Occam's Razor

A couple of months ago, I stopped by our local CVS because I had asked for my medication refill to be ready and was passing by and I had asked for it to be ready earlier that day. I went into the store and immediately queued up in a long line at the pharmacy register. I was fifth in line. As I stood there, another five people queued up behind me. There are four registers including the one at the drive thru. But there was one guy at the front register looking tired and hassled. Behind the counter there were plenty of pharmacists and other people, but none of them could be bothered to actually help shorten the line.

After about fifteen minutes and advancing only one space in the line (one customer had innumerable issues) I said rather loudly, “It sure would be nice if they opened another register” hoping someone would take the hint. Of course they didn’t. They kept doing all this important stuff behind the counter, which apparently doesn’t include the “service” part of CVS. (CVS supposedly stands for “Convenience, Value and Service.”)

After twenty minutes with still two people ahead of me did something I rarely do (used a curse word in public) and told my wife we’re moving pharmacies. I … just … could … not … take … it … any … more! This particular incident was one of the more egregious exceptions, but it was hardly unusual. It’s like the staff is on lethargy pills. And clearly there are no managers on duty trying to make the experience more pleasant for customers. Even their drive-thru is no silver bullet. There is often a line and when it move it move so slowly.

I’d mind this less if we had fewer medicines. I have just one prescription, but my wife must have a dozen. So we are constantly shuffling by the CVS to pick up medications. And half the time when you go to pick them up, they are not ready at the time you asked for using their automated system. We have learned to not even bother to go to CVS until we get an automated call back, often a couple of days after the date and time you requested the medicine.

So why not take it to a non-CVS pharmacy? I checked with our health insurance plan and we can also get prescriptions filled at Walgreens. It’s a bit further away but every time I am in there, there is no line at the pharmacy counter. So we started to move prescriptions there.

But it turns out that if you need a 90-day supply, you pretty much have to get it from CVS. That’s because our health insurer, like most of them, contracts with just one pharmacy chain: CVS. If we want to buy them at Walgreens, we would have to pay a lot more because it suddenly becomes an out of network pharmacy. For 30-day supplies, Walgreens is fine. But since most of our medications are for maintenance drugs, CVS is must be. Costco is another possibility: buy it at their wholesale price, but it’s 25 miles each way. It’s not a realistic alternative.

But wait! There is an alternative! We can mail order them from CVS, actually Caremark in this case because CVS bought them. But since there are a lot of these, we have to coordinate a lot of paperwork to do it mail order. It’s at least as much hassle in our case to do it mail order as it is to go to our local CVS.

We could go to another CVS and hope for a better experience there. Our closest CVS is three miles away. There is one downtown, about the same distance, but that introduces a parking hassle and there is no drive thru. Otherwise, it’s about a seven-mile drive to the next nearest CVS. And there’s no guarantee our experience will be better at that CVS either.

CVS is everywhere. They were our pharmacy before we moved from Northern Virginia too. The service was somewhat better there, in that prescriptions tended to be available when you asked for them, but there were often long lines at the pharmacy counter or drive-thru windows there too.

CVS harassment comes in many forms. Their “helpful” automated service though is too much help. We get these calls most days with prescription reminders. Still, even if you call in your prescriptions and tell the system the date and time you want to pick it up, if their workload is such that they can’t physically get it done in time, the system won’t tell you. You have to learn from experience. You practically need a chart with all your medications on them to keep track of what has been called in, when you asked for it and whether you got a call back saying it was actually fulfilled and ready for pickup.

Our local CVS may be one of the worst ones, but it’s clear that there is a general problem with CVS pharmacies. It’s not too hard to figure out. First, they have way more business than they can handle because most health plans use CVS. Second, they don’t have enough staff. The pharmacists are usually running around at warp speed. Phone calls often ring off the hook. As for counter staff, when I do see them they look apathetic and/or hassled. Most likely they aren’t paying them a living wage, as evidenced by their faces changing so often.

One can understand why health insurers want to minimize costs. CVS is trying to lock in this market, as they are everywhere, and are probably seriously underbidding their costs to insurers. So there are pressure points and they are its customers, people like us who simply have to endure a lot of frustration and hassle just to get timely and relatively affordable medicine.

Our wonderful free market hard at work. As for CVS: it’s not convenient, I get no value from going there, and their service sucks.