“How do we ensure our patient drops and loses ~80% of his pills and that he slices the absolute fuck out of his fingers in the process?”
They’re locking my mental health goals behind a fidgety Saw trap built from scissors and miserliness.
I’ve had boxes where there were several single pills snipped from their blister packs rattling around in them. These pills in particular are tiny, like you can’t even feel them in your mouth when you take them, but they expect me to be able to finesse one out of a single blister with at least 3 extremely sharp and piercing corners on it 😒
If you’re a pharmacist and you do this, please go ahead and take the pills yourself, you clearly need 'em more than I do, ya sick fuck.
Uh, former pharmacy tech here… I don’t know what you want us to do. If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I’m gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there’s gonna be a single one left over. Do you want these pills to just be thrown away? If they don’t have enough pills on hand to make your prescription with the full sheet, would you rather they delay your prescription so they can order some nicer looking ones?
I get that it can be frustrating dealing with those blister packs, but freaking out at the pharmacist/ tech that a. did not put the pills in a blister pack and b. doesn’t have any option but to dispense medication on hand, seems pretty misplaced. Like, I wouldn’t think something was wrong with the Walmart cashier for selling me a pair of scissors in security packaging.
The app seems ungrateful. Stop giving them the pills.
People bitch about everything they don’t understand. Some meds are too fragile to just put into a plastic bottle, or exposed to air.
Tbh, a pharmacist shouldn’t really do anything with the actual medication other than dispensing it correctly. In Sweden, every package is individual; the pharmacist should never be opening them nor touching the blisters in normal cases. It significantly reduces risks for the patient and ensures traceability.
It is a bit less efficient though, as pharmacies need to stock up different qualities of the same dosages: Stilnoct(zolpidem) 10mg for example has two different packages: 14 tablets, or 28 tablets. If you have a prescription for 28 tablets, you can’t buy two 14-tablet packages. And if you were to have a 14 prescription, you can’t buy the 28 and ask the pharmacist to throw away the other blister. But I think it’s a worthy tradeoff to eliminate the majority of human mistakes.
In Sweden, every package is individual;
Same here in Denmark.
The only place I’ve ever seen pills given out of the package is at the vet and in hospitals or by a doctor, and it’s for obvious reasons dictated by circumstances.If we need 10 of some pill, they come in boxes of 10. I have no idea wtf is going on with splitting up packages to get 20?
PS: The example with the vet was worm treatment, those pills were in individual blisters, and you can get only one at a time I think due to EU regulation. It was then put in a package made specifically for that. And there were no sharp edges.
We used to get 3 at a time, to administer as needed, but apparently we aren’t allowed to get more than 1 at a time now.
Also the price has trippled to buy 1 compared to what 3 used to cost. So a 10x price jump!!!This is interesting. Do all pills come in blister packs in Denmark? Over in the US it’s actually somewhat rare for prescription medication to come in blister packs. Typically over the counter prepackaged medication will come in blister packs, but prescriptions are almost always unpackaged pills in a bottle. The pharmacist counts out the number of pills and puts them in the bottle as well as attaching its label to match the prescription. Prescriptions are typically written based on pills per day and the number of days to either take the medication or else for the prescription to cover. E.G. the doctor makes out a prescription like “take one pill twice a day for 60 days”, and then the pharmacist will give you a bottle with 120 pills in it.
France: never seen a bottle IRL. Used to be blister packs, and if you needed 21 pills but they came in packs of 20, you got 19 too many and they lived forever in your medicine cabinet.
Now pharmacists are allowed to open packs of antibiotic pills and only dispense the exact number you need, and pics like the OP can happen. Most pharmacies don’t do it though.
Here in the Netherlands I’ve never had any medication that wasn’t in blister packs. They are always full boxes. Boxes have anti-tamper seals and a unique serial number that the pharmacist has to scan when issuing (to prevent fake medication). Pills are individually packaged to prevent contamination.
Almost everything is blister packages, which I personally find a bit annoying.
We can’t even get normal pain killers without them being in blister packages, and we can only buy limited amounts to prevent teen suicide attempts by painkillers.
That part however I’m OK with, because allegedly it’s supposed to actually work. 👍 😀Honestly, I can see that. A lot of suicides are spur-of-the-moment, and the more a person has to actively work at it, the less likely they are to actually follow through on the attempt. Even just those couple seconds of working at it to get a whole box of blister packs open could be enough for a lot of people to stop, think, and say “actually wait”.
Yes but more than that, the packages are also too small for use for suicide attempts. So you need to stack up with a few packages first too.
It’s a minor inconvenience, but I’m OK with it, because they claim it is actually working.
I never really thought so much about the time it takes to squeeze out the number of pills it takes to work. Which absolutely may be a factor too.
There are bottles as well, but it’s not as common. And they’re factory-produced bottles that are tamper resistant – not like those orange ones in the US. So it’s basically the same safety as blisters, other than its easier for the patient to spill.
I’m not 100% sure, but I think most of the groundwork for this situation is from EU Directive 2001/83/EC. Medical products need to have a lot of information provided, and it just gets simpler to have boxes with blisters to meet all the requirements, and gives safety at the same time.
I can’t imagine how hectic it must be for pharmacy techs in the US. Despite requiring 5 years of school to be a pharmacist here, the job is basically being a glorified cashier… Unless the person has any questions, you simply check their ID, check in the national registry that enough time has passed since their last collection (particularly if it’s a controlled substance), collect a package from the shelf, print out a label to put on the box (containing their name, doctor, dosage, instructions), scan the label and package, collect payment, and that’s it.
A few years ago Germany started to ensure that blisters are not repackaged, too.
It’s so weird to me as here we just get one box of pills and done 🤷
Here we usually do too, unless the doctor prescribes a weird number for some reason.
My doctor doesn’t even prescribe an amount. I just get whatever amount the pharmacy feels like. I’ve gotten a box with 30 pills (one daily so enough for a month), box with 60, back to 30, and the last time they gave me a box with 100. I’m not complaining, less refills so less hassle but it kinda makes me wonder how they decide the amount lol
Here the doctor decides, thank God. It means she can prescribe months worth of meds and I only pay 5 Euro. I always have to pay those 5 Euros for any amount (unless it’s asthma meds, those are free).
I think I pay a flat rate as well, not so sure tho haven’t checked in a while. But just like you it’s a couple of euro so it’s not that bad of a screwover I suppose
I hear you. They should be on a roll, like film 😁
If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I’m gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there’s gonna be a single one left over. Do you want these pills to just be thrown away?
Order of 6 pills - give a 3x2, you now have a 2x2.
Order 9 pills - give the 2x2 and a 1x5, you now have a 1x5.
I see your problem, but I don’t see how that can turn into “a 10x1, a 4x1, a 2x1 and another 2x1” as your best choice. That looks like he got the left-over-pile after a day of ever order getting from a new pack.
Honestly, I don’t know why you even have to open a package. I’ve never seen that, and I’ve been in some long pharmacy queues. Never been to US though.
If I need exactly 10 pills, I get a box with 10 pills, packed in a factory like any other box of pills.
That looks like he got the left-over-pile after a day of ever order getting from a new pack.
I’m saying that’s exactly what happened.
Never been to US though.
Things are done very, very differently here than most places. Blister packs are pretty uncommon, as are “per-patient” packages.
We rarely get bottles of 14, 30, 90 or whatever to give to the patient. It’s usually a giant “stock bottle” of like, 100, 500, 1000 pills that get counted out according to the prescription.
Your example of using the leftover from one script to the next works if you’re a single person in a small-ish pharmacy and it’s an uncommon drug, but when you’re one of 4 techs in a shitty retail pharmacy, you’re not going to ask every other person if they have a 2x2 strip of this med in their pile of go-backs, or spend time min-maxing the most efficient way to get the most pills in the least amount of strips. You’re gonna fill the thing as quickly as possible, because the medicine is what’s important, and you’re not gonna hold the backlog of prescriptions up because someone wants the nice complete pack of 10 and not the leftovers that are bound to pile up.
You are saying what I’m saying, and what everybody else is saying. But with a tone of defending it, as if it can’t be better.
Don’t give any customer your “trash pile”. Either take the time to do it right, or throw away the trashpile, or accept that customers feels like people are saying they feel.
Don’t make up excuses, the things you say you won’t do is not what is needed.
Things are done very, very differently here than most places.
Maybe that’s the problem. Everybody else has figured it out. I know you can’t change that, but lots of people could if they wanted to.
Don’t give any customer your “trash pile”. Either take the time to do it right, or throw away the trashpile, or accept that customers feels like people are saying they feel.
… You have to give someone the trash pile. Technicians are not going to throw away thousands of dollars of pills a month because the packaging is “MILDLY” frustrating. Your comment reads like a preachy teenager who has all the answers to every problem.
I don’t know why you’re trying to tell me how to do my job when a. you’ve very clearly never done anything remotely adjacent to it and b. Ive said that I don’t even do that job anymore.
In order to remedy this “MILDLY” frustrating problem that happens every so often, the entire distribution network of drugs in the US would need to be reworked from the ground up to start dispensing per-patient packages. Which, if you think that’s the most pressing problem the US medical industry needs to fix… One, I’ve got a bridge to sell you, and two, don’t make up excuses, do it right, get it changed, become a technician and start throwing away pills and refusing to fill people’s scripts with loose blister packs… Be the change you want to see and all that.
Why doesn’t the customer just take the couple of minutes at the beginning of the month to dispense the blister packs into a daily pill box organizer?
Or just take a pair of scissors and round off the edges?
Just saying the problem is as easily or more easily solved by the customer as it is by the tech.
Certainly no medication should just be thrown out because the packaging is inconvenient. Making the techs take more time just means making the meds more expensive than they already are.
Obviously the real answer is to overhaul the whole system, but we live under an oligarchy here. Individual people have no power past barely the local level.
a shitty retail pharmacy
AKA pretty much every pharmacy these days, since these pharmacy companies are large enough to own the insurance companies.
What a fucking disgusting mess the US medical industry is.
Blister packs should be illegal. Creates waste. All pills should come in recyclable plastic bottles.
Many medicines need a hermetically sealed environment for storage. They break down from moisture in the air, being exposed to oxygen for a prolonged time can cause the active ingredients to break down. Even some of the binders and stabilizers can grow bacteria and mold.
Like bro this person can’t figure out that we have tools for cutting things open? Scissors? Nail clippers? Small blade? Hobby knife?
Could also use a nail file on the sharp edges, or use the curved nail clippers to clip the sharp point. Seems like a lot of solutions to me
There a few many reasons why plastic bottles aren’t the best option for some medications and it comes down to the technical specifications of the drug as well as drug safety regulations.
Iirc, bottles aren’t optimal for formulations that result in friable (brittle) tablets, or those that need to be packaged in a reduced oxygen environment so that you can take out a tablet individually without exposing all the others to regular air, and so that they’re easy to handle and transport individually without exposure to contaminants in the environment up to the moment that they need to be ingested.
I encourage people to look deeper into pharmaceutical technology. It’s a fascinating field full of surprises.
Here in my country (at least public healthcare, which my mother and I use, and the private provider my grandfather uses), pharmacists give you enough full boxes to cover the month, even for controlled substances, even if that means giving a few extra pills.
As an example, I take 1 ½ Risperidone pills daily, which makes 45 pills a month. Boxes are 20 pills each, so they give me 3 boxes (60 pills). The leftovers helped me a couple of times I was sick or otherwise couldn’t get the refill on time.
There was only one time where they gave me two boxes and a blister (50 pills), but it was still a full blister.
I’ve had insurance only cover exactly 30 days once per calendar month. Not much of a problem until you’re trying to pick up your refill on the 31st.
Same here in Germany. I’m pretty sure, cutting and repackaging pills would be illegal.
Here in Sweden, I’m pretty sure pills are only distributed individually like that in controlled settings (elder care facilities, etc). Otherwise you just get the whole box.
This is likely the fault of the pill manufacturer who the pharmacy is at the mercy of.
In Japan, this is the norm. They’ll throw each drug in its own zip lock bag but piecemeal like that is all you’ll get. And people grow really old over here.
I don’t find this mildly infuriating. I think this is a responsible way to deal with a precious resource.
Pills aren’t really precious resources… They cost like cents to make, aside from a few very expensive special ones
The expensive part is all markup
The expensive part is the outrageous costs of R+D that goes into drug discovery and trials, with the majority ending in failure. Not excusing the awful profiteering that goes into pharmaceuticals also, but the end product being cheap to produce isn’t the only cost that companies incur.
Sure, but the R&D is largely subsidized because it’s a common good. Pharmaceutical companies generally take over when it’s already a pretty safe bet… It could fall through during clinical trials, but they don’t pay for the massive R&D they did traditionally. Sometimes they even just buy the patent
There’s overhead, but the vast majority is just profiteering
The expensive part is all markup
So we can waste the pills if we find a way to keep all the markup safe?
Also the idea that pills costs “cents to make” is pretty flawed. Even if you ignore all of the R&D money that goes in to making newer pills, the sterilized environment they need to be manufactured in is gonna jack the cost up too.
It’s like saying a cup of fresh, ice cold water that you’re getting handed to you in the middle of the desert is only “a few cents worth of water”. Yeah, but the fact that it exists in the middle of the desert for you to consume is what made it a “precious resource”.
The r&d costs come from government grants these days
Yes, a sterile lab is expensive, but like normal business expensive. It’s very achievable to build, drug cartels manage it just fine. Universities and YouTubers have no problem doing it with pretty modest funding
Yes, there’s overhead. But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing
That’s why other countries can afford to sell them for cents - they really are that cheap to make
Yes, a sterile lab is expensive, but like normal business expensive. It’s very achievable to build, drug cartels manage it just fine.
This bit right here told me that I didn’t need to take this too seriously. An actual medical lab is not comparable to cocaine plants in the Congo.
But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing
This is the exact same point from the previous comment. You cannot just look at the material cost of something and say, “see? It only costs cents to make.” Go buy a part that goes in a car engine - it’s just a few cents worth of metal! But, you can’t just take a hunk of metal and magically form it into car parts, there’s a manufacturing process and it’s expensive. That’s part of where the cost comes from. It doesn’t matter if you can make the most expensive pill in the world out of 10 cents of flour if you need a $10 million dollar assembly line to process it and turn it in to what is useful. They aren’t just taking a premade substance and pressing it into pills, there’s numerous chemical reactions and processes taking place.
That’s why other countries can afford to sell them for cents - they really are that cheap to make
You start your comment off with saying that R&D is subsidized, and end with saying “other places can sell them for cheap cuz they really are that cheap.” In these other countries, the drug company is not selling the medication directly to the public for pennies, it’s getting subsidized by the government to make it affordable for citizens. Granted the government is not paying US cash prices, but companies simply are not selling direct to consumers for 10x less than other places.
Look, this is coming from someone who fucking hates the predatory medical industry, especially that of the US. I used to work as a very small cog in it. There are absolutely places where prices are disgustingly manipulated and people are taken complete advantage of. Things exist today the way they are because of corporate greed and the continuance of putting profit over people. We can accept all of this as true, and still recognize that producing drugs at a medical grade, with medical levels of consistency and purity, is a difficult, expensive task that requires resources to accomplish. Medication needs to be cheaper (it’s my belief that it should be no direct cost to the user), but momentum is instantly removed from the cause when we use arguments based on a limited grasp of reality.
I think you’re misunderstanding what I’m saying.
Yes, the companies need to sell the pills for a certain amount to make a profit, due to infrastructure and overhead. The R&D is a whole complicated thing, let’s just lump it in as overhead and put it aside
The pills themselves cost basically nothing to produce each, a batch will cost money but normally they’re consistently pumping out huge batches
So, most manufacturers have programs to retrieve pills. If you have 4 pills at the end of the roll, they can be reclaimed so patients can get a complete strip, because the pills themselves cost so little. They do the same if you end up with a small number of pills left in the big bottle, you can’t mix batches because of expiration dates and expiration. So you send them back, and they give the pharmacy a credit
I’m sorry, I can’t continue this conversation. It’s clear that you’re just kind of saying things that sound right. Your only argument is, “the pills themselves cost nothing to make” while ignoring everything that makes the pill cost money. Economics and cost analysis does not work that way. And in 7 years of working in a pharmacy, never once have we ever sent incomplete strips of meds to the manufacturer to get a complete pack. That is just not a thing that happens anywhere on a regular enough basis for it to be taken into consideration.
What do you do with expired meds, does the pharmacy eat the loss?
Do you mix and match pills with different expiration dates to fill a prescription? From different manufacturers?
I’m genuinely asking. What I described is how things work here, and while our healthcare system is insane, this is one part that makes sense to me
If you’re bitching about this maybe keep working on the mental health and negative thought patterns
This is a perfectly valid complaint and diminishing it is wild. Imagine if your health was locked behind an infuriating puzzle every day. Ffs have some empathy.
Never said it isn’t a valid complaint, the tone it’s wrapped in clearly depicts an unhealthy mental attitude though
I agree it’s a valid complaint, as in it’s expected to be complained about. It’s not so valid to expect the pharmacy to actually change anything. There are a million and one solutions to their problem. If it’s just the sharp edges, they can clip those off with some rounded nail clippers. If they have trouble getting them out of the pack, there are any number of tools/solutions to get the pill out to make it easier.
I think this post is valid as mildly infuriating, since it’s not that big of a deal. But calling it an infuriating puzzle is pretty wild. Idk what puzzles you are doing
Some mornings I barely have the patience to split my pill in half, if I am motivated enough to even take it. If I had to deal with this crap every morning I would be exasperated too
I just wanted to say, I enjoy your writing style. You very vividly illustrated your emotions
Cut around the edge of the cup part of the blister with a razor, with the blade against the of the flat part of the circle.
Or just around the circle of foil from the other with something with a point. Sometimes the tip of a safteypin will do
What’s mildly infuriating is this post. How do you think they make these prescriptions? Do you ever consider how other people do their jobs before you go moaning? You’re a fucking Karen.
“they may provide a shitty product, but have you considered their feelings?”
You’re allowed to be pissed off, even when other people do their best.
Pharmacist does not make the product or how it’s manufactured or distributed, dum dum.
And yet it’s still ok to be pissed off at the situation.
Is the problem that he insulted the pharmacist in his rant?
They’re clearly pissed at the pharmacists. Did we read the same rant? Why insult them at tall? Twice. Once in the title, once in the rant. It’s not okay to take out your anger at people who can’t change the situation for you.
Eh… I see what you mean, and agree. I read it differently at first.
I’ll raise you the time I decided to be menace and put a blister pack back in the pyxis like this:
(to be clear, this was neither a high alert med nor a narcotic)
STFU bitch.
Oh neat, a hater in the wild.
Oh neat. Another shitty bitch that can’t handle a single minor inconvenience. Please stay out of the wild. We don’t need that regulated.
Bruh you’re in mildly infuriating, you lost?
:) cute, need a handout to refill those meds?
