John Fleming was midway through his 30-day prescription for blood pressure medication when he noticed something peculiar. There were only five pills left in the medicine bottle, not the 15 he should have had.
“I called the pharmacist and told him,” says the 54-year-old director of the National Afro-American Museum and Cultural Center in Wilberforce, Ohio. The pharmacist’s response: “Oh, we’re sorry. Just come in and get the rest of the pills.”
Fleming later switched pharmacies, but his problems persisted. He began feeling light-headed after starting a new prescription called Lopressor, a drug designed to control blood pressure.
“Turns out this pharmacist had given me 25 milligrams of the drug, not the 50 milligram doses my doctor prescribed,” recalls Fleming. “The pharmacist was very apologetic, but I was upset. What happened wasn’t life-threatening at that point, but it certainly impacted how I felt.” If Fleming had continued taking the drug at the wrong dosage, however, he may have been at risk for a stroke.
Consumers like Fleming are wondering why pharmacists can’t seem to follow doctors’ orders when it comes to dispensing medication. In some instances, patients are shortchanged on the number of pills or in the dosage prescribed. In more serious cases, patients can receive the wrong medication, with fatal results. An estimated 100,000 people die from prescription drug use every year, according to a study reported in the Journal of the American Medical Association.
These errors stem from the great changes sweeping the pharmacy industry. Hospitals and large-chain drugstores have cut staffing to hold down costs and increase profits. At the same time, pharmacists’ workloads have increased due to the additional paperwork required by insurance companies.
This is a major reason for the errors and slow service consumers face at the pharmacy counter, says Michael Hogue, a pharmacist in Albertville, Alabama, and member of the American Pharmaceutical Association. “Your pharmacist literally becomes an insurance agent. While dispensing medication, he or she is likely to be on the phone trying to process your insurance claim.”
In the case of Fleming’s short supply of blood pressure medication, Hogue says it’s likely the insurance carrier had a limit on the quantity that could be dispensed at one time. “Most consumers don’t realize that their insurance company won’t allow for more than a 15- or 30-day supply of medication. Whenever you get fewer pills than prescribed, ask the pharmacist if your insurance carrier has limits on that prescription,” advises Hogue.
And what about the wrong dosage Fleming received? Hogue blames poor management at many of the largechain drugstores. “Many of the chain pharmacies are not managed by a pharmacist who understands the need for time to process an order. They may be managed by someone who puts pharmacists under lots of pressure to fill orders quickly, and that leads to errors.”
Larry D. Sasich, a pharmacist and analyst with the Washington, D.C.-based Public Citizen Health Research Group, a watchdog organization for consumer health issues, calls it the prescription mill. “There may be one pharmacist behind the counter and two technicians.