1. Would pharmacists dispense at a financial loss in an emergency?
Ross Ferguson1, Johnathan Laird2
1Writer, locum pharmacist, and managing editor at Pharmacy in Practice 2RPS Board member, independent prescriber, and Commercial Director at Pharmacy in Practice
Introduction
Results
Pharmacy in Practice is a popular website edited by practising pharmacists. It aims to offer news, insight, information and advice for pharmacists. As part of a regular feature on Pharmacy in Practice, it presents dilemmas that pharmacists may face in practice.
The purpose of the dilemmas are to explore the attitudes and opinions of pharmacists, to stimulate debate, and explore possible solutions.
The hope is that when faced with similar situations in practice, pharmacists are better prepared, and also that pharmacists who have faced these dilemmas reflect on their performance.
Aims
To gauge the level of financial loss pharmacists were willing to incur to ensure patients got their medicine.
To determine whether urgency to start the medicine, as presented in this scenario, would affect that decision.
To explore whether they would tell patients what they had done for them.
To explore the levels of autonomy they had to dispense at a loss.
Methods
The dilemmas are posted on the Pharmacy in Practice website and promoted via a dedicated Twitter account and Facebook page. Pharmacists participate by responding to a series of questions.
We presented pharmacists with the following scenario:
“You are the manager of a high street pharmacy – you are very busy as it is the Friday before a bank holiday. A patient presents with a prescription for a generic medicine which you don’t have in stock. You do, however, have the brand, which you know is more expensive.”
We then posed the following questions:
What is the maximum loss you would be prepared to accept on this dispensing?
The difference in cost between the brand and the generic is £11. The patient explains she is desperate to start her medicine today and is going on holiday tomorrow. Do you dispense the brand at a loss of £11?
If you decided not to dispense the medicine at a loss, would your decision be different if you owned the pharmacy?
If you decided to dispense the branded item at a loss of £11, would you explain to the patient what you had done for them?
Would you inform your line manager, or the owner of the pharmacy that you have dispensed an item at a loss?
Note: not everyone who read the dilemma participated in the polls
Conclusions
Most pharmacists in this scenario were willing to dispense prescriptions at a financial loss in an emergency situation for the benefit of patients, and seemed confident in making this decision autonomously. Around half of them would do this without alerting patients to the financial implications and most would not inform their line manager.
References
Acknowledgements
Results last accessed July 9, 2017.
We would like to thank the readers of Pharmacy in Practice for participating in our dilemmas.