If you’re like a lot of people, you go to the pharmacy as much as 10 times as often as you go to your primary care doc—but have never actually talked to your pharmacist. That’s too bad, because the person filling your prescriptions can do a lot more than dole out meds.
“Pharmacists have doctorate-level education and specialize in medications the way doctors specialize in diagnosing,” says Ashley Garling, Pharm.D., a clinical assistant professor at the University of Texas at Austin College of Pharmacy. “That means we can help you decide the best course of action when it comes to most health conditions,” whether that’s recommending that you see your doctor or go to urgent care or assuring you that an over-the-counter treatment should do the trick.
Knowing all your pharmacist is capable of doing is especially helpful now, as continued efforts to limit exposure to the novel coronavirus have prompted many pharmacies to expand their services, adds Garling.
“In most states, pharmacists are able to administer vaccines and perform tests for COVID-19, flu, blood sugar, blood pressure, and cholesterol. Many can also prescribe oral contraceptives and travel medications, which can save you a trip to see your doctor.”
All the more reason to find a pharmacist you connect with and establish a relationship as you would with any health care practitioner, says Stacey Curtis, Pharm.D., a community pharmacist and a clinical assistant professor at the University of Florida College of Pharmacy. Remember, your pharmacist is on your team. “Your pharmacist is the gatekeeper for all the medications you’re taking and can bridge a gap between you and your various doctors,” says Curtis. “Most people don’t recognize how important that bridge can be.”
Another helpful service most patients have no idea pharmacists are eager to provide: an overall review of everything you’re taking, including vitamins, supplements, and other over-the-counter remedies in addition to your prescriptions—something that can help you optimize your treatment plan, eliminate unnecessary drugs, and highlight important drug-food or drug-drug interactions, says Garling, adding, “If you know how to work with your pharmacist, it can go a long way toward improving your overall health.”
The best part: Making this happen is as simple as knowing a little more about how pharmacies work and what exactly pharmacists do. Consider this your cheat sheet.
How to avoid medication mix-ups
Drugstores have mechanisms in place to make sure you get the medication you’ve been prescribed. But alas, pharmacy errors do happen—in fact, they harm at least 1.5 million people every year, according to the Academy of Managed Care Pharmacy. These simple strategies can help you stay safe.
1. Say yes to a chat with the pharmacist.
People often hurriedly decline the offer to talk to the pharmacist, but it’s smart to accept every time. “You can catch a lot of errors before you walk out,” says Michael Gaunt, Pharm.D., a medication safety analyst and an editor for the Institute for Safe Medication Practices. “The pharmacist should ask questions to ensure that you’re on the same page about the med. You can also ask things like, ‘Does this medication have any special storage instructions or side effects?’” They can tell you the best time to take it too.
2. Say the name of the drug out loud.
Before you leave a doctor’s appointment, know whether new meds were prescribed and, if so, why. When you pick up an Rx, verify the med name. “There are a lot of electronic steps between your doctor and your pharmacy,” says Rebecca Lahrman, Pharm.D., an assistant professor at The Ohio State University College of Pharmacy. “For example, when your doctor goes to prescribe a medication you discussed, there may be a long drop-down menu to choose from—which means the incorrect one might arrive at your pharmacy.” One study found that 13% of dispensing errors were due to inaccurate or omitted transcriptions.
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3. Open the bag.
Confirm that your name is on both the bag and the box or bottle that contains the medication, says Gaunt. If it’s not what you expect, tell the pharmacist. They will ask for additional identification, such as a birthday. “This is especially important if you have a common surname, like Smith, or if there’s a John Smith Sr. and Jr. in your house,” adds Lahrman.
4. Look at your med.
If it’s a refill and it looks different, ask your pharmacist why. “Often it’s a result of a change in the manufacturer for a generic medication, but it’s always good to double-check,” Lahrman says. Your pharmacist will make sure it’s the right drug. If you’re taking a medication that’s new to you, read the label and make sure you understand the directions.
5. Report any problem.
It’s important to speak up about mistakes, because someone else might have gotten your med accidentally and could be at risk. First, call your pharmacist to report it and see what happened. “If there was an error, the pharmacist will fix the problem and give you any new instructions,” says Lahrman. “Then reach out to your doctor’s office to let them know, especially if you’ve taken an incorrect medication.” Reporting the error also helps identify system issues to prevent further errors. If it’s a large issue, your pharmacy and your doctor will likely report it to the state board; you can also report the issue to the Institute for Safe Medication Practices.
How pharmacies are designed to prevent errors
✔️ The computer: When a prescription comes in, a special software system flags any contraindications (say, an allergy or an interaction of the drug with something else you’re taking). If all looks good, your pharmacist will pull the drug from the shelf and scan the product into the computer to make sure it’s the right one and the correct strength. “This bar code technology will stop them from continuing if something is wrong,” says Garling.
✔️ The shelves: One in four medication errors comes from confusion over a drug name. That’s why look-alike and sound-alike meds are usually stored on different shelves. “Each pharmacist can organize medications as they like,” says Garling. “If they realize that they or their technician has a tendency to grab the wrong bottle, most pharmacists will put that medication on a different shelf to avoid potential errors.”
✔️ The labels on the bottles: Many pharmacies use what’s called “tall man lettering”—in which three or four letters in the drug name are capitalized so it can be more easily distinguished from sound-alike medications. For example, bupropion (an antidepressant and a smoking-cessation aid) can be easily confused with buspirone (an antianxiety med), so labeling them buPROPion and busPIRone will make it more likely that a pharmacist or pharmacy technician will grab the right one.
✔️ The lighting: This may seem obvious, but lighting a pharmacy well has been shown to reduce dispensing errors, because it lets pharmacists and technicians see more clearly what medication they’re selecting.
✔️ The credit card machine: You’ll be prompted to check boxes and sign to indicate that you’ve either accepted or declined counseling.
✔️ The phone: Prescriptions are coming from doctors’ offices constantly. “Pharmacists spend a lot of time on the phone with practitioners and also patients, asking about different medications that might be more effective or less expensive as well as discussing any safety concerns,” says Sarah Vordenberg, Pharm.D., a clinical associate professor at the University of Michigan College of Pharmacy.
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How to save money on medications
One recent study that looked at 49 top-selling brand-name drugs found that the median cost of those treatments increased 76% from 2012 to 2017—a trend the researchers say isn’t likely to slow or stop any time soon. But these six tips should help lower your out-of-pocket costs at the pharmacy.
1. Ask what the price would be if you paid for it on your own.
Sometimes going through insurance means shelling out more for meds—and pharmacists can’t really suggest not going through insurance, says Brianne L. Porter, Pharm.D., a pharmacist and an assistant professor at The Ohio State University College of Pharmacy. “The best way we can get around this is if you ask what the price would be if you paid without insurance.”
2. Consider filling your Rx at a mom-and-pop shop.
Independently owned pharmacies tend to have more negotiating power than chains whose larger parent companies dictate pricing. “A smaller business will have more control over what prices they can offer, even coming down close to what the drug costs them, because they’re in the business to make health care accessible to everyone and they have that flexibility versus larger chains,” says Porter.
3. Apply for a patient-assistance program.
If you have to take an expensive brand-name drug, you might qualify for significantly discounted prices. You’ll have to apply for these programs, which includes submitting financial information, but the hassle could be worth it. “I’ve seen patients get free prescriptions for several months and even up to a year,” says Porter. Check out the Medicine Assistance Tool to see whether you qualify.
4. Download an app to compare prices—and try to negotiate.
An app like GoodRx will let you compare Rx costs at various pharmacies and show you coupons you can use at more than 70,000 pharmacies in its network. “Doing this legwork and then sharing what you find with your pharmacist can possibly give you negotiating power,” says Porter. “If I know another pharmacy is offering a drug for $10, I’ll have some incentive to match that price or go even lower if I can.”
5. Ask your pharmacist if there are manufacturer coupons.
While this might not be the best solution for maintenance drugs you have to take over many months, it can help cut your out-of-pocket costs in the short term.
6. Inquire about cheaper alternatives.
Your pharmacist may do this automatically, but it doesn’t hurt to ask whether a lower-priced alternative exists for something that’s costing you a lot of money. For example, there might be a generic option for a drug your doc has prescribed or a prescription medication that’s cheaper than an OTC drug.
What to know before buying meds online
To make sure you’re dealing with a reputable, safe online pharmacy, be certain you can tick off everything on this list:
✔️ The website lists a street address in the U.S.: Drugs have different names and uses in other countries, so there’s no guarantee that you’ll get the drug your doc prescribed if you order from a pharmacy outside the U.S., says Michael Swanoski, Pharm.D., an associate professor at the University of Minnesota College of Pharmacy.
✔️ The pharmacy is licensed by the National Association of Boards of Pharmacy (NABP): You can find a list of accredited digital pharmacies here. You’ll also want to make sure the pharmacy has a dispensing license for the state in which you live, says Swanoski.
✔️ You’re required to provide an Rx from your doc: There are no exceptions, says Swanoski. “If you’re able to get a prescription med without an Rx from a licensed practitioner, it’s a major red flag.” If the site provides doctors who will prescribe meds, Garling says it’s really important to ensure that the site is U.S.-based, has U.S.-licensed physicians, and is a U.S.-licensed pharmacy to avoid scams and counterfeit meds.
✔️ A pharmacist is available to answer your questions: No matter how you get your prescriptions filled, you should be able to ask a pharmacist questions about your med.
Should you use auto-refill?
If it makes your life easier—and you’re communicating with your doctor or pharmacist about any big change that might affect treatment (such as weight loss or pregnancy)—go for it. But if you’re not sure about an Rx that’s being automatically refilled, speak up with questions, and never be afraid to decline the medication even if it’s already been refilled.
This article originally appeared in the April 2021 issue of Prevention.
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