Unfair Playing Field

Yesterday at work, I had one of my nice Medicare D patients come into the store with a stack of papers in her hand.  She looked my way and asked if she could speak to me for a few minutes.  She proceeded to lay out a series of papers discussing her Medicare D options during this year’s enrollment window, which closes in three more days.  Based on the information that she had, she was being told that next year our pharmacy is still in her network and she would still be able to use our pharmacy; however, it would be at an increased out of pocket expense.  She was being directed to one of the local Chain Store Pharmacies who has a preferred contract with this particular insurance company. 

We have been serving this customer for over 15 years.  We know her profile, her doctors, and she has developed a relationship with both of the full time community pharmacists who work here at the store.  She is now being told that if she transfers her prescriptions to this Chain Store pharmacy, she has the potential of saving over $400 per year in co payment costs.  This is an unfair playing field.

Of course, we discussed service.  We talked about how we are available for consultation and any time we are open she is able to call us and get a pharmacist on the phone and discuss whatever medical related question she has.  She totally agreed with me about our service; however, $400/year comes to more than $30/month and she is on a tight budget.  This is a significant savings in cash flow for this particular customer.

Selling our service is a reasonable argument to maintain business when we are going up against a mail order pharmacy.  To many people, it is perfectly reasonable to maintain prescriptions at a community pharmacy and pay a little extra for their refills so they have access to a community pharmacist  who is familiar with their medication profile.  This argument is not so strong when the patient is being told they can use any pharmacy in the network; however, they will receive a substantial discount if they use this particular chain store preferred pharmacy.

In the past, we have had many situations where patients have transferred their prescriptions somewhere else for convenience, then, after 2-3 months they have transferred their prescriptions back to our pharmacy because of the service.  They appreciate the relationship they had developed with us and are willing to drive a little further or work our hours into their schedule to utilize our service.   I don’t know if this will be the same situation for a Medicare D patient on a limited budget. 

I find the whole scenario very frustrating that a Medicare D patient is being told they need to transfer their prescriptions from a pharmacy that they have used for over 15 years in order to save $30+ dollars per month.

Here is what could have been done differently.  When the open enrollment time comes around, look for more than just the best cost.  Look for the best cost at the pharmacy that you want to use.  There are many different Medicare D programs available and they all want to have your business.  Different Medicare D programs are affiliated or aligned with different and specific Chain Store entities.  If you are linked into one of these programs, you will be directed to that pharmacy.  Look for a program that allows you to pick the pharmacy that you want to use.

Follow this link to the Medicare D prescription plan finder tool.  This will help you find the plan that is best for you.


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