Swiss Saturday: The Pharmacy

by Evil HR Lady on June 8, 2019

It’s a Saturday before a Monday holiday (Pentecost) and so of course, that’s when I needed to get a prescription. Fortunately, my area has a number of drop in clinics (like urgent care) that are open on the weekend, off I popped to the big city–15 minutes on the bus–to see a doctor.

My normal doctor is within walking distance of my house, which is super handy. His office is in an apartment building, and I’ve thought if I had a chronic condition, I could just move into that building, because how convenient would that be?

When I see him and need a prescription he generally just hands me the medication. In the canton I live in, Basel-land, doctors can disperse their own prescriptions. He keeps a store of the things he’s most likely to prescribe in his office. It’s super convenient. I only have to go to the pharmacy for unusual things or for controlled substances. Otherwise, it’s one-stop shopping.

But, because I needed a doctor and a prescription on Saturday, I headed into the clinic which is in Basel-stadt, which is a different canton. (Or half canton if someone is going to get picky in the comments.) They don’t allow doctors to hand out drugs. So after an exam and the doctor concurring that antibiotics were, indeed, needed, she handed me a prescription.

Off I went to the pharmacy, which is the topic of this post–even though it took a while to get there. I handed my prescription and my insurance card to the tech behind the counter. He scanned my insurance card (it has a chip!) and, even though I’d never been to the pharmacy before, it automatically put my name and address into his system, which he verified with me.

This particular pharmacy has their storeroom not visible to the customer. He put the prescription in the computer and someone (or a robot–I don’t actually know) grabs it and sends it via pneumatic tube to him. He printed out a label, stuck a sticker on my box, put another sticker on my paper prescription, walked two steps and showed the prescription and the box to the actual pharmacist, and handed me my medication. Total time at the pharmacy? Two minutes.

What didn’t he do? Count any pills.

In my 10 years of life in Switzerland, I’ve never had a pharmacist count any pills. Prescriptions come in blister packs or bottles with the amount pre-counted. Daily medication comes in bottles or packs of 30. Other medication comes in a count of how many the doctor is likely to prescribe. Incidentally, the doctor prescribed 3 days of antibiotics for me (twice a day, so 6 pills) but it came in a box of 10. They didn’t pop out the extra 4 pills so I wouldn’t take them. (I suppose they wouldn’t give me extra if it were oxycontin or something–not that they do that around here. The Swiss will do everything in their power to avoid pain medication.)

I also never pay a copay at the pharmacy. I do have a copay on my medication, but they bill my insurance directly (Switzerland does private insurance–we pay about $1400 a month for health insurance for a family of 4.). My insurance company will then bill me the difference. This is in stark contrast to the doctor who will bill me directly and then I submit the bill to the insurance company for reimbursement.

Now, on occasion, the pharmacy hasn’t had the medication I needed. In that case, as long as I drop the prescription off by 4:00 pm, it’s ready by 8:00 am the next day. Otherwise, it’s never been more than 2-3 minutes between handing over my prescription and walking out the door with medication.

Not needing to count pills saves so much time. I wonder why the US hasn’t moved to such a model for medication.

{ 14 comments… read them below or add one }

MariaRose June 8, 2019 at 6:14 pm

Unusual situation for both seeing the dicta day getting prescriptions filled. I guess antibiotics are packed in a certain amount and based on your prescription you got more than needed. With the problem of both overuse of antibiotics and resistant superbugs, that specific prescription should have been counted.
Over here in the states (USA) most prescriptions (except for opioids) are given based on how the manufacturers packages them ( 30/90 day supply) in bottles. I don’t think pharmacists here are counting either. But your description of the layout of the pharmacy didn’t include lines of customers ( perhaps because they aren’t inside another facility)
But you also made a comment about your healthcare costs for your family of 4. ( which was incidentally more than my rent). But you apparently get a higher coverage of care, like your example of getting an appointment last minute for a Saturday and no waiting for service either and getting prescription filled in about 2 minutes at any location pharmacy. Glad to hear that you get excellent service.
Incidentally does that coverage eliminate any and all out of pocket costs?

Reply

Evil HR Lady June 8, 2019 at 6:23 pm

It was an urgent care center–walk in, first come, first served. I had to wait an hour for the appointment.

There’s rarely much of a line at the pharmacy, but there was rarely much of a line at the CVS where I got my prescriptions in the US. It’s just there you had to come in twice–once to drop off and once to pick up (unless your doctor sent the prescription over electronically).

Health insurance here is expensive, but salaries are also higher. My husband and i each have a $2000 deductible and my kids don’t have any deductible.

There are no markups on care, like in the US.

Reply

Goober June 10, 2019 at 10:34 pm

I haven’t had a paper prescription in a number of years in California. The feds strongly encourage electronic records, but the insurance companies and medical groups (and pretty much all doctors are members of one or more medical groups) require it, period. Usually in a system that any doctor in the group can access at need, so I don’t need to carry a medical history with me when I go to a new specialist. (It’s far from perfect, of course. There are several competing computer systems for this, and they are 100% incompatible with one another. My primary care recently dropped all the medical groups he’d been dealing with except one because of this.)

As for counting, in my experience (at a national chain pharmacy), stuff that doesn’t come prepackaged from the manufacturer is put into the bottle you take home by an automated machine – which does, indeed, count them.

Reply

Jim Grey June 8, 2019 at 11:56 pm

I always enjoy Swiss Saturday. Fascinating to see how things work in der Schweiz.

Reply

Chris Hogg June 9, 2019 at 12:18 am

Speaking of robots (and you might ask the next time you visit), a year or so ago I read an account of a 5-year test / study in a hospital pharmacy (California?) evaluating a robot pill dispenser: 100% accuracy, zero errors.

Reply

Texan In Exile June 9, 2019 at 7:10 pm

My mail-order drugs – imitrex – come in a blister pack. I hate that packaging so much. The last thing I need when I have a migraine is trying to get the darn pill out.

(I agree this is a better process for accuracy, but can’t they figure out how to make a blister pack that is easy to open? I have to use scissors.)

Reply

Mr. Cajun2core June 10, 2019 at 3:07 pm

I know the feeling!

Reply

BethRA June 10, 2019 at 4:58 pm

They come in a blister pack at my pharmacy, as well. I keep a small pair of first-aid scissors in the package and just cut through the stupid things.

I could kiss the person who invented imitrex, but I could throttle the person who created that packaging.

Reply

Cajun2core June 10, 2019 at 3:06 pm

It seems to me that wasting pills is wasting money and would only raise the cost of healthcare. I could be wrong though.

Reply

Evil HR Lady June 10, 2019 at 3:11 pm

It’s got to be cheaper to throw away 4 antibiotic pills than to pay a pharmacist to count every pill.

Reply

Cajun2core June 10, 2019 at 8:19 pm

That is a good point. But does the pharmacist count them or a pharmacist tech (do they even have those in Switzerland)?

Also, antibiotics are usually cheap but if they do that for every medication, there may be some medications that are extremely expensive. It might be cheaper for those to have the pharmacist count them. If a medication cost 30 dollars a pill and it takes 2 minutes for pharmacist to count them it would save 120 dollars. I would think it would be worth it.

However, if a pharmacist in Switzerland makes more than 120 dollars an hour, then I have some serious thinking to do! 🙂

Reply

Texan In Exile June 12, 2019 at 2:25 pm

I think the variable cost of manufacturing most pills is pretty low. It’s the high overhead – R&D costs for many unsuccessful drugs – applied to product that is actually sold that makes them expensive.

But if you are throwing away actual pills, you are probably throwing away something that costs only pennies or less to make.

My imitrex used to have a retail price of $30 a pill, but now that it’s generic, it’s a couple of dollars a pill. It didn’t suddenly become cheaper to make – it’s not patent protected and consumers have options, so now the market is setting the price.

Reply

Mr Salty June 10, 2019 at 3:32 pm

I pay $1655.46/month for my high-deductible health plan, COBRA for four (“that bites!”) I shudder to think what a conventional plan would run.

Reply

Kobayashi June 11, 2019 at 12:04 am

I just get most of my prescriptions mailed to me 🙂

Reply

Leave a Comment

Previous post:

Next post: