on daily medication, and how I've been stockpiling is like this: My doctor can write a new prescription 2 weeks before the 3 months period is up, so I ask her after 2 months, I soon get the prescription and mail it in, a week later I get the order. I'm a full 2 weeks, sometimes more, ahead. I put 2 weeks worth of the new pills into my stash, and repeat again 2 months later. So far I have a couple month's suply. I should have almost 6 months supply by december, counting the new 3 months prescription I will get then. 6 months might not sound much to those stockpiling for one or 2 years, but to me it's enough.

Also, using brand-name only prescriptions has always been a problem in supply/delivery. Many times the pharmaceutical company simply can't keep up with the demand, especially if the med is new and popular. The gov. often times puts quotas on how much the companies can produce, as in the case of a schedule II med. For example, Ritalin is classified as such and the brand-name is often in short supply, but the generic isn't. If you decide to use a generic brand, you should do some research on the company that makes it and it's reputation. Doctors and trusted pharmacists are a good starting point.

-- Chris (%$^&^@pond.com), August 11, 1999.


CVS is a nightmare.

-- Mike Lang (webflier@erols.com), August 11, 1999.

Old Git:

This JIT distribution/inventory system will absolutely choke when the herd starts to stampede.

An example I have is a 12JUL99 rain check from K-Mart for canned sardines and herring. About ten days later K-Mart stocked their JIT resupply. The Pantry clerk informed me that there had been a big demand for these canned fish in K-Marts, so they had trouble filling orders. First they would replenish the shelves, then they would fill the rain checks. The products were not in their stocking warehouse, so I guess they had to contact the manufacturer/fishery for more. Take the boats back out again, boys.

I don't know how many more weeks will pass until the rain check is filled, but these are the times of prosperity. I dread the upcoming crush of consumer demand which will choke JIT.

When everyone is told their favorite items are out of stock and may not be available for weeks or months, people will NOT accept that. They'll react negatively.

Who knows how many will lose it and go blasting away to vent their frustrations and rages?

But medicine is a very critical issue, and I think many, many will die if they don't have certain drugs which allow them to live free of pain and advancing diseases.

The insurance companies's JIT allowance for medications is shameful.

I don't see anything good developing out of this as we approach Y2K and beyond.

JIT has many weak links, and many will break weekly.

CVS has PVS (Pollyanna Vegetative State).

-- Randolph (dinosaur@williams-net.com), August 11, 1999.


Elaine: consider taking a bus to the Mexican border. Buses can be much cheaper than air fare, especially if you live in a city dominated by a single airline. If you are currently employed at a job that pays well and/or have no time off, see if you can find an unemployed friend/relative to make the trip for you.

www.y2ksafeminnesota.com (newly updated)

-- MinnesotaSmith (y2ksafeminnesota@hotmail.com), August 11, 1999.


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