good pharmacy

[cellio]

Kudos to Franck's Avalon Community Pharmacy, recommended to me by my vet.

I have never actually been to this pharmacy. Truth be told, without consulting a map I couldn't tell you where Avalon is. (It's, um, a suburb, somewhere.) I have never met my pharmacist. However, even though they are not especially local, they deliver. One of my cats is on a maintenance drug that has to be compounded; I call them, they use the credit-card number I have on file with them, and two days later the drug fairies being a bag to my door.

The same cat was recently diagnosed with a new malaise. My vet told me that it's best if he gets half a tablet twice a day, but if that's too hard for me I can just give him one tablet once a day. (Breaking pills can be hard.) However, when the drug fairies did their thing, I was pleasantly surprised to find that they had sliced all the tablets neatly in half for me. I asked my vet about it; she did not ask them to do that. They looked at the prescription and did something to help me out.

I currently get my own maintenance drugs through a mail-order program through my insurance. I'm guessing that a regular pharmacy won't be able to give me the discount the mail-order place gives (two months' co-pay gets three months' medicine), but I should ask. And while I don't often need other medicines, I know where I'll call when I do. These guys are great!

Comments

[kayre]

Wow, that's great service!

Nice to know

[rob-of-unspace.livejournal.com]

Our vet has given up on pharmacies for a lot of prescriptions and compounds them in the office.

She knows I'm a chemist, and so with a recent prescription, assumed I could handle it. Finding some of the necessary measuring devices turned out to be a bit more difficult than I expected. Did it, but it wasn't easy.

Re: Nice to know

[cellio]

Wow, I wouldn't have expected a vet to have you roll your own, even if you are a professional. (For that matter, I guess I assumed that at least some ingredients would be controlled substances.)

Re: Nice to know

[rob-of-unspace.livejournal.com]

It's for benadryl in the water for Chauncey. He ripped all his feathers out on his chest. Whatever caused that has stopped, but the new feathers coming in are bothering him. The benadryl helps keep down the itching and keeps him from ripping out the new ones. The benadryl isn't being used as a sedative -- in some children and cockatoos, it can make them hyper.

"Rolling my own" is the only reasonable way to do it. For some weird stuff in the past, I had to do some serious chemical work. Fortunately, we have a mortar, pestle, and measuring equipment.

One apothecary tried with another prescription, but the result was unusable for birds. Would have worked fine for dogs or cats, though.

[baron-steffan.livejournal.com]

"I was pleasantly surprised to find that they had sliced all the tablets neatly in half for me. I asked my vet about it; she did not ask them to do that. They looked at the prescription and did something to help me out."

We do that sort of thing all the time. There are pill-splitting devices available, cheap. We sell 'em, but some folks (especially the elderly) have a hard time with them, so we'll split their pills for them. No sweat.

As for competing with mail-order, that's probably a no-go. That's an incentive that the insurances dangle in front of you. It's to their (financial) advantage. Often the manufacturer, the insurance, the PBM (the agency that handles the online claim processing for the insurance), even the pharmacy chain itself, are all part of the same monopolistic vertical structure. And they get away with it, because, well, you're just naive if you think these goons don't live in each other's wallets. (Google "CVS RI Celona" to see how far that can go). CVS is looking to buy CareMark, a major PBM. Merck (the mega-manufacturer) owns Medco, another mega-PBM. Walgreen's and the AARP are in cahoots with a major Medicare insurance. The chains get to put their damn logos on the Medicare-D cards, implying that our customers have to go to those chains (which they don't). Sometimes they do allow us to opt-in to the "three months for one copay" deal, but if we do, they reimburse us way below cost, so we're essentially paying money to have a patient take several hundred bucks' worth of merchandise out the door.

As far as vets "giving up" on pharmacies, specialty compounding is a niche business that the average store isn't going to handle: the administrative, regulatory, and inventory costs have become staggering. But here in RI we have two such pharmacies, to which we're always referring patients. So the vet can send out the work. He undoubtedly gets a better profit by keeping it in-house, though.

[cellio]

Yeah, I assumed (but didn't know for sure) that the drug companies, insurance companies, and mail-order places were all in bed together. (Mine's Medco, by the way.) I'd rather give the business to a local phramacist, but with a $25-per-month copay on two different medicines, the "three months for the price of two" deal is significant. And obviously I wouldn't want the local pharmacy I'm trying to support to lose money in trying to compete.

My vet originally recommended these guys because of the compounding (which, as you say, not everyone does), but she's been perfectly willing to call in other stuff there too, like the current drug (for hyperthyroid). The only one she hasn't been able to send there is Clavamox; if I understood her correctly, it's not a people-drug so they aren't allowed to dispense it.