“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.
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
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
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.
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.
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.
What do you do with expired meds, does the pharmacy eat the loss?
Do you mix and match pills with different expiration dates to fill a prescription? From different manufacturers?
I’m genuinely asking. What I described is how things work here, and while our healthcare system is insane, this is one part that makes sense to me
It depends. In the US we have “prescription only” medication (things like antibiotics, diabetes meds, etc) as well as “controlled” medication (things like Norco, Xanax, morphine). With my former employer, we would go through the pharmacy and find non-controlled medication that was due to expire soon (3 or 6 months, I don’t remember) and send them back to our wholesaler for a partial credit. Packages had to be whole and unopened. With controlled medication, there is no sending back; the pharmacy holds the medication until it is actually expired, then sends it to be disposed of.
Different expiration dates, yes, different manufacturers, generally no but if there’s no better option we would. In the US we generally fill from stock bottles containing several hundred or thousand pills, so one bottle can last a few months worth of prescriptions. When we go from one bottle to the next, the expiration dates between the two generally won’t be the same. When I left the company, we had a system that scanned the bottle we used and could read the expiration date; if the med expired in over a year, the label printed would just have an expiration date of 1 year from the current date. If it expired in less than 1 year, it would give a notification, and we’d manually enter the exact expiration date on the label.
Ah. Laws vary by state, mixing and matching manufacturers is illegal in my state, the manufacturer must be on the bottle along with a description. I’m less certain about the expiration date thing, but I believe here they require them all to come back to the same batch in case there’s an issue (including improper storage of the bottle or something)
I’ve been told this is how it works by a pharmacist when they were having trouble filling my rx, and we were talking about controlled substances in particular
The expensive part is the outrageous costs of R+D that goes into drug discovery and trials, with the majority ending in failure. Not excusing the awful profiteering that goes into pharmaceuticals also, but the end product being cheap to produce isn’t the only cost that companies incur.
Sure, but the R&D is largely subsidized because it’s a common good. Pharmaceutical companies generally take over when it’s already a pretty safe bet… It could fall through during clinical trials, but they don’t pay for the massive R&D they did traditionally. Sometimes they even just buy the patent
There’s overhead, but the vast majority is just profiteering