Heather Free, PharmD
Heather Free, PharmD, practicing pharmacist in Washington, DC, and spokesperson for the American Pharmacists Association. Pharmacist.com
If you count on your pharmacist only to count your pills, you’re missing out on an important medical ally. Pharmacists are highly educated about medications and the human body. And they tend to be a lot more accessible than doctors. You usually can consult with a pharmacist for free simply by showing up at a pharmacy—no need to be filling a prescription at the same time. These days, many pharmacists can provide a range of health-care services, thanks in part to changing state and federal laws. Also: Technological advances are freeing up pharmacists to spend more time with their customers. Ten things your pharmacist might be able to do for you…
Find cheaper options on prescriptions. Your doctor likely has no idea how much the pills that he/she is prescribing will cost you. Pharmacists not only see how much you must pay out of pocket—if appropriate, they can recommend low-cost generic drugs that may work just as well as the pricier name brands…advise you when paying out of pocket for a drug is cheaper than your insurance or Medicare co-pay…and/or offer money-saving pill-splitting strategies. Your pharmacist can call your doctor’s office on your behalf to work with the doctor to find a more affordable but still effective medication, including to confirm whether it’s OK to substitute a generic for a name-brand product.
Even if your pharmacist has not done this for you in the past, it’s worth trying again. Legislation passed in late 2018 banned the “gag orders” included in many pharmacy/insurance company contracts—clauses that prohibited some pharmacists from sharing money-saving advice with their customers.
Prescribe certain medications. Pharmacists in a few states are allowed to prescribe certain medications, saving patients the time and cost of seeing a doctor. This is most common with birth control pills (in California, Colorado, DC, Hawaii, Idaho, Maryland, New Mexico, Oregon, Tennessee, Utah, Washington and West Virginia, according to the National Alliance of State Pharmacy Associations)…tobacco-cessation products (in Arizona, California, Colorado, Idaho, Indiana, Iowa, Maine and New Mexico)…and the opioid overdose treatment naloxone (in most states).
In Idaho, pharmacists can prescribe drugs for a much wider range of common health issues, including strep throat and urinary tract infections…and Oregon has a formulary of drugs that pharmacists can prescribe, including diabetic testing supplies, inhalers and epinephrine injectors. Visit the National Alliance of State Pharmacy Associations (NASPA.us) for more information on resources available in your area.
Sort your pills into pill packs or other dose-by-dose dispensers. Some pharmacies can, upon request, package pills in dose-by-dose blister packs or another system designed to make it easy to remember which pills you’re supposed to take when. These packs also help you monitor whether you’ve already taken a day’s dose. This service might be offered for free or for a fee.
Reduce pharmacy trips by coordinating prescriptions. Many pharmacies offer “medicine synchronization”—they’ll work with the insurance company to shift the refill dates of multiple ongoing prescriptions so that the customer has to stop by only once or twice each month to pick them up. That isn’t just convenient…it reduces the odds that the patient will forget to refill a prescription and miss doses.
Review what you take to make sure they all work well together—including prescription and over-the-counter (OTC) drugs and herbal and vitamin supplements.The typical person age 65 or older fills 20 or more prescriptions each year—and some of those drugs could impact the effectiveness of others. It isn’t just prescription drugs that can be problematic—OTC drugs and herbal supplements can cause dangerous interactions as well. Example: St. John’s wort, a medicinal herb commonly taken for depression, can decrease the effectiveness of some blood pressure medications.
Your pharmacist likely can conduct a free “medical reconciliation” upon request, reviewing the drugs you’re taking and confirming that they’re compatible with one another and appropriate for your current medical conditions. It’s worth having this done—the Institute of Medicine has estimated that at least 1.5 million preventable adverse-drug events occur each year due to a lack of review by medical professionals. Many doctors are specialists and aren’t necessarily looking at the big picture when they prescribe. The same goes for walk-in clinics that you may go to once for a specific problem. You could ask your doctor to review your medicines, but a study published in American Journal of Health-System Pharmacy found that the reconciliation process is more accurate when a pharmacist conducts it. If you use OTC drugs or herbal supplements—and/or fill prescriptions at multiple pharmacies (which is not a good idea)—bring a list of these or the pill bottles themselves when you ask your pharmacist to conduct a reconciliation. Your records in the pharmacists’ computer systems likely list only prescription drugs that you obtain at that pharmacy (or at other pharmacies in the same chain).
Administer vaccinations. Flu shots are not the only vaccination offered by many pharmacies. Details vary by state, but often vaccinations for diphtheria, hepatitis A and B, human papillomavirus, pneumonia, shingles and tetanus are available as well, plus vaccinations for international travel. While you may still pay a co-pay for the vaccine, you avoid the cost of an office visit.
Perform an annual wellness visit. Some pharmacies now offer “wellness visits” that are just like the wellness visits provided at doctor’s offices—only without the long delays often required to get on a doctor’s schedule for a non-emergency appointment. During the visit, a pharmacist would take basic health measurements, such as blood pressure…ask a series of health-related questions…and do basic screening for signs of cognitive impairment. This wellness visit would be conducted by a pharmacist or potentially by another health professional employed by the pharmacy such as a nurse practitioner. Results are sent to the primary care physician for follow-up.
Conduct cholesterol, blood glucose, flu, HIV or hepatitis tests. Some pharmacies now conduct tests such as these on a walk-in basis, no appointment or prescription necessary, often for just $10 to $30, which can be less than the co-pay that often must be paid to have these tests done at a doctor’s office. Occasionally pharmacy tests are completely free. Pharmacies usually do not report these test results to doctors, but patients can use the results to determine whether they should see their doctors. If you are reactive to the flu test, the pharmacy can provide treatment.
Provide guidance with the selection and use of OTC drugs. Pharmacists aren’t just experts in prescription drugs—they’re knowledgeable about OTC drugs. Unfortunately, few pharmacy customers bother to ask for their guidance before picking medicines off shelves. Tip: Always ask a pharmacist’s advice before choosing a cough-and-cold medication. Many of these feature a cocktail of drugs, some of which you might not need…or might have side effects that you don’t expect.
Provide specialized knowledge about specific health needs. Like doctors, pharmacists can have board-certified specialties including cardiology, geriatrics, oncology, organ transplant, pediatrics and psychiatric drugs. If you have health needs related to one of these specialties, it could be worth seeking a pharmacist in your area who has that certification—he/she would be ideally suited to offer medicine-related guidance to patients in this area. Example: A pharmacist certified in geriatrics will be well-versed in age-related decline in liver and kidney function and what that means for older patients’ ability to process medicines.
Ask local pharmacies if they have a pharmacist who is board-certified in the specialty relevant to your health. You also can look for local pharmacists certified in this area on the Board of Pharmacy Specialties website (BPSweb.org). This site lists pharmacists by specialty, name and town but not by pharmacy. Enter the names of pharmacists you find listed here into a search engine along with your state and the word “pharmacy” to determine where these local specialists work.
