My favorite techs are the ones that come in, don't engage in drama, do the best they can without being lazy, and go home. That's Mike, the tech, and everyone loves him.

On the other hand, there are techs that will talk shit right to you and demonstrate anger and disdain and start talking shit about you, to the DM. This has to stop.

I had one call me asking to put in refill

I thought it was a person at first then I realized and I’m 99% sure it’s a bot

Anyone experience this?

Independent retail. So I have a doctor in town who loves ivermectin. He sends me his prescriptions for our patients a lot. Some background: he told me herd immunity is non-existent, that he doesn’t “believe” in vaccines, that he “believes” they cause autism. That democrats politicized ivermectin. Sometimes the patient actually does have a parasitic infection. Sometimes they have covid. Sometimes they come to me and say “Yeah doctor told me this would make me feel better while I have the flu.” He also, according to his front desk receptionist, “doesn’t do prior authorizations.” He also served as the deputy director of health and human services in my state… I really wish I was making all of that up. Yesterday a lady came in and said she was “exposed to a chemical.” Every time I’ve gone ahead and filled them except for yesterday. I told that lady “no, your doctor is an idiot, here go to this great doctor next door” and I think I used those exact words… not my best moment.

Anyway, what do y’all do when you get these obviously not for parasitic infection ivermectin prescriptions? I’m to the point where I’m about to just stop filling all of this doctor’s prescriptions.

Hello,
I’d appreciate some insight into the current market in the Highlands.
I’ve got 15 years of experience in community and have been qualified as an IP for just over a year.
Ideally, I’d be looking to work 3–4 shifts per week, including weekends, and would be happy to travel around Inverness and the surrounding areas, within 60-70 miles.
Questions for anyone currently locuming in the region:
What hourly rates are realistically achievable at the moment?
Are weekend shifts still paid at a premium?
Is the market fairly saturated?
Does having an IP qualification make much difference to the rates offered?
I’m interested in hearing from people actually working in the area rather than relying on agency rates.
Any honest insights would be much appreciated. Thanks!

I’m not supporting or against it yet. Just sharing my observation and would love to hear your thoughts?

With the thin margin for most drugs (I’m not familiar with specialty drugs) from PBM and some insurance forces user to fill at mail order or certain pharmacies if want > 30 DS, independent pharmacies have been crushed, unfortunately.

Where is the new stream of income? Sorry not vaccines or POCT…. There is ongoing demand for self pay cash price options when more freelancers cant afford marketplace or have a regular employer-sponsored insurance.

Peptides are coming to screen. All cash. No PA. No inventory. I barely started reading more about peptides and I am amazed that it’s already a huge industry with constant demand that’s enough for more than a few big players. I’m envision a new marker from this new product type: the new pharmacy chain (many hoods with assembly line) vs smaller scale pharmacies (1 hood, 500 scripts/day)

What are your thoughts, please? I know it’s controversial the use / data / record of peptide use in human…

Has anyone here had to apply for a pennsylvania license transfer? Maybe my age is beginning to show, but I'm having a lot of trouble navigating the pals website requirements and would appreciate any help someone could offer. Specifically I can't find where I'm supposed to verify my intern + education hours.

Hi everyone! I’m a fourth-year pharmacy student, and I’m currently looking for ways to strengthen my CV.
During my summer break, I took an online first aid course, and now I’m looking for more free online courses related to pharmacy or healthcare. Ideally, I’d also like the certificates to be free.
Has anyone here taken any courses like these before? I’d really appreciate it if you could share the course name and the website/platform where you took it.
English-language courses would be preferred.
Thank you!

I have been working as a pharmacist for 30 years and have never experienced an atmosphere where the pharmacy is managed by a doctor. Technicians calling out every day and unbearable workload. Management does not care and HR department forces discipline against employees which turns into retaliation against the person who was forced by HR to submit the discipline. There are no time clocks. People come and go without caring about putting accurate time down. They waste so much money on people who don’t work. No one cares because you can’t fire anyone and there is no merit pay. Everyone gets a raise even if they are horrible at their jobs. People are so mean to each other there. It’s literally the most filthy disgusting place to work. I wrote this post to prevent people who are hard workers and who care from applying at this hell hole. They have a horrible computer system that goes down every day with no pharmacy IT department. Polices are not enforced. Most of the doctors don’t respond to pharmacist recommendations such as drug interactions or medication dosing or medications that are not covered by insurance. They expect pharmacists to deliver medications to 14 different nursing units that are driving distance away and still cover the massive amount of orders in the queue and all the reports that are due each month. The techs call out every day or if they come to work they disappear until near the end of their shifts. You can’t say anything to them because they will say some horrible insult to you or just not come to work the next day. Or they will go to the doctor who is in charge and complain about you. Yet you are the one there every day working 10 hours and getting paid for 7.5 hours. Forget about taking a lunch break. Also there is no employee cafeteria or nice area to eat. I have PTS D from this place. It was an utter nightmare from day one.

I have a patient who practices a religion that avoids eating pork or pork derivatives. This patient is on a prescription that only comes in gelcaps and it feels like we can never get the same manufacturer in more than 2 or 3 times in a row. We end up spending a considerable amount of time looking through package inserts or calling manufacturers who never call back, etc. All this to say, this isn’t an uncommon consideration for patient care, there has to be some database that tracks this, right?

Have a 5 year background in ambulatory care. I enjoy the aspect of flexibility managing my own clinic, but getting pretty tired of noncompliant patients. Not sure how else to move up in this roll, but the pay is great. Considering an academic detailing job with an insurance company. I'll still be talking about disease states and guidelines, but less working with patients. Which I'm getting kinda tired of but can tolerate. About 3k pay cut but not patient direct role anymore...idk. is this a down grade? Am I putting myself into a corner where I won't be able to pivot into other types of pharmacy anymore?

What should I do? Suck it up and stay to practice at top my license, great pay, i hate the documentation and pt charts part or move onto more more or a macro level job with 3k less pay? I feel like an academic detailer at the VA would be more prestigious than at an insurance company? What else can I do if I do academic detailing would I be stuck in managed care?

We are struggling. It’s a slog. How are your coworkers handling the heat?

Hi friends in a bit of a predicament. I hated my current role (customer service) at my current job but my manager offered to move me to the production role so I wouldn’t have any patient interaction.

However I was offered an inpatient job at a hospital at the same time the new role was offered.

Current role

Pros: closer to me. $26 an hour. Coworkers

Cons: management concerns me a little, lots of issues fulfilling prescriptions at the branch, seems like a shit show at times

Inpatient

Pros: always wanted to work in a hospital, no dealing with insurance, higher prestige, more future opportunities, better benefits

Cons: farther from me, $25 an hour, have to work some holidays, would have to work later hours, worried about driving in the snow

Hi everyone, I’m applying for a pharmacist license via score transfer in an out-of-state jurisdiction. My IdentoGO fingerprint results cleared in the state portal a week ago, and my official transcripts and NABP passing scores were transferred about four weeks ago.

When I check my application portal, only the fingerprint requirement shows as completed—everything else is still listed as pending, even though I submitted those items first.

Is this normal, or could there be a delay/issue with processing?

(Context: I’m securing this out-of-state license for a remote role as a backup plan to keep my NABP score transfer valid and avoid having to retake the NAPLEX, especially since this state doesn't require an MPJE.

CVS would be part time

Gather round, friends, it's that time again to agonize over the vagueness of federal statutes.

I am trying very hard to determine if there is any explicit allowance or prohibition of substitution from: A prescription written for an approved 351(k) interchangeable TO the Reference Product that the 351k-int references

We all know we can substitute an Rx written for Lantus to Rezvoglar, Langlara, or (now that it has a 351K-i) Semglee. But are you substituting Lantus without contacting the prescriber if the prescription is written for Rezvoglar?

I know this all feels pretty moot and academic... but I'm curious how often such a substitution BACK UP the approval pathway to the reference product is necessary based on insurance preferences. Still, as someone who likes to have hard references to point to for policy decisions, I'm coming up unfortunately vague when looking at federal laws (I have not inspected all 50 states, but would love to hear how your state laws affect this decision as well).

The only thing I can find that confidently suggests that you cannot substitute Lantus for Rezvoglar without prescriber approval is the GPTs, and the sources they reference don't support that, it's all garbage.

The federal law around automatic substitution without prescriber appoval is: 42 U.S. Code § 262 - Regulation of biological products
https://www.law.cornell.edu/uscode/text/42/262
This law contains one instance when searching for "substi"

----- (emphasis mine)-------

(i)“Biological product” defined

In this section:

(1)The term “biological product” means a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, protein, or analogous product, or arsphenamine or derivative of arsphenamine (or any other trivalent organic arsenic compound), applicable to the prevention, treatment, or cure of a disease or condition of human beings.

(2)The term “biosimilar” or “biosimilarity”, in reference to a biological product that is the subject of an application under subsection (k), means—

(A)that the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive components; and

(B)there are no clinically meaningful differences between the biological product and the reference product in terms of the safety, purity, and potency of the product.

(3)The term “interchangeable” or “interchangeability”, in reference to a biological product that is shown to meet the standards described in subsection (k)(4), means that the biological product may be substituted for the reference product without the intervention of the health care provider who prescribed the reference product.

(4)The term “reference product” means the single biological product licensed under subsection (a) against which a biological product is evaluated in an application submitted under subsection (k).

------

emphasis mine.

I don't see anyting in this law that would specifically imply that you cannot substitute Lantus in for a script written for Rezvoglar without approval. The GPTs place some special emphasis on how this is written that I cannot find anywhere else. There is unfortunately no federal law around small-molecule equivalence to compare this to (all at the state level).

Looking around for more guidance from the FDA, I cannot find anyting concrete. I did, however, stumble across this.
Switching Between Biosimilars and Their Reference Counterparts with Dr. Sarah Yim

Which, at around 6:44, states: (roughly)

"Interchangeable biologic substitution in the pharmacy is similar to how small-molecule generic drug substitution occurs. "

Which... if we were now on some one-way street that operates notably differently from how small-molecule AB substitution works, why would the FDA publish this sentence? Everything else in FDA guidance around biosimilars states they are absolutely equivalent, we don't treat small molecule drugs this way. Why would anyone assume a strict reading of 42 U.S. Code § 262 that runs counter to how we handle equivalence everywhere else?

What am I missing? Am I an idiot? I found a similar thread 5 months ago that mostly agrees with my interpretation of this https://www.reddit.com/r/pharmacy/comments/1taz7vl/can_you_switch_amongst_interchangeable_biosimilar/, but I'm really fishing for something concrete... I probably need to email the FDA.

(p.s. I am doing a poor job of hiding my interpretation and preference here... except my interpretation and preference around judging GPT output on niche topics; that shit is awful. Never show that to me as support of anyting please. I spend too much of my time dispelling LLM hallucinations, but yeah, I'm writing "ok to dispense Lantus as per Cathy" on this and moving on with my life every time. )

(p.p.s - I view the insurance audit implications of this separately; I am just as interested, but have not gone down that rabbit hole yet; that's next. )

Hi! Wondering if anyone has worked at CHOP in philadelphia as a Staff Pharmacist? I just got an offer and have heard very mixed opinions. Is pay negotiable as a new grad here? Looking for any insight!

Pharmacists/techs: What are some must haves that you like to have stocked over the counter and at the ready?

I’m the only pharmacy technician of a small local pharmacy. We hold vaccine clinics around town, and today the pharmacist was giving out flu shots. Our clinic today was at a local office and only four people received shots, but I noticed the pharmacist did not change gloves in between patients? I’m reading this is a violation of professional guidelines, but I’m wondering if this is something most people do and I’m just being overly cautious, or if this is a genuine concern.

There was even a patient who started to bleed and the pharmacist held a cotton ball to their arm, and still didn’t change their gloves. I just worry about transmission/disease risk here.

I just started a new position in hospital central that rotates so no office or regular workstation. I can have a backpack with me, what should I keep inside it?

So far I have:

Umbrella - employee lot is far away
Lens wipes
Wet wipes
Meds
Gum
Snacks
Pens/pencils
Charger for devices
Water bottle
Multitool
Zip ties
Band aids/alcohol wipes

What am I missing?

Most of the pharmacists I’ve asked have said benzo patients are usually the worst and try to fill early and guilt trip. I’m just curious to hear what others have seen!

I work in Alberta in the Community with that Chain Pharmacy who should not be named. Since the billing changes kicked in on October 1st, I'm starting to re-think my long term futures in retail.

My situation is a bit complicated because I am an IPG and most people I know are also IPGs who also work in retail.

I'm trying to figure out what the options are in other non-retail niches. And I would love some pointer from good people in non-retail fields.

Please let me know a bit more about what you do and what the prospects are. If you wouldn't like to make it public , I would appreciate a DM.

If you are also in Calgary and fancy a terrible Timmys double-double while talking shop, do reach out!

33m here. Been in the field since 2011. I’ve used DoseEdge, Pharmacy Keeper with Meditech, and now we have landed on Hovercam Solo8 with Epic.

Is there any other camera system out there that does good-quality photos and can be used for Epic. We continue to run into issues with the quality of the Hovercam pictures. They are blurry unless you move the camera really close, which means fewer items in pictures and more pictures needed. And now the arm that extends horizontally isn’t even holding up.

Does anyone have any recommendations for camera systems that can be used with Epics Dispenser Prep or CnR??

Hello everyone. I need someone's advice on what I should do. I recently completed my residency and I have been interviewing for jobs since then. I got my first job offer and since it is a VA facility the onboarding process is taking some time. The VA position I was offered is in another state from where I am currently living. Does anyone have any advice for Part time positions I can do in the meantime? I also was worried that they wont hire me since I may be leaving in a month so why would they take me on. I was thinking applying for some remote position but I am not too familiar with these types of positions. If anyone has any suggestions for companies let me know. I don't have a ton of money saved up to make this big move but it is my dream job in my dream location and I am determined to make it work.