Monday, October 20, 2014

I Stand This Night In Awe Of The Evil Brilliance of CVS. Or, Maybe Republicans Aren't Always Wrong About Everything.

"Drugmonkey there's some sort of typo in your headline" you're saying. "You've never once had anything good to say about CVS,  I know you make more than your share of slips on the keyboard, but this time is the whopper of them all. "

Except it wasn't a typo. Yes, I once made a joke about the company getting into a new scandal every month that turned out not to be a joke because they seriously do seem to get busted for something with every turn of the calendar page.

And yes, the second most visited page in the history of my little blog garden is that in which I gave space to a CVS employee who opens up on the company with both barrels. I've said it before and I'll say it again, I've never....seen the hatred CVS employees seem to have for their corporate master.

But I meant it when I just said I am in awe of them this night. They may have just made the move from evil to evil genius.

Let's back up a bit and remember the last time the company made national headlines, getting even the President of The United States to notice they were no longer going to sell tobacco in their stores. Speculation ran rampant as to the motivations of such a move, which was estimated to cost them $2 billion in annual sales. "Well, tobacco is a no growth category" the conventional wisdom went, "they evidently feel the good publicity will be worth whatever loss in revenue will occur, and it probably will help their Minute Care clinics pick up a contract or two. "

Oh how you underestimated these guys mainstream business pundits. It's more than just a contract or two at stake here.

For those of you playing along at home who don't follow the prescription processing industry, I'll mention here that CVS also owns Caremark, the second largest prescription benefit manager  in the country.

Now hold onto your seats, because here it comes, via The Wall Street Journal's Pharmalot blog: 

Caremark... will soon require some customers to make an extra co-payment, in some cases up to $15, on any prescription that is filled at a pharmacy selling cigarettes and other tobacco products

...and in one fell swoop my friends, CVS can potentially cripple it's two main rivals though the 1 in 4 Americans whose prescriptions are managed by Caremark. Absolutely fucking brilliant. "We'll be agnostic [about] where the consumer fills their prescription," said CVS CEO Tom Ryan when the merger with Caremark was under regulatory review. " Well, it looks like they just found religion.

And I'm just....not sure how I feel about this. Other than being awed by the evil brilliance of the plan. I mean, there's no way you can say this isn't using the power of oligopoly to deliver Walgreens and Rite Aid a kick to the nuts, but ...if I were in a position to do it, I'd be more than happy to crush either one of those company's testicles. And you know, tobacco in pharmacies IS stupid. It was a burr up my ass every day I worked for Rite Aid and had to stare at the cigarettes on the other side of the store while selling people asthma meds. I even once wrote my State Representative and Senator, who was on the health committee at the time, making a case for the California pharmacy board to deny a license to any location that sold tobacco. Never heard back from the Representative. Got a letter full of nothing from the Senator.

Yet here we have a brutal bastard vs bastard vs bastard free market business free for all accomplishing what impotent government officials gave nothing but lip service to. The other "Big Two" are gonna either give up tobacco or lose a shitload of prescriptions.

Which... is exactly what should happen. I guess the free market wins this round, said the pinko pharmacist who never did sell tobacco in his store.

Sunday, October 19, 2014

The Return Of Rick Scott, Who May Finally Get The Karmic Payback He Deserves, For The Most Incredible Of Reasons.

The political junkies among you may already know which direction the wind is about to take this post, but stick around, I want to make sure you get the whole recap here, not that it will matter.

I've warned you, and those of you in Florida in particular, about Rick Scott more than once. Rick Scott is a crook. A thief whose company, a chain of for-profit hospitals by the name of Columbia/HCA, ripped off Medicare and Medicaid to the tune of over a billion dollars, and then had the chutzpah to enter the debate over President Obama's health care plan with privately financed commercials emphasizing that any solution had to be built on "accountability and personal responsibility"

I'm not making that up. By all means do a Google search and double check me.

I asked you to remember this the next time you start to judge the Medicaid momma who comes in your store looking for some free Tylenol for her feverish kid. To maybe keep some perspective when comparing her actions to the rich white crook. Instead, you made Rick Scott the governor of Florida, which I understand some may consider a fate worse than death. In Rick Scott's world though, it is considered a validation of his lifestyle.

He went on to refuse to take any of the free money the federal government was offering states to expand their Medicaid programs. Perhaps because he was no longer in a position to steal any of it.

But Rick Scott may be about to get his comeuppance. Not because of his unethical business practices mind you, nor for his rank hypocrisy. Rick Scott my friends, has finally done something far worse in this day and age.

He looked stupid on television.

According to, Scott's hissy fit "cost him two or three critical points" in the opinion polls, flipping his slight lead into a slight deficit.

Christ on a cracker.

So here's our lesson for the day. I want you to imagine what would have happened if Rick Scott had a political instinct that was even slightly honed. If he had just acted like a grown up and ignored the fan, or even if he brushed off some charm skills and make a little joke about it. Holy cow depending on the quality of the quip he could have crushed his opponent right then and there. After stealing a billion dollars. And shouting for all that would hear, after stealing a billion dollars, about the need for "accountability" I want you to think about that for awhile and what it says about the viability of our democracy.

Because the answer my friend, with apologies to Bob Dylan, is quite literally, blowin' in the wind.

Monday, October 06, 2014

Back When It Wasn't So Busy, Ebola Made A Guest Appearance In This Very Blog.

Original blogpost airdate January 31,2008

President Wankerhead Will Release A Budget Proposal For The Federal Government Monday, Prompting Joy For Reasons Other Than He'll Never Do It Again.

From this morning's New York Times:

In his new budget to be unveiled Monday, President Bush will call for large cuts in the growth of Medicare, far exceeding what he proposed last year, and he will again seek major savings in Medicaid, according to administration officials and budget documents.

Reached for comment in the lung of an elderly woman at Grady Memorial Hospital in Atlanta, Mycobacterium tuberculosis said "While on the surface the cut in health care funding for America's elderly and poor would seem to be a good thing, we have to remember that the conditions setting the stage for my comeback are not all financial. It is my sincere hope that the money my prey spends for health care will not only not cover the cost of inflation, but that Americans will never realize that they could actually spend less and be more effective in their genocidal campaign against my species by simply copying the health care system of Canada."

"Overall, I'd say the president's budget makes me cautiously optimistic" concluded the bacterium.

At its headquarters in Kinshasa, Democratic Republic of Congo, the Ebola virus issued an emotional, short statement:

"HUMANS DIE!!!!! said the virus through an interpreter. "ME FIND YOU! YOU MAKE JOB EASIER!!!!!"

Sources said Ebola was especially excited about the president's proposal to to reduce special Medicare payments to teaching hospitals by $23 billion dollars*


Meanwhile, a spokesman for bird flu promised that if Bush's funding proposals were accepted by Congress, it would limit its effects only to those without good health insurance once it developed a way to cross the species barrier.

"We have our best viruses working on how to infect humans more effectively" said the spokesman. "But we are willing to spare the rich among you if you only give us a chance to taste sweet, sweet, human blood"

"You can trust the word of a bird flu virus" he concluded. What's in your wallet?

*You know the quotes are made up. The special cut in funding for teaching hospitals, however, is real.

Sunday, September 21, 2014

Jazzfests And Milestones.

I heard the note and held on to it as long as I could. Held on until the last one of the night was played I did, the gloom slowly settling inside my mind as it came just as assuredly as the fog was settling in outside on the bay. One last trumpet blast and the Monterey Jazzfest was over for another year. Maybe my last year.

Unemployment is like slowly spiraling down a drain. You wake up the next day and almost nothing has changed, you've probably slept in a little and actually feel a little better than when the alarm clock ruled your life the day before. You work on your resume' a little and fantasize about landing that position that has none of the problems of your now ex-job.

The day after that you wake up and realize you're getting low on coffee and empty on cash. The drain on your resources begins. You make the first withdrawal from the ATM that has no assurance of ever being replaced.

The trappings of affluence slowly start to fall away. The day before Jazzfest I had used the last of my Laphroaig and begun my unemployment gin in the plastic bottle. As much as CVS wants the world to think of them as some sort of health center now that they stopped the tobacco it remains a wonderful place to find cheap ways to rot your liver.

Jazzfest tickets are a crown jewel perk of the affluent. Being used that night two years ago in a different world from when they were purchased. There had been no bites on the resume'

And I wasn't kidding myself that there ever would be. I had just spent the last seven years flipping the middle finger to the decision makers in my industry and there wasn't any assurance I wasn't in a long, slow drain spiral, spinning off the comforts of the comfortable until I slid into homelessness with nothing but a pair of once-fashionable eyeglasses.

That was probably an exaggeration I kept telling myself. But make no mistake, life is different when the soul-crushing large checks those pharmacy chains can write you stop coming in.

At least I had an uncrushed soul now.

I couldn't hold on to that last trumpet note forever so I picked up the bag with the vinyl copy of Miles Davis' Bitches Brew that I probably shouldn't have bought and started walking and when the lady at the gate said "see you next year" I almost cried.

And I kept walking home and thinking and walking and falling and spinning a little closer to that drain. The money isn't the worst part of being unemployed. It's that persistent feeling of uselessness. When you wake up and make that coffee run you are surrounded from the moment you leave your condo with people with a purpose. The gardener. The plumber that just drove by. The people riding the bus to work. They all have a function this day, a role to play in this world that is humming along and you do not.  The most you can think of yourself is as some sort of spare part.

That's what it feels like from the moment you get out of bed. So the day after Jazzfest two years ago I didn't get out of bed.

But...that was two years ago. Tonight, I just got back, from this years Jazzfest. The Roots kicked ass and I'm getting married in April and I haven't been this happy in a long time.

And to the decision makers in my industry, or, should I say, my fellow decision makers now, this middle finger's for you. I haven't forgotten. Here's to a good many more years of it being right in front of your face.

Friday, September 12, 2014

I Am Nothing If Not A Man Of My Word.

I needed a favor and I mindlessly threw in a deal sweetener. It probably wasn't necessary. The Angry Pharmacist is actually much nicer than you would think, and he probably would have done it for me anyway. But I said it.

"If you do this for me I'll even write something Republican friendly on the blog"


OK, let's see here.................


Ummmmm....Oh. I think I have something. Here we go:

Neither Marco Rubio, or any other Republican, has ever cut off the head of anyone on a video broadcast on the internet throughout the world.

That I know of.

I think the fact that the bloodthirsty religious whack jobs of the GOP limit themselves to abortion clinic bombings, and the occasional doctor assassination, and that they choose not to film their acts for propaganda purposes, reflects somewhat positively on their character when compared to the bloodthirsty religious whack jobs of ISIS.

Glad I got that off my chest. I must be more careful with my promises in the future.

Monday, September 01, 2014

Area Blogger Traumatized By Threat From Anonymous Douche.

DRUGMONKEYLAND, CA-  In a development that might shake the pharmacy blogging world to its very core,  longtime publisher of the "Your Pharmacist May Hate You" blog Drugmonkey received an email today that may forever change his relationship with the completely never sarcastic blog he has been publishing since February, 2005 (Longer than The Angry Pharmacist, regardless of what he says on his Twitter feed) The potentially earth shattering message read, in whole:

Your writing style usually rides a fine line between informative and entertainment in the form of satire. Lately, your use of sarcasm has been taken to such heights that it feels like I'm reading The Onion. I don't like The Onion. 

I am a long time fan of your page and satisfied owner The Pharmacy Rip Off List, but if this is a sign of things to come then you may loose me as a an advid reader.

"It was like my world had ended" Drugmonkey said from his undisclosed location deep in The Sierra Nevada Mountains. "I mean, I realize I had taken the blog in a completely different direction with my post about Walgreens executives getting millions of dollars in severance pay after making a billion dollar error, but never in my wildest dreams did I realize an Onion rip-off article, which I had never, ever attempted before, might alienate one lone reader the way it seems to have done here."

"So after I read this I realized I had a choice. Have my writing style associated with an award winning, incredibly popular, wildly successful cutting edge comedy publication, or take a chance on "loosing" an "advid" reader.

(Look, I realize I may need a copy editor more than most people, but is anyone on the internet ever going to get this right ever again?   Loose is the opposite of tight for fuck's sake, and lose is the opposite of gain or win)

After a bout of weeping The Drugmonkey continued. "I was lost and unsure how to handle this. I prayed and cried. I went on a Native American visionquest journey and reached deep into my soul, and finally, I think I may have the answer."

"I will offer a full refund to this unsatisfied asswipe who is evidently the center of the universe. Every penny they have ever paid to access my blog shall be returned. I will also realize that anyone who claims to be a "long time fan" and never seen an Onion-like post is full of shit. "

At press time The Drugmonkey was unsure if he should change his mind and beg forgiveness from the asshole.

Sunday, August 31, 2014

An Innovative, Outside The Box Incentive Program From Industry Leader Walgreens

Deerfield, IL- Corporate executives at Walgreens, the nation's largest pharmacy chain, today announced a new employee bonus program that they promised would "shake up the retail industry, if not the entire business world" at a press conference at its Zug, Switzerland Illinois corporate headquarters.  "We're turning conventional thinking upside down" stated company CEO Greg Wasson. "How? Well hang on to your seats. By rewarding.....failure"

According to Wasson, effective immediately, all Walgreens employees will receive anywhere from 0.75 to 1.2 percent of any financial errors they are responsible for in direct payments from the company. "Now granted, to a cashier whose drawer is off by ten dollars at the end of a shift, a payment of an extra dime may not mean much, and let's face it, a store manager getting an extra ten dollars for a deposit off by $1000 certainly won't be a game changer. That's why I'm announcing the start of this program with two executives who we think will become emblematic of what we're trying to accomplish. Wade, Kermit, step on up here."  

Mr. Wasson was then joined at the podium by Company Chief Financial Officer Wade Miquelon and President of pharmacy, health, and wellness Kermit Crawford*

"Now, these two men were recently responsible for a billion dollar forecasting error when projecting our upcoming Medicare business" Mr. Wasson continued. "And there's no company where a billion dollars isn't a good sized chunk of change, so naturally, we have to let them go. But not before, and I want everyone to know this, we load them up with payments and compensation worth $8.5 million and $12 million, respectively."**

"That's right" Wasson said "Write that down for the whole world to see. Make a billion dollar fuckup at Walgreens and walk away rich!"

Asked how a plan that rewarded failure could possibly further the company's interests, Wasson replied "That's the genius of this whole thing. Like I said, this won't mean a whole lot to the vast majority of our employees. Right now that is. But what it does is let them know that if they work their way up to a position where they are responsible for a whole lot of dollars, well...then the world is their oyster. So what we're gonna have here is 250,000 employees striving every day to reach a position of greater responsibility so they too can have a $10 million screwup payday. And quite honestly, 250,000 store-level employees giving their best is worth far more than one fuckup at the top."

While executive-level business people were almost universally positive in their reaction to the new bonus program, others were more skeptical.

"I don't see how this changes current executive compensation practices at all" said Harvard business professor Camfield Rosenburg. "And to be effective, the expansion of fuckup bonuses to store level employees would have to be coupled with a policy where promotions to positions of great responsibility were based on positive performance. And I didn't see anything in today's announcement to indicate such a change has taken place."

After the press conference, Miquelon and Crawford issued a joint statement that read simply "Moneymoneymoneymoney Brrrraaaahhhhhaaaahhhaaahhhaaaaaaaa!!!!!"

*As much as I would like to say I made this up,  "Kermit Crawford" is the guy's real name. 

** I didn't make  this up either. In case you were too lazy to click on the link, these guys made a billion dollar screwup and were rewarded with millions of dollars in severance money. 

Friday, August 15, 2014

Why The Fucking Flexeril Isn't Covered Anymore.

More than a few of you have come across this situation by now I bet. In the midst of a chaotic, stressful workday you finally snag an easy one. Thirty flexeril. Yay. Two seconds and we'll have this one right out the.....

Then you see the insurance reject. Prior auth required. What. The. Fuck.

We've all come to expect this with the bullshit drugs of course. And the expensive meds  with cheap alternatives. I'm looking at you Lyrica. One of the missions of the insurance companies is to save money after all.

But Flexeril? Are you kidding me? The generic is cheap as dirt. So I repeat, what the fuck? "They must be doing this for no other reason than to get me to crack" you might be thinking. "They've decided they must make each and every prescription a herculean effort to get out the door. There is a war on my sanity. Because there can be no logical reason to slap a prior auth on a seven dollar med."

Oh but there is a reason my poor underinformed retail drone. Logical or not can be a matter for debate, but read on to find out  why that insurance company pain in your ass just got a little bigger.

I'm going to go out on a limb here and say that rejected Flexeril claim was for a Medicare Part D patient. I know this because while you, my poor pillcounter, are still stuck in that outdated world where insurance companies obsess about nothing but money 24/7, I have seen the future, that bright new paradigm where the health care powers that be now obsess But in completely new and innovative ways. Where an obsession with the dollar can lead to scrutiny of the most absurdly inexpensive of insurance claims.

It works like this. Someone got the bright idea that Medicare should do more than just sit there and pay claims sent in by the health care professional types. That since he who pays the bills can make the rules, they should use their bill-paying influence to try and influence quality of care. It was decided that Medicare would start to rate its Part D plans like AAA rates roadside motels, with a one to five star system.

So far this sounds OK, right? After all, who could argue with an effort to improve medical outcomes?

Next step involves how to go about being able to show how a large, paper-pushing, figure obsessed bureaucracy is improving things for the oldsters. How do we do that? We can't really just go around saying, " 'Ol Doc Johnson over there at Blue Cross of Lower Damnation does a pretty good job, Five stars for them!!" now can we? We need things to measure, so as we can compare like to like. Outcomes this year versus outcomes last year, Blue Cross versus Humana. In short, we need a way to generate numbers we can use in place of that unreliable human subjectivity.

I'll stop here the throw in the olive in the martini. Those star ratings are worth big bucks to the insurance companies, as Medicare pays bonuses to the highest rated plans.  It's estimated that the difference between a 3 star and 5 star rating is worth about $200 million to the plan getting rated.

That's right, the principle of using metrics to judge performance that has been such an unqualified success in making chain drugstores efficient customer service utopias has now been expanded to the realm of clinical judgement. In this case, Flexeril, the muscle relaxant that been part of the standard treatment plan for all sorts of painful conditions for longer than I have been alive, has been classified by some bureaucrat as a "high risk" medication for the oldsters. And a plan that goes over a 3% threshold of "high risk" meds is ineligible for a 5-star rating, and all the megabucks that goes with it.

So yeah, good luck getting them to approve that claim.

Except chances are, if you have a brain in your head and no desire to torture yourself, you won't even try. You'll notice that even if you moved heaven and earth and got that claim approved, the five dollar copay that would result isn't all that much less than you would normally charge a person with no insurance at all. As a matter of fact,  you could just say hell with the insurance company, charge the person five bucks,  make just a little less on the prescription than you would have anyway, and save yourself a hell of a lot of hassle.

It's a win win. And if grandpa gets a case of brain fog after popping a pill or two and falls down the stairs, it still goes down as a win for the insurance, as they don't have a claim for the "high risk" med on file, and therefore won't get dinged.

Meet the new health care order my friends. Where everyone wins, except the drugstore who made a little less on a prescription than they normally would have. And Medicare, who just paid out a big bonus that had zero impact on quality of care. And grandpa, who just fell down a flight of stairs.

Which means no one really won except the insurance companies.

Which means the new health care order looks a lot like the old health care order.

But at least you know why that pain in your ass is a little bigger now.

You're welcome.

Monday, August 11, 2014

Into The Mailbag We Go.......

Got this one as a comment to this post about the fun times people have working for CVS. Thought it deserved to be out front on its own:

Being a regular pain medication customer of CVS, I find it hilarious that not one single pharmacist will take ownership for their own fuck-ups. After getting rear ended at a stand still by a car traveling 60+ mph last year I was left with 8 bulging discs and an immense amount of pain that I will have to endure the rest of my life. My insurance won't work with Walgreen's so I got stuck with having to deal with CVS. I have a prescription for Tramadol and I don't know how many times I was supposed to have a script ready only to be told by my pharmacist that it can't be filled! You want to talk about a living hell? Try going through a Tramadol withdrawal on top of serious back pain! I am going through it again as we speak. I went back to my prescribing doctor and even pleaded to be put on anything else and he told me that there was nothing else that would help. He adjusted my prescription to where the frequency was 1 to 2 tablets every 4 hours as needed on a 120 count bottle. I have had one refill and one renewal since the adjustment and just had the online app tell me that my script was ready for a refill. I only had a few pills left so this seemed right. I put in the order online and was told it would be ready at 11:00 am. I show up at 1 pm and get told that they can't fill my script because it is too soon! They try to tell me that it was supposed to be a one month supply and I look at the label on my bottle and see "1 dose every 4 hours as needed". I talked to my prescribing doctor and he verified that he did not change the script. So some fuck head pharmacist filled out the script wrong the last time I renewed and I'm left to suffer until I can get this mess sorted out. Having just started a new job, this is the worst time to be going through this and I hope there is a special place in hell for all the fuckers at CVS who have repeatedly fucked me over. I am lodging a formal complaint with the pharmacist board. I have had enough. Meanwhile you fucktards whine about corporate pressure and how horrible it is. Then fucking quit! I can't quit my pain! Stop bitching and take ownership of your actions. Jesus Christ what a bunch of whiny fucking babies you all are . . .

Actually it was the answer I wanted to make sure everyone saw. Here goes:

Dear Whiny Douchebag:

Imagine you just got a letter from your insurance company about your tramadol coverage, and in it it said for you to get any more refills, you had to suck my dick. I bet you'd be all like "No way!! You guys can go to hell!" Right? Or at least something similar.

At least I hope so, 'cause I'm not getting any kind of hot chick vibe from your writing style.

Now, let's say I came to you and said for $15 a month, I'll tap you with a magic wand that will make sure your pain is under control and you will never have to go through tramadol withdrawal ever again. Assuming you're not a liar, (Many, many people with these type of stories are.) I bet you'd say something like "Wow! tramadol withdrawal sucks so bad, and I have this new job now with some dough coming in, and I work better when I'm not in pain, That's a bargain!! Sign me up!"

Well guess what Mr. Whineyfuck, this is your lucky day. because I am about to give you a clue as to how you should have been able to solve your problems all along.

I brought up my first point to show you that there is no law that says you have to do what your insurance company says. You wouldn't (I hope) suck my dick to get your tramadol, and you don't have to go to a pharmacy run by incompetent clowns. I'm not about to defend CVS here. The obsession with short staffing that permeates the chain drug world ensures that many people go through your type of experience.

Notice I said chain drug world, which means I wouldn't count on your Walgreen's being any better.

So what's a hurtin' tramdol dependent dude supposed to do? That's my second point. If you came into my place, I'd have you fixed up in about 5 minutes. Ten tops. And I'd charge you around $15 dollars a month without your insurance. If I happened to be in your fucky company's network, it'd be even less.

I'd also tell you the maximum dose of tramadol is 8 tablets a day, so your doctor kinda fucked you if he really did make out a prescription for 1 to 2 tablets every 4 hours. Do the math.

Which brings us to our conclusion. I'm not sure why I have to tell you this, but you don't have to be your insurance company's little bitch boy. Take some ownership of your own life, get your head out of your ass, and find yourself a real pharmacy. It'll cost you less than a Jackson. And if avoiding a life of pain and withdrawal isn't worth that much to you, then you'll get no sympathy from me.

You're welcome asswipe.

Thursday, July 31, 2014

A Random Book Excerpt, Because Not Everyone Should Pay To Experience My Wisdom.

Actually, now that I read that, very few people do. Pretty much anyone at anytime can come up to me at the store and pick my brain. Now that I think about that I'm kinda jealous of these people now. Able to ask me a question whenever they want. Lucky them.

Wait, now that I think about it even more I realize I can ask myself a question and experience my wisdom anytime I want. Whether it's 2 in the morning or during my morning shower or even in the middle of sexual intercourse.

I am the luckiest man on earth, and it would be mean of me not to share me.

Here you go:

Chapter 7: Atralin

The Med

Atralin is a brand name for the topical acne medicine tretinoin, and tretinoin was my teenage savior. Regular use, a little peeling to let me know I was using too much, a sunburn or two to teach me those warning stickers put on by the pharmacy weren’t just for show, and the volcanic mountain range that had erupted on my face eventually went into submission. The fact tretinoin can make acne worse before it makes it better was a little disconcerting, but after a few weeks, this pimply faced future professional was convinced tretinoin was a gift from heaven. I was now free to become socially awkward based only on the merits of my actions and not on the condition of my skin. It felt better somehow to know my awkwardness was now earned.

To make it even better, as I approach middle age, tretinoin has now also come into wide use in the treatment of facial wrinkles, making it easy to think of it as some sort of lifetime sex appeal in a tube. There are some people who would pay a lot for lifetime sex appeal, no questions asked I bet. Valeant Dermatology, the same company that brought us the rip-off acne med Acanya I talked about earlier, seems to have made that bet as well.

The Scam

Some of you more astute readers may have read the above description of tretinoin and wondered if I wasn’t talking about Retin-A. I was. Retin-A was the original topical tretinoin, and is now saving the complexions of the children of its first generation of users. Drugs this old have generally lost their patent protection and are available as money-saving generics, and Retin-A is no exception. Funny thing about this med though, even though it’s sold in different strengths, including 0.05%, and even though it’s available in both a cream and a gel formulation, one way you can’t get it is as a 0.05% gel. This is where Valeant saw its opportunity.  It introduced Atralin, a 0.05% gel form of tretinoin and marketed it as a new product not substitutable for a generic. The price? $250 for a 45 gram tube. Over four times the price I found for the same size 0.05% cream with a little shopping around.

Neither the cream nor the gel has been shown to be more effective by the way. Keep that in mind when you’re making your purchasing decisions.

Once again however, a little looking around will lead you to a “savings offer,” where insured patients, most insured patients that is, will pay $25. If you’re one of the lucky ones who qualifies for that $25 copay though, just remember your pharmacy has submitted a claim to your insurer for $250. Uninsured patients will pay $75 with the savings card. Which means Atralin is a product whose primary purpose it would seem, is to drain money away from your insurance company and those people not savvy enough to look for coupons, and into the coffers of Valeant Dermatology.

What To Do

Unless you’re just a really big fan of topical gels, there’s little if any reason to buy Atralin. Just stick with the generic Retin-A.

Actually, let me take that back. The box design on the generic tretinoins can be a bit boring. They have plain old boxy letters and tired plain color schemes. So if it's important to you to have stylish graphic artwork in your medicine cabinet, then by all means, go for the Atralin.

The rest of us though, can take the money we save on our lifetime sex appeal in a tube and spend it wining and dining our soon to be many suitors.

Or come stalk me at the store.

Lucky you.