Virginia Regulatory Town Hall
Department of Health Professions
Board of Pharmacy
Regulations Governing the Practice of Pharmacy [18 VAC 110 ‑ 20]
Action Pharmacy working conditions
Stage Emergency/NOIRA
Comment Period Ended on 11/22/2023
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11/7/23  7:57 am
Commenter: Anonymous

Call to Action
The very fact that this forum has been created should speak volumes to the BOP and to any corporations that will listen. The profession of pharmacy is in dire need of significant changes and they need to be made and implemented sooner than later. Thank you for granting a thirty minute, undisturbed, rest period. Unfortunately, I have only been able to utilize this break a handful of times since my company chooses to leave the phones on, windows open, and techs still performing approved tasks. 
The need for more hours, more techs, more overlap, less metrics, etc have been duly noted on the previous comments. I whole heartedly agree with all of those issues and what we need are solutions. The BOP should take a deep dive into the causes of ALL of our problems, not just the obvious ones. One thorn in our side is GoodRx (and other similar "discounts") and it should be against the law. It has cheapened our profession more than the $4 plans ever did. It has made polypharmacy worse than it was before (if that's possible). To charge us a fee every time we submit a claim with $0.00 reimbursement is absolutely ridiculous when all they have is the cost of advertising and printed cards/app. Doctors distribute these coupons for them without even knowing how it works. It is unlawful. Even more unlawful are DIR fees. At the retail level, we are doing good to break even as it is. We don't need PBMs making the rules, changing the rules without notice, and then still coming up with reasons to take more money away from us whether we abide by the rules, meet all the criteria, or complete enough MTM documentation to make any of that money back. I don't see how this seems right to anybody other than those filling their pockets with the money our pharmacies deserve and have worked tirelessly to earn. Please encourage our legislators at all levels of government to address this NOW. I don't see how independent pharmacies can possibly compete in this type of environment and some of the smaller communities that only have an independent pharmacy are paying the price and it is not one bit fair to anyone. 
I sincerely feel that there should be a patient education campaign or a public service announcement of some kind issued by the BOP that would give patients an idea of the challenges we face and some explanations as to why their rx isn't ready when they show up five minutes after leaving urgent care, or why their $5,000 rx may require a prior authorization after the doctor just explained to them how imperative it is that they be on it and the steps that are necessary to hopefully, eventually end up with a paid claim, why the supply chain is so messed up and why no pharmacy in town has their hydrocodone/apap 10/325 (and countless others that currently aren't available), why we more often than not will need their actual, physical insurance card in hand so that we can accurately bill insurance. I could go on and on. If patients had even a little bit of understanding as to what we're going through, maybe, just maybe they would show us a little grace as we are pulled in so many different directions in our efforts to safely and accurately dispense their medications. 
We need qualified, competent, trustworthy technicians and they need to be paid appropriately. We used to say a pharmacist is only as good as his/her techs. Well we may as well say we just can't be that good anymore because most of our tech help does not care about the end result of what we do. They don't even care enough to get to work on time. The right people for this job need to get paid what they are worth across the board if nothing else just to boost morale and we need to find these people NOW.  That would go a long way in my book. As it stands now, IF we can hire someone, by the time we invest the money in them to get them trained, they leave to work for another business that pays more. So then we've lost the person and the investment and we rarely can hire any techs from a competitor because we are not competitive with pay. When the people working at Buc-ee's cleaning the bathrooms are making more than pharmacy technicians who play a vital role in the accuracy and efficiency of filling, billing, and selling prescriptions to our patients, then THAT's a problem. 
We need a much better way to handle the entire process of administering vaccines. The paper forms patients have to fill out should be universal or made electronic to at least simplify this part of the process. There should be a nurse or a designated pharmacist scheduled and advertised on days that vaccines are to be given. Also we should not have to give every single vaccine under the sun and it is almost impossible to work shots into our normal workflow. The chances of a misfill or other problems are significantly increased when trying to balance all the many tasks we are asked to do all day, every day. What if in the hustle and bustle of a busy day, a patient receives the wrong vaccine? At that point it's too late. God forbid this should happen but it could. Then what?
We need easier, more streamlined ways to bill coordination of benefits claims. They should either work or not work. Keep the federally funded critieria if you must, but just allow us to put the information in and bill it without having to guess at eight or so other coverage codes, use time that we could be doing other things, and STILL wonder if we're doing them correctly or not.  
I never in my wildest dreams thought when I started in pharmacy just over twenty years ago that we would be facing the obstacles, challenges, and just outright abuse that we deal with on a daily basis. I have strongly considered a career change and feel that I would be fully justified in doing so. There is no way I can, in good conscience, encourage a student to sign up for this for the rest of their life. Also, I would never want my kids to follow in my footsteps and pursue a career in pharmacy or anything even remotely related to it. 
CommentID: 220620