Why are pharmacies so slow?

Factual Questions
1

I’ve got bronchitis. Today I went to the drug store to pick up the drugs to treat it: an inhaler, antibiotics, and cough syrup.

I handed the pharmacist my prescription and she went and pulled all three drugs off the shelf. She didn’t have to count pills or measure anything out. Everything was already packaged in the proper dosage.

“Okay,” she said “Come back in 20 minutes and we’ll have them ready for you.”

I came back in 20 minutes and they weren’t ready. It actually took 45 minutes.

They weren’t particularly busy. Why did it take so long? I understand they have to type up a label and stick it on, and enter the transaction in their computer system … but, seriously, 45 minutes? What am I missing here?

2

Do you have insurance? Were any of the drugs on the controlled substances list? Either of those might have necessitated double-checking information with either the insurance company or the prescribing doctor.

3

I got antibiotics, an antihistamine inhaler, and cough syrup with codeine. Nothing exotic.

I do have insurance.

4

Wikipedia says codeine is a schedule I controlled substance when not combined with at least two other active ingredients. Maybe that’s it?

5

Maybe there were others in a queue that you weren’t aware of. Many pharmacies enable people to call in refills via an automated phone line, for instance.

6

The classic blog post addressing this

7

I’d call codeine pretty exotic.

8

Ya know, I looked at that list and for the life of me I couldn’t figure it out…then I realized it’s the Canadian Controlled Substance list. In the states I believe codeine is CIII.

9

The regulation of codeine is weird. In the US, it’s a controlled substance, more regulated than your average prescription drug, but in the UK, it’s available without a prescription.

10

I wouldn’t. In fact I think most people would consider it pretty mundane.

11

Other people are in front of you…there is probably only 1 guy actually filling the bottles. They count and recount you pills and make sure it does not interfere with other meds your on. Doctors prescribe conflicting meds a lot more than you would think

12

It’s not exotic, it’s narcotic.

13

I recall one time at Walmart I left my prescription for my blood pressure meds and an inhaler. She said, “About 45 minutes,” which was fine as I had to shop anyway.

I came back in 45 minutes and the pharamacist says, “Oh I didn’t put you in, just a minute.” She types some stuff into a computer, it prints out two labels, she slapped them on an inhaler and a bottle of sealed pills, (she didn’t have to count them) and handed to me. Time total about 3 minutes.

So I am thinking the pharmacy has a lot of back orders from the day, plus they probably have a standard time for everyone in the place. Like 20 minutes or 45 minutes.

I guess you have to think of it like this. When the pharmacy opens, they probably have back orders off the Internet and phone refills and if they have say 30 that came in over night and you’re first in line in the morning, you’re really 31st in line but you wouldn’t see that.

14

Depending on the dose it’s OTC in Canada too.

15

The blog Your Pharmacist May Hate You addresses this and many, many, many other questions about the pharmaceutical industry in a sort of tongue-in-cheek manner. He’s done a post about this very thing.

Why Your Prescription Takes So Damned Long To Fill.

16

Psst, apollonia, check post #6.

It’s ok, I’ve done the same thing myself more times than I care to tally up…

17

Doc: Take X.
Me: I’m on Y, if I take X, my liver will reenact the lunchroom scene from Alien.
Doc: OK, don’t take X.

I worked in a pharmacy for 10 years, and my mom’s a pediatric nurse, I know more than average about drugs.

18

Well, it IS a morphine derivative.

19

There is a lot that goes into filling a script when we get one, it isn’t as simple as “slapping a label on a box”. First we need to decipher what the doctor wrote, sometimes it is easy, sometimes it involves calling the doctor’s office. Then it gets typed into the computer system, then we need to run it through the insurance. This again could be easy if you’ve been there before and the drug is covered, or it could be hard if your insurance company doesn’t want to cooperate. Once all that is done, we can finally print the label, and count or slap it on the box.

Once the script is counted, labeled, etc, it needs to go to the pharmacist to check. Most of the time, this is the actual bottleneck in the process. There is only one pharmacist (most times), and every prescription has to be checked by him/her. This is where the pharmacist does a drug interaction check to make sure none of the drugs interact with each other, or with anything else you are taking, or if they do interact, the interaction isn’t clinically significant. The pharmacist also has to make sure the prescription was typed and filled correctly by the techs. If there is any errors or if the pharmacist wants something changed (wrong verb, change 5 mL to 1 TSP, etc) , they will most of the time the pharmacist will send it back to a tech.

Now, during all of this, the phone is still ringing, there are other patients in front of you, a tech will ask you to decipher a script, or ask what the generic is for a brand. You’ll have patients asking the pharmacist a question on a drug, a doctor calling in a new prescription, a patient wanting to know if the doctored called in their medication, so the pharmacist has to check the voice mail, or even just some customer asking you where the trash bags are kept.

If someone drops off a prescription in person, I will tell them a minimum of 15 minutes, if they drop it off in the drive thru, it’s a minimum of 30 minutes. That is even if I’m going to do it right away. If I rush a script through without distractions, I can get a new script done in about 5 minutes, a refill in about 2 to 3 minutes.

Oh, and Codeine is a C-II if by itself, C-IV if mixed with another medication (like acetaminophen in Tylenol #3), and a C-V if used as an anti-tussive (Like with Robitussin AC).

20

‘Cuz they just don’t get no respect.