The adderall shortage has hit me hard over the last year, but I finally found a pharmacy that is able to fill my script every month. I occasionally try other pharmacies closer to me and they tell me they are still in back order for months. The one that has it consistently is a super small mom-and-pop shop and even major pharmacies like CVS have been out for ages. How do some pharmacies get it all the time and others don’t?
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Some stock up to reduce ordering or maximize price breaks, others will reorder consistently to meet current demand.
Your example is a perfect comparison for this!
The mom-and-pop shop ordered a nice round number to be ready, and they don’t have a lot of traffic to get through their stock.
CVS will go through a lot, and every week will order what they expect to need for the next week.
Some of the large chain pharmacies keep minimal stock on hand. One by me gets some stuff in almost everyday. The small mom and pop type pharmacy gets what they expect to sell in two weeks at once. Common medication they get large bottles of 1000 or more while the chain store may get 200-300 size bottles everyday. Once they are out they can’t get it delivered but the store with 1000 of them may only sell to 10-20 people and have supply for longer.
Now I’m not an expert. I also experienced the shortage, and switching to a mom and pop pharmacy also consistently has it in stock.
From the little searching I did I thought I saw something about since it’s a controlled substance pharmacies are allotted a certain amount. By nature of the big pharmacies having lots of customers fighting over the limited supply, smaller pharmacies have less customers competing for the allotment.
Independent/mom and pop pharmacies often have multiple vendors they get their stock from. This gives them multiple options to get things that are in low supply.
Believe it or not, the chains only use one primary vendor for the things not carried directly by our main warehouse, such as C2 medications (Adderall and the like). CVS uses Cardinal, and Walgreens uses McKesson.
So you’ve basically got several thousand stores attempting to order a significant quantity of medication daily. Manufacturers are only able to produce so much at one time, so it has to be allocated. Believe me, the backordered medications are ordered daily, they’re not trying once and then forgetting about it.
There’s a ton of variables. I’ve worked in both. At the large chain, they can order every day, but they go through a LOT more. They usually order through their corporate first, then have 1-2 backup wholesalers that they’re discouraged from using often by corporate. The government sets restrictions on the supply chain for narcotics, so they can hit their limits faster. Many huge chains order a ton of meds and store them in warehouses to distribute later on. This can alleviate some short term shortages.
Ma & Pop stores don’t have big warehouses to deal with shortages, so they’re more at the whim of the market and can be hit harder with shortages. Wholesalers will generally allocate short stock to their largest accounts, so Ma & Pops lose out there too. They can usually order every day and can use as many wholesalers as they wish. This variety in wholesalers can lead to them finding things the big chains can’t sometimes. When I worked at the big chain, we had 2 sources to order from. When I was at the Ma & Pop, we had 5 or 6.
That’s not very ELI5 though.
Pharmacies don’t keep large backstocks. Not in stores, not in warehouses. It’s about expiration dates. Yes, drugs most often have a long shelf life, but there are legal limits to when they have to sell-by.
Price depends on the company’s buying power. Kaiser, for instance, has enormous buying power. They’re the largest corporation in California, and have almost half of the health care market.
That’s how they can give patients insulin for around $20 a bottle.
They pull a lot of weight in contract negotiations.
Cvs has warehouses where they store loads of drugs that can then be sent to individual cvs pharmacy locations. They do this to avoid being affected by a backorder, or so they claim. What they fail to realize or refuse to admit is that this makes them a significant factor in EVERYONE ELSE’S BACKORDER.
Sincerely, another pharmacy worker who had to explain to uncountable patients that just because CVS has Adderall in stock doesn’t mean we do.
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