“How do we ensure our patient drops and loses ~80% of his pills and that he slices the absolute fuck out of his fingers in the process?”
They’re locking my mental health goals behind a fidgety Saw trap built from scissors and miserliness.
I’ve had boxes where there were several single pills snipped from their blister packs rattling around in them. These pills in particular are tiny, like you can’t even feel them in your mouth when you take them, but they expect me to be able to finesse one out of a single blister with at least 3 extremely sharp and piercing corners on it 😒
If you’re a pharmacist and you do this, please go ahead and take the pills yourself, you clearly need 'em more than I do, ya sick fuck.
Here in my country (at least public healthcare, which my mother and I use, and the private provider my grandfather uses), pharmacists give you enough full boxes to cover the month, even for controlled substances, even if that means giving a few extra pills.
As an example, I take 1 ½ Risperidone pills daily, which makes 45 pills a month. Boxes are 20 pills each, so they give me 3 boxes (60 pills). The leftovers helped me a couple of times I was sick or otherwise couldn’t get the refill on time.
There was only one time where they gave me two boxes and a blister (50 pills), but it was still a full blister.
I’ll raise you the time I decided to be menace and put a blister pack back in the pyxis like this:
(to be clear, this was neither a high alert med nor a narcotic)
Uh, former pharmacy tech here… I don’t know what you want us to do. If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I’m gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there’s gonna be a single one left over. Do you want these pills to just be thrown away? If they don’t have enough pills on hand to make your prescription with the full sheet, would you rather they delay your prescription so they can order some nicer looking ones?
I get that it can be frustrating dealing with those blister packs, but freaking out at the pharmacist/ tech that a. did not put the pills in a blister pack and b. doesn’t have any option but to dispense medication on hand, seems pretty misplaced. Like, I wouldn’t think something was wrong with the Walmart cashier for selling me a pair of scissors in security packaging.
People bitch about everything they don’t understand. Some meds are too fragile to just put into a plastic bottle, or exposed to air.
It’s so weird to me as here we just get one box of pills and done 🤷
Here we usually do too, unless the doctor prescribes a weird number for some reason.
My doctor doesn’t even prescribe an amount. I just get whatever amount the pharmacy feels like. I’ve gotten a box with 30 pills (one daily so enough for a month), box with 60, back to 30, and the last time they gave me a box with 100. I’m not complaining, less refills so less hassle but it kinda makes me wonder how they decide the amount lol
Tbh, a pharmacist shouldn’t really do anything with the actual medication other than dispensing it correctly. In Sweden, every package is individual; the pharmacist should never be opening them nor touching the blisters in normal cases. It significantly reduces risks for the patient and ensures traceability.
It is a bit less efficient though, as pharmacies need to stock up different qualities of the same dosages: Stilnoct(zolpidem) 10mg for example has two different packages: 14 tablets, or 28 tablets. If you have a prescription for 28 tablets, you can’t buy two 14-tablet packages. And if you were to have a 14 prescription, you can’t buy the 28 and ask the pharmacist to throw away the other blister. But I think it’s a worthy tradeoff to eliminate the majority of human mistakes.
In Sweden, every package is individual;
Same here in Denmark.
The only place I’ve ever seen pills given out of the package is at the vet and in hospitals or by a doctor, and it’s for obvious reasons dictated by circumstances.If we need 10 of some pill, they come in boxes of 10. I have no idea wtf is going on with splitting up packages to get 20?
PS: The example with the vet was worm treatment, those pills were in individual blisters, and you can get only one at a time I think due to EU regulation. It was then put in a package made specifically for that. And there were no sharp edges.
We used to get 3 at a time, to administer as needed, but apparently we aren’t allowed to get more than 1 at a time now.
Also the price has trippled to buy 1 compared to what 3 used to cost. So a 10x price jump!!!This is interesting. Do all pills come in blister packs in Denmark? Over in the US it’s actually somewhat rare for prescription medication to come in blister packs. Typically over the counter prepackaged medication will come in blister packs, but prescriptions are almost always unpackaged pills in a bottle. The pharmacist counts out the number of pills and puts them in the bottle as well as attaching its label to match the prescription. Prescriptions are typically written based on pills per day and the number of days to either take the medication or else for the prescription to cover. E.G. the doctor makes out a prescription like “take one pill twice a day for 60 days”, and then the pharmacist will give you a bottle with 120 pills in it.
France: never seen a bottle IRL. Used to be blister packs, and if you needed 21 pills but they came in packs of 20, you got 19 too many and they lived forever in your medicine cabinet.
Now pharmacists are allowed to open packs of antibiotic pills and only dispense the exact number you need, and pics like the OP can happen. Most pharmacies don’t do it though.
Almost everything is blister packages, which I personally find a bit annoying.
We can’t even get normal pain killers without them being in blister packages, and we can only buy limited amounts to prevent teen suicide attempts by painkillers.
That part however I’m OK with, because allegedly it’s supposed to actually work. 👍 😀Here in the Netherlands I’ve never had any medication that wasn’t in blister packs. They are always full boxes. Boxes have anti-tamper seals and a unique serial number that the pharmacist has to scan when issuing (to prevent fake medication). Pills are individually packaged to prevent contamination.
There are bottles as well, but it’s not as common. And they’re factory-produced bottles that are tamper resistant – not like those orange ones in the US. So it’s basically the same safety as blisters, other than its easier for the patient to spill.
I’m not 100% sure, but I think most of the groundwork for this situation is from EU Directive 2001/83/EC. Medical products need to have a lot of information provided, and it just gets simpler to have boxes with blisters to meet all the requirements, and gives safety at the same time.
I can’t imagine how hectic it must be for pharmacy techs in the US. Despite requiring 5 years of school to be a pharmacist here, the job is basically being a glorified cashier… Unless the person has any questions, you simply check their ID, check in the national registry that enough time has passed since their last collection (particularly if it’s a controlled substance), collect a package from the shelf, print out a label to put on the box (containing their name, doctor, dosage, instructions), scan the label and package, collect payment, and that’s it.
A few years ago Germany started to ensure that blisters are not repackaged, too.
I hear you. They should be on a roll, like film 😁
If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I’m gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there’s gonna be a single one left over. Do you want these pills to just be thrown away?
Order of 6 pills - give a 3x2, you now have a 2x2.
Order 9 pills - give the 2x2 and a 1x5, you now have a 1x5.
I see your problem, but I don’t see how that can turn into “a 10x1, a 4x1, a 2x1 and another 2x1” as your best choice. That looks like he got the left-over-pile after a day of ever order getting from a new pack.
Honestly, I don’t know why you even have to open a package. I’ve never seen that, and I’ve been in some long pharmacy queues. Never been to US though.
If I need exactly 10 pills, I get a box with 10 pills, packed in a factory like any other box of pills.
That looks like he got the left-over-pile after a day of ever order getting from a new pack.
I’m saying that’s exactly what happened.
Never been to US though.
Things are done very, very differently here than most places. Blister packs are pretty uncommon, as are “per-patient” packages.
We rarely get bottles of 14, 30, 90 or whatever to give to the patient. It’s usually a giant “stock bottle” of like, 100, 500, 1000 pills that get counted out according to the prescription.
Your example of using the leftover from one script to the next works if you’re a single person in a small-ish pharmacy and it’s an uncommon drug, but when you’re one of 4 techs in a shitty retail pharmacy, you’re not going to ask every other person if they have a 2x2 strip of this med in their pile of go-backs, or spend time min-maxing the most efficient way to get the most pills in the least amount of strips. You’re gonna fill the thing as quickly as possible, because the medicine is what’s important, and you’re not gonna hold the backlog of prescriptions up because someone wants the nice complete pack of 10 and not the leftovers that are bound to pile up.
a shitty retail pharmacy
AKA pretty much every pharmacy these days, since these pharmacy companies are large enough to own the insurance companies.
What a fucking disgusting mess the US medical industry is.
This is likely the fault of the pill manufacturer who the pharmacy is at the mercy of.
In Japan, this is the norm. They’ll throw each drug in its own zip lock bag but piecemeal like that is all you’ll get. And people grow really old over here.
I don’t find this mildly infuriating. I think this is a responsible way to deal with a precious resource.
Pills aren’t really precious resources… They cost like cents to make, aside from a few very expensive special ones
The expensive part is all markup
The expensive part is all markup
So we can waste the pills if we find a way to keep all the markup safe?
Also the idea that pills costs “cents to make” is pretty flawed. Even if you ignore all of the R&D money that goes in to making newer pills, the sterilized environment they need to be manufactured in is gonna jack the cost up too.
It’s like saying a cup of fresh, ice cold water that you’re getting handed to you in the middle of the desert is only “a few cents worth of water”. Yeah, but the fact that it exists in the middle of the desert for you to consume is what made it a “precious resource”.
The r&d costs come from government grants these days
Yes, a sterile lab is expensive, but like normal business expensive. It’s very achievable to build, drug cartels manage it just fine. Universities and YouTubers have no problem doing it with pretty modest funding
Yes, there’s overhead. But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing
That’s why other countries can afford to sell them for cents - they really are that cheap to make
Yes, a sterile lab is expensive, but like normal business expensive. It’s very achievable to build, drug cartels manage it just fine.
This bit right here told me that I didn’t need to take this too seriously. An actual medical lab is not comparable to cocaine plants in the Congo.
But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing
This is the exact same point from the previous comment. You cannot just look at the material cost of something and say, “see? It only costs cents to make.” Go buy a part that goes in a car engine - it’s just a few cents worth of metal! But, you can’t just take a hunk of metal and magically form it into car parts, there’s a manufacturing process and it’s expensive. That’s part of where the cost comes from. It doesn’t matter if you can make the most expensive pill in the world out of 10 cents of flour if you need a $10 million dollar assembly line to process it and turn it in to what is useful. They aren’t just taking a premade substance and pressing it into pills, there’s numerous chemical reactions and processes taking place.
That’s why other countries can afford to sell them for cents - they really are that cheap to make
You start your comment off with saying that R&D is subsidized, and end with saying “other places can sell them for cheap cuz they really are that cheap.” In these other countries, the drug company is not selling the medication directly to the public for pennies, it’s getting subsidized by the government to make it affordable for citizens. Granted the government is not paying US cash prices, but companies simply are not selling direct to consumers for 10x less than other places.
Look, this is coming from someone who fucking hates the predatory medical industry, especially that of the US. I used to work as a very small cog in it. There are absolutely places where prices are disgustingly manipulated and people are taken complete advantage of. Things exist today the way they are because of corporate greed and the continuance of putting profit over people. We can accept all of this as true, and still recognize that producing drugs at a medical grade, with medical levels of consistency and purity, is a difficult, expensive task that requires resources to accomplish. Medication needs to be cheaper (it’s my belief that it should be no direct cost to the user), but momentum is instantly removed from the cause when we use arguments based on a limited grasp of reality.
I think you’re misunderstanding what I’m saying.
Yes, the companies need to sell the pills for a certain amount to make a profit, due to infrastructure and overhead. The R&D is a whole complicated thing, let’s just lump it in as overhead and put it aside
The pills themselves cost basically nothing to produce each, a batch will cost money but normally they’re consistently pumping out huge batches
So, most manufacturers have programs to retrieve pills. If you have 4 pills at the end of the roll, they can be reclaimed so patients can get a complete strip, because the pills themselves cost so little. They do the same if you end up with a small number of pills left in the big bottle, you can’t mix batches because of expiration dates and expiration. So you send them back, and they give the pharmacy a credit
I’m sorry, I can’t continue this conversation. It’s clear that you’re just kind of saying things that sound right. Your only argument is, “the pills themselves cost nothing to make” while ignoring everything that makes the pill cost money. Economics and cost analysis does not work that way. And in 7 years of working in a pharmacy, never once have we ever sent incomplete strips of meds to the manufacturer to get a complete pack. That is just not a thing that happens anywhere on a regular enough basis for it to be taken into consideration.
STFU bitch.
Oh neat, a hater in the wild.
I just wanted to say, I enjoy your writing style. You very vividly illustrated your emotions
What’s mildly infuriating is this post. How do you think they make these prescriptions? Do you ever consider how other people do their jobs before you go moaning? You’re a fucking Karen.
“they may provide a shitty product, but have you considered their feelings?”
You’re allowed to be pissed off, even when other people do their best.
Pharmacist does not make the product or how it’s manufactured or distributed, dum dum.
