Pharmacy Closures and What This Means for the Epilepsy Community

- Clinician's Corner

By: Jeannine Conway, PharmD, BCPS

You may have seen news stories of pharmacy staff walking out of the pharmacy due to a stressful environment and unsafe understaffing. You may have also experienced finding your pharmacy closed due to short-staffing.

Why is this happening?
Community pharmacy is not immune to the challenges the healthcare system as a whole has been grappling with during the peak of COVID and today. Just like hospital based staff have experienced high rates of burnout and people leaving their positions, community pharmacies absorbed a huge portion of the immunizations that were delivered, resulting in overwork and burnout. Immunizations are expected to be administered on top of all the other prescriptions they are expected to fill for patients.

Additionally, there are economic pressures due to the structure of pharmacy benefit management contracts. Very often, a medical insurance program and/or employer will separate out medication coverage and route it through a different company than other medical expenses. It is becoming common for pharmacies to lose money dispensing a prescription, which has led to closures of some pharmacies, especially independents. Larger businesses may be able to absorb the losses through selling of other merchandise or services.

What can you do?
Consider what you need from your pharmacist and pharmacy. Do you like knowing your pharmacist and having a more personal experience? Then a local independent or smaller chain pharmacy may be a better fit. If you build a relationship with the pharmacist and the team, they can be helpful with unexpected events. For example, if there is a delay in getting a prescription renewed and you run out of pills, they may be able to give you a few days’ worth of medication while it gets resolved. The tradeoff may be more limited business hours and more challenges if you need to transfer a prescription to another pharmacy organization. Do you travel often and appreciate the convenience of a pharmacy with many locations to fill your prescriptions at? Then a larger, national chain may be a better option for you. The tradeoff includes you may not have the same pharmacist(s) that gets to know you individually. Regardless of the pharmacy, you should be able to seek out your pharmacist for medication-related questions and concerns-they are the medication experts! You can ask them if they feel they have working conditions that allow them to focus on getting prescriptions filled correctly.

What if I find my pharmacy closed?
If it’s a large chain, you may be able to have another location within the same chain transfer and fill your prescription. Keep in mind, they may be absorbing workload from the closed pharmacy and there could be a significant wait or delay. If your prescription is filled and waiting for pick up, that is a big challenge. This is because insurance will not pay for another pharmacy to fill it as they view it as duplicative.

It is possible and legal to transfer most prescriptions between pharmacy businesses. The short staffing has made it more difficult as the pharmacist at one location must talk to the pharmacist at another location. Your prescribing neurology provider may be able to help. Let them know if you are having difficulty obtaining your medications. They may be able to send a new prescription to your new pharmacy. If your neurology office has sample medications, that be a temporary supply to bridge the gap between pharmacies.

Do your very best to request refills and obtain the refill before you are out of pills. This will give you a buffer in the event something unexpected, like a pharmacy being closed or a blizzard, happens. The label on your bottle indicates how many refills are left and the date the refills are good until. Most prescriptions have to be rewritten every 12 months. Some antiseizure drugs are controlled substances and the prescriptions need to be rewritten every 6 months. Using a pill box is an important tool in keeping track of your supply. It can help prevent you taking extra doses because you forgot if you took your medication. It can help you know when you have missed a dose and determine if you can still fit the dose into your day.