Granted, some moms will want to fill their script at Wal-Mart, where they can also buy a gallon of milk, get their oil changed and eat lunch. For others, they just want to have the medicine and get back home. Milk and oil changes can come later. :)

The Wal-Mart formulary is also quite limited. Although the supercenter says it offers ~300 drugs, they count the same drug many times depending on the dosage. For example, generic Prozac qty. 30 at strength A, generic Prozac qty. 30 at strength B, etc.

Finally, Wal-Mart’s $4 formulary doesn’t include many pain medications, and I don’t think it offers any types of controlled substances. When you just had a root canal in the oral surgeon’s office, paying $15 for your pain medicine is much appreciated. The alternative can be more expensive, and probably very embarassing as you drool in the grocery store waiting room. Yikes.

The bottom line: in-office medication dispensing thrives on the concepts of convenience and privacy. Save a trip to the pharmacy, and get your STD medication from your doctor, and not the 18 year old kid who fills your script at the grocery store.

These doctors don’t stock hundreds of thousands of dollars of medicine! According to what I’ve learned about the service (from Allscripts and other suppliers), you stock 20-40 of your most common generic medications. They come prepackaged and safety sealed. When it’s time to write a script for one of the drugs you stock in your office, you ask the patient if they want to save a trip to the pharmacy by receiving their prescription in the office. Most say yes, some say no.

The physician doesn’t usually bother to bill the insurance company. It’s usually a cash and carry model. Most patients are willing to pay $10 - $15 out of pocket for the convenience of skipping the pharmacy. For many patients, $10 - $15 is the same as their generic prescription insurance co-pay.

You can make extra money by dispensing medicine at the point of care, but it’s my understanding most physicians offer the service to improve satisfaction and treatment compliance. In most cases, you’re talking about an extra $10,000 - $15,000 a year … just enough to make it worth the effort.

I hope this is helpful.

EMR Guy

On top of that - listen to endless complaints on why it isn’t $4 like Wal-Mart or FREE like Publix.

There might be $$$ in it - but I don’t see a lot of docs trying to do this. The exception would be a large, corporately managed group. But the logistics still don’t work. There is a reason that many pharmacies are now 24/7/365 - I don’t think you would see that at your clinic. Plus, I know pharmacies are not getting less busy and are sometimes inconvenient, but they actually know the process. Can you imagine the wait at the office by the time you show up for your appt., wait for a script to get filled. Talk about planning for the day……

Yeah you could sign up with this consulting firm to do all the grunt work, but how much is left after that? I think pharmacies make $5-10 per Rx on average. Take their fees out, and I am making $2.50 a scrip. Plus, with everything transitioning to mail order, you are talking about filling acute antibiotics and that’s about it.

Geat idea, I guess, but not practical. Plus a good chunk of my patients like to stop at the drugstore to restock their beer or cigarettes. I likely won’t put in a beer cooler in my office.