Save Mart closing pharmacy

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storewanderer
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Re: Save Mart closing pharmacy

Post by storewanderer »

Alpha8472 wrote: October 4th, 2022, 4:23 pm The major profit of pharmacies today is vaccinations. Each vaccination is very profitable except for COVID vaccinations.

You get an administration fee along with the cost of the vaccine. The profit of one shingles vaccination equals the profit of dozens of prescriptions. For shingles you have to get 2 shots and you get twice as much profit.

Opening up a vaccination only pharmacy could be very profitable. The second major source of profit is insulin. Insulin is very expensive and very profitable. Many mail order pharmacies dislike refrigerated items because the cost of shipping refrigerated items is very high. Kaiser Permanente Health Insurance does not deliver insulin or other refrigerated items. It is not profitable for Kaiser. Kaiser members must pickup insulin and refrigerated items at the pharmacy.
How does Kaiser handle insulin and refrigerated items for people on one of their plans but nowhere near a Kaiser pharmacy, like someone in Susanville or Bishop for example? Are they allowed to obtain from a store pharmacy?
lake52
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Re: Save Mart closing pharmacy

Post by lake52 »

storewanderer wrote: October 5th, 2022, 12:54 am
Alpha8472 wrote: October 4th, 2022, 4:23 pm The major profit of pharmacies today is vaccinations. Each vaccination is very profitable except for COVID vaccinations.

You get an administration fee along with the cost of the vaccine. The profit of one shingles vaccination equals the profit of dozens of prescriptions. For shingles you have to get 2 shots and you get twice as much profit.

Opening up a vaccination only pharmacy could be very profitable. The second major source of profit is insulin. Insulin is very expensive and very profitable. Many mail order pharmacies dislike refrigerated items because the cost of shipping refrigerated items is very high. Kaiser Permanente Health Insurance does not deliver insulin or other refrigerated items. It is not profitable for Kaiser. Kaiser members must pickup insulin and refrigerated items at the pharmacy.
How does Kaiser handle insulin and refrigerated items for people on one of their plans but nowhere near a Kaiser pharmacy, like someone in Susanville or Bishop for example? Are they allowed to obtain from a store pharmacy?
Kaiser doesn’t even want you to come to their pharmacies these days, they’d rather mail you the items. I’d imagine that is what they’d recommend in this case.

That being said, you can apply for authorization to utilize another pharmacy. I’ve never witnessed the process but I’d imagine living far away from a Kaiser pharmacy would be an acceptable reason.
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Re: Save Mart closing pharmacy

Post by J-Man »

How does Kaiser handle insulin and refrigerated items for people on one of their plans but nowhere near a Kaiser pharmacy, like someone in Susanville or Bishop for example? Are they allowed to obtain from a store pharmacy?
Kaiser, like many HMOs, has a restricted coverage area based on the county or ZIP code where you reside. Neither Susanville nor Bishop is in their coverage area.
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Re: Save Mart closing pharmacy

Post by buckguy »

storewanderer wrote: September 29th, 2022, 9:47 pm
HCal wrote: September 29th, 2022, 3:29 pm
storewanderer wrote: September 28th, 2022, 11:53 pm I think the point is coming where more and more insurances will just flat out require mail order for routine medications. You can go to a physical pharmacy for immediate need/single time prescriptions but once refills start becoming involved- mail order.
I don't think that will happen for a while. Many people aren't comfortable with mail order (elderly), experience theft of packages (apartment buildings) or don't want household members to see/tamper with their medications (teens on birth control).

But if that ever happens, I think the majority of physical pharmacy locations will no longer be viable. Most of their business (and profits) comes from routine medications. The occasional customer needing an urgent or one-time prescription isn't going to sustain the salary of a pharmacist except in a limited number of locations in the large cities.
Today's 50 somethings who order everything online (including prescriptions) are tomorrow's elderly.

I see very few teens patronizing pharmacies.
Beyond the question of whether they'd pick-up their own scripts, adolescents use are relatively infrequent users of health care compared to their proportion of the population and chronic diseases are very rare in this population.

I see plenty of under 50s at my local CVSs picking up prescriptions (and there are multiple stores in walking distance). Ditto Walgreens. Mail order formularies may capture most available generics (CVS' mail supplier is Cardinal which only stocks generics) but that leaves other drugs including those that become necessary when the supplier switches to some less effective generic.

Judging from my recent experience with vaccinations (Giant, Safeway, Walgreens and CVS), pharmacies are not very efficient at delivering them even when they have staff dedicated to vaccination. Depending on the vaccination, I sometimes have had other options (workplace, doctor's office) and prefer them to the pharmacy experience which seems to be a real amateur hour kind of thing. If vaccination is profitable, it's because they do it in the cheapest way possible which probably doesn't build a lot of customer enthusiasm.

A vaccination-only store would need large volumes from bigger trading area than would be true for individual stores. It probably would need various kinds of regulatory oversight and enough space for confidential waiting areas and safe disposal. The future of pharmacies has long been touted to be the "minute clinic" model which would provide basic care, do screenings, dispense medications, vaccinations, etc. Even with some stores clearly being remodeled for this and others open, it's taken 10-15 years to even begin launching this and there may be local issues because of conscience clauses about delivering certain medications or procedures.
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Re: Save Mart closing pharmacy

Post by Alpha8472 »

Kaiser Permanente has done mass vaccination clinics and it is always a mess. The nurses at Kaiser have had some serious vaccination errors. The Kaiser COVID vaccination clinic in Walnut Creek, California accidentally gave the wrong dose of the Pfizer vaccine to patients last fall. This led to them sending out emails saying if patients wanted another shot, they could go back and get it.

Nurses are not as knowledgeable about the actual vaccines as pharmacists. Many nurses get confused on how to reconstitute and mix the vaccines. Since they do not have a pharmacist double check their work, nurses often make vaccination errors. Pharmacists are experts in the proper preparation and handling of vaccines.

It is less likely that a pharmacist would make a vaccination error than a nurse. Pharmacists have 4 years of Pharmacist School while nurses may only have 2 years. When I worked in a hospital the nurses made so many mistakes that Pharmacists had to write out detailed instructions on how to prepare and give medications on the medication labels. Many of these nurses have foreign degrees and many have difficulty reading English.

Nurses follow medication instructions, but the pharmacist writes them and handles the drug plan.
storewanderer
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Re: Save Mart closing pharmacy

Post by storewanderer »

J-Man wrote: October 5th, 2022, 7:16 am
How does Kaiser handle insulin and refrigerated items for people on one of their plans but nowhere near a Kaiser pharmacy, like someone in Susanville or Bishop for example? Are they allowed to obtain from a store pharmacy?
Kaiser, like many HMOs, has a restricted coverage area based on the county or ZIP code where you reside. Neither Susanville nor Bishop is in their coverage area.
So what if you are traveling and get sick and need to obtain a prescription in one of those places outside their coverage area? Seems like these coverages should be statewide at the very least... we have had similar issues in Nevada; at one point there was no insurance company willing to sell insurance in a couple rural counties for the ACA plans but eventually they found a provider and twisted another provider's arms to get them to sell plans in those counties...
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Re: Save Mart closing pharmacy

Post by Alpha8472 »

Kaiser is notorious for not covering care if you are outside of Kaiser territory. They claim you need to pay out of pocket and then you can file for reimbursement. Kaiser of course will rarely ever approve payment unless Kaiser deems it life threatening.

If you need routine care, Kaiser will not cover it. Kaiser does claim they have telephone advice nurses and if you are lucky you can schedule a telephone appointment with a doctor. Telephone appointments could take days to obtain.
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Re: Save Mart closing pharmacy

Post by Romr123 »

Was in California several weeks ago. Had always assumed Kaiser=Kaiser, but met an acquaintance (Medicare/Kaiser insured) who lives in Hawaii and comes back to California every 4 months for some treatments (prostate cancer). Even though Kaiser is in Hawaii, it's considered out of network except for emergency, so he comes back. Just assumed any Kaiser was equivalent---apparently not. They don't have a hospital in the Coachella Valley, and last year shifted from Desert Health to Eisenhower for hospital care (apparently they do have a doctors' office or two).
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