July 26, 2005
This (Pharmacists) Madness Must Be Stopped
Several states allow pharmacists to decline to fill prescriptions based on their conscience. Other states are trying to require that pharmacists provide medicines that doctors have prescribed. Now federal lawmakers are holding hearings on so-called ‘duty to fill’ laws.So went the introduction to a story on NPR’s Morning Edition I listened to this morning.
In my mind this debate can have only one outcome: the doctor/patient relationship should be upheld in every case. No third party should be allowed to insert their moral judgment into the doctor/patient relationship, period, unless invited to do so! Pharmacists, like the rest of us, have a right to their opinions, however misguided, but they should not be allowed to let those opinions adversely affect the people they are supposed to be serving. And yes, they have a right to their individual principles, but those principles should not be allowed to interfere with patient care.
And make no mistake, they are in the service industry, all they do it dispense drugs, and occasionally dole out advice. Pharmacist, though a valuable link in the chain medical chain of care in America, are not indispensable, and are certainly not specialist, like doctors. Who, after all, is a Pharmacist to substitute his or her judgment for that of the doctor or the patient? Frankly, I find the whole business of refusing to dispense drugs because of you religious beliefs repugnant and just another sign of how far the falsely righteous will go to foist their belief system on us all.
If they are morally opposed to birth control and might be required by their employers to pass out prescription birth control pills or the morning after pill, then their professionalism and duty to their customers should prevail. If they still object, then they should find another profession, one in which their conscience will not be overly burdened. Or at least have to decency to refer the customer to another Pharmacist whose brain is not clouded with self-righteous religious dogma.
Will a bill pass out of Congress that will end this madness once and for all and compel Pharmacist to fill prescriptions or find another job? Its doubtful, and even if the a Bill did manage to pass both houses with its common sense still intact, Bush would never sign it into law because he lacks; well he is just lacking so much its hard to know where to begin.
Make sure you read all the way past the list of the drugs (below).
The woman who wrote this, Sharon Davis, is a Budget Analyst out of Federal Offices in Washington, D.C.
Did you ever wonder how much it costs a drug company for the active ingredient in prescription medications? Some people think it must cost a lot, since many drugs sell for more than $2.00 per tablet.
We did a search of offshore chemical synthesizers that supply the active ingredients found in drugs approved by the FDA. As we have revealed in past issues of Life Extension, a significant percentage of drugs sold in the United States contain active ingredients made in other countries.
In our independent investigation of how much profit drug companies really make, we obtained the actual price of active ingredients used in
some of the most popular drugs sold in America.
The chart below speaks for itself.
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Celebrex 10 0 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%
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Claritin 10 mg
Consumer Price (100 tablets): $215.17
Cost of general active ingredients: $0.71
Percent markup: 30,306%
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Keflex 250 mg
Consumer Price (100 tablets): $157.39
Cost of general active ingredients: $1.88
Percent markup: 8,372%
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Lipitor 20 mg
Consumer Price (100 tablets): $272.37
Cost of general active ingredients: $5.80
Percent markup: 4,696%
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Norvasec 10 mg
Consumer price (100 tablets): $188.29
Cost of general active ingredients: $0.14
Percent markup: 134,493%
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Paxil 20 mg
Consumer price (100 tablets): $220.27
Cost of general active ingredients: $7.60
Percent markup: 2,898%
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Prevacid 30 mg
Consumer price (100 tablets): $44.77
Cost of general active ingredients: $1.01
Percent markup: 34,136%
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Prilosec 20 mg
Consumer price (100 tablets): $360.97
Cost of general active ingredients $0.52
Percent markup: 69,417%
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Prozac 20 mg
Consumer price (100 tablets) : $247.47
Cost of general active ingredients: $0.11
Percent markup: 224,973%
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Tenormin 50 mg
Consumer price (100 tablets): $104.47
Cost of general active ingredients: $0.13
Percent markup: 80,362%
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Vasotec 10 mg
Consumer price (100 tablets): $102.37
Cost of general active ingredients: $0.20
Percent markup: 51,185%
_________________________________________________
Xanax 1 mg
Consumer price (100 tablets) : $136.79
Cost of general active ingredients: $0.024
Percent markup: 569,958%
_________________________________________________
Zestril 20 mg
Consumer price (100 tablets) $89.89
Cost of general active ingredients $3.20
Percent markup: 2,809%
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Zithromax 600 mg
Consumer price (100 tablets): $1,48219
Cost of general active ingredients: $18.78
Percent markup: 7,892%
_________________________________________________
Zocor 40 mg
Consumer price (100 tablets): $350.27
Cost of general active ingredients: $8.63
Percent markup: 4,059%
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Zoloft 50 mg
Consumer price: $206.87
Cost of general active ingredients: $1.75
Percent markup: 11,821%
_________________________________________________
Since the cost of prescription drugs is so outrageous, I thought everyone should know about this. Please read the following and pass it on.
It pays to shop around. This helps to solve the mystery as to why they can afford to put a Walgreen’s on every corner.
On Monday night, Steve Wilson, an investigative reporter for Channel 7 News in Detroit, did a story on generic drug price gouging by pharmacies. He found in his investigation, that some of these generic drugs were marked up as much as 3,000% or more.
Yes, that’s not a typo…..three thousand percent! So often, we blame the drug companies for the high cost of drugs, and usually rightfully so.
But in this case, the fault clearly lies with the pharmacies themselves.
For example, if you had to buy a prescription drug, and bought the name
brand, you might pay $100 for 100 pills.
The pharmacist might tell you that if you get the generic equivalent,
they would only cost $80, making you think you are “saving” $20. What
the pharmacist is not telling you is that those 100 generic pills may
have only cost him $10.
At the end of the report, one of the anchors asked Mr. Wilson whether or not there were any pharmacies that did not adhere to this practice, and he said that Costco consistently charged little over their cost for the generic drugs.
See the costco.com pharmacy site, where you can look up any drug, and get its online price. It says that the in-store prices are consistent with the
online prices. I was appalled. Just to give you one example from my own experience, I had to use the drug, Compazine, which helps prevent nausea
in chemo patients.
The generic equivalent, cost $54.99 for 60 pills at CVS.
At Costco, and I could have bought 100 pills for $19.89.
For 145 of my pain pills, I paid $72.57. I could have got 150 at Costco
for $28.08.
Although Costco is a “membership” type store, you do NOT have to be a member to buy prescriptions there, as it is a federally regulated substance. You just tell them at the door that you wish to use the pharmacy, and they will let you in. (this is true, I went there this past Thursday and asked them.)
__________________________________________
NOTE: Not all medications are cheaper, and some generics aren’t available, but some are significantly less costly. The important thing is, it’s important to shop around, becuase prices vary greatly.
__________________________________________
check out: costco.com
This is an interesting policy issue, if only because what’s right is not so cut-and-dried. The debate hinges on whether or not a pharmacist is considered a medical professional or a merchant.
I don’t think Pharmacist’s take the hippocratic oath. I don’t know the degree to which they are allowed to “advise” in medical terms (it’s not like they are writing the prescription).
So at the end of the day, I’m just not sure I have an issue with a pharmacist (presuming he is the proprieter of his own pharmacy) deciding not to sell something he is morally opposed to in the same way I don’t have a problem with a convenience store owner choosing not to sell porn.
It seems like he is exercising his 1st amendment right, and though I personally disagree with his decision, I cannot say wholeheartedly that it is wrong of him to do.
Of course, if there is something in the Pharmacist’s Oath or Code of Conduct that dictates otherwise, then my opinion is subject to change. But if not, then the consumers have every right to simply patronize another pharmacy.
Posted by: Andrew L. at July 26, 2005 10:52 AMThe pharmacists themselves don’t set prices (unless privately owned).
One way to cut down on costs would be to replace all pharmacists with computers and machines.
A doctor could call in a Rx, the computer could check the medication for interactions, etc., and count out and dispense the medication, and then mail it (or deliver on-site to customer). It could all be easily automated. In fact, a computer could probably do this job better and much faster.
Dan:
Its not really applicable to look at the cost of ingredients within a pill compared to the markup. The ingredients are not where the massive costs are. The massive costs are contained in the research not only for the successful drugs that reach market, but also for the hundreds that do not. It takes an average of 18 years of research from day one to when a drug reaches the market.
That having been said, the problem I have is not with the cost of the drugs, but with the fact that pharm companies are making record profits. If their costs are high, and the resultant prices are high, so be it. But when profits are high, that means they are gouging the market.
V. Ed:
I don’t have a problem with pharmacists not providing a certain drug, as long as it remains available. Companies have the choice of what to sell and what to provide. The only time I would force a pharmacist to provide a drug would be for health issues—-ie, if that drug were not provided, there could be adverse health issues for the patient.
I had a vasectomy years ago, and the doctor refused to do it unless my wife joined us and approved it. One could say that MY medical rights were violated in some way, or one could say that the doctor was using HIS right to provide services in a manner he felt was correct.
I found him to be a wonderful doctor (shaved me down there faster than i’d ever dare shave my face, but no nicks, thank goodness). I agreed with his approach, and found him to be well within his moral and professional rights.
Seems to me this is the same type of thing as with the pharmacists. Now…..if I’d been a woman, and he wouldnt allow an abortion without the approval of the husband……boy, the NOW crowd woulda been up in arms, i’m sure.
Posted by: joebagodonuts at July 26, 2005 11:11 AMd.a.n,
As a user of a large quantity of drugs, I have conducted many cost analyses. Your post is absolutelt brilliant in delivering a much needed message. Thanks,
That said, I think there are factors to be considered that I did not see in your piece. These are : a) the cost of labor to manufacture the drugs and b) the cost that it took to develop the FIRST pill in each catagory.
I think it reasonable for drug companies, pharmacists, etc. to mark up costs for profit purposes.
V. Edward Martin,
Very nice piece, timely as well. I agree that a pharmacist should not be able to refuse to dispense drugs prescribed by physicians for reasons of conscience or religious conviction. I do however think that pharmacists should be able to (I have instructed mine to) :
1. Verify that a prescription is not in conflict with another drug I am taking
2. Refuse to fill a prescription issued by a doctor who is on a “watch list” for possible inconsistent practices
Posted by: steve smith at July 26, 2005 11:19 AMJBOD,
Good post. I have only one comment-Shouldn’t the assumtion be that if a doctor prescribes a drug, there will be adverse health affects if that drug is not taken? If not, why not? What standards are we to use to determine adverse health affects?
I agree that a law on this topic will not be passed. Maybe the best way to deal with it is for the pharmacists themselves (as a group) to decide what is ethical conduct, have standards, and be admitted to a professional organization (I don’t know how much of this actually happens).
I’m thinking like law—lawyers often have to do things that they themselves find wrong to maintain legal ethics, and if they “follow their concience” they can be disbarred. Doctors are also confronted with ethical issues, and regulate themselves. This way, you know going into pharmacy school that you have certain ethical obligations as a pharmacist, and if you don’t like them, get a different job.
Joe—
I am glad you and your doctor got along so famously, but he really had no right to deny you; your medical records and or procedure are yours alone. You have a right to medical privacy. I do not see the parallel here. Yes, these women can take their business elsewhere, but why should they have to? If the insurance you pay for dictate that you use such-and-such Pharmacy, then you have a right to get what you are paying for irregardless of someone else (bigoted) opinion.
I think it reasonable for drug companies, pharmacists, etc. to mark up costs for profit purposes.
Really? Even to the point of 225,000 percent? That seems a little excessive.
And d.a.n’s post covers generic drugs. By the time a drug goes generic, the pharma co. has made back it’s research costs (and then some - like 200,000 percent).
Obviously we want the pharma companies to make a profit, but there’s profit - and then there’s PROFIT.
VEM, that’s an interesting piece. And I agree with you on it. Andrew may be right about a pharmacy’s right to refuse service, but they shouldn’t.
Posted by: American Pundit at July 26, 2005 11:34 AMDan
Have you ever bought software of music over the Internet? The variable cost of that product is zero, so any markup if infinite. This is true of any intellectual property. Reminds me of a story.
This guy has plugged pipes and calls the plumber. The plumber comes by and says that he can fix the problem for $100. The guy says, “Sure, I can’t live with the problem”. The plumber takes out a little hammer, gives the pipe a short sharp whack and everything works fine. The guy says, “$100 for that? I want an itemized bill.” The plumber gives it to him. It says: Whacking pipe - $.05. Knowing how to whack the pipe - $99.95.
Dan—
While I applaud your enthusiasm in bringing your comments to the table, I fail to see what your comments have to do with my original post. The only connection is the fact that we are talking about prescription drugs. Do you have anything to lend to the discussion pertaining to my original post?
I care less about a drug store selling whatever they choose, than the fact that Americans pay the reasearch costs for Canada and Mexico to get cheap drugs.
We may have to protect them with our military, we don’t have to fund their healthcare.
If its an American drug company, we fund the damn research thru grants and universitys.
I’m no fan of price controls, but canada and mexico can pay the same price we pay or all funding should end.
Posted by: Beagle at July 26, 2005 12:10 PMI think maybe all their profits are spent on marketing. I recently found myself flipping through “O” (The Oprah Magazine) and there was at least 4 full page ads for prescription drugs. Don’t ask me what they were all for though I just read “O” for the articles.
My problem with drug companies is that they are in the business of selling drugs, not curing people. Of course they are in it for the money.
As far as pharmacists go, if you own your own shop then maybe you do have a right to sell what you want, but as a professional you should have some rules of conduct that should be followed. If that includes selling drugs are are ethicaly opposed to than too bad.
Posted by: monkeywerks at July 26, 2005 12:31 PMAsk doctors what they think about pharmaceuticals advertising.
They get wined and dined a lot (a whole lot).
Some doctors don’t prescribe the least expensive medications, when they could.
d.a.n
I have talked to doctors about it and it actually frightened me. The get wined and dined as long as they prescribe, if they stop prescribing, there goes the freebies.
Makes you wonder when you leave the doctors office with your prescription.
Posted by: monkeywerks at July 26, 2005 01:16 PM…While I applaud your enthusiasm in bringing your comments to the table, I fail to see what your comments have to do with my original post. The only connection is the fact that we are talking about prescription drugs…
V.E.M.
Pharmacists can do what ever they want.
Do you think we need another law ?
Let the market system work it out.
If a pharmacist continues to refuse medications prescribed by doctors, those pharmacies won’t be in business long. Patients will go some where else to get them, and there are plenty of places to get them (e.g. Canada, Mexico, etc.).
Yes, I realize it takes a lot of money for research and development. I’m not for price controls either. Let the market system deal with the prices. At the moment, we’re getting gouged, but it won’t stay that way forever, as more competition and competing pharmaceutical companies are created. One sure way to screw it all up royally, is to ask the U.S. government to meddle in it. They will be only too happy to meddle and later be totally unaccountable for their disasterous handy-work.
Dan—
I am not willing to let the market “work it out.” The “market” is not to end all and be all of human existence. The “market” is not the answer to everything; in fact, lately, it is not the answer to much.
Most people seem to think that the pharma companies pay for all this research and development. Fact is, much of the R&D is taxpayer funded. In 2003, for example, publicly financed pharmaceutical research totaled $27 billion, nearly equaling domestic drug research by all businesses combined.
Then, this taxpayer-funded research is sold for next to nothing to pharma companies, who are given exclusive rights.
Take Taxol (one of the best selling cancer drugs ever) for example. $500 million in public money funded research and testing for this drug. The government then granted exclusive production rights to Bristol-Myers Squibb for a mere 0.5% royalty. Americans then had to buy this drug at prices marked up to 2000& over production costs.
The same thing is true of AIDs drugs. GlaxoSmithKlein and Boehringer-Ingelheim have monopoly patents on the drugs AZT, lamivudine and nevirapine. All three drugs were produced through taxpayer funded-research, the research was then given to these corporations for a 1% to 4% royalty. The companies then sold the drugs at prices upwards of 173% of production cost, without any form of competition to regulate prices. This makes these corporations’ efforts to keep generic drugs out of Africa even more reprehensible as far as I’m concerned.
This is how the “free market” works in the pharmaceutical industry.
Isabelle:
I understand your point about Taxol etc and how the research is funded. But consider that it is our government that decided a 0.5% royalty would be acceptable. I dont mind the govt helping with funding for the public good, since medicines do help society. But recognize that the govt typically screws things up through the levels of bureacracy.
Letrs allow the market to work—it always has worked. But lets also hold govt accountable for stupid deals like the Taxol deal. Lets NOT bring the government further into it so they can approve more stupid deals.
note: Ive taken your information at face value. Its possible it isnt correct, but even if not, the gist of my comments remain unchanged.
Posted by: joebagodonuts at July 26, 2005 03:05 PMIt’s easy to say “go to another pharmacy” when you live in a large urban environment where there is a Walgreens on every block. But what about those middle Americans in rural areas with only one phamacist that won’t dispense the percriptions they need? Should they have to travel miles out of their way to get the medications they need?
Posted by: Michael at July 26, 2005 03:15 PMso if we say it’s ok for pharmacists to refuse to sell you medication…
can check out clerks refuse to sell you food if they think you are too fat?
can movie ticket sellers refuse to sell you tickets to a movie you want to see because they don’t like the movie?
pretty silly eh? pharmacists train for over 6 years to do what? sell drugs to people.
if they wanted to evangelise…they should have joined the clergy.
Posted by: views at July 26, 2005 03:43 PMMy main problem with the whole ‘just take you business somewhere else’ is that we don’t apply that rule to any where else. Because I’m vegetarian, if I take a job at TGIFridays, does that mean I don’t have to serve people burgers because it offends me? Do I have to serve Christians if the offend me? If I work a Borders bookstore, do I have to sell people Bibles if it offends me?
Maybe the pharmacist is the one who ‘should just go somewhere else’?
Posted by: justin at July 26, 2005 04:00 PMBack to the original subject…
You know, I never thought about pharmacists not filling a prescription because of their moral beliefs. It just never occured to me, as I have never been put into that position.
But one thing that does concern me is pharmacists not filling prescriptions because they are afraid to.
I have a friend…my boss actually…that has a back problem that is out of control due to really screwed up surgery. He takes massive amounts of pain pills, including oxycontin, just to be able to function. He doesn’t get high off the pain pills…let me make that plain from this point on. He only takes them so that he can function. Without them, he would be bedridden in massive amounts of pain.
Now here’s the concern. The DEA has been popping pharmacists who fill prescriptions for massive amounts of pain killers, resulting in pharmacists refusing to fill those prescriptions.
So what’s a person who’s in terrible pain to do? Sweat it out? Stay at home and (more or less) become a “ward of the state” when, in actuality, they want to be productive members of our society? Are they to be denied a substance that helps them act and feel halfway “normal”?
What’s your take on this?
Posted by: Jim T at July 26, 2005 04:01 PMI think that the answer to this issue is a relatively simple one:
If the pharmacy has the item in stock, the prescription must be filled.
Pharmacists are licensed by the state to dispense highly regulated commodities. As such, they are imbued with a substantial public interest that must supercede their personal moral beliefs. The state has a right to compel people who are engaged in a public service to promote the general welfare regardless of any individual moral or ethical principles.
If you thought that killing another human being under any circumstances was a sin, I’d suggest not joining the Army. But if you did join, you’d better be prepared to pick up a gun regardless of your personal morality.
Finally, if Congress does act, as it should, to ensure the health of its citizenry by compelling pharmacists to fill legitimate prescriptions, I would suggest that the penalty for violating this statute should be a permanent revocation of the pharmacist’s license. In this way, violators would be induced to find more appropriate careers.
Posted by: Chuck Hanrahan at July 26, 2005 05:15 PMDan,
“One way to cut down on costs would be to replace all pharmacists with computers and machines.”
There are some compound drugs that the Pharmacist still has to mix himself. That is why they are licenced. Also he must sign off on any tech’s work. Bottom line he is still responsible even if he doesn’t do the work himself.
The Doctor is supposed to know about the drug inneractions that is why there is a PDR, or Physician’s Desk Reference.
As for the pharmicist not dispensing certain drugs on moral grounds, I suppose that is his right. As of now there are no laws prohibiting him from being an ass.
IMO if he wants to impose his morals on someone else he should be in another business.
As for the pharmicist not dispensing certain drugs on moral grounds, I suppose that is his right. As of now there are no laws prohibiting him from being an ass. IMO if he wants to impose his morals on someone else he should be in another business.No argument on that. I just get a little tired of those that want a new law for everything they don’t like. Besides, these incidents are few and far between. I’ve never witnessed it, or heard of it from anyone else I know. And, since there’s a pharmacy on practically every corner, it’s not a problem. The best thing to do is complain to the manager of the pharmacy. In most cases, that pharmacist probably won’t have a job there for long.
There are some compound drugs that the Pharmacist still has to mix himself. That is why they are licenced.Those compounds could probably be prepared by computer.
The Doctor is supposed to know about the drug inneractions that is why there is a PDR, or Physician’s Desk Reference.I’d never rely completely on a doctor. It would be wise to check yourself. There are lots of books and places on the internet to do that. It’s wise to question and research everything that doctors and pharmacists do. I’d probably be dead now had I not questioned a prescription once given to me. Medical mistakes kill an estimated 100,000 people per year (in the U.S. alone).
For those that can, become informed.
First, know what ails you, and ask your doctor all about it. Then, research it on the Internet. Patients should feel entitled to inquire about their care no matter how sick they are. Secondly, know about your drugs. Studies show that thousands die each year because of medication errors…many that were not detected by both the doctor or pharmacist.
Chuck:
Finally, if Congress does act, as it should, to ensure the health of its citizenry by compelling pharmacists to fill legitimate prescriptions, I would suggest that the penalty for violating this statute should be a permanent revocation of the pharmacist’s license. In this way, violators would be induced to find more appropriate careers.
I disagree with you on this one, and I don’t think the outrage is justified. There are many many doctors who will not do abortions. There are many doctors who will not do a great many things.
I think the answer is disclosure. It should be a very simple thing in our society to diisclose what you are opposed by reason of conscience. My doctor the other day had a handheld in her pocket. In that handheld was all sorts of information. For her to crosslink which pharmacies would are would not prescribe a certain drug would be a small chore.
Why force this moral belief on each other??
Craig
Posted by: Craig Holmes at July 26, 2005 11:50 PMCraig:
” There are many many doctors who will not do abortions. There are many doctors who will not do a great many things.”
This has nothing to do with it, it is apples and oranges.
” For her to crosslink which pharmacies would are would not prescribe a certain drug would be a small chore.”
Pharmacies and/or pharmacists do not prescribe drugs, doctors do.
There are many areas where numerous drugstores are not available, and many insurance companies that limit what drugstores can be used. In my case, there is only one pharmacy my insurance company will cover within a 70 mile radius.
Pharmacists have no business making medical decisions, their job is to fill the legal prescriptions as they are presented. If they know the patient’s other medications, they are to inform the doctor and/or patient of a conflict.
If they feel what they have to do is against any religious or other principle they may hold, they belong in another line of work.
Posted by: Ruth at July 27, 2005 12:28 AMBeagle,
I’m no fan of price controls, but canada and mexico can pay the same price we pay or all funding should end.
If it were that simple, I might agree with you. From what I can tell, it’s not. In the personal research I’ve done, comparing pricing between U.S. pharmacies and Canadian ones, I came across a very strange thing. The drugs I was looking at (Paxil, for one example) were actually manufactured in the U.S., and then shipped to Canada. In spite of additional shipping costs, Canadian pharmacies sold the product for one-third the price U.S. pharmacies did.
To make matters worse, many of the generic versions are being manufactured by the same companies that create the “name brand” versions. The generic version of Paxil, for instance, is available in Canada, but my local U.S. pharmacy said they were not available as generics. Where in the supply chain the price gouging is coming from, I have no idea, but I think it likely that the brunt of it is the pharmaceutical companies themselves. They get to decide where, and how much, to sell their products too (outside of the retail markup by a pharmacy).
As to the main point,
I think forcing a Pharmacist to fill a prescription by law is insane. We don’t need a law to take care of this. The market will take care of itself. If a pharmacist refused to fill a prescription for me because of moral, instead of medical, reasons, I would quit using them. They have just lost my business, and likely the business of every one of my friends. A business cannot stay in business without customers.
Posted by: John at July 27, 2005 12:32 AMI look at this from a different angle. If a pharmacy decides as a company policy not to provide a certain product, let’s use the example given already such as porn, that would be one thing. However, if a clerk at a store that agreed to sell porn refused to ring it up then that would be a different scenario.
Unless the Pharmacist is the owner of the Pharmacy and has decided his location will not sell certain items, to me, the individual pharmacist does not have the right to refuse to fill a prescription on moral grounds.
Posted by: lisa renee at July 27, 2005 02:38 AMDan—
It not a problem until it happens to you, or yours, and then I suspect it will become a problem. And I have heard of plenty of around my town; it seems Illinois is ripe with religious zealots. To his credit—and trust me he deserves very little—the governor of my state is the first in the nation to say enough is enough, fill the prescriptions.
John—
As I have stated before, the market is not the answer to all human ills. And quite frankly I am tired of religious zealots inserting their personal beliefs into everyone else’s lives! If you do not want to take birth control and have fifteen children that is your right as an adult, just as it is my right not to have fifteen children by using legal birth control. In my mind “the market” has very little to do with this. Pharmacists are licensed professionals who should either care out their duties or find another profession; the market be damned!
Craig:
“Why force this moral belief on each other??”
Because healthcare is not based on moral beliefs — it is based solely on the health of patients for doctors, and solely on dispensing drugs to customers holding prescriptions for pharmacists.
A doctor who will not perform an abortion, or refer a woman to a place where she can get an abortion when her life depends on it should not be in the medical profession. Period. The hippocratic oath is very straightforward and does not make certain special exceptions for the personal moral beliefs of any doctor.
Here is just one example: I know a woman who had one of her heart valves replaced with the heart valve of a pig when she was a teenager — she was told at that time that she cannot ever give birth to a child because when a woman becomes pregnant, her heart greatly increases in size, and this would mean certain death for her since the replacement valve she received could not similarly expand. So, any doctor who would refuse to give or refer her to an abortion if she accidentally did become pregnant would be automatically breaking the hippocratic oath they took at the start of their career.
Moreover, there are vast numbers of women who take birthcontrol pills for many and various health reasons. Others might need to use the morning-after pill because they could die if they tried to have a child. Therefore, doctors must prescribe these things, and pharmacists have no right to deny them to anyone holding a prescription for them.
While the first amendment absolutely gives both doctors and pharmacists the right to speak out against abortion or any form of birth control in their private lives, it is clearly their professional duty to write prescriptions/dispense drugs during working hours, rather than make any kind of moral judgements for their patients/customers.
To say otherwise would mean we want to allow doctors to break their professional oath simply because of their moral beliefs, and not only give pharmacists the ability to be judge, jury, and executioner, but also give them the right to deny the women standing on the other side of their counters their life, liberty, and pursuit of happiness.
V.E.M.
Sorry. I didn’t know the problem was so prevalent in Illinois. After doing some research, there are some instances of it in Texas, even though I’ve, nor any friends, family, or associates have ever witnessed it.
lifenews.com/nat324.html
lifenews.com/nat421.html
An Eckerds pharmacist (now owned by CVS) refused a “morning after pill” to a rape victim.
Eckerds said the pharmacist did not follow store policy.
He was fired.
In another instance, a CVS pharmacist refused to fill a birth control prescription. CVS said the pharmacist did not follow store policy.
He was also fired.
So, it sounds like the problem is being handled just fine down here.
Posted by: d.a.n at July 27, 2005 12:21 PMPharmacies that continue to do this are going to get boycotted (if they haven’t been already).
When it comes down to a choice between sales profits of the Pharmacy chain, and supposed morals of the pharmacist, which do you is going to win out ?
If the pharmacy is privately owned by a pharmacist (an increasingly rare thing these days), shouldn’t a pharmacist be allowed to sell only what he chooses to keep in stock ?
Forcing people (i.e. a pharmacy) to sell something they don’t want to sell sounds a bit too controlling. That may be an abuse of the law. That’s why the market should be allowed to sort it out. Some pharmacies will still sell medications that some will not. And, if enough people don’t like the stance of certain pharmacies, they can boycott those pharmacies.
Then, pharmacies will exist for those that think one way or the other, since everyone will never think the same way.
The last thing we need is to unnecessarily get lawyers and courts involved, and make more laws duplicating numerous existing laws. For one thing, you can not legislate morals, and you can not force people to sell things they don’t stock or don’t want to sell. However, a pharmacy chain, if they so choose, should do what they do have every right to do (in Texas anyway): fire the pharmacist.
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Main Entry: boycott
Pronunciation: ‘boi-kot’ Function: transitive verb
Etymology: Charles C. Boycott died 1897 - English land agent in Ireland who was ostracized for refusing to reduce rents
: to engage in a concerted refusal to have dealings with (as a person, store, or organization) usually to express disapproval or to force acceptance of certain conditions.
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Interesting…I was wondering where that term came from.
Just a thought that keeps running through my head: had anyone ever heard of pharmacists refusing to fill prescriptions on moral grounds before the Republicans got religion? I will duck.
Dan:
“Forcing people (i.e. a pharmacy) to sell something they don’t want to sell sounds a bit too controlling. That may be an abuse of the law. That’s why the market should be allowed to sort it out.”
That may work fine in the big cities, although I think any healthcare issues do not follow the “market” system with any success. What about the folks in rural areas with no other access?
Posted by: Ruth at July 27, 2005 03:03 PMProbably cheaper too.
Check out the prices at COSTCO’s pharmacy.
Dan:
That would be great if:
1. My insurance company covered the mail order pharmacy (where do you find one?).
2. My insurance company covered the COSTCO pharmacy.
2. Overnight both ways? Isn’t that two days if you’re lucky? What if the doctor needs you to start immediately and doesn’t have samples?
These are just some of the things that people with the easy answers don’t think about: the situations other people are in.
Posted by: Ruth at July 27, 2005 05:24 PMIt should be interesting to see how this pans out. In the event the pharmacists win, and get to perform their profession according to thier personal beliefs, I’m thinking of getting some EMT training to become a paramedic. In addition to my personal belief that ambulance driving, with all the lights and sirens, is cool, I occassionally find religious folk objectionable, and question if extending their lives is really best for society. If I could get a paycheck, fulfill my lights and siren fantasy, and impose my personal beliefs all at the same time… well… HOT DAMN!
=)
Posted by: Taylor at July 27, 2005 10:00 PMAdrienne:
Because healthcare is not based on moral beliefs — it is based solely on the health of patients for doctors, and solely on dispensing drugs to customers holding prescriptions for pharmacists.
A doctor who will not perform an abortion, or refer a woman to a place where she can get an abortion when her life depends on it should not be in the medical profession. Period.
“when he life depends on it”. Most conservatives agree with your statement when you add those words to it. That is really not much of an issue.
The issue raised by NPR is the morning after pill. The legislation is in effect forcing pharmicists to both stock and sell the morning after pill, even if they are opposed for reason of conscience. Basically that means the law is forcing prolife pharmacists to participate in a drug induced abortion.
My solution is simply disclosure. Pharmacists should disclose to the medical community when they are not willing to dispense these drugs. I really don’t see this as an inconvenience. Doctor offices routinely give out samples. In a true emergency doctors can give out samples of the drug.
Is the answer to only have prochoice pharmacies in this country?
Craig
Adrienne:
Furthermore , Sandra Day O conner’s idea is to make sure the woman’s needs are not inconvenienced.
If a woman cannot get the morning after pill, she can have an abortion. If the pharacists are required by law to disclose to the medical community their unwillingness to participate, then the doctor can prescribe to another pharmacy, or if non is near give her a sample.
This should be a nonissue. We should be fighting over something else.
Craig
Posted by: Craig Holmes at July 28, 2005 12:08 AMI feel like we may benefit from looking at this issue in reverse.
What if, instead of refusing to dispense a drug on moral grounds despite having a doctor’s prescription, their morality led them to dispense a drug despite not having a doctor’s prescription? Would that be equally acceptable? If not, why not? Both situations involve replacing a doctor’s judgment with the morality of the pharmacist.
Or an even simpler scenario:
Let’s say there was a vegetarian working at your favorite fast-food joint, and they refused to sell you that thick juicy burger they have sitting back there because it went against their beliefs… they’ll only fill your order for a salad, a drink, or an ice cream cone. Maybe they’ll give you a fish sandwich, if you’re lucky. Or maybe it’s not even a vegetarian, maybe it’s a Catholic and it happens to be a friday in Lent, and it’s an actual religious belief that you should not eat meat on those days… are they within their rights refusing to fill your order?
Hell, let’s take the whole morality issue up a notch… what if we get a pharmacist who is a Christian Scientist? Literally every pill in the pharmacy would be against their religious beliefs. Would they be justified in denying all prescriptions on that basis?
Where do we draw the line when we let a pharmacist’s individual morality intrude in the health care system?
Posted by: Jarin at July 28, 2005 04:14 AMRuth wrote: That would be great if: 1. My insurance company covered the mail order pharmacy (where do you find one?). 2. My insurance company covered the COSTCO pharmacy. 3. Overnight both ways? Isn’t that two days if you’re lucky? What if the doctor needs you to start immediately and doesn’t have samples? These are just some of the things that people with the easy answers don’t think about: the situations other people are in.
Ruth,
Well, insurance is a separate issue.
Your doctor can call in the prescription to a pharmacy that will fill the order. Not all pharmacies will reject the order.
In some states, pharmacists that refuse to fill prescriptions get fired. So, you might want to get it filled in one of those states, and have it mailed to you.
Unfortunately, if you need a prescription fast, you may have to go somewhere else to fill the prescription, or wait one day for over-night shipping. However, in the long run, I think these occurrences of pharmacists imposing their beliefs onto others will only last a short while, because such pharmacies will go out of business, be overwhelmed with law suits, or the pharmacists will get fired. The market forces are more powerful than the hypocrisy of a handful of pharmacists.
In the mean time, people should boycott the pharmacies that won’t fill doctor’s prescriptions. That may be an inconvenience for a while, until that pharmacy is run out of business and replaced with a pharmacy that will fill doctor’s prescriptions.
Personally, I think any pharmacist that imposes his morals on others in such a way should be fired by the pharmacy. If it’s his/her own privately owned pharmacy, it should be boycotted. The market can solve this problem without new laws or getting lawyers and politicians involved, which will probably make the problem worse.
Likewise, with the fast-food example Jarin provided: (1) boycott that restaraunt; perhaps, take out an ad in newspapers or set up a web-site to advertise the behavior of said business that attempts to impose it’s beliefs onto others (2) never go back if they won’t serve what’s on the menu; just like you don’t go to Pizza Hut expecting to buy fried chicken, (3) tell management about the problem; the employee will be fired in most cases.
But, before we start asking for new laws and litigation, think about this:
(1) While a pharmacist (say a privately owned pharmacy, run by that pharmacist) is possibly wrong for imposing his/her beliefs on to others, that pharmacist has not broken any law.
(2) What’s the basis for a law to force a pharmacist to sell a product they don’t want to sell (may not even have in stock)?
(3) Isn’t a law forcing someone to sell something they don’t want to going too far in the other direction? Isn’t such a law as wrong or possibly more wrong? Since when do people have to sell something they don’t want to ? Wouldn’t such a law be a larger violation of rights? How did a pharmacist refusing to sell a certain drug violate anyone’s rights ?
(4) Not everything requires a law suit or new law.
(5) Do you really want to involve government, lawyers, and politicians unnecessarily? That risks making the problem worse.
(6) Why not let the market work it out? That way, no one’s rights are violated.
Dan:
This isn’t a matter of a pharmacy refusing to sell something off the shelf. Like refusing cigarettes to underaged buyers.
This is refusing to fill legal prescriptions for medical conditions. IT IS NOT THE PHARMACISTS JOB to in any way affect the treatment of the presenter of the legal prescription.
Have you forgotten how many people would support such a pharmacy? You think the market would work this out? The folks who support what the pharmacist is doing would preclude the “market” from working as you suggest.
It’s almost like you are defending pharmacists. They don’t need to be in that job if part of the job offends their sensibilities.
I gave up a good paying job because my personal ethics would not allow me to continue to do questionable (at best) things that went against my understanding of the law and right and wrong. That’s the right way to handle conflicts with personal beliefs.
The “market” does not solve everything.
Posted by: Ruth at July 28, 2005 12:18 PMRuth,
I agree completely that it’s not the pharmacists job to refuse certain prescriptions.
No, I’m not defending pharmacists at all.
Personally, I think it wouldn’t be too hard to replace them with computers and automated storage/retrieval systems.
No, I agree again. The market doesn’t solve everything, but this is one instance in which it can and will. Why? Because not everyone believes the same way. There’s nothing to prevent a pharmacy opening where pharmacists don’t have any problem filling the prescriptions written by doctors.
Also, what is the legal argument to force someone to sell something they don’t want to?
To make a law doing that would be more wrong than what a handfull of hypocritical pharmacists are doing.
And, when it comes down to sales profits and a few hypocritical pharmacists, which do you think will win ?
Just boycott those pharmacies. They’ll start firing those pharmacists, because profits are more important. Wait and see. That’s what happens here in Texas. They get fired.
Denton, TX: lifenews.com/nat324.html
N. Richland Hills, TX: lifenews.com/nat421.html
Jarin:
What if, instead of refusing to dispense a drug on moral grounds despite having a doctor’s prescription, their morality led them to dispense a drug despite not having a doctor’s prescription? Would that be equally acceptable? If not, why not? Both situations involve replacing a doctor’s judgment with the morality of the pharmacist.
I disagree. Refusing to sell a drug that a doctor prescribed on moral grounds is one thing. Selling a drug that the doctor did not prescribe is practicing medicine and is already illegal already. Obviously practicing medicine without a license should be illegal.
If doctors should not be forced to perform abortions, pharmacists should not be forced to fill prescriptions of morning after pills.
Craig
Posted by: Craig Holmes at July 29, 2005 03:28 PMRefusing to sell a drug that a doctor prescribed on moral grounds is one thing. Selling a drug that the doctor did not prescribe is practicing medicine and is already illegal already.
Both are practicing medicine. In each case, the pharmacist is making a medical decision, despite the fact IT’S NOT THIER JOB to do so. Once a physician has written a medical prescription, the medical decision part of the job is done.
If high school student A doesn’t turn in their homework at all, and high school student B turns in homework from 2 chapters ago, what grade do they both get for the assignment? An F?
If soldier A refuses to fire at the enemy because he’s a pacifist and soldier B turns and shoots his ally standing next to him, what do they both get? Court marshall?
If my friend neglects to return his library book and I put a copy of my phone book in the drop slot at the library to say I returned my book, what do we both get? Late fees / book replacement charges?
When you’ve contracted to do a task, not doing that task and doing something completely wrong that you’ve decided of your own will leads to the same results. You haven’t done your job.
My grandma always used to tell me:
“If a task is once begun,
You’re not finished till it’s done,
Whether the task be great or small,
Do it right or NOT AT ALL.”
Oh my! Was granny a repug? =/
Posted by: Taylor at July 29, 2005 09:04 PMI disagree. Refusing to sell a drug that a doctor prescribed on moral grounds is one thing. Selling a drug that the doctor did not prescribe is practicing medicine and is already illegal already. Obviously practicing medicine without a license should be illegal.
Yes, it is illegal. That’s kind of my point. It’s something we know already is wrong and should not be tolerated. And it’s equivalent to not selling a drug that a doctor HAS prescribed. Both are making a medical decision for a patient without a license to practice medicine. Denying medication is just as much a medical decision as providing it without a prescription. Both are wrong, and both should be illegal.
If doctors should not be forced to perform abortions, pharmacists should not be forced to fill prescriptions of morning after pills.
First, pharmacists aren’t just refusing to fill prescriptions of morning after pills, some are also refusing to fill prescriptions for oral contraceptives (“the Pill”). Second, there’s a vast difference between a doctor deciding not to perform a procedure, and a pharmacist deciding not to give a patient a drug a doctor has prescribed. The doctor has the training necessary to make both judgments. The pharmacist does not, and is in fact practicing medicine by denying the patient access to medicine a doctor has said she needs. In some of the cases involving the Pill, the oral contraceptive was not prescribed for birth control but for other conditions. The Pill lowers women’s risk of heart disease, stroke, uterine and ovarian cancers, and high cholesterol. There are even many instances of pharmacists refusing to give back or transfer the prescription so it can be filled elsewhere. In some cases these are pills that need to be taken within a certain amount of time to work, and yet they have even been denied to rape victims on these religious grounds. This is clearly making a medical decision for the person, and is practicing medicine without a license. Finally, there’s a very large difference between dispensing a drug (a neutral chemical) that has the capacity to end what you believe is human life, and doing it yourself as a doctor would have to in order to perform an abortion. This is underlined by the fact that many of the pharmacists involved have also asked their customers what they plan to use the Pill for, and if the answer is contraception they have THEN refused to dispense it. So it is not about not wishing to sell a product because they think the product is immoral, it is specifically about preventing others from making a particular medical decision that they believe is immoral. This isn’t their job.
Posted by: Jarin at July 30, 2005 02:00 AMI certainly do NOT want a pharmacist to over-ride a decision made between and DR. and patient. IF that person want’s that kind of power….go to medical school and become a DR! Then they can make that decision based on facts not questionable “faith”! I’m still burned about the bogus “pharmacist” who failed to allow a mother of 6 the option of having MORE kids. Woman’s NEXT weapon will become refusing so-called “marriage rights” of the husbands if they don’t want to get preggers. Is that what men want??????
Posted by: Kim at August 1, 2005 11:36 AMWoman’s NEXT weapon will become refusing so-called “marriage rights” of the husbands if they don’t want to get preggers. Is that what men want??????
Slow down before you label “men” as behind the pharmacist stuff… many of the pharmacists who have been refusing contraceptives and the morning after pills have been female, and men (including myself) have already spoken out about the outrageousness of what these so-called pharmacists have been doing.
Posted by: Jarin at August 2, 2005 02:11 PM
