Does a local pharmacy keep stock of all drugs, all the time?

October 17, 2014 4:59 AM

If I get a prescription from a doctor and take it to a pharmacy, they seem to be able to fulfill it there and then. How? Do they keep a stock of all drugs on hand? Seems unlikely but I have yet to visit one and they didn't have the stock. How does it work?
posted by MarvinJ to Health & Fitness (28 answers total)

On several occasions (though not recently), pharmacies have had to special-order prescription drugs for my wife. Also, one of our cats needed a drug that the pharmacy didn't have on-hand, though this drug is also used for humans.
posted by alex1965 at 5:01 AM on October 17, 2014 [1 favorite]

I have had pharmacies unable to immediately fill a prescription. So my thinking is that they carry an inventory of frequently prescribed drugs that is just a little broader than you expect.

There seem to still be some cases where a pharmacy prepares a drug from some precursor on-hand, but I've only had this happen once.
posted by grobstein at 5:07 AM on October 17, 2014 [4 favorites]

If you visit a pharmacy and they're out of stock, they either order them and you wait, or you go to another pharmacy that (hopefully) has stock.

Much like anywhere else that's out of stock on something specific.

This is more likely to happen for a very unusual prescription at a pharmacy you are not a regular customer of, or for medication that has political forces behind it (i.e. quotas on the medication or it's ingredients due to their potential to be used for recreational drugs) that limits it's availability.
posted by Ashlyth at 5:09 AM on October 17, 2014

Best answer: I recently got a backstage tour of my local pharmacy because they have installed a computerised dispensing system I am fascinated by and the pharmacist owner was kind enough to indulge me. (And also let me dispense things like aspirin from the console. SO COOL. It's like this but cooler.)

This is my local corner pharmacy and yes, they keep stock of over 1,500 commonly prescribed drugs. When they run low on inventory of a drug, they are alerted by the system and re-order at an assigned level and normally get the drugs in the next day.
posted by DarlingBri at 5:15 AM on October 17, 2014 [3 favorites]

Yeah, you probably just don't get anything unusual, or anything that's been subject to a shortage. Pharmacies run out of stuff all the time, either because there's not enough call for it or because the manufacturer has been shut down or isn't making enough to supply demand. (EG the ADHD drug shortage a few years ago.)
posted by pie ninja at 5:16 AM on October 17, 2014 [2 favorites]

I'm on a prescription for a couple of daily medications that aren't that common in the overall population, and my prescriptions always have to be ordered in. Generally, it's just a day's wait, but if I somehow run out and need it right away, I'm generally able to go to another pharmacy in the chain that has it.
posted by xingcat at 5:46 AM on October 17, 2014

Well, this is a classic inventory management and demand planning problem. Basically a pharmacy would estimate future demand based on past demand for a given drug. For common drugs (say Viagra) for which regulations aren't especially onerous, this is pretty easy to do. For common drugs for which regulations are onerous (Adderall) this is harder for obvious reasons. And for uncommon drugs this is pretty much impossible, also for obvious reasons.
posted by dfriedman at 5:48 AM on October 17, 2014 [1 favorite]

Best answer: When my wife was getting Cellcept on an off-label use we'd often have them be unable to fill some or all of the script. Not too surprising given the high price (then astronomical) of this drug. But the big chains seem to have pretty advanced just-in-time inventory systems and we never had to wait more than 36 hours for it to be fully filled.

Don't understimate how well developed JIT concepts are at this point. With a good inventory tracking system and predictive algorithms that pharm can keep a pretty wide variety of stuff without a huge space.
posted by phearlez at 6:01 AM on October 17, 2014 [3 favorites]

Best answer: I've had pharmacies unable to fill prescriptions due to stock issues. Once I had a pharmacist supply me with half a packet of a drug instead of a whole one and an iou for the rest. She said they packaged them on site, and were literally down to their last 15 tablets. I've also had them call other pharmacies for me, or call my doctor to see if they can give an equivalent medication that they do have in stock. I don't get anything too unusual, either, but maybe I go to smaller pharmacies than you do.
posted by lollusc at 6:12 AM on October 17, 2014 [1 favorite]

Most of the meds we get are either in stock or in the local distribution center. If I can't get in the usual turnaround time (two hours), I can get it after 2pm the next day.

For more complicated drugs, it usually requires a pre-approval anyway, and then 24 to 48 hours to dropship from the manufacturer.
posted by Buttons Bellbottom at 6:15 AM on October 17, 2014

Response by poster: Thanks all - seems I just got 'lucky' with the meds prescribed. Need to have something super popular or rare to have to wait.

the improvement of stock management programs makes sense too.

- case closed
posted by MarvinJ at 6:28 AM on October 17, 2014

Also, in case the trivia of pharmacy management interests you...

I used to date a stocktaker. Pharmacy stock taking is a specialist thing in that you need some training and experience at it but it doesn't have an special educational qualifications beyond being highly numerate.

So anyway, periodically (at least annually) most pharmacies have an outside firm come in and do stocktaking. They will count and itemise every packet of every drug on every shelf, as well as all of the retail items out front. This manual count of drugs is then matched to the store's own inventory.

This is used for valuation of stock in trade for tax purposes and insurance purposes but is also used to control for staff pilfering. You can have a rarely dispensed drug and the inventory system says you have 8 units but the stocktaker show you have 2. Someone has walked with 6 units. This difference is called shrinkage.

Stocktaking is a core loss prevention metric for pharmacies, pub/bars, and petrol forecourts/gas stations (because: cigarettes). Drugs, bottles of booze and cigarettes are easily transportable, high value and readily sold on. It's all very interesting!
posted by DarlingBri at 6:45 AM on October 17, 2014 [3 favorites]

I'll just add one more case: Once (and its only happened just the once!) a major storm disrupted deliveries enough that the local pharmacies ran drastically short on common antibiotics - I had just had a minor dental surgery. The county instituted some sort of need-based rationing - surgeries yes, sinus infections had to wait - and my pharmacy had to call around to see who had it in stock and I had to go to that pharmacy to get exactly two days of dose. On day three the new shipments arrived and everything went back to normal.

I live in blizzard country and that's only happened the once and it was a big enough deal that it led the local news, because it required a very unlucky confluence of events.
posted by Eyebrows McGee at 6:49 AM on October 17, 2014

(But I've definitely had the pharmacy fill half a script, especially later on a Sunday, and had to come back the next day for the rest. Especially pain medication, I assume because it's so tightly controlled. But in that case I could go to a different pharmacy to get the whole thing or whatever.)
posted by Eyebrows McGee at 6:52 AM on October 17, 2014

Big city, chain pharmacy: I think at least once or twice a year I'm given a partial quantity of one of my (common) medications because they've run out or a delivery is late/messed up. The remainder is usually available the next business day.
posted by Room 641-A at 6:54 AM on October 17, 2014

When I was a pharmacy technician, we ordered every evening and received the order the next morning. We almost always had everything in stock. There are a few really expensive items that aren't used very often that we would only have one of and, if that was needed twice in one day, we could call other pharmacies to 'borrow' it (happens maybe once a year). I only worked in independent pharmacies. I think chain pharmacies may be different. I've have a friend who has to special order one of her prescriptions every month. If she used a good independent, they would just have it ready for her.
posted by myselfasme at 7:21 AM on October 17, 2014

I have a couple prescription medications I take every day, and once in a blue moon the pharmacy will be out of the drug or have enough in stock for only a partial refill. It happens, just not often.
posted by Metroid Baby at 7:27 AM on October 17, 2014

When Walgreens doesn't have my medication, they order it and tell me to come back the next day. When Sam's doesn't have my mom's medication, even if it is a common one, they order it but don't get it in for a week. Evidently different systems there.
posted by artistic verisimilitude at 7:42 AM on October 17, 2014

I have had a vast array of prescriptions filled by my small local non-corporate pharmacy and the only times the didn't fill it within 10 minutes were when 01) it was something that had to be compounded and 02) when it was a transdermal patch medication. For the latter, they even called a nearby Duane Reade for me to see if it was in stock there, and that other pharm also didn't have any at hand.
posted by poffin boffin at 7:43 AM on October 17, 2014

They don't keep stock of everything, but they do know what is most frequently ordered and generally keep just about everything that you might need in stock. I am prescribed a controlled substance, and I usually have to leave my prescription at the pharmacy and come back 3-4 days later, depending on what day of the week and time I dropped it off.
posted by Urban Winter at 7:47 AM on October 17, 2014

Just a quick tip from my experience: Dedicated pharmacies like Walgreens or CVS seem to keep a huge amount of things in stock. Pharmacies at my local grocery store and similar places have much less variety and long wait times. I stick with Walgreens now; I've never had them NOT have something in stock. It's just the wait for a controlled substance to be filled that's annoying, but they don't drop the ball on fulfilling it and texting me that it's ready when the FDA rules finally allow them to fill it.
posted by KinoAndHermes at 8:07 AM on October 17, 2014 [1 favorite]

The pharmacy at Kaiser definitely does not stock everything. I recently had to jump through lots of hoops to get something that they don't normally carry or prescribe. I have never had this issue with a bigger chain pharmacy though (even for the exact same med that I had trouble getting from Kaiser).
posted by rabbitrabbit at 8:20 AM on October 17, 2014

I go to a national chain drugstore in a small, rural town.

They have almost always had prescriptions in stock, even if they were called in or delivered that day. On rare occasions, I'll have handed the pharmacist or tech a script for something for myself or my wife where they've said "we don't have that in stock, but I'm getting a delivery of it tomorrow and you can pick it up after 3."

I've never had to wait more than two days for a prescription (and that was when a major snowstorm delayed their delivery by one day); maybe I've just been lucky.
posted by tckma at 9:36 AM on October 17, 2014

I've had this problem once, and it was also with Kaiser. The medication wasn't particularly unusual, but the prescriber insisted on a format that was not in stock (blister pack, rather than giving very specific dosage instructions). As I recall, they did not offer to have this delivered, and I spent the rest of the day trying to find another drug store that both had the blister pack and accepted my insurance.

(In the end, the best I was able to do was a store that would order it and give me a small discount for not having compatible insurance. Had I been more assertive, I would have insisted the original pharmacy order the specified dose.)
posted by casualinference at 9:49 AM on October 17, 2014

I work at a small town drugstore. Last time I was at work we and pretty much everyone else in the county were out of norcos because of their change into CII.

We do get next day deliveries, so insanely expensive drugs that we don't currently have anyone on generally take a day to get. Not bad, really. Most of the delays we see are where the doctor wrote something that a) is in a strength that doesn't actually exist b) forgot something critical like quantity or drug name or c) wrote for something that was pulled off the market forever ago.

Or where your insurance hates you, but everyone knows about that already.
posted by Trifling at 9:52 AM on October 17, 2014 [1 favorite]

Related:
Every pharmacy has a list of drugs it carries called a formulary.

I did at times have to go off base and pay a co-pay for a drug not carried (at all -- not even available via special order) by the military pharmacy on base. In one case, they later added the drug to the formulary and then I was able to get it at the hospital, like I usually did for most things.

So, if you have a specialty item, sometimes you have to call around and find out who has it on their formulary. If it is not on the formulary, you can't get it through them. If it is on their formulary, as noted above, most pharmacies do a pretty good job of keeping stuff in stock such that most orders can be filled promptly.
posted by Michele in California at 10:24 AM on October 17, 2014

I recently experienced this a couple of times. This was on drugs I thought for sure would be in stock. The one I had to wait 3 days for because I brought the script in on a Friday afternoon (Haldol was the drug if anyone cases). But that's not happened again. It was Walgreens, FWIW.
posted by kathrynm at 2:34 PM on October 17, 2014

Almost every time I refill a particular prescription, I have to wait 2-4 days for them to restock it. It's a large dose of an expensive brand-name drug, the only one currently in its class, that only treats a certain complication of one chronic illness.

I also take a large quantity of another uncommon pill (one full manufacturer bottle is 270 pills; I take 390 monthly), and sometimes they'll need to restock before they can fill it, or give me a partial refill.
posted by WasabiFlux at 4:32 PM on October 17, 2014