Can a Drug Coupon Put You at Risk?

Mona Jamaldinian, PharmD Candidate 2008
Shenandoah University
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

Buy, buy, buy! It’s hard to turn on the television or open a newspaper without being bombarded with advertisements. Companies spend millions of dollars on getting the consumers’ attention. Advertising may be a good way to draw attention but it has a downside as well.

Every weekend the local newspaper is filled with advertisements for Target, Rite Aid, Safeway, or CVS, just to name a few. Inside these advertisements, pharmacies place a coupon designed to draw the customer away from their existing pharmacy to another pharmacy by offering a gift card ranging from $15 to $30 for each new or transferred prescription. These gift cards can be used to purchase store merchandise.

Pharmacy coupons have become so valuable that people request information leading to finding them online. There are even websites designed to teach the consumer how to collect and use these coupons repeatedly to make money. Although these coupons sound like a great deal, using them may pose a serious health risk to the consumer.

The Risks of Using Pharmacy Coupons
Before transferring your prescriptions to different pharmacies, it is important to know the risks associated with using multiple pharmacies. If you are a patient who is taking three medications, you could transfer your prescriptions to three different pharmacies using three coupons and collect three gift cards. For example, you could transfer your blood pressure prescription to the pharmacy across the street and receive a $30 dollar gift card. You could take your cholesterol prescription to another pharmacy and receive a $15 gift card. Finally, you could take your heartburn prescription over to the pharmacy across town and receive a $20 gift card. At the end of the day you could have made $65 in gift cards.  This may sound like a good deal but what you are losing is the review of all your medications by one pharmacist. 

Many medications have side effects that are made worse when combined with other medications. Some medications may interfere with how other medications work. In this case, your three original prescriptions were safe to take together. The pharmacist had all of your drug information at one pharmacy and was able to determine these medications are safe for you. If the following week you go to another doctor and are prescribed an antibiotic, there is no way a pharmacist can determine if all four of your medications can be safely taken together.

Always Use One Pharmacy
Each time you fill a prescription at your pharmacy, the pharmacist performs certain checks to make sure your medications are safe. These checks include

• Making sure all your prescriptions are safe to take together and do not interact
• Ensuring you are not taking two of the same medications.
• Checking your drug profile to make sure you are not allergic to any ingredients in your medications
• Ensuring the prescription is written for the appropriate dose and that the directions are correct.

Each pharmacy maintains a profile of all the medications you have filled at that pharmacy. This record also shows any drug allergies you may have. This information is updated each time you fill a prescription. If, however, you fill a prescription at another pharmacy, the pharmacist does not have the complete drug record to review and this dilemma puts you at risk. In our example, taking the antibiotic and the cholesterol medication at the same time may put you at risk for liver damage.
  
When a Coupon Costs You Money
All it takes is one medication error and your costs to treat the problem will be much higher than the value of the coupon you cashed in earlier. One medication error can lead to additional doctor visits, lab tests, hospitalizations, and even surgery. In the long run, the cost of correcting a medication error far exceeds the value of your gift cards.

Table 1: Your total gift card value from using pharmacy coupons

Table 2: Your gift card value will be wiped out if you are injured due to a medication error.

The $85 that you obtained through gift cards could cost you over $ 9000 in medical expenses if you  are injured by a medication error because a pharmacist never had an opportunity review all your drugs for interactions.

What Do Your Local Pharmacists Think?

“ The intention of the coupon is to encourage patients to use our pharmacy but unfortunately I think the entire pharmacy coupon transfer process leads to patients using many different pharmacies. This creates an issue with providing accurate information on drug interactions and counseling due to a lack of a complete drug profile.”
Christine Coleman, RPh, Falls Church, VA

“ The coupon is not effective because patients use them for gift card shopping. This is especially critical in the elderly because they use multiple pharmacies and we can’t check for drug interactions. The prescription transfers are usually for a temporary period of time so patients can receive the gift cards, so I don’t think it is good for the business either.”
Mina Kim, PharmD, Fairfax, VA

“The pharmacy transfer coupon sends people store hopping so it’s difficult to check for consistency in drug dosage, drug interactions, multiple doctors, and fraud. In the long term it affects the patient’s health. I don’t think patients realize all the processes and reviews that go into filling one prescription. They try to go to the cheapest pharmacy, so it’s more about the money than their overall health.”
Suzanne Resnick, RPh, Fairfax VA

How to Protect Yourself?
Your pharmacist is the final security check to ensure patients are taking their medication correctly. When you transfer your prescriptions to different pharmacies, it makes it impossible for the pharmacist to review all your medications. To avoid drug interactions and duplications it is important to follow these simple steps:

1. Use only one pharmacy. Do not transfer your prescriptions to several different pharmacies.
2. Every time you visit a doctor, bring ALL your medicines with you, including over-the-counter drugs. Have your doctor look at these medications with you.
3. If you are using a new pharmacy, bring all your medicines with you. Tell the pharmacist if you are taking any over-the-counter medications and if the doctor has given you any drug samples.
4. Express any concerns you have regarding the price of your medicine to your pharmacist.  Show them the prescription coupons from competitors and ask the pharmacy to match the offer. Most pharmacies will match or beat the competitor’s offers.

Medications are an investment in your future. Although pharmacy transfer coupons may provide you with gift cards, the cost of treating a drug interaction may be more, even life threatening. It is safer and more cost-effective to take all your prescriptions to the same pharmacy so your pharmacist can make sure your medications are safe to use together.

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