Showing posts sorted by relevance for query cvs. Sort by date Show all posts
Showing posts sorted by relevance for query cvs. Sort by date Show all posts

Wednesday, June 02, 2010

CVS Makes An Honest Mistake. And By Honest Mistake I Mean Rips Off Its Customers. Probably To The Tune Of At Least A Million Dollars.

You know how it's illegal, if you run a store, to advertise one price for a product and then charge another, higher price for that product when a customer comes in to buy it? That's why we have rain checks and stuff. Because it's totally illegal to get someone's business by promising to sell something at one price and then charging another.

Unless, evidently, you're CVS. From that bastion of the liberal media, The Wall Street Journal:


Many customers of CVS Caremark Corp.'s SilverScript Medicare prescription-drug programs have been paying higher prices than they were promised when they signed up for the plans in late 2009.
CVS blames the problem on a computer error, which it says caused prices for brand-name drugs to be listed about 4% lower than they should have been. It says the error appeared in data CVS supplied to the Medicare website that allows senior citizens to do comparison shopping between rival prescription insurance plans.
CVS says it has been charging consumers the higher prices since the beginning of 2010.
Many senior citizens use the price-comparison tools in November and December to shop for their Medicare Part D drug coverage for the following year. The tools allow Medicare recipients to plug in the drugs they take, and provide comparative costs for various plans. The inaccurate information, which appeared from Oct. 8, 2009, to Jan. 8, 2010, made the CVS plans seem more attractive than they should have been.

Holy Nader's Raiders Batman!! Surely the guardians of the consumer that toil away in the halls of Washington's bureaucracy will ensure there will be hell to pay for this. Especially with that socialist Obama in charge now, there's just no way a corporation can get away with overcharging its customers. Get ready for the wrath of righteousness CVS!!!!

CVS notified the federal regulator, the Centers for Medicare and Medicaid Services, about the problem in January. A Medicare spokesman said regulators worked with CVS to craft a response plan, under which CVS would offer a refund for the price difference, but only to consumers who specifically requested that. The Medicare spokesman said CVS also agreed to help unhappy customers switch to another plan.

That'll show 'em.

CVS sent letters of apology to affected customers starting in late March. A letter reviewed by The Wall Street Journal didn't mention the possibility of a refund, but directed a recipient with questions to call a toll-free number to discuss "your options."
"Did I pay too much for medication?" the letter said in question-and-answer format. The answer: "No." The letter said the drugs were "priced correctly at the pharmacy, but may have been higher than what the price-comparison tools estimated."
An affected consumer who recently called CVS's toll-free number said he was told he could file a "grievance" to seek a refund for brand-name drugs bought up to that date, but only if he had a printout of the original inaccurate pricing information from the Internet.
A CVS spokeswoman said that consumer's experience wasn't consistent with the company's policy, which is to provide a refund if asked.

So.....I'm gonna do a little back-of-the-envelope math here. Let's say every CVS store has 15 customers in one of these SilverScript plans, and each of these customers has two $120 brand-name prescriptions filled.

Let me know if you think these assumptions unreasonable. I don't think they are.

So, 15 customers x 240 dollars x 4% "mistake" in the advertised price = 144 extra dollars per CVS store. Ho-hum.

Until, that is, we multiply that by the 7,000 retail pharmacies that CVS operates. Do that and now we'll see that "mistake" netted CVS an extra one million dollars of pure friggin' profit. The equivalent of filling an extra 667,000 prescriptions at the standard $1.50 insurance dispensing fee. It's a lot easier to hit a few "wrong" buttons at corporate headquarters while inputting data than it is to fill 667,000 prescriptions. Especially since CVS didn't have to hire the one extra pharmacist and two technicians they would budget to fill 667,000 prescriptions.

And they're gonna get to keep most of that money. Because how many people are going to 1) Notice 2) Be pissed off enough to argue over $10 and 3) Successfully get past the help desk flunkie who's feeding them bullshit about how to get their money back?

Not many. They're totally gonna get away with it.

And just in case you still think this whole episode might really have just been a mistake, ask yourself what would have happened if some schlep would have sent the wrong data to Medicare with a result being that it cost CVS a million dollars by making them undercharge their customers.

That fictional sonuvabitch would have been fired the next day and you know it. And would most likely be working now for Rite-Aid, earning stellar performance reviews.

I'm not saying CVS deliberately ripped people off. But, yeah, it sure is a lot easier to make a "mistake" than it is to actually do more work. Or renegotiate your contract with Medco.

I report. You decide.

Thanks to JayPee, whose blog first tipped me off to this.

Monday, October 18, 2010

CVS, An Everyday Miracle If You're Into Meth. Not So Much If You're Into Breathing.

It's a CVS twofer this day my friends. First we go to the Garden State, where the local FOX affiliate tells us the tale of a woman with asthma and her drugstore's commitment to her well being:

Just after seven o'clock Thursday morning, Katherine O'Connor and her boyfriend were walking home from a McDonald's in Garwood, New Jersey, when she suffered an asthma attack.
Her inhaler was at home. The couple was near there, but a CVS on North Avenue, near Cedar Street, was closer. They went in and found the pharmacist on duty.

Time for one of those CVS everyday miracles.

He was told the inhaler with tax would cost just over $21. He was short a dollar and change.
"I said 'Can you just give her the pump. She's on the floor wheezing," Jack said. "I didn't know if an ambulance would get there on time. He said there was nothing he could do for me."
CVS corporate offices sent Fox 5 a statement: "The well-being of our customers is our highest priority..."

"Right after money" they didn't add but believably could have "Every sweet sweet, last precious dollar...."

This being Fox news I can imagine the next line from the anchor desk being something like "Bob, what do you suppose is the connection between what happened here and the proposed Obamacare death panels?"

You could say this was just the case of one CVS pharmacist out of thousands using incredibly poor judgement, an isolated incident, and you would be right. Just like the one CVS Pharmacist who proposed a trade of Xanax for sex or the other CVS pharmacist who practiced at a CVS store without actually being a pharmacist.

Or the CVS pharmacist who posed a customers information on a Craig's list sex ad when the customer pissed him off.

Exactly how many isolated incidents have to occur before it's a pattern? Because I gotta tell ya, while Walgreens has almost the same number of stores and pharmacists, the bat-shit crazy ones always seem to be employed by CVS.

Our next story isn't about some random nutjob though. This one would be a failure at a higher organizational level:

The smurfers loved CVS. And CVS loved them back.
The giant drugstore chain became the go-to spot for hordes of shady buyers, called smurfers, who ran around scooping up over-the-counter decongestants under orders from bad guys who cook up methamphetamine.
Since 2005, federal law has limited how much pseudoephedrine a person can buy (no more than 3.6 grams a day). And retailers, like CVS, are supposed to police that by checking IDs and requiring people to sign for the stuff
But the chain switched from a paper logbook to an electronic system to keep track of things. The computerized ledger didn't prevent the same person from making a bunch of pseudoephedrine buys on the same day. And store employees, the feds say, were told to obey the computerized system's approval of sales, even if they had their doubts about the buyers.
Other retailers did a much better job on complying with the law, so the smurfers took their business to CVS, the feds say.
In a statement, CVS Chairman and CEO Thomas Ryan said, "We have resolved this issue, which unfortunately resulted from a breakdown in CVS/pharmacy's normally high management and oversight standards."

High management and oversight standards. The same standards that resulted in the company paying $36.7 million for ripping off Medicaid.

The same high standards that resulted in them "accidentally" charging people enrolled in CVS/Caremark's Medicare part D plans too much.

The same high standards that had two of their executives fighting off charges they tried to bribe a Rhode Island state senator. High standards would be avoiding even the appearance of impropriety. At least at most companies.

Again I'll ask, how many isolated incidents does it take before it's officially a pattern? Their "high standards" seem to be about as effective as the extensive pre-employment screening process they claimed to have when they got busted for hiring the fake pharmacist.

Who by the way, evidently had no problem practicing pharmacy the way CVS expects it to be practiced.

Something stinks here my friends. Something here totally smells like a rotten company.

Thanks to the alert readers who tipped me to the stories.

Monday, March 17, 2008

I Know I've Been Picking On CVS A Lot Here Lately, But It's So Damn Easy.

First, they show that no independent is gonna outdo them when it comes to pharmacy services, even creepy pervy pharmacy services:

Baltimore County police said yesterday that they arrested a former CVS pharmacist and charged him with trading drugs for sex.

Ramon Bautista Juta, 54, of the first block of Trumpet Court in Perry Hall was charged with two counts of possession of narcotics with the intent to distribute, possession and distribution of a controlled dangerous substance, forgery of prescriptions and prostitution, police said. Juta had worked at the CVS in the first block of Compass Road in Middle River, police said.

According to authorities, a woman told them that Juta had asked her to provide sexual favors in exchange for prescription pills she used. Police said the medications included Lortab and Xanax.

Ha ha. But I think this is more indicative of what CVS has done to the profession:

A woman has been charged with impersonating a pharmacist and police say anyone who had a prescription filled by her should have their medication checked. During a routine compliance check at the CVS pharmacy at 4405 East Riverside Drive, the State Board of Pharmacy discovered what it believes to be an unlicensed person acting as a pharmacist.

CVS released this statement Thursday:"Nancy Rose McGowan gained employment as a CVS pharmacist under false pretenses through the use of forged identification documentation and by using the identity of a pharmacist licensed to practice in Texas who is not currently living in the State. By using another pharmacist’s identity, she was able to pass CVS’ extensive pre-employment screening process"


You can stop right there CVS PR hack. You see, I'm thinking the whole point of a pre-employment screening process would to be to...um.....I dunno.....maybe keep a fake pharmacist from practicing at one of your stores?

"During (The Board's) compliance check, they asked her to produce her credentials showing she was in fact a pharmacist, she was unable to do so," said Austin Police Detective Billy Petty

Yeah.....hella extensive screening process you've got there CVS. Turns out all you had to do was actually ask to see her license. Tell me again how government can't do anything, and how we should leave things to the private sector? 'Cause it was the government that caught the fake pharmacist. Leave it up to CVS and some numbnut would be passing out Coumadin in Austin to this day.

Which says a lot about what it's like to, ahem....."practice" pharmacy at a CVS. Evidently she was performing all the professional duties CVS expects from a pharmacist just fine. Because once again, CVS didn't have a problem with her until the state board showed up.

CVS. An Everyday miracle. As long as you don't ask any questions that are too hard or otherwise want your pharmacist to do anything pharmacy-school based.

Thanks to the alert reader who tipped me off to the CVS perv.

Wednesday, March 14, 2012

Nation's Journalists Give Up, Will Just Report Once A Month CVS Probably Fined For Something Again.

TAMPA, FL- At its national convention here today, The American Association of Business Journalists agreed that any story about leading drugstore operator and pharmacy benefits manager CVS/Caremark that involved the company being the target of a law enforcement investigation, getting sued, reaching a settlement while admitting no wrongdoing, or assuring the public that despite this incident "we value nothing more than the relationship we have with our customers" is no longer officially newsworthy. The resolution was proposed, debated and passed nearly unanimously in a record 15 minutes.

"I admit I'm a little sorry to see the old newsroom staple of the 'shocking CVS' story come to an end" said Robert Mitchell of the Providence Journal. "I have fond memories of covering the trial of two CVS executives who were accused of trying to bribe a Rhode Island state senator, and the story about the CVS pharmacist who received over $4 million for exposing how the company was overbilling Medicaid was a compelling tale about the little guy prevailing over the giant corporation, but by the time we heard of how they were overcharging customers in their Medicare Part D plans, we were really stretching for a unique angle to present"

At one time, the abundance of material produced journalists who specialized in specific aspects of the company's legal troubles.

"My beat was the out of control CVS pharmacist" said Melinda Gomez of the Associated Press. "My editor assigned me the woman who wasn't a pharmacist who was able to do what CVS expected of its pharmacists with no trouble story, but by the time we got to the CVS pharmacist who used customer information to post a fake sex ad on Craigslist it was taking up so much time we made it a full time position. Or maybe that was after the CVS pharmacist who let a customer have an asthma attack when they were a couple dollars short. Wait. No. It was when the CVS pharmacist wanted to trade Xanax for sex. Oh hell, I don't remember. It all blends together after awhile."

Many agreed that the high point of the CVS as unethical news story came with the revelation that the company seems to be disregarding the obvious intention of the North Carolina Board of Pharmacy that pharmacists in that state should not work more than a 12 hour shift. 

"I've never met the man who wrote that story" said Mary Russel of the Columbus Dispatch, but his raw sexuality comes through in every word. The way he made that spokesman look stupid with just a few phone calls to CVS stores shows an intellect that I can't help but to find attractive."

Some expressed concern that CVS, once in the spotlight, may have started acting out in an effort to gain more attention.

"I remember joking that at least they haven't been busted for actual illegal drug sales, but almost right after that came the crystal meth story, and then the DEA suspending the license of two of their stores for going through almost 21 times the amount of oxycodone an average pharmacy does. It was almost like they felt the need to do something more and more outrageous to stay in the news. The only thing now I can think of  they haven't done is rape or kill anyone in cold blood."

"That I know of." He quickly added.

The resolution added that while these type of stories no longer met the definition of news, and reporters would no longer be assigned to cover them, it was still perfectly acceptable to say something about CVS doing something stupid in cases where space or dead airtime needed to be filled, as the company gives no indication of changing its ways. 

Thursday, May 17, 2012

One Thing I've Learned About CVS Employees. They Really Seem To Hate CVS.

I mean really hate CVS. Every company has its disgruntled and malcontents, and I've found those types can be useful ones to seek out when I'm writing about drugstore shenanigans. But man, every time I put out a call for people willing to give me the skinny on these guys, I am inundated with volunteers. No other company even comes close.

And now, I don't even have to go seeking. This email from a CVS employee showed up completely unsolicited. I know every company has executives that like to play business hardball, but it's becoming clear that this company is distinguishing itself in an industry that seems to take pride in treating its employees like shit.

Of course I could be wrong. Having given space to this employee, I'll happily give more to anyone who would like to pen a rebuttal. Anyone who's itching to tell the world all the great things CVS is doing to advance the profession, or even just how they aren't as bad as the other guys.

The offer is open. There's an email link to the right of this page where it says "tell me what you think"

Without further delay, from a CVS employee. Complete and unedited.


I open this post with a quote from Hunter S. Thompson:


"In a closed society where everyone is guilty, the only crime is getting caught. In a world of thieves, the only final sin is stupidity."


Why do I quote Thompson when talking about CVS, or indeed any Corporate Pharmacy? Because we live in a culture that silently condones cheating and fudging to make the numbers look good. If you work in retail, you know what "The Numbers" are. If you don't, I won't waste time explaining it. If you google "Triple S" or "Key Pharmacy Metrics" you'll get it. Let me get to the heart of what's wrong with CVS's culture of numbers:


If a store is not selling enough scripts (notice I didn't say filling), getting high enough ratings on the Triple S/KPM, or their inventory is out of whack in any way - they get endless hassles from district. This forces stores to do whatever necessary to make themselves look good. Refilling scripts without asking patients, filling dubious CII scripts to make their script budgets so they can maintain staff levels, and literally stealing receipts to boost their customer survey scores. This sort of thing is ignored by the higher ups because it boosts the district's numbers, until someone blows the whistle. I've seen Pharmacists fired not because they were cheating at the scores, but because they slipped and forgot to cheat one month and made it far too obvious that they were doing so.


Notice that it wasn't a manager or district supervisor who called attention to the CVS stores in Sanford, FL who were filling ridiculous scripts for Oxycodone and other narcotics from pill mill doctors. They were tickled pink and the gobs of money that were coming out of these stores. If a technician hadn't blown the whistle and called attention to what was going on, it would still be happening and those stores would still be the most profitable ones in the area. Once it was out, CVS immediately sent emails to every store with instructions that no one at any level talks to the press. CVS associates are to forward all requests to some yahoo in the corporate PR office (Head of Media Relations or some such nonsense). Everytime we see that email, we know that something's gone wrong again for CVS somewhere in the country. We've seen that email more in the past 4 months than in the previous 2 or 3 years combined. The CEO and everyone high up in management said the same thing, "It was irresponsible of these people to accept these dubious scripts and to keep filling them. They did so in contravention of CVS policy." Policy that was quickly changed from "Fill the scripts, or you're fired!" to "We stand behind you. Don't fill scripts that you think are improper or outside the standard of care." shortly after this story hit the airwaves.


Pharmacists used to be able to simply wave these people off by saying that it was out of stock, but now that's been abolished too. The policy changed again, "You can only say you're out of stock if you are legitimately out of stock. Otherwise you have to explain to the customer that you cannot verify the script and will not be filling it because in your professional opinion..." et cetera. Why? We were never given a real reason. My theory is that it's a way of ensuring that these people end up at our competition rather than another CVS. Maybe it's some sort of reverse Honeypot trap, trying to get Walgreens or Rite-Aid to fill a pill mill script and get them nailed to the wall instead.


Going back to that earlier point, about people being fired for not filling scripts they thought were bogus? Not an exaggeration. Customers would complain to corporate and demand the Pharmacist give a full explanation why they would not fill the script. These dressing down sessions would end in a filled prescription for the patient and a gift card for their inconvenience.


The culture of numbers is to blame for the CVS stores in Sanford filling those bogus scripts. That culture is also responsible for CVS's outside vendor of scripts Cardinal Health losing the DEA license at their Lakeland warehouse for providing those stores with the narcotics. Now CVS has to appeal and fight to have those stores' DEA licenses restored. At the same time they're fighting to fix these two stores, they're going to close two completely legitimate stores in other locations that do good business for their communities.


It sucks to work for a company with such a warped sense of priorities, but what can you expect from a retail company that sees pharmacy only as a way to make money? A store doesn't make it's RX Script budget by filling scripts, but only by ringing them through the register. 'Did you fill 4500 scripts this week, while lacking two technicians? Well, you only rang 1950, so we're cutting your hours again. You'll have to let someone go. What's that? You won't be able to cope with the extra workload? I'm sure you can go somewhere else then and we'll get someone who can, and boost your store's Triple S at the same time. Bye!'





It's disgusting, and we're stuck with it.



Wednesday, November 09, 2011

What Better Way To Cut Through Bullshit Than With A Good Old Fashioned Debate.

The Drugmonkey settles in behind a very statesmanlike looking podium as the buzz among the crowd settles into a low whisper. A bald, clownish-looking man enters stage left while four tired and rumpled people slowly stager in from the other side. The four are offered a seat and they immediately burst out in tears of gratitude. They sheepishly ask if there are snacks or perhaps bottled water that will be provided during this event. Not one asks about restroom facilities, as if they have no expectation of nature calling. The low whisper in the auditorium drifts into silence as the Drugmonkey takes the microphone.

"Good evening, and thank you all for coming to tonight's event. As you all know, pharmacy faces tremendous challenges as we move forward into the 21st century, and views differ as to how the profession will best meet the obstacles before us. One thing is for sure, no matter what direction pharmacy ultimately takes, CVS/Caremark will play an integral part. With over 7000 stores and control of one of the nation's major Pharmacy Benefit Managers, some will already say that as CVS goes, so will go the profession. With that in mind, we present tonight's debate, "CVS, a progressive force for the future or an embarrassment to pharmacy?"

"First let me introduce Tom Menigan, CEO of The American Pharmacists Association."

"Thank you for the opportunity to be here Drugmonkey. I gotta say our new headquarters in Washington, D.C. is much nicer than this dump though."

"And now, four pharmacists currently employed by CVS"

"May we speak now?"

Let me jump in here and let you know that while this debate took place only in my imagination, every word attributed to APhA's CEO comes from this post on his blog, while the words from the CVS pharmacists come from actual messages I have received in my e-mail box. 

"Mr. Menigan, would you like to make an opening statement?"

"Recently, Megan Sheahan, Michelle Fritts, Erika Trevino, Olivia Putman, and I visited a CVS Caremark pharmacy in the Dupont Circle neighborhood of Washington, DC, where I received my annual influenza vaccination. We had a chance to see their advances in patient care, including numerous systems upgrades to assist pharmacists in identifying, monitoring, assisting, and documenting patient care activities and outcomes."

"Interesting. I think what I'll do now, as opposed to the traditional role of debate moderator, is step back and just let the two sides engage in a little back and forth. CVS pharmacists, you're up next."

"This pharmacy keeps enacting brand new programs (more things to do). I refer to myself no longer as a pharmacist. I am now a prescription salesman. I do not counsel, I do not care about outcomes, All I am supposed to care about is getting another script filled."

"By improving patient engagement through enhanced interactions, pharmacists have created new ways to improve clinical care and provide counsel that can improve adherence. By using increased technology and maximizing the use of pharmacy technicians in the pharmacy, CVS pharmacists are improving the health of patients while lowering the overall cost of health care."

"I managed to stick out 4 years at CVS before the fateful night of January 2nd, the Monday after New Years and the busiest day of the year when I worked a 14 hour shift with one 10hr technician, filled 300 prescriptions, fell asleep driving home and ended up crashing my car into a median. As soon as I woke up, I gave my notice and went to a grocery store pharmacy, making the same money with much better hours and 10 times less stress."

"The CVS team of Papatya Tankut, Cherise Wilson, Scott Staso, and Rosaline (Rosy) El-Khoury showcased recent patient care initiatives the company has implemented to allow pharmacists greater opportunities to interact with patients and prescribers."

"This is not why I got into pharmacy, I am not a telemarketer, I am no salesman, but I am that person that will tell you, 'don't take tylenol while on that'. I would give anything just to be a pharmacist again."

"It’s clear to me that the organization is taking enhanced pharmacists’ services seriously."

"There are the traditional complaints about retail and then there are the extreme cases and CVS is one of those.... CVS takes the cake with pharmacist abuse."

"Let me just jump in here now, since the subject of pharmacist abuse has come up. Mr. Menigan, what do you have to say about published reports that CVS systemically ignores the will of the North Carolina Board of Pharmacy, which has mandated a 12 hour workday for pharmacists, by having pharmacists in North Carolina routinely work 14 hour days?"

Since APhA has never said a word about this flouting of a law it helped defend, you can insert 30 seconds of the sound of crickets chirping in the background here. 

"Very well then. Well it seems that one thing is crystal clear tonight. The views of The American Pharmacists Association differ sharply from those of actual pharmacists. Mr. Menigan, you managed to get your message out even when outnumbered 4 to 1 by people in the profession you claim to represent. That's quite a feat, but to be honest, not at all unexpected. I see the corporate special interests that actually control pharmacy have come with their pocket now, which means it must be time for you to crawl back in. Thank you for being here, and thank you you to the CVS pharmacists who have to be back at work for a 14 hour day bright and early in the morning. Try not to drive into any highway medians on the way home!

And a special thanks to our audience here at the Medco auditorium and around the world on C-SPAN and online. Be sure and tune in next time when Walgreen's Chairman and CEO Greg Wasson will discuss the topic, "How tobacco sales can drive top line pharmacy revenues" Until then, goodnight, and be sure to meet that flu shot quota!!


Sunday, October 07, 2012

In This Season Of Debates, I Present Pharmacy Showdown Number Two. It's CVS Vs. CVS.

Good evening ladies and gentlemen, and welcome to the second in our series of pharmacy debates. You may remember last time we were here and discussed the impact of  drugstore chain/pharmacy benefits manager CVS Caremark upon the profession. Tonight, we'll go from the general to the specific as we address the topic "Does CVS enroll people in their 'readyfill' automatic prescription service without the patients consent?" We have two guests tonight, first off, CVS spokesman Mr. Mike DeAngelis.

"Rot in hell Drugmonkey. If you think a few weeks of unemployment are tough, you just wait until we're done with you"

Ha ha....he's quite a kidder that DeAngelis. Next up we have CVS Supervisor Ryan Barna. Mr. Barna oversees about 50 CVS stores in the New Jersey area.

"He's not kidding Drugmonkey, we're going to bury you"

Very well then, but first things first. Mr. DeAngelis, recent stories in the Los Angeles Times paint a picture of CVS customers systematically being enrolled in your automatic refill service without their consent. These are serious allegations, as this could, under some interpretations, be considered insurance fraud, as claims are being filed for medicines a patient never asked for. Both the New Jersey Department of Consumer Affairs and The California Board of Pharmacy have expressed concerns, and the LA Times articles imply that this might be happening as a result of pharmacists being pressured to meet a quota of program enrollment. We've flipped a coin backstage, and as a result you get to make the opening statement.

(Note, every statement below attributed to DeAngelis  and Barna come straight from the Times articles. Except for the final statement, which really happened in my imagination.) 

"It is not our policy to refill prescriptions without a patient's authorization"

Very well then. Mr. Barna, do you have a rebuttal?

"You need to go out and make this happen this week and every week going forward"

I see. You were, of course talking about a specific number, 30% of phone calls to patients that were expected to result in repeat business. It would seem that we have a clear distinction between the positions of the two of you then. Mr. Barna, if I could ask a followup question. What would happen if pharmacists did not meet this quota?

"Major personnel changes. Please understand this is not the road I wanted to go down, but action plans/phone calls/advice haven't yielded the result we're all looking for & it's time for a change in leadership in certain stores."

OK, but our topic is whether CVS ever filled prescriptions without a patient's authorization. Mr. Barna, if pharmacists called patients and could not reach them, what did you instruct them to do and say regarding those patient's prescriptions?

"We tried calling you several times this week on this past-due prescription" and that "I went ahead and filled it so it would be ready for you."


Mr. Deangelis, this seems pretty clear. Do you have a rebuttal?

the company says this is an example of an overzealous manager going too far, not a practice followed by CVS pharmacists nationwide.

Mr. Barna, you called the procedure you outlined to the pharmacists you supervised...what was the term? CVS.....

"best practices."

Yes, best practices. And I will point out here that the Times articles point out incidents of unauthorized prescriptions being filled in both New Jersey and California. Mr. DeAngelis, is it possible for one overzealous manager in New Jersey to affect your operations in stores located on the other side of the country?

"It is not our policy to refill prescriptions without a patient's authorization,"

Yes....I seem to remember hearing that somewhere before. And with that ladies and gentlemen we've reached the end of tonight's debate. Mr. Barna, since Mr. DeAngelis got to make the opening statement, we'll give you the final word.

"Thank you. As spirited, and at times heated, as tonight's debate was, I'd like to point out that my opponent and I actually have a great deal we agree on. We are both working for a strong and profitable CVS, and share a desire to make the company the best it can be. More importantly though, we share a bigger goal. Your immediate and total destruction Drugmonkey. Mr DeAngelis and I could not hate you more, and wish nothing but for you to be erased from this very planet, preferably in a painful way. Short of that, we would like to make it possible that both you and the LA Times shut the fuck up."

And on that note of agreement, we close this night's debate. Tune in next time, when our topic will be "A share or Rite Aid stock or a Diet Coke, which is the better value for your dollar and a half?" Until then, have a wonderful evening.

(Special thanks to the multiple alert readers who tipped me to this story)

Tuesday, February 04, 2014

I Provide Much Needed Aid To The American Prescription Filling Consumer. Seriously, You Need To Read This Post Before You Get Your Next Prescription Filled.

Because, Mr. and Mrs. American pill popping consumer, you need my help. You evidently really need my help. I'll start with a snippet from Drug Topics, the world's greatest trade magazine that employs the world's  greatest pharmacy columnist:

When it comes to filling scripts at retail pharmacies, a shopper behavior study indicates CVS is the top consumer choice, followed closely by Walgreens.

"Sad but not surprising" those in the profession are saying. "They are the two biggest, managing to shoehorn themselves on nearly every street corner in the country."

....The study also provided insight into why consumers choose certain pharmacies

"Well this will be useful." us insiders are now saying. "It will be good to know exactly how these behemoths managed to get in this position of market dominance."

"CVS shoppers (68%) were most concerned with quality;"

Everyone in the profession just now shot coffee out their nose. Seriously. Even if they weren't drinking a cup when they read that, the shock of what they just saw instantly created coffee out of nothing and made it spew forth from their nostrils.

Some families got more than they bargained for at a New Jersey CVS drugstore when their childrens' prescriptions for fluoride pills were filled with a popular breast cancer drug instead. 
Tamoxifen, the drug mistakenly given to the kids, is a popular estrogen-blocking drug, used to treat many breast cancer patients with estrogen-receptor-positive cancers.

Yup, at CVS quality is job one.  Here's some more:


Police say a 26-year-old woman has been filling pharmacy prescriptions with false credentials.
Nancy Rose McGowan has been working at a CVS pharmacy in East Austin for about two months, using the identifying information of a licensed pharmacist and a counterfeit US Army ID card. 
She was arrested last Thursday after a Board of Pharmacy investigator reported her to police as a person acting as a pharmacist without a license. The board was conducting a routine compliance check at the drugstore.

Routine compliance check turns up what CVS' pre-employment screening process doesn't. Hell yeah. That's what quality is all about. I could go on, but I'll just say I'm thinking the American consumer has been bamboozled, or perhaps is smoking large quantities of crack while participating in shopper behavior studies. Back to the Drug Topics article::

Walgreens pharmacy customers cited speed of filling prescriptions, while Rite Aid customers identified price as their most important factor in choosing a pharmacy.

The 20 minutes plus I routinely spend waiting to talk to a human when calling my local Walgreen's makes me lean more towards my crack-smoking hypothesis. Also, a hint to Rite Aid customers: I used to work there and know exactly what you've been paying.  Wave your little Wellness Plus card around all you want, but 20% percent off an astronomically high price is still pretty damn high.

But I'm here to help my friends. To be a problem solver as opposed to just a bitch and moaner. The next time you let one of the Big Three pharmacy giants start to make you feel all warm and fuzzy with the power of a multi-million dollar marketing campaign, take a look at this chart from your good friends at Consumer Reports, the highly respected and not nearly widely enough read journal that tries to keep you from wasting your dollars:






Seems pretty self-explanatory, but just in case it's not, I'll point out CVS, Walgreen's and Rite Aid all come in dead last for "speed and accuracy." As a matter of fact, it kinda looks to me like CVS is tied with the Son of Sam for worst rating in everything.

By the way, take a look at where your local independent drugstore stands. You'll want to start at the top.

So American Public, I'm not sure exactly on what you were basing your perception of CVS quality. Something besides evidence apparently. Now however, you know what has been obvious to pretty much everyone in the pharmacy world for at least a decade.

CVS sucks. You're welcome.

Thursday, July 26, 2012

Remember When I Wrote Awhile Back About CVS' Policy To Screw Walgreen's Pharmacists And Their Customers Who Need Prescription Transfers? And How CVS Employees Said It's A Policy Widely Ignored?

Evidently their overlords were not happy:


No word whether signatures are to be in blood.

In case you missed it, the nation's most professional pharmacy chain... that starts with the letter "C"... and has a second letter of "V" has decided that regular prescription transfers aren't quite enough of a pain in the ass. They also have determined that their pharmacists have a lot of extra time, and more pressing professional concerns than things like the upcoming flu season, like lying to other pharmacists for example. Here's a copy of that policy I wrote about earlier:




And just to make sure they're doing what they are told:





My favorite part is the "privacy office," where one can report someone messing around with a customer's prescription without the customer's permission:

"Hello, Anita? I need to report a privacy violation"

"Yes?"

"We had a customer very upset that a pharmacy automatically tried to fill one of their prescriptions without their permission"

"Awesome!! How sure are you that this skulduggery really happened?"

"Oh I'm 100% sure"

"Yesssssss!!!! We're finally going to sock it to those Walgreen's bastards!! No one initiates filling a customer's prescription without permission and gets away with it!! That would be a violation of the sacrosanct privacy that is so dear to us!"

"Well, here's the thing, it's already been in the paper, The Los Angeles Times actually"

"That's OK, we're still not going to let them get away with it!!"

"And the other thing? It's us. Here's what the paper says:"


But B.G. Stine, 52, of Torrance had a decidedly different experience when he stopped by a CVS branch to fill a couple of prescriptions for his brother, Mike, who has Parkinson's Disease

Normally, Stine said, he gets Mike's prescriptions filled at the in-house pharmacy of his 64-year-old sibling's retirement community in Seal Beach. But the pharmacy was able to fill only two of the four prescriptions during a recent visit, so Stine headed over to the nearby CVS.

He said he handed the CVS pharmacist the prescriptions and waited about 15 minutes. The pharmacist then had him sign a clipboard to show that he'd received the drugs, and that was that.

A month later, it was time to get the prescriptions refilled. Stine went, as usual, to the retirement community's pharmacy to pick up the drugs. 

This time, the pharmacist informed him that he'd have to pay the full $600 price for the medications that had been out of stock last time. CVS apparently had already filled the prescriptions and billed Mike's insurer.

"I couldn't believe it," Stine told me. "They just went ahead and did it, locking us out of having insurance cover it anywhere else."

He said he immediately returned to the CVS branch and asked to see the manager. She explained, Stine recalled, that Mike had agreed to enroll in CVS' ReadyFill program when he got his prescriptions filled last time.

"I informed her that he couldn't have done that because it was me who'd picked up the medicine, and I never agreed to anything like that," Stine said. "The manager's face just went blank. It seemed like this wasn't the first time she was hearing this complaint."


I don't mean to pick on CVS so much, really I don't. But there's just so much material, and their employees are so willing to talk. I have never seen anything like the level of anger CVS people have towards their employer. Today's deep pill was the latest in a long line of them.

Something tells me Anita's phone is gonna be pretty quiet. As long as the focus is on other companies that is.

Sunday, June 30, 2013

Non-CVS Pharmacy Company Fined For Wrongdoing.

In a shocking press release made public this month, the Drug Enforcement Administration confirmed that the latest target of a pharmacy related investigation was not leading drugstore operator CVS.

"We have concluded an investigation into the diversion of oxycodone through legitimate pharmacies in the state of Florida and onto the streets of cities throughout the country, and have concluded that it in no way involves CVS." said lead field agent Dirk Bradford at a press conference at DEA headquarters this afternoon. "As unbelievable as it may sound, CVS is in no way accused of doing anything wrong at this time."

The investigation uncovered stores that had sold as many as 2,200,000 pills of oxycodone over the course of a year and not a one of them was a CVS. Seriously. The company that has over the years been accused of among other things, bribing state senators, employing fake pharmacists, overcharging both the Medicare system and individual Medicare recipients, as well as letting a customer have an asthma attack in one of their stores because they were a couple dollars short had nothing to do with this scandal.

I'm not kidding you. Six stores lost their DEA license in Florida over this. And a company that is not CVS will pay an 80 million dollar fine.

Walter Brombach, a retail analyst at Goldman Sachs expressed concern the company was losing its competitive edge.

"After being a trailblazer in showing just how far a corporation can go in skirting the law to profitability, these latest developments raise the specter that CVS' competitors may be catching up and developing their own ways of calculating the reward/risk ratio of defying accepted laws and social norms. That being the case I am immediately downgrading my rating on the stock from 'strong buy' to 'hold"

Other analysts were more optimistic, noting that CVS had its own oxycodone scandal in 2012 and this was simply a case of others mimicking the industry leader.

Reached at the company's headquarters in Rhode Island, CVS spokesman Mike DeAngelis said "We remain committed to serving our customers and will work with the proper authorities.....wait....no....this isn't us.....no comment."

Tuesday, September 18, 2012

I Started This Night Intending To Write Onion-Like Satire About This, But It's Really Not Funny. CVS Is A Drug Pusher.

I mean, it would be really easy to do some tongue in cheek stuff about how the DEA protected the mom and pop drug dealers of Sanford, Florida from corporate chain competition when they pulled the controlled drug registrations of two CVS stores, and I got a couple hundred words into it, but....

I kept thinking about one of my favorites, back when I had customers. In her mid 30's, but maybe the mental capacities of a 12 year old. She was sweet and deeply troubled. Good Lord that woman had been through some shit that left her with pain both physical and mental, but you couldn't help but to see the goodness popping up through the surface of the storms that went through her mind. You have no idea how hard I rooted for her.

Now she's dead. Because another drugstore filled a prescription they had no business filling. Kinda like those two CVS stores in Sanford. Except those two CVS stores in Sanford were doing it a lot more often.

The DEA says those two stores were pumping out enough oxycodone to supply a city with eight times the population of Sanford. Which means people are almost assuredly dead now that wouldn't have been. People who lost their battle with demons that taunted them, with a little help from the friendly pharmacy that looked the other way. Mothers have no sons, lovers are alone, friends are only memories.

I'll bet you though, that every one of those tortured souls were asked at the pharmacy counter, not about the addiction that was destroying them, but if they had their annual flu shot. A few of the deceased probably met their end with a blood stream full of narcotics and antibodies against this year's  A/Victoria/361/2011 influenza strain.

If only there was great profit in getting them the help they really needed.

This is what your profession has come to. CVS is the single strongest player in the pharmacy field. On the cusp of being dominant. Walgreens just screwed themselves business wise and Rite Aid... is hardly worth mentioning. The independents have been devastated and the Wal-Marts and Safeway's that fill a few scripts do it mostly as a side business. Until an ambitious Vice-President decides he wants to make a name for himself by making the prescriptions profitable, which means he'll take a look at how CVS did it.

The accusations of bribery

The overcharging of the taxpayer.

The overcharging of their customers.

The person not a pharmacist who was perfectly able to do everything CVS expects of one.

The defiance of a body responsible for regulating the profession and protecting the public.

How the lax narcotic controls were preceded by lax controls of the materials needed to make crystal meth.

These are the people who now control your profession. Perhaps it's the onset of maturity, maybe it's the crankiness of stress, but you know, tonight, I just don't think it's funny.

CVS had the chutzpah to sue to challenge the suspension by the way, and says “We are reviewing the decision, evaluating our options and determining the best way to continue to serve our customers”

I might suggest, that if they were the slightest bit worried about the best way to serve their customers, none of this would have happened. I might suggest, that the best way to serve your customers CVS,  is not by enabling them in ways to kill themselves.

Back when we were in control of our profession, that used to be obvious.

Monday, March 26, 2012

Right On Cue, Here's This Month's CVS Fuckup

“Nothing is more central to our health care operations than maintaining the privacy of plan members"

Really. Kinda makes me wonder how well they do the jobs that *aren't* as central to their health care operations.  Courtesy of the Boston Globe and an alert reader:

CVS Caremark Corp. said Friday that it mistakenly sent letters to about 3,500 Tufts Health Plan members, giving them personal information about the medical conditions and medications of other members enrolled in a supplemental Medicare plan managed by Tufts 
The mistake was due to an unspecified “programming error,” CVS Caremark, pharmacy benefits manager for the Tufts Medicare Preferred Plan, said in a statement. 
“We are monitoring this situation and CVS Caremark’s response and outreach to Tufts Health Plan’s Medicare Preferred Plan members,” said Sonya Hagopian, vice president at Tufts Health Plan, which is based in Watertown and operates in Massachusetts and Rhode Island.
The “medication information” letters went out to the wrong addresses in late January and early February, mostly to members in Massachusetts. Each letter included another member’s name, the name of a drug prescribed, and the general types of conditions that treatment is used for, according to CVS Caremark, based in Woonsocket, R.I. 
CVS Caremark said it has no evidence that information was used improperly and that the company promptly corrected the programming error. No other specific information, such as financial account numbers or insurance identifiers, was included in the letters, it said. 
The company said it notified people whose names and information went to the wrong addresses. CVS Caremark said notices were also sent to the recipients of that information, asking them to mail the letters back or confirm they were destroyed. “Nothing is more central to our health care operations than maintaining the privacy of plan members’ personal information,” its statement said. “CVS Caremark sincerely apologizes for any inconvenience or concern this incident may have caused.” 
CVS Caremark spokeswoman Christine Cramer said the company would not discuss the incident beyond what it said in the statement. 
Tufts’ Medicare Preferred Plan is the brand name for a family of supplemental products and options the health insurer offers to seniors who receive Medicare, the federal insurance program for older residents. The preferred plan has about 104,000 members overall.

Monday, October 22, 2012

In The Spirit Of Friendship And Cooperation, I Continue To Help A CVS Executive With A Vexing Problem.

OK......I swear I am not trying to turn my little blog garden into a CVS attack vehicle. I am sure that the other "BIG 2" do plenty of dastardly deeds worthy of mockery and exposure. As a matter of fact, I know personally that one of them does. But, the CVS material keeps popping up in my mailbox. Like I've said before, CVS' employees really.....really....seem to hate their company.

Some of my regular readers may remember Ron Snow, Manager of Professional & College Relations at CVS Caremark. I wrote awhile back how Ron had a problem that he just couldn't seem to get a handle on. It bothered his brain enough that he wrote an article in the Indiana Pharmacist’s Alliance quarterly magazine looking for an answer. Ron you see, just couldn't understand why today's smart young men and women seemed a little less than enthused with a career with his type of company:

I am not sure when the change started, but over the past few years I have noticed an inferiority complex growing among community pharmacists. For many years the proud neighborhood pharmacist was known as the most trusted professional, but now he/she has turned into someone with self-image issues. Why has this change taken place? The way I see it, this is a complicated issue with no easy answer.

Ron, the day The Drugmonkey came across your words was a very lucky one for you indeed, because there is indeed an easy answer. Take a look:

Subject: Pharmacy Service real time update *URGENT*
Date: Fri, 25 Mar 2011 10:20:12 -0400
From: RBarna@cvs.com
To: ;

Team 4,
· We are self destructing this week on rx service!!!! 84.7; two days left let’s pick it up TODAY!! 
· 59.2 on addressed by name, 63.6 on wait time- Are we serious??? Do you think I will accept results like this? 
· Wake up and start delivering excellent service results NOW!!! You’ve worked too hard this month to throw it all away 
· If you’re not able or willing to lead your team to deliver excellent service to each patient each time please let me know so we can discuss your exit strategy- one thing I won’t accept are poor service results &; neither should you


That's an actual, real email from someone in your own company Ron. His name is Ryan Barna, a CVS District Manager from New Jersey. Maybe you've met him. If not you can certainly write to him. That's his real email address up there. Ryan sounds like the type of guy who likes to get emails. Maybe you could talk about his part in the looming federal investigation of CVS' apparent habit of enrolling customers in an automatic prescription program without their permission. 

Ryan Barna seems to be awful upset that only 59.2% of customers that responded to a company survey said someone used their name. He sounds like he's blue in the face and maybe his head's gonna explode. Kinda seems like he's totally ready to fire people for not using people's names.

Almost like to him that is the most important thing in the world.

Back to what you wrote Ron:

What prompted me to think about this image problem was a recent conversation I overheard between a couple of new grads that was centered on their career choices. The first grad talked excitedly about his choice of starting a career with a hospital where he was confident that he would eventually get the opportunity to move into a “clinical” position in the not too distant future. The second grad sheepishly commented that he was “just going to work for so-and-so pharmacy” because he did not want to give up his 3 years of service with the company. I did not hear any passion of excitement in his voice about his future career plan.

Ron, imagine you are a college student, and a pretty damn good one. Pharmacy school isn't easy to get into, you know that, and it's even harder to get out of. Years and years of fighting to fill your brain with pharmacology, biochemistry, microbiology, kinetics.....the Krebs cycle. The Krebs cycle can still give me nightmares to this day.

You remember what it's like, don't you Ron? That sense of accomplishment when you finally walk across that stage to get your degree, the gradual seeping in that you really are a drug expert, the first time you knew something a doctor didn't!! And now you can take a position where you're gonna put that knowledge to work in a clinical hospital setting making a real difference in patients health outcomes.....

OR ELSE YOU'RE GOING TO GET THREATENING EMAILS AT WORK FROM SOME NEANDERTHAL WHO SAYS THE MOST IMPORTANT THING YOU NEED TO CONCENTRATE ON IS USING A NAME!!!!! NOW!!!!! DO IT DO IT SO IT DO IT OR I'LL FIRE YOU!! I SWEAR TO GOD I WILL YOU PIECE OF SHIT!!!!!

Ron.....really....the answer is pretty easy now isn't it?

I'm glad I could help.

Once again, that address is RBarna@cvs.com

Wednesday, August 08, 2012

Before We Get To Tonight's Main Event, Someone Insults The Honor Of CVS, And I Correct Them.

This all started with a piece in the Los Angeles Times that said people seem to have a way of ending up on CVS' automatic filling program (which they call ReadyFill) who never asked to be put there.

CVS' (spokesman Mike) DeAngelis denied that any production quotas exist for ReadyFill.

Seems pretty cut and dried. No quotas. Case closed.

I recently sent the following email to my district manager regarding our ReadyFill quota (playing dumb): 
To which he replied:
"Our target on ReadyFill is set at 40% of all ReadyFill eligible prescriptions." 
So CVS DOES have a ReadyFill quota despite Michael DeAngelis (LA Times article) saying there is no quota.

That was from my mailbag this night. And this letter writer could not have been more wrong. As you can see, CVS has a target, not a quota. Get your facts straight because the difference is very important.

It's like the difference between a program called ReadyFill and one called AutoFill. Get it now? I'm glad I could clear that up. Because being signed up for a program against your will to meet a target is way different than being automatically signed up for a program against your will to meet a quota. I'm sure patients understand that.

Because if there wasn't a huge difference between being pressured to meet a target and being pressured to meet a quota, that would mean CVS lied to the LA Times, or at least was disingenuous. And no corporation is more trustworthy than CVS.

Wednesday, June 09, 2010

Dear Pharmacy Benefit Managers, There Is Now An Oligopoly On Both Sides of Your Contract. Prepare To Reap What You Have Sown.

I've known this day was coming for years. I wish I would have written about it earlier so you would all know how wise I am.

I did used to joke about it with District Managers though. As the years went by and the competitors became fewer, I would regularly say things like "When are we going to be be big enough that we can start telling the insurance companies what we are willing to let them pay us?"

The answer, if you're Walgreens, was yesterday:

Walgreen Co., the nation's largest drugstore chain, landed a punch on CVS Caremark Corp. when it said on Monday that it won't fill prescriptions for patients newly covered under pharmacy-drug plans administered by CVS's Caremark unit.
Walgreen said it objects to how some CVS prescription plans use discounts to prod patients with chronic conditions to use either CVS stores or its Caremark mail-order pharmacy. Walgreen also cited CVS Caremark's "unpredictable" reimbursement rates and lack of information when patients transfer to other plans. Working with CVS, it said, is "no longer in the best interests" of customers, pharmacists and shareholders.

Never before can I remember a drug chain growing a pair and standing up to an entire Pharmacy Benefits Manager like this. There have been squabbles over individual contracts from time to time, and occasional gamesmanship when it came to a state Medicaid plan now and then, but it takes way bigger cajones to take on corporation number 18 in the Fortune 500 than it does to pick on a state government these days.This is huge. This has the potential to inconvenience middle class people, and possibly a few who are affluent.

Granted, this particular PBM is owned by Walgreen's main retail rival, which gives the Pharmacy America Trusts an extra incentive to go after them, but still, this is a step up from picking on the poor people. A big fight is brewing between two of the two-and-a-half major drug chains left in this country. Who do we as a profession root for?

Injuries, mostly. One of these corporations has a pilot program that has turned pharmacists into cashiers in lab coats and the other has de-professionalized its operations to the point where they can evidently hum along just fine with someone in charge only pretending to be a pharmacist. Wasn't it Rocky II that had that cheeseball ending where both Rocky and Apollo Creed knock each other out and are simultaneously struggling to get up before the final bell? Something like that would be ideal.

But something like that will most likely not happen. Walgreens and CVS will huff and puff over the next few weeks or months. They will arch up their backs and growl like two tomcats in the alley at three o'clock in the morning, and in the end, they will reach some sort of agreement that will spare the middle class any inconvenience. After all, as far as I know even with the poor people it never got to the point where the trigger was actually pulled on them.

But, the precedent has been set. In the post Revco, Super-X, Phar-Mor, Eckerd, Duane Reade, Reliable, People's Drug, Brooks, Drug Emporium, and Longs world, Walgreen's has woken up and realized it can threaten any PBM with an immediate loss of 12% of the locations where that PBM's members can have prescriptions filled. The people at Medco must be shitting their pants right about now. And while the prospect of Medco shitting its pants is a happy one, I do hope Walgreen's takes a few head punches first. I plan to sit back and watch this one like a white guy at a California prison riot.

Thursday, May 28, 2009

It's A Shame Someone Had To Look Death Right In The Face To Illustrate Points I've Been Making Here For Years.

And it's a shame that that someone wasn't born in Canada, where none of this would have happened. If that were the case I could have spent the day writing about how the utter incompetence of CVS is making my worklife miserable. 

But the story of how I am being penalized for the fuckups of CVS when I do not work for CVS will have to wait. Today you're going to meet Eric De La Cruz. From all accounts I have seen, Eric is a pretty normal 27 year old, except for the fact he developed severe dilated cardiomyopathy. Bad news the dilated cardiomyopathy is. Those of you in the professions already know this means his heart will get progressively weaker until it's transplant or death. 

So Eric was sick, and he was ready to do everything he could to get better. Had he been born in Toronto, or London, or Paris, or Tokyo, that would be the end of this story and I could move on to how CVS sucks pud for making me bail out their sorry asses. Eric had the bad taste to be born in the United States though, where no private insurance company was gonna touch a kid with major heart troubles with a ten foot pole. Eric was placed on Nevada Medicaid. 

"Oh, well that sounds like the end of the story then" You must be saying. "Go ahead and tell us how CVS is ruining your life when you are in no way affiliated with CVS"

Nope. Because Eric was also rude enough to reside in Nevada, where there are no heart transplant centers. Nevada Medicaid will not pay for out of state care. So Eric would just have to die. Two times a court of law told Eric he was just gonna have to die.

That's what happens in the hodge-podge blend of senseless private for profit and 50 separate state government run except for the parts that aren't government run programs that we call a health care system in this country. If you're in the wrong place with the wrong problem you just have to die. 

Which is why I say burn it down. The whole fucking thing. What passes for a health care "system" in this country needs.....to be.....destroyed. Because what would save Eric....his only hope....was the one part of our system that is national socialized medicine. Medicare. 

If Eric could get covered through Medicare, the federally run health care plan that offers universal coverage for the nations oldest and sickest citizens for far less overhead than private plans, he could get back to only worrying about if a compatible heart would become available and the monumental task that is recovering from having a major organ ripped out of your body and replaced. Fortunately for Eric, Medicare is overseen by politicians and not CEO's. Politicians need votes, and when Eric's sister raised a ruckus about the screwing her brother was getting, the politicians realized letting one of their constituents die so publicly might not be the best way to get those votes they need. Eric was granted Medicare coverage. So thanks to his sister and the national socialized medicine part of our health care system, he has a chance. 

It shouldn't have been necessary. The ruckus raising. You shouldn't have to have a sister like Eric's to have a chance to live. Because not everyone has a sister like Eric's.

So burn it down. The whole fucking system. You, and me, and Eric, and everyone else in this country deserve a hell of a lot better. 

CVS sucks.

Monday, October 20, 2014

I Stand This Night In Awe Of The Evil Brilliance of CVS. Or, Maybe Republicans Aren't Always Wrong About Everything.

"Drugmonkey there's some sort of typo in your headline" you're saying. "You've never once had anything good to say about CVS,  I know you make more than your share of slips on the keyboard, but this time is the whopper of them all. "

Except it wasn't a typo. Yes, I once made a joke about the company getting into a new scandal every month that turned out not to be a joke because they seriously do seem to get busted for something with every turn of the calendar page.

And yes, the second most visited page in the history of my little blog garden is that in which I gave space to a CVS employee who opens up on the company with both barrels. I've said it before and I'll say it again, I've never....seen anything....like the hatred CVS employees seem to have for their corporate master.

But I meant it when I just said I am in awe of them this night. They may have just made the move from evil to evil genius.

Let's back up a bit and remember the last time the company made national headlines, getting even the President of The United States to notice they were no longer going to sell tobacco in their stores. Speculation ran rampant as to the motivations of such a move, which was estimated to cost them $2 billion in annual sales. "Well, tobacco is a no growth category" the conventional wisdom went, "they evidently feel the good publicity will be worth whatever loss in revenue will occur, and it probably will help their Minute Care clinics pick up a contract or two. "

Oh how you underestimated these guys mainstream business pundits. It's more than just a contract or two at stake here.

For those of you playing along at home who don't follow the prescription processing industry, I'll mention here that CVS also owns Caremark, the second largest prescription benefit manager  in the country.

Now hold onto your seats, because here it comes, via The Wall Street Journal's Pharmalot blog: 

Caremark... will soon require some customers to make an extra co-payment, in some cases up to $15, on any prescription that is filled at a pharmacy selling cigarettes and other tobacco products

...and in one fell swoop my friends, CVS can potentially cripple it's two main rivals though the 1 in 4 Americans whose prescriptions are managed by Caremark. Absolutely fucking brilliant. "We'll be agnostic [about] where the consumer fills their prescription," said CVS CEO Tom Ryan when the merger with Caremark was under regulatory review. " Well, it looks like they just found religion.

And I'm just....not sure how I feel about this. Other than being awed by the evil brilliance of the plan. I mean, there's no way you can say this isn't using the power of oligopoly to deliver Walgreens and Rite Aid a kick to the nuts, but ...if I were in a position to do it, I'd be more than happy to crush either one of those company's testicles. And you know, tobacco in pharmacies IS stupid. It was a burr up my ass every day I worked for Rite Aid and had to stare at the cigarettes on the other side of the store while selling people asthma meds. I even once wrote my State Representative and Senator, who was on the health committee at the time, making a case for the California pharmacy board to deny a license to any location that sold tobacco. Never heard back from the Representative. Got a letter full of nothing from the Senator.

Yet here we have a brutal bastard vs bastard vs bastard free market business free for all accomplishing what impotent government officials gave nothing but lip service to. The other "Big Two" are gonna either give up tobacco or lose a shitload of prescriptions.

Which... is exactly what should happen. I guess the free market wins this round, said the pinko pharmacist who never did sell tobacco in his store.

Saturday, September 08, 2012

Meanwhile, Over At CVS......

From the mailbag...I almost hesitate to post this, as I fear it might give the other "Big 2" an idea to rip off.

But what the hell, I'm not part of that rat race anymore. Here we go:

I go into work on Wed and we have been sent CVS "thank you" cards to be HAND WRITTEN by the pharmacist and given to the preselected ESI transfer patients when they pick up their RX's. It should say some of the following things: 
-thanx for choosing CVS
-offering flu shots
-offering text messaging
-soon will have electronic signing at pickup
-CVS can have your entire profile and screening for drug interaction
-one on one patient /pharmacist counseling with expert drug info
-Blah blah blah blah blah
-Card is in an envelope and presented to patient at pickup

Bwwwaaaahhhhaaahhhaaaaaaa.....damn good thing they're not having the techs do this. Intensive pharmcotherapy such as this is exactly why I applied to pharmacy school.

By the way, I think this might be a good place for a little mash up with some words by Ron Snow, Manager, Professional & College Relations at CVS Caremark. He wrote these for the Indiana Pharmacist’s Alliance quarterly magazine and they come via the blog of Jim Plagakis. Jim gave me the break that got me into my gig at Drug Topics, which probably contributed to me getting fired from my last job. Which means I owe JP one huge-ass favor:

I am not sure when the change started, but over the past few years I have noticed an inferiority complex growing among community pharmacists. For many years the proud neighborhood pharmacist was known as the most trusted professional, but now he/she has turned into someone with self-image issues. Why has this change taken place? The way I see it, this is a complicated issue with no easy answer.

Now back to my CVS source:

In addition we are calling every one of the ESI patients to give them the same info that is one the card and then we fax all of the calls made daily to the DM...In addition to THAT, the techs pass out 20% off coupons to each patient targeted for purchases in the front thru September. In addition to THAT, we are to delay the transfers of all ESI patients' rxs for an hour and then call the patient to find out why they are transferring...I think you already know this...

Yeah....no easy answer at all as to where those self image issues could be coming from....after 6 years of busting your ass for a doctorate...huh....yup, no idea.

Back to Ron:

What prompted me to think about this image problem was a recent conversation I overheard between a couple of new grads that was centered on their career choices. The first grad talked excitedly about his choice of starting a career with a hospital where he was confident that he would eventually get the opportunity to move into a “clinical” position in the not too distant future. The second grad sheepishly commented that he was “just going to work for so-and-so pharmacy” because he did not want to give up his 3 years of service with the company. I did not hear any passion of excitement in his voice about his future career plan.
Why did not this recent grad not show more enthusiasm for his community pharmacy choice?

Not a clue did you make your readyfill quota. What could it be?

I believe one reason is the focus/pressure that schools are putting on grads to complete a residency...Unfortunately, I have been informed numerous times by interns that they are left to feel inferior if they choose not to pursue a residency.

Really? You know...Here's just a wacky theory....I'm just gonna....maybe I shouldn't...it's kinda crazy.....oh what the hell....maybe.....

....they are. Just a little bit ahead in their professional development than the person who got a doctorate so they could be ordered to fill out these all day.





Just a crazy idea. Back to my CVS Deep Pill:

Its all so crazy...and so demeaning to the employees and NO health care info given to patients at all...I am an old school RPh and it is killing me...

I know, but if those pharmacy schools would just let up on their pressure to put kids in residencies, everything would be fine.

.I know you feel the pain also

Felt the pain. And hoping never to feel it again. You have no idea how much I want this clinic to offer me a gig. I want. To be. A Pharmacist again.

Sigh.

Thursday, February 18, 2016

This One's For The Kids.

Because you need to know what's waiting for you on the other side of a pharmacy degree, and no one else is gonna tell you.

Your professors aren't gonna tell you.

The corporate hacks you interview with aren't gonna tell you.

The American Pharmacists Association isn't gonna tell you. They're there to let you know provider status will create a world where every child gets a puppy and unicorns frolic in the pastures shitting rainbows all day long.

But you need to know. So when I saw this out on the internets I figured I'd put it here where some of you kids would see it. There's not one word in here that surprised me. As a matter of fact, I'd be surprised if you weren't treated to some variation of this if you make the mistake of slinging pills for the corporation. Read it and weep. Then figure out what you're gonna do about it.

This was around the point where back in the bad old days I would have put in some sort of joke about how it was too late for me, but you can still save yourselves.

But it wasn't too late for me. Which I guess means this post isn't just for the kids. I sure as shit didn't have any special entrepreneurial skills  when I set out on my own. I didn't even know what happened to the money after I dropped it off to the community college hack on my way out the door.

Yet here I am am. Three years now and counting. If it's too late for you to find another major I have every reason to believe you could do it too.

No one at CVS probably even read this letter. More people will see it here than at their corporate headquarters. Nothing will change there, but that doesn't mean it has to be this way.

It doesn't. You don't have to accept this.

The letter's long and maybe not of much interest to people outside the profession, but if you're thinking about your major, or if god forbid you're close to accepting a job with one of the chains, you need to read every word.

Then figure out how to keep this from happening to you.

__________________________________________________________________


To Whom It May Concern,

Please accept this letter as notice of my resignation from the position of pharmacist at CVS Health.

As per the terms of my employment contract, I will continue to work for the company for the next 2 weeks, completing my employment on February 26, 2016. If there are any areas in particular you would like me to focus on during my notice period, please let me know. As always, I will continue to give my best effort – I want to leave my team in the best possible situation, and I hope that the new pharmacy manager gets off to a good start.

Although this should be difficult decision to make, I have recently come to recognize that it is really the only decision left, largely due to what I feel is a serious deficit in my immediate supervisor's management abilities. I recognize that she is a strong pharmacist, and I have a lot of respect for her as such, but I have spent the last 3 years under her supervision becoming increasingly frustrated with the state of our district and the way it has been handled. I can no longer keep these feelings of frustration and hopelessness to myself, and will detail some of them below. I hope you will understand my reasons for moving on.


I will start with the broader issues, involving the company as a whole. Let me lead off by saying that I have worked for CVS for 10 years, from intern to pharmacy manager. I have worked in 3 different states, under different management teams, and weathered many storms with and for CVS. I had a colleague, who has about the same tenure, say to me the other day, “I used to recommend that all of my friends try to get jobs here. It was such a good company to work for. Now I tell them to stay far, far away.” I hear this sentiment echoed over and over again throughout the world of retail pharmacy, from those who were previously employed by CVS and from those of us who’ve stuck around, faithfully holding up our ends of the bargain and hoping CVS would see the error in their ways and do the same. The downfall of CVS as a desirable employer began when Tom Ryan retired. His philosophy was always people-driven. He wanted to run a healthcare company, one that took care of and did right by its patients. He wanted us to be able to provide the best possible patient care, and valued our customers as people, not as dollars. He valued his employees as individuals – raises were merit-based and people were recognized for their accomplishments, encouraged, and rewarded.


When Tom Ryan’s reign ended and Larry Merlo took over, it did not take long for their corporate philosophy differences to become apparent at the ground level. Technician hours were slashed; business metrics became the focus over patient satisfaction metrics; employee satisfaction declined and turnover went through the roof; employee benefits were cut, including the extension of the tenure required to achieve an extra week of vacation, stock options, and hiring everyone in at part-time employment to ensure that they didn’t have to be paid health insurance benefits; CVS acquired Caremark (not sure how the FTC allowed this) so that they could force their insurance recipients to use their own pharmacies and as such could lower their service standards to abominable levels, because patients had no choice but to use CVS. They no longer represent what ANYONE went to pharmacy school for, except maybe the paycheck. We are no longer healthcare providers – we have been relegated to being dispensing machines without regard to our own safety or that of our patients.


Now, these corporate changes began several years back. They are not my primary reason for leaving, despite the fact that they are significant. I came to terms with working for one of the corporate giants that was selfishly destroying our society by hurting employees and customers so that the upper echelons of management could bring in money hand over fist. I told myself that it was just the unfortunate way that capitalism in the US has gone, and that it was out of my control. My true reasons for leaving, now, after all this time, are more personal and immediate. Since my prior pharmacy supervisor, Sarah Freytag (the best manager I have ever had the pleasure of working for) moved into a corporate position a few years ago, my district has steadily declined under the management of [pharmacy supervisor name]. I have been underwhelmed with the quality of the management team we’ve had since her departure, and have become increasingly frustrated with the lack of response to the district’s decline.


It starts with respect. My current pharmacy supervisor treats her pharmacists and technicians with zero respect. As pharmacists, we are not even acknowledged as individuals with varying backgrounds and skill sets. Really, I think that it comes down to the fact that she does not spend enough time out in her district or talking to her pharmacists to know us as people, and doesn’t have the slightest inclination as to what we are individually capable of within our roles as retail pharmacists. As an example, a few months back I had text her to let her know that the website was down for our supplier, and I wasn’t able to place an order for the store I was filling in at. Her response was to call the store manager at home (after the order cutoff time had long passed) and ask her to call the store and talk me through how to place an order. I have worked for CVS for nearly 11 years – I have very successfully managed multiple pharmacies, and trained dozens of new technicians in the process. We have been ordering essentially the same way the entire time I’ve worked for the company. I thought to myself, “Does my immediate supervisor really think that I am that ignorant of the functions of my job? Would she really not know that sending an order is something that is well within my comfort zone, and not something that I need someone to talk me through? I can talk someone through just about any procedure in the CVS computer system with my eyes closed.” It really opened my eyes to the true lack of leadership that I was dealing with.


I’ve always felt like [pharmacy supervisor name] didn’t like me. I’ve never understood why, or what I was doing wrong. I’ve never had much feedback, positive or negative. In the 3 years I’ve worked under [pharmacy supervisor name], I’ve never even had the courtesy of having a review (which should be done annually, according to company policy). Last year, I received a very small percentage raise, much below the standard I had seen across my 10 years. I hadn’t had a review, so I checked my online personnel file where the written reviews are stored. I pulled up all of the reviews in there, 1 from Sarah and 2 from [pharmacy supervisor name]. The two from [pharmacy supervisor name] were both blank – all I could find was a rating of “Meets Expectations”. I emailed her to inquire about my raise amount since I had received an average rating, and asked if there was something I should be doing differently to improve my chances of getting a better raise next year. I never got a response.

Finally I called her, and she told me that she didn’t have anything for me to work on, but that my raise was low because my pay was high compared to other pharmacists in the company with the same title and tenure (PT Floater, 10 years of service). So now, my supervisor was telling me that it really didn’t matter what my performance level was or how hard I worked, that I was going to get a menial, ridiculous raise each year regardless, because I had worked very hard to move up earlier in my career and was now situated above some other people who hadn’t worked as hard. This year when I went to fill out my side of my review, my goals that [pharmacy supervisor name] had set for me revolved around “Manager Controlled Profits”, which involves script budgets and payroll management. Last year’s review was in March, and I had been floating since the previous September – the goals she had set for me weren’t even relevant to the job I was in. [pharmacy supervisor name] has so little respect for her pharmacists that she doesn’t even know who they are with respect to what positions they hold under her, and can’t even bother herself with writing out relevant reviews and goals for them.


But the lack of respect goes beyond that. Interns and technicians are essentially abused, and pharmacists are treated as pawns that should have no say or even opinion on their own career paths. I have seen technicians asked to take their day off to drive across town, pick up a cookie for a new pharmacist that was just licensed (and only one or two of the many, mind you) as congratulations, deliver said cookie to the pharmacist, and drive back home, all without pay.

I have seen countless interns on management rotations forced to work in stores as free labor, not to be shown a single thing about how to be an effective manager. I was even told by one intern that she was forced to personally deliver a narcotic prescription to an angry patient’s home – the patient’s regular pharmacy did not have her medication in stock, so the intern had to pick up her prescription hardcopy at the regular store, take it to another store to be filled, then drive it to the customer’s home. The patient was irate and somewhat unstable (I had spent over an hour on the phone with her myself a couple of days prior), and the intern was put in a very uncomfortable position where her personal safety was compromised so that the [pharmacy supervisor name] didn’t have to deal with the situation. Needless to say when [pharmacy supervisor name] asked her if she was interested in working for CVS, the answer was no.


As far as my personal situation goes, I have always been extremely flexible with CVS. I worked full-time until the birth of my daughter 4 years ago, and have since gone back and forth between full- and part- time, floater and pharmacy manager to meet the needs of my district. I have experienced swings from being told there are no hours for me to being asked to go back to full-time a couple of months later, and always taken it in stride and done whatever was asked of me. I have managed “challenged” pharmacies and turned them into “excellent” pharmacies,

I have been told by multiple pharmacy managers that I am the only floater they have ever had that will go above and beyond my daily duties of filling prescriptions to actually help them run their stores, and I have been told by technicians that I am the best boss they’ve ever had. I have a very strong urge to work my hardest and do my best regardless of whose store I’m in, whether the final outcome of how the store is doing is my responsibility or not, and I find my biggest frustration with floating was knowing that if I had more time at a store, I could make a bigger difference. This lead me to recently volunteer to manage a pharmacy that was really struggling, despite the fact that I have opened a small business and have a 4 year-old at home, and really want to be working part-time. I decided that for a while, I could sacrifice my personal needs to help my district succeed.


The back story on the situation at this store needs to be explained, as it is one of the major faults I see in [pharmacy supervisor name] management outlook. Since turnover has been so high under [pharmacy supervisor name], she has developed a habit of hiring the first person that walks in her door, regardless of their abilities as pharmacists or managers. She has also decided that the best way to get a pharmacy manager in a store that is in need is to force someone who doesn’t want the position and/or can’t handle the position to do it anyway. My biggest issue with this is with newly licensed pharmacists who have just graduated from school. They have no experience as a pharmacist, no experience being the one in charge of everything that’s going on that day, no experience handling being pulled in 8 different directions at the same time, and no experience managing people. They are not only being expected to magically become strong, fast pharmacists overnight, but they are expected to do so in very busy stores, and even as pharmacy managers.


In this particular store, 4 technicians were accepted into pharmacy schools at the same time. They were all scheduled to start their programs in August. The pharmacy manager was working on getting new technicians hired to replace them, and the staff pharmacist gave notice that he was moving away. The first terrible decision of a long series of terrible decisions was to, at the same time that the staff pharmacist and all the technicians were leaving, pull the pharmacy manager out and transfer him to another store. This left my store with no leadership, no permanent pharmacist, no technicians, and no one to follow through with the new hires. She decided to promote a staff pharmacist from another store (45 minutes away) and have him commute to my store to be the pharmacy manager, and put a newly licensed pharmacist in as the staff.

At the same time, the pharmacy manager at his original store gave his notice. [pharmacy supervisor name] decided that the best call was to let the transferring pharmacist remain at his original store as the pharmacy manager, and to force the newly licensed pharmacist to be the pharmacy manager at this store, with no steady partner for support. This was one of the worst decisions she could possibly have made, both for the pharmacist and the store.

Our district has plenty of experienced staff pharmacists who are plenty capable of being pharmacy managers. In this situation, I cannot understand why you would not take an experienced pharmacy manager from a slightly slower store and move them to this busy store, take an experienced staff pharmacist and promote them to a pharmacy manager at the slower store, and then take the newly licensed pharmacist and allow her to “get her feet wet” as a staff pharmacist. Dumping a new pharmacist into a management position is never a good idea. Dumping them into a super busy store is never a good idea. Combining the two is a terrible idea. Needless to say, the new pharmacist quit, leaving the store with no regular pharmacists and severely understaffed with technicians. I had been floating there some, and in an effort to keep the new pharmacist (who I had worked with when she was hired as an intern) I volunteered to take over as manager of that pharmacy, thinking that this would allow her to relieve some of her burden and be able to hang in there. I did eventually get put in as pharmacy manager, but not until a couple of weeks after the new pharmacist had left the company and the store continued to struggle, with no support from management.


About the time I was put in as the pharmacy manager at my store, [pharmacy supervisor name] went on maternity leave. I strongly believe that the only reason I was allowed to take the position was that she wasn’t there to say no – she had decided several months back that she would not staff me permanently in a store because she did not want to accommodate my schedule restrictions.

I was told by the district manager and the interim pharmacy supervisor that, when I expressed concerns with the way things had been managed to this point, that, “We’ve been doing things the [pharmacy supervisor name] way for a while now, and it’s obviously not working. Now we’re going to do things my way.” I was under the impression that meant that I would be staying in this store for several months, allowing them time to hire a staff pharmacist for the store, get the technician staffing under control, hire a pharmacy manager, make sure the pharmacy manager was capable of handling a store of this volume, and then make a transition once the store was stabilized.

Unfortunately, as soon as [pharmacy supervisor name] came back from maternity leave, this plan went out the window. In my first conversation with her after she was back, I asked when she could get me transferred into this store permanently, so I could access all of the tools that are only available to pharmacy managers. Her response was, “Why would I transfer you there? You aren’t the pharmacy manager there. You aren’t going to be the pharmacy manager there. We’ve already got someone to replace you, and I just heard back today that he passed his drug test and background check.” Here we are back to respect, and treating people with some basic human decency.

I was shocked. I asked her about my pay, as the pharmacy manager position awards you a $1 per hour increase – she informed me that she would NOT be backdating my pay for the time I had been manager at the pharmacy, because despite the fact that I had power of attorney and was managing the pharmacy, I was not actually the manager there. All of this was completely sprung on me, in a completely tactless and inappropriate way, while I was in the middle of my shift. I felt the entire situation was extremely inappropriate, and I called the district manager. I was told that this was always the plan, despite the fact that one week earlier when she had been in my store, I had mentioned that I heard they had a partner for me, and she had acknowledged that and said she was excited that we were moving in the right direction. She and the interim supervisor had asked me to apply to the internal job posting for the manager position, and even had me spend my personal time writing a resume for the job. There are two options here – they were leading me on, lying to me about their intentions for me, or they lied more recently, informing me that this was always the plan.

Either way, I’m not satisfied with being treated that way. It’s not the decent way to treat anyone, and especially someone who has dedicated their professional life to CVS and volunteered to make personal sacrifices for the betterment of the district.


Now, my career is up in the air, my job in turmoil. No one has bothered to discuss with me what the plan is for my future, where I want to go and what I want to do. My store is in a state of unknown – under my guidance, turnover has stopped and my technicians are once again happy to come to work. We went from running consistently 500-700 scripts past due, to consistently running on time, and even occasionally getting some cleaning and organizing done, despite the fact that we are still understaffed by 60 technician hours a week.

Now, a pharmacist that is new to CVS is being sent in to manage the store. As has been described, throwing unknowns into this store hasn’t been very successful. It’s a tough store. It’s old, small, poorly laid out, and very fast-paced. We have recently grown by about 20% (just in the last few weeks) and have been able to maintain, but the technicians who have been through all of this just a few short months ago are terrified that a new pharmacist will not be able to handle the store and that it will return to how it was. I hope that’s not the case, but to be honest, no one knows.

One interview with someone isn’t going to show you that, and once again we are back to our old management tactics of putting all of our stock in one person to hold it all together. I even volunteered to stay on as the staff pharmacist, feeling that this would bring some stability to the store and that I could be an excellent supporting pharmacist to a new pharmacy manager that is not familiar with CVS’ system and the exact expectations and requirements of the job. This suggestion never even received a response beyond “We’ll talk…” which we never did.


I am not happy to be writing this letter. I had high hopes that a new district manager would bring real change, and that the district would no longer be subjected to the irresponsible and destructive management style that [pharmacy supervisor name] has brought with her.

Despite all of my frustrations, I still struggled with this – my professional career has only ever known CVS. I have made countless friends through this job, in technicians, pharmacists, front store staff, and patients. It’s difficult to walk away. But my hope is lost, my faith is gone. I hope for everyone else’s sake – all of those wonderful people who are still hanging in there, hoping for improvement – that I am wrong and change does come.


Thank you,
Lindsey Hoehn
PharmD