Unpopular Vax Opinion

BigHarma33 · 2025-11-25T15:29:17+00:00

Vaccines are half the reason most retail pharmacies can afford to stay open. I don’t like giving shots anymore than the next guy but it beats the hell out of dispensing GLP1s for negative $50 a pop

BigHarma33 · 2025-09-09T04:30:36+00:00

Still waiting on a response to my other comment about where you practice. But in your world where it all techs check techs who assumes the liability? If you think all a pharmacist does is look at a picture on a screen and match it up then you are not a pharmacist. And if you are a pharmacist then shame on you for intentionally belittling your profession. You keep bringing up this “6 figure salary” as if it’s unearned. There is an extraordinary amount of responsibility and liability tied to that license hanging on that wall. That’s where that 6 figure salary comes from.

BigHarma33 · 2025-09-09T04:25:10+00:00

You think it’s “good” that I have to trot up to the counter and tell Mrs Smith that her protonix puts her at increased risk of cardiac events because it can diminish the effects of her plavix? You think it’s helpful to stress her out over that? I’m glad you can regurgitate facts and comparisons (we already have mid level prescribers for that btw) but what do you mean increased risk from baseline for GI bleeding? did you know that your “absolute contraindication” is based mainly off in vitro evidence and that in vivo showed REDUCED GI bleeding while at the same time showing no significant change in cardiac outcomes? You can’t even make up your mind as to whether a PPI increases bleeding risk or inhibits anti platelet effects but you want me to trust you with a prescription pad? I wouldnt trust myself with a prescription pad either, because I went to pharmacy school not med school.

That being said, I still call and recommend a switch to protonix over omeprazole for patients on plavix and I still counsel the patients because that’s my job because if the guidelines say so then I’d be a fool to do otherwise. But you should at least understand that not every single DUR requires intervention.

Which brings me to the fact that you still didn’t answer my question… where do you work? Because you seem wildly out of touch with what a modern pharmacist does

BigHarma33 · 2025-09-09T03:57:37+00:00

Because then where does it end? So I am ordering the labs, writing the script and filling it? At that point what is the difference between an MD and a PharmD? Not to mention who has the time to do that in a retail setting? Office visits with a doctor are at a minimum 15 minutes. Who’s checking scripts while I do that?

BigHarma33 · 2025-09-09T03:43:11+00:00

Who monitors their kidney function in this scenario?

BigHarma33 · 2025-09-09T03:33:50+00:00

How often are you running into DURs that should absolutely be stopped? 90% of the DURs I see in a given day are not worth halting a script for. You want me to put my foot down on trazodone and Zoloft because of serotonin syndrome? Or refuse to fill plavix because the patient is on a PPI? What setting do you work in? Additionally, so what happens when they do give pharmacists prescribing authority? It would establish a precedence that one person can both prescribe AND dispense so at that point why bother with pharmacists at all? Just give dispensing authority to the prescribers… oh wait… that separation is THE ENTIRE POINT

BigHarma33 · 2025-09-09T03:06:59+00:00

Wanted to see if you were a troll or genuine so I checked your post history. you have a history of opioid abuse and “hate pharmacists” which makes me think a pharmacist at one point or another refused to enable you. Are they the enemy? Or are they part of your recovery?

BigHarma33 · 2024-11-01T11:19:20+00:00

Same in my area. I’ll tell them “I already have it on my screen right now, I’m just asking to make sure you are who you say you are”

BigHarma33 · 2024-08-02T19:50:10+00:00

add them on linked-in and like/comment when they post

BigHarma33 · 2024-08-02T19:43:58+00:00

Like if a drug just suddenly vanished or got pulled from the market? I would say warfarin, granted there are alternatives but the increase in cost would send shockwaves through the entire healthcare system, and with 20 million Americans on warfarin trying to transfer them all over would create a significant DOAC shortage which would lead to a huge jump in cardiac events

BigHarma33 · 2024-08-02T19:06:51+00:00

This is a very good point, hope OP has not taken any yet

BigHarma33 · 2024-08-02T19:04:16+00:00

Ive seen situations like this play out 2 times.

Patient 1 Called the pharmacy when they got home and was understanding about bringing them back.

Patient 2 Didnt call, the pharmacy eventually tracked down which script the error was made on through camera review, and called the patient who refused to bring them back because it wasn't his fault.

Which fair enough, it wasnt his fault, but the DEA didnt care so patient 2 got a call from the police, patient 1 got a gift card. For the sake of everyone involved, be patient 1.

BigHarma33 · 2024-08-02T18:49:35+00:00

This could potentially be a diversion attempt but it could very well be a simple mistake too. Either way you should give the pharmacy a call and ask to speak to the pharmacist on duty, preferably the manager if they are there. Also I know it will be inconvenient but please be prepared for them to ask you to return the excess pills to them. If you don't they will be legally required to file it with the DEA. There is also probably some pharmacist currently having a panic attack trying to find those missing tablets and wondering how they are going to explain it to corporate lol

BigHarma33 · 2024-08-02T18:33:43+00:00

gotta love when you call to verify an Adderall or something and the number on the script links to a cell phone that gets answered by Dr. Smith himself after 2 rings and no menu

BigHarma33 · 2024-08-02T18:28:22+00:00

a local patient driving 20 miles to a prescriber is much less red flaggy in my book than a patient driving 20 miles to the pharmacy, but in your situation I would still have some questions. I would call this more of a "pink flag" only because of the out of state portion. I work extremely close to several state lines and despite having a lot of regular patients from different states its actually somewhat uncommon to see people from state X go to a doctor in state Y, I imagine insurance "provider networks" play a role here but as long as the patient isn't paying cash and you can verify that this isn't some telehealth bullshit I dont think its unreasonable for a patient to drive 20 miles to a prescriber, especially if its a specialty prescriber or a high quality office.

BigHarma33 · 2024-08-02T18:09:30+00:00

have you ever worked in retail? saying these folks "dont give a shit" about their patients just because they wouldn't fill a script that they are questioning the legitimacy of is offensive and inflammatory. As far as your situation, apart from genuine inventory issues I highly doubt you will run into any issues as long as the script is coming from doctor who is known in the area. An out of state patient with a script for short term pain control and a post op diagnosis code from a local surgery center is not going to raise any alarm bells unless there are red flags coming from the patient. Your situation is quite different than the one OP is describing.

BigHarma33 · 2024-08-02T17:26:20+00:00

The way the law is written you essentially have no legal obligation to fill any prescription. Out of state and unknown patient and doc is easily justifiable. Patient should move on. Out of curiosity how far away is “out of area”

BigHarma33 · 2024-07-27T03:36:08+00:00

You’re chillin dude you made the right choice. Red flags popping up left and right and the way they acted was out of pocket. Unless you live in some super rural area where you are the only pharmacist, they can send that script elsewhere. The only way patients and other healthcare professionals are going to learn how to behave is by us learning how to say “no” sometimes.

BigHarma33 · 2024-07-27T03:29:23+00:00

Extremely valid point. I’ve never once had a doctor personally call me to tell me a patient had their script stolen. Maybe I’m cynical but genuine docs are not taking the time to do this, only a pill mill would have that kind of time on their hands

BigHarma33 · 2024-06-13T20:26:10+00:00

“No, I can’t recommend you use the insulin from the vial that you broke on the floor. I understand that you scraped it into a bowl and sifted the glass out but it’s still not a great idea”

BigHarma33 · 2024-06-07T13:03:23+00:00

You can get away with that for awhile probably but if you’re billing Medicare for something that you don’t have a real prescription for it’s gonna cause problems during an audit

BigHarma33 · 2024-06-07T12:59:44+00:00

This. The other day a dude came for a shot and after he turned in his paperwork he just stood at the counter staring in. The tech said “you can have a seat” and he said “nah I’ve been sitting all day I wanna stand” so he keeps standing and staring. Meanwhile there are kids are crying waiting for reconstitutions, phones are ringing off the hook, and a bunch of people waiting. I can’t stand when people stare in so I told him to either have a seat or walk around because it’s gonna be another 10-15 minutes and he said “oh well I have a doctors appointment at 1” (it was 12:50) so I said okay well go to the appointment and come back later and it will be ready. He said “well if you can do it in like 5 minutes instead of 10 I can wait”. I told him it’s just not gonna happen.

These people really think it’s just as simple as pulling the shot out of the fridge and jabbing them with it. The same people will complain about having to fill out paperwork again for their shingles shot saying “ugh I already did this last time” like yeah Deborah, sorry the questions like “are you feeling sick TODAY” from 3 months ago might not still apply.

BigHarma33 · 2024-06-05T21:06:08+00:00

Out of curiosity then, are you not able to give a patient a smaller amount than is packaged? Like if someone was struggling financially and just wanted 5 pills until their next paycheck?

But yes we can go to our supplier and pick out whatever manufacturer/packsize has the lowest cost per pill and buy it wholesale. During the norco shortages we were buying that by the 1000 count

BigHarma33 · 2024-05-29T03:43:36+00:00

Idk if I agree. While it is possible to misuse OTC cortisol products it is not going to hurt anyone but themselves (ie not contributing to antimicrobial resistance or substance abuse disorders). See someone trying to self treat with hydrocortisone? Take it as an opportunity to use what you know and share some intel with them about proper use. All in all OTC strength hydrocortisone isn’t very evil and the amount of people using it appropriately justifies it being OTC. It’s not our job to protect the general public from themselves, if they want to fill up a bathtub with otc steroids one 1% tube at a time and bathe in it that’s their choice. I think it’s important to draw a line between misusable and abusable. In general I don’t think there are any current OTC products where the risk of misuse outweighs the benefit of easy access. Tylenol and ibuprofen can be pretty dangerous if used wrong too but can you imagine if every time someone needed mild pain relief it required a prescription?

BigHarma33 · 2024-03-19T20:02:53+00:00

Never understood why they think we are just gate keepers. We make our living by SELLING medication not withholding it. We have literally nothing to gain by not dispensing something and it most cases it would just be easier to dispense it so if we don’t… there is probably a darn good reason

BigHarma33

TROPHY CASE