The rapacious behavior of big chain pharmacies

As a rule, the big chain pharmacies strive to increase profits by understaffing and devising performance “metrics” that must be met by pharmacists. Basically, the performance metrics amount to dispensing as many pills as they can. To sell more drugs, the pharmacists are required to call doctors and doctors’ patients—dozens a day—to persuade them to prescribe more drugs or, in the case of patients, to request additional refills. Doctors complain that pharmacies bombard them with requests for refills that patients have not asked for and should not receive. The refills are closely tracked by the pharmacy and can factor into employee bonuses. In addition, pharmacy personnel are supposed to persuade patients picking up prescriptions to sign up for automatic refills, switch from 30-day supplies to 90-day, and contact their doctor with a “proactive refill request” if a prescription was expiring or had no refills.

As to understaffing, in addition to the tasks described above, pharmacy workers are expected to give flu shots, tend the drive-through, answer phones, work the register, and counsel patients. One pharmacist said that on one day he filled 552 prescriptions—about one every minute and 25 seconds. (He quit the next day.)

Of course, plenty of mistakes are made. Here are some examples: blood pressure medicine instead of asthma medication; ear drops instead of eye drops; a chemotherapy drug instead of an anti-depressant; estrogen instead of an anti-depressant. The woman who took the chemotherapy drug died. When people sue, they’re required to sign non-disclosure agreements in order to get their settlements.

In the US, people spend more than $300 billion on prescription drugs every year. About 70 percent of of these are dispensed by chain drugstores. CVS garners a quarter of the country’s total prescription revenue and dispenses more than a billion prescriptions a year. Near as I can tell, they're the worst. Best avoid them.

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