DRUG STORE NEWS FOR THE PHARMACIST, FEBRUARY 1995 l


    No sir!,” said an angry Mrs. Philmore, a regular at the pharmacy where I was ‘temping" that day. She fixed me with a cautious glare, as if she expected me to grab her purse and run for the frozen food section.
     “Don’t you give me any of those 'genetic' substitutes. I can read, and I know all about what you druggists are trying to do.”
     She was infuriated that I had suggested a generic on the prescription for Keflex she had presented. Though her physician had signed on the “substitution allowed” line, she was insulted that I would have the temerity to try and switch brands on her just so I could make my bounty and get richer than I already am by selling her an inferior product.
     ‘With people like you filling prescriptions it’s no wonder health care costs are skyrocketing," she hissed.
     "Im sorry I’ve offended you," I said in an effort to soothe her misguided ire. “The generics we dispense are very carefully selected. They’re exactly the same in all important aspects and much less expensive. Another brand of cephalexin is not so much a substitute as it is an option for the consumer, and..."
     I looked up to discover that I was talking to myself. Mrs.Philmore had stormed off to complain about my shady shenanigans to the store manager, or perhaps even to the high priest of discount stores presiding somewhere over the rainbow in a land called Arkansas.

Luckicst man alive?
     I shrugged and returned to my growing pile of prescriptions to enter. After a few hundred more, I could
take a short break while I counted all those mounds of gold coins we all accrue as an unavoidable benefit of
practicing pharmacy. I don’t know about you, but I frequently feel guilty amassing all this wealth at the
expense of my hapless patients. But then I think of my villa on the Riviera, my Lear jet, and my fleet of yachts, and I realize that it’s all worth slaving away 10 or 12 hours a week filling prescriptions. We're just so darned lucky to be in a profession where we can charge $120 for a Prilosec order and pocket $110 of it.
     You do feel lucky, don’t you?

     Just then, the store manager showed up with armed guards and hauled me off to the dungeon behind the layaway department. They trained the bright lights on me and made sure I knew they didn’t appreciate my sleazy business practice of accepting bribes from pharmaceutical manufacturers to switch patients
between brands, like the REDBOOK article described.
     “But that’s not what I was..."
     The rubber hoses and bamboo shoots put a stop to my protests, and they explained further. REDBOOK ran an article in its January issue entitled "The New Drug Money,” in which pharmacists ("druggists,” as they are deprecatingly called in the article) are portrayed as money-grubbing charlatans, "bounty" hunters simply out
to make scads of money at the expense of their trusting patients.
     At the heart of the issue is the recently scrutinized marketing practice of manufacturers who offer cash incentives for pharmacists who successfully switch patients from the products of competitors. In the pharmacy world, most of us are now aware of the controversy surrounding the issue and would astutely avoid even the appearance of wrongdoing by aligning with such practices.
     I don’t pretend to be qualified to rule on the ethics of this marketing ploy for other pharmacists. In my
practice, I’ve not even been asked to consider such action, nor have I come across another pharmacist who was involved; and I practiced in 34 different pharmacies last year.
     But concerning the ethics of maligning our entire profession in a national magazine, yes, you could say I
have an opinion. We, as a group, have been accused of dishonesty of the worst kind and blatant lack of professionalism, and the general public is going to have difficulty understanding the truth of the matter. Some of
us will have difficulty understanding the difference between this controversial practice and routine generic substitution. How can we expect the public to understand this quagmire?
     More importantly, how do I convince Mrs. Philmore, one among millions of victims of the misconceptions of the lay press, that I really do have her interests at heart when I recommend generics on some products?
     As for dealing with erroneous complaints from corporate management, I give nothing but my name,
rank and license number.

FTP
Kendall Shaw is ri pharmacist!
writer who works relief and con-
tributes regularly to FTP.