iHeart MedGuides

On each and every day, thousands of people visit their physicians to discuss their aches and ailments. More often than not, these people leave the office with a prescription in hand or on its way to the pharmacy via e-script, phone, or fax. When this happens, it generates business for retail pharmacists. If your pharmacy is anything like mine, a good portion of these prescriptions are for antidepressants and NSAIDs. You already know what comes next.

The MedGuide.

You know, those handy tear-off sheets that give the patients extra information about their medications. The information that is above and beyond what is included in the drug information that is printed for each prescription.

In theory, the MedGuides are good. They warn the patients about some of the more dangerous things that may happen while taking a particular medication. But the MedGuides aren’t provided to the patients before they receive the medication… they are stuffed into the bag for the patient to review once they get home. After they have dropped sixty bucks for their Celebrex copay or a couple hundred bucks for their Humira. Then the retail pharmacist gets the call about how dangerous the medication is (even though they were counseled) and the patient wants to return it.

It seems to this pharmacist that the physician should be the health care provider who should be responsible for distributing the MedGuides. After all, aren’t they the ones who are choosing to put the patients on these dangerous medications? Don’t they discuss the risks and benefits of therapy with the patient prior to selecting which medication to use? If the patient isn’t sure, shouldn’t they discuss it in the office with the physician prior to bringing the prescription to us?

If a MedGuide isn’t distributed, it’s the pharmacist who takes the blame. In my state, failure to distribute the MedGuide can land you a misbranding citation. In our digital world, you would think that the MedGuides would print automatically with every order that requires one. But they don’t. I’ve only worked with one system that automatically prints the MedGuides and I was shocked when it did. You would think that the software vendors would be required to supply the MedGuides for the medications.

At least the NSAIDs and antidepressants have the generic tear-off MedGuides by the bulk. I checked the warfarin that sits on my pharmacy shelf. The labeling had exactly one MedGuide included. So I then checked my propoxyphene-apap 500-count bottle… one MedGuide. So for these drugs, I get to run to the FDA website to print off a 5 to 8 page MedGuide because the manufacturers aren’t required to provided a sufficient number of these for each bottle of their product.

Physicians aren’t required to provide them prior to ordering medications. Software vendors aren’t required to include them with the patient information sheets. Manufacturers aren’t required to provide adequate quantities of them. Pharmacists must distribute them or face potential fines if they aren’t distributed. It seems to me that pharmacists are getting the short end of the stick when it comes to the MedGuides.