Sometimes when I hand a patient a prescription she’ll ask, “Where should I get this filled?” “Pretty much anywhere except Walgreens,” I answer, “unless you actually enjoy long waits and, if you’re taking a pain med, getting a humiliating third-degree runaround from the pharmacist. Me? I wouldn’t buy a toothpick from the place.”
I usually get a surprised look in response.
“It’s not just about prices,” I continue. “In fact, a recent survey of prescription prices conducted by Consumer Reports showed that CVS is pricier than Walgreen’s. It’s the unmitigated corporate cynicism of Walgreens that gets my goat. Don’t get me started…”
But now you’ve got me started.
Walgreens and Switzerland
I’m sure you heard about the Walgreens plan to move to Switzerland to save some serious big money on corporate taxes. You may also have read that last month they officially changed their minds.
If you didn’t know the precise number they were planning to save on taxes, it was just about $4 billion over the next five years. Of course, being a US-based company, with Americans being its primary customers, that $4 billion would have been your money in the pipe on its way to Swiss banks. The cash would have then been divvied up among Walgreens shareholders and executives, which makes me wonder how much more than an annual salary of $13.7 million CEO Greg Wasson could actually want.
As this piece lays out, $4 billion in lost taxes could fund:
- All the prescriptions filled by all patients enrolled in the VA for the next 1½ years.
- Health insurance for 639,000 Medicaid recipients.
- Health insurance for 3.5 million children in the Children’s Health Insurance Program (CHIP).
But fearing “consumer backlash,” which might have hurt corporate profits (and his annual bonus), CEO Wasson had a change of mind, though I’m sure not a change of heart. Did you notice Wasson saying anything about $4 billion to Switzerland being “morally wrong”? That’s because, despite the Supreme Court decision to the contrary, corporations are not actually people with a sense of right and wrong. Corporate decisions are based on profit, period.
Which brings us to tobacco
Every time I hear the jingle or see a sign with the Walgreens motto “At the Corner of Happy and Healthy,” I visibly cringe. Talk about corporate cynicism.
Several months ago, a couple dozen US attorneys general sent letters to the CEOs of America’s biggest retailers urging them to stop selling cigarettes and other tobacco products. Although most of you smokers pick up your Marlboros at convenience stores and gas stations, 15% of cigarettes are sold through the drug and grocery chains. CVS responded rather quickly and next month will quit selling cigarettes. Other chains, like Safeway, Kroger, and Walmart, are in the “considering” stage.
Walgreen’s simply declined to comment.
And this year, almost 500,000 Americans will die from smoking-related illness. “Happy and healthy,” my a–!
Treating the customer as criminal
In 2013, Walgreens badly botched its controlled-drug inventory system in Florida. They were socked with an $80 million fine over federal charges that their ability to control the sales of narcotics at some stores was a failure. From that point forward, the company took a self-righteous stance, treating customers like drug dealers and doctors like suppliers.
I wrote an earlier Health Tip about a fax sent by Walgreens to primary care physicians informing them that pharmacists might be calling to discuss exactly why a pain med had been prescribed, how long the patient would be using it, and (get this) asking if we doctors were running urine drug tests on our patients to make certain the medication was being taken correctly and not shared with others. Here’s a copy of the fax they sent.
Physician groups immediately began opposing this as an intrusion into their privacy (which it is, but it’s also seriously insulting to our patients). From my own point of view, I think the opposition is having an effect. I’ve been receiving fewer calls from Walgreens pharmacists than I did several months ago.
However, you as a patient are certainly not of out of the woods. You’re guilty until you can clear yourself. To your Walgreens pharmacist, if you’re a patient in pain and you hand over a pain med prescription, you’re immediately regarded as sleaze. You might find the pharmacist handing back your prescription with a “We don’t have it in stock–call around, try another store.” What they really want is for you to take your pain prescription to a competitor.
Why? You’re too much work for them. Take a look at this secret checklist, recently sent to every Walgreens pharmacist. BTW, it was not for public viewing, but likely placed online by a disgruntled pharmacist or pharmacy tech.
I’ve linked to this intense clip from the film “Magnolia” in a previous Health Tip. If you’re prepared for a shock, here’s Julianne Moore, picking up the pain med prescriptions for her dying husband. This could easily be the consequence of the Walgreens secret checklist.
Where should you get your prescription filled?
Much depends on the drug benefits of your health insurance.
- If you have excellent, no-hassle coverage, I suggest you find a small independent pharmacy in your neighborhood or town. It’s definitely pleasant to be recognized when you walk into the store, or to be asked by the pharmacist when you phone how you’re getting along. The big retail pharmacies are essentially huge Family Dollar/White Hen Pantries with a pharmacy tucked in the back. You may have discovered how they fill your prescriptions s-l-o-w-l-y because they want you to shop around while you wait.
- If you don’t have great coverage and you have a lot of out-of-pocket expenses, use Costco (membership not required), Walmart, Sam’s Club, or Kmart. The generic prices from these retailers are excellent.
- You can save serious money using the online mail-order pharmacy Health Warehouse or you can print a coupon from GoodRx and use it anywhere.
- It’s less expensive not using insurance for many generic drugs, a fact that often surprises people. For example, three months of generic Norvasc (a blood pressure med) costs less than $10 at Health Warehouse. Plus after ten weeks they’ll send you an email reminder to order your next three-month supply. No trip to a drugstore, no waiting in line, and best of all no co-pay.
- If you know you feel better on a brand-name drug but your insurance refuses to pay for it, have your prescription filled by mail at a Canadian pharmacy like Universal Drugstore. Prices are excellent and the professional staffers are “Canada-friendly.”
Be well,
David Edelberg, MD
Thank you sharing this information.
Dose Pharmacy
The reason walgreens or any pharmacy tells you your script can only be transferred once is because it’s a controlled substance and by law can only be transferred once. It’s not the pharmacy staff trying to be mean, short or think that you’re a drug abuser by they are adhering and in forcing the law that way they don’t get in trouble.
Pharmacy
Im so glad that you did this article, I have been so fed up with Walgreens pharmacy for a very long time! I have been treated like a criminal one to many times! If you have a customer service area in your store, which the pharmacy is…then you should be friendly to your customers. I shouldnt have to have an argument with the pharmacy attendants when Im in pain and they give me a hard time (I am being nice right now) they wont be getting my money anymore! They also told me that I could change locations 1 time. At that point in time I was traveling quite a bit, their advertisment was untrue! They said you could fill a prescription anywhere in the country without hassle, NOT TRUE! I was totally shocked by their attitude. I had the best relationship with my town pharmacy! Then they sold out to CVS…I wasnt happy about it but gave it a chance…They are so good to me and they all know me and I know them! I got lucky on that one! Very happy with CVS ♡
Bernadette Lord
Dr. David Edelberg,
The issue many global companies have with U.S. taxation is that all earnings worlwide are subject to U.S. Taxation. When a company “inverts”, they still owe taxes on any U.S. generated profits. Foreign profits are taxed differently. The opposite of progress i.e. Congress needs to redi tax laws. Important point-any tax a company pays is ultimately passed along to the consumer in the form of higher prices. TINSTAAFL-there is no such thing as a free lunch.
(From a former resident of 78th & Aberdeen)
Michael Lawler
It is very common in my state for the VA to overprescribe painkillers, and all local pharmacies will fill any and all scripts when you pay with cash…no questions asked. Even though our family member was on a ‘narcotics contract’ through the VA…they told us it was to keep him honest…and no one ever monitored it on the other end…resulting in his death at 57. His monthly habit had reached 1180 painkillers, and the DR. said this is not excessive as many in pain take 100 painkillers daily. I have all the documents if interested.
Mae Eldridge
Sounds like Walgreens receives its financial advice from Bruce Rauner which is one of the reasons I will not vote for him and I stopped shopping at Walgreens a few years ago for another reason.
However, It is remarkable that very few people pay attention to the contempt with which “US” companies hold them taking their money and jobs overseas. Thanks, I’m passing this article around.
Maryanne Burgess
Hi Margo
From my perspective, undeniably to the “left,” your comments are a great justification to end capitalism altogether, once and for all. A corporation, existing solely as being beholden to its shareholders, and generating revenue for profit to be divvied among them, apparently is free from any other obligations no matter how distasteful or immoral. To generate profits, it’s okay for a corporation to endanger human health, pollute the environment, devastate landscapes,
bribe government officials, encourage colonialism. Actually, since corporations have been doing all this for centuries (the British East India Company were the first to invade India), maybe its time we start reigning them in a bit
Dr E
This is a tough one for me, because my experience with CVS/Caremark is awful. Talk about treating the patient with a pain script like a criminal! And as an insurer, they are terrible at covering meds or providing valid reasons why they can’t. And the service is nearly always better at Walgreen’s and the stores are neater. Too bad our hometown company can’t behave better.
Judy
Should anyone be upset by Walgreens’s continued sales of cigarettes, or believes that Walgreens (or any other retail pharmacy) is hypocritical in being both a pharmacy as well as a seller of “unhealthy products”, these consumers have the right to shop elsewhere at retailers where such offending products are not found.
Walgreens is a publicly traded company and as such its primary obligation should be to make a profit for the benefit of its owners (shareholders), as well as follow their wishes as to corporate policy. Although I have never smoked, and only very rarely drink a can of pop, I support Walgreens’s right to sell any legal products that it chooses, if Walgreens feels it can best make a profit that way and its shareholders approve. We increasingly live in a nanny state, which I abhor. I find Walgreens’s refusal to cave in and cease the sale of still-legal products to be actually refreshing, although I myself rarely shop there for a different reason (prices).
Margo Milde
Margo,
While you are busy wasting energy on “abhorring” a nanny state, the company you describe is contributing to major public health concerns, which most certainly is the responsibility of the state. Shareholders and profit only? I thought we were getting beyond that. What about me, the customer, the reason corporations exist? I am NOT necessarily free to go elsewhere as you so blithely state. As mentioned in a previous note, I travel when working and I don’t always know where to. If I want to know specifically what meds I’m taking (unlike with CVS), I’m pretty much forced to use the only competitor within convenient distance from my unknown destinations. It’s not like I can just hop over in five minutes Costco when I’m in a new city. Stop acting like customers don’t matter, that only shareholders do, that my health doesn’t matter, that the addictions that can truly strangle people are going to make them likely to shop elsewhere because they can “choose” to. A dose of reality and a bigger dose of compassion is greatly needed by your most cold, rigidly capitalistic values. Be careful, it’s attitudes like yours that make socialism look very appealing.
Beth
Hi Kem
Actually you may not know this, but from a physician’s point of view, although junk food wins no prizes, cigarettes are a lot more dangerous to your health. The fewer outlets for cigarettes, the better we all are. As long as we’re giving kudos to “the corner of happy and healthy,” do remember that although cigarettes are sold up front, back in the pharmacy section Walgreen’s stocks an enviable assortment of inhalers for tobacco induced chronic lung disease. In fact, if you’re housebound and terminally ill from emphysema, as icing on the cake, Walgreen’s maintains a respiratory services division that delivers oxygen tanks to your home. I would alter one of your sentences slightly…”at least Walgreen’s is honestly cynical about what they sell…”
Dr E
Good for Walgreens for sticking to their guns on tobacco. It is so hypocritical for companies like CVS to pat themselves on the back for “protecting public health” while they continue to sell soda, junk food, and diet pills. Don’t tell me that you care about public safety when half the products in your store cause chronic health problems! At least Walgreens is honest about what they sell and doesn’t try to insult me with their pandering.
…Not that I’m a fan of Walgreens. I haven’t stepped inside one since they tried to charge me $20 for a a 10-day supply of Amoxicillin.
Kem
The issue for mail order is that some people travel for work and not always to locations we know about in advance, and mail often doesn’t get to their locations on time–too risky. Also, with ALL prescriptions only covered for 30 days by my insurance, this makes the travel/mail order problem that much greater. I’m not real clear on this, but I understand CVS uses their own label for drugs, so I don’t know if I’d be getting a generic, many of which affect be badly (some don’t). Having weighed all this, Walgreens is easier to deal with because of their national computer network. Wish there were another way.
Beth Murphy
I switched from Walgreens to Costco years ago and never looked back. For price and customer service I cannot recommend enough.
Cindy
Thanks for these suggestions. I thought I was the only person that hated the Walgreens pharmacy.
daphne black
Dr. Edelberg,
I most whole heartedly agree with this. Yes, there will be people who abuse the system. I’m sorry, and my comment will seem harsh, but my concern is for pain patients. Addicts and abusers have made it impossible for real patients to get medication. It seems that we take the side of the person abusing and make everyone else suffer. I wrote about Walgreens as well and didn’t have the fax they sent out. Thank you for this post!
Rosemary Lee
Hi Debbie
Apparently the multiple doctors prescribing Norco were not following standard narcotic prescribing practices. Every state has a website that tracks the control drug use of every patient. Whenever doctors write a controlled rx, it a few seconds they can check the site to make sure they’re the only ones prescribing. If they spot more than one prescriber, they can (a) discuss this with the patient, or (b) simply not do additional prescribing for that patient. Actually, for patients suffering chronic pain, the actual addiction rate is extremely low. Patients want pain relief and don’t want to endanger the relationship with their prescribing doc
Dr E
Hi Kay
I’m certainly not suggesting that anyone buy all their meds from Canadian pharmacies but for those in which the pharmaceutical companies are stiffing the Americans but not the Canadians, it does seem a reasonable option. For example, Lexapro (brand) is $250 for 30 tablets in the US while the exact same drug by same manufacturer is $42 in Canada
Dr E
Great information. I go to CVS because it’s more convenient. Now I’ll shop there for other reasons too. I’ll avoid any company whose name begins W-A-L. I already boycott Walmart.
Addie
My brother is a Walgreen’s pharmacist. I’ll ask him about his experience and will share this blog with him.
Stephanie
Dr. Edelberg,
Thanks for the very good information. I will certainly use their competition you mention at the end of the article and be done with Walgreens! (Even though most corporations are exactly like Walgreen’s)
Andrea Winship
Hey Doc, can you speak to the epidemic of prescription pain medication addiction too? I have an 85 year old family member that sought help from numerous physicians for chronic stomach pain and constipation. The pain wakes him at night and he can’t sleep. Only diagnosis has been a frozen sphincter muscle. Treatment has been prescriptions for ambien and norco…for years…by multiple doctors. We believe he now has narcotic bowel syndrome.
His addiction caused him to take more than was prescribed so he duplicated a norco prescription and Walgreen’s alerted his doctor. If they hadn’t, we wouldn’t have known that he needs help. To make matters worse, his primary physician then sent him a letter and dropped him as a patient with no explanation. We are trying to get him help and many treatment programs do not accept Medicare.
My point is that this is a complex issue. I don’t know what the solution is, but I felt the need to respond.
Debbie
I am confused by the your suggestion of buying drugs from Canada, but boycotting Walgreens for moving out of the country.
kay cone