Learning new things

I had some time without patients this afternoon, so I went in to help Irma, our pharmacy tech, to put away the drug shipment that arrived yesterday. $18,000 for two-months' worth of drugs!

There used to be another tech besides Irma, but her contract was up, so she left for Ogden, Utah (small world, huh?). So with boxes and boxes and bottles and bottles, there was work to be done.

Although her inventory is computerized, the prices had to be placed on each individual piece. I figured I could help with that, as it was not too complex, but I had to keep reminding myself to make certain I wasn't putting the prices for the 500 mg tablets on the 250 mg tablets and vice versa. So, I spent about an hour or so helping out.

It was great for me. I spend a lot of time running back and forth to the pharmacy, which is not far from my office, asking what drugs are available in any given class and then the inevitable "how much per tablet" because so many of my patients have no insurance but pay out of pocket. I have been happy overall with the drug selection and the affordability of them.

We practice medical economics here. We don't use the newest and greatest drugs, but we have everything we need to treat our patients effectively. It was great for me to actually work in the pharmacy so that I could become familiar with the available drugs.

Sadly, we have a LOT of asthma here on the island (so much for the idea that most asthma is environmental - not much pollution here) and most of my patients simply use albuterol MDI to treat their asthma. The problem with that is that albuterol really does not treat asthma but simply rescues the patient from an asthma exacerbation. I've made it part of my mission to treat the asthma by controlling it, and that is done with inhaled steroids. While albuterol is about $45 a month for an inhaler, a steroid inhaler is $150! To convince a patient that they need to spend that kind of money to control their asthma is difficult if not impossible. As cheap as prednisone is, it seems that anything else that has a steroid in it is very, very expensive. Nasal spray for allergies, inhaled mist for asthma, and steroid drops for eyes are all expensive. Can't seem to figure that out.

But it's not all dismal news. Our generic meds are like 10 cents a pill and I do have access to most of what I consider needed. So as a result of my stint in the pharmacy, I feel better prepared to prescribe what we have available.

Thanks Irma!