Here we go with the hoarding message again. Note the person that stated "We are not dependent on computer systems." LOL. My girlfriend works in a pharmacy and she is on the floor laughing very hard. Excuse me, do have a few extra valiums, yes, I am in your computer, yes I have refill rights.

http://www.currents.net/newstoday/99/06/16/news14.html

By David McGuire, Newsbytes

The greatest danger to patients needing prescription drugs in the year 2000 will come not from downed computers and failing distribution systems but from unnecessary hoarding and lack of consumer preparedness, according to drug industry leaders and the chair of the President's Council on Year 2000 Conversion.

"The greatest risk to this supply chain is not Y2K but (rather) if people are uncomfortable with the system," John Koskinen told Newsbytes. The chair of the President's Y2K council, Koskinen spoke today at a press conference on the Y2K readiness of pharmaceutical companies and other entities involved with the nation's prescription drug supply. If frightened citizens begin trying to hoard medications, it could place a strain on pharmaceutical back-stocks, he said.

The Council, in conjunction with pharmaceutical industry leaders, patient advocates and other health care industry stakeholders, is looking for ways to foster education and outreach programs aimed at quelling consumer concerns about drug supplies, particularly in rural and underserved areas, Koskinen said.

In areas that may be served by only one or two pharmacies, it is particularly important to let citizens know that they will be able to get their life-sustaining medications, Koskinen said.

Y2K compliance won't be a debilitating problem for the nation's drug manufacturers, chain drug stores and community pharmacies, industry insiders said at today's press conference. As of now, most systems are either fully compliant or quickly becoming so, industry leaders said.

And even if all pharmacy computer systems aren't compliant, patients will still have access to medications, Kurt Proctor, senior vice president, pharmacy policy and operations for the National Association of Chain Drug Stores told Newsbytes. "If you need your medication, I'm going to do everything I possibly can to get it to you," Proctor said. "We are not dependent on computer systems."

A patient advocate at the conference agreed with the industry's rosy outlook on pharmaceutical Y2K compliance. Brain tumor patient Laurene West, who has been involved with the Council's Y2K efforts from the outset, said, "Because the pharmaceutical industry has responded with such effort, I believe we will all be okay."

West exhorted the media not to publish inflammatory stories about the dangers of Y2K noncompliance in the drug industry.

While industry leaders urged citizens not to hoard drugs, they also stressed the need for patients to make sure their personal supplies do not dwindle to less than a five-to- seven day's-worth of drugs.

Although the five-to-seven day guideline has been industry standard for some time, industry leaders are reemphasizing it in anticipation of Y2K. That cushion should be more than enough to sustain patients if any distribution glitches crop up, Koskinen said.

The Council website is at: http://www.y2k.gov

-- y2k dave (xsdaa111@hotmail.com), June 16, 1999

Answers

The inevitable counterpoint:

http://www.y2kcenter.org/news/0614pr.html The Center for Y2K and Society, posted this article today, an excerpt -

PHARMACEUTICAL Y2K ASSURANCES "UNJUSTIFIABLY OPTIMISTIC," EXPERTS SAY

Washington, D.C., June 14 -- The reassuring message on prescription drugs and Y2K issued today by The White House and the pharmaceutical industry is unjustifiably optimistic. "Acting upon this message may leave some patients without critically important medicines in January 2000," the independent nonprofit Center for Y2K and Society said today.

The Center was reacting to a statement by the White House Pharmaceutical Roundtable that the pharmaceutical supply system will continue to function normally on January 1, 2000. But Norman Dean, the Centers executive director, pointed out that the Y2K problem is interconnected among all sectors of society and not simply a set of discrete challenges to be worked out on an individual basis.

-- Jon Johnson (narnia4@usa.net), June 16, 1999.

Uhhh, Mr. Proctor, you said:

>>And even if all pharmacy computer systems aren't compliant, patients will still have access to medications, Kurt Proctor, senior vice president, pharmacy policy and operations for the National Association of Chain Drug Stores told Newsbytes. "If you need your medication, I'm going to do everything I possibly can to get it to you," Proctor said. "We are not dependent on computer systems." <<

Not dependent on computer systems? How about the automatic inventory control, in which once a prescription is punched into your computer it is put on the list to be refilled and later sent to your supplier?

Sounds like the old joke, Mr. Proctor (got to be some connection here...) about the finding that there are nearly as many instances of colon cancer as lung cancer...... and that now we've got to find who is going around blowing smoke up everybody's ---.

Beached Whale

-- Beached Whale (beached_whale@hotmail.com), June 16, 1999.

I agree with their findings. The pharmaceutical manufactures will be able to deliver product to the pharmacies. Also the pharmacies should be able to dispense the meds without computers.

Lets hit the pharmacy side. You take a prescription to the pharmacy. They punch it into the computer which prints out a lable. The prescription is numbered and put into a file. For a refill, without the computer, the bottle is handed back to the pharmacist, the prescription number is on the bottle. The pharmacist goes to the file and pulls the original prescription reads that there are refills and thus fills the prescription. If there is no computer to punch the data, the hand method works just slightly slower. A number is placed on the prescription and on the lable. The lable is hand typed and filled. The prescription goes into the file in numbered sequence. The original prescription by law must be maintained for 5 years in the pharmacy.

Now for the problem of distribution. This is where people see the problem of computers getting in the way. The pharmacies send the med requests to the distributer's computer, the orders are filled and mailed to the pharmacy(delivered by truck). The Pharmaceutical companies also recieve the bulk orders from the distributers and fills their orders in the same type of process.

Now suppose that computers are out of the picture, how do you get your meds to the pharmacy. One possible way would be by the following. The pharmaceutical companies have sales people who periodically stop at every hospital and every pharmacy in the US. With this network, the actual sales people(detail men) could pick up the orders from the pharmacies and hospitals and arrange for the supplies to be moved from the manufacuturer to the pharmacies and hospitals without the distributer. This system was inplace before Lilly developed the distribution system that we have today.

Now I do not know where Y2K dave's girlfriend works but I would bet that she is not the pharmacist. If she was, she would know the laws about dispensing prescriptions and would not have seen the computer as being a necessary part of delivering a prescription to the patient.

As for the pharmaceutical companies ability to deliver products, many of the manufacturing processes do not require computers to make the product. The exceptions would be insulin and vaccines where process controlls are needed for end fermentation processes. Most other aspects of making a tablet or capsule do not require the use of a computer.

Your delivery of pharmaceutical will not be a problem. IF other pharmaceutical companies have difficulties, the only products on the market will be from one company. Those products will be Anacin, Advil, Robitussin, Dimetapp, Axid, Denorex, Prep H, Primatene, Effexor, Inderal, Lodine, Premarin, Triphasil, Isordil, Ativan, Centrum, and over 100 more products covering things from head to toe.

-- Ned P Zimmer (ned@nednet.com), June 16, 1999.

Thanks Ned,

I guess we'll all just return to life in the 70s for a few weeks.

I know that they can be written out, but productivity is going to take a major hit, no matter what workaround is found.

Do any pharmacies still have typewriters for typing out labels?

How legible is your handwriting? To an elderly person with bad eyesight?

Would it really hurt the pharmaceutical industry if people went to get their prescriptions a week early for the next six months?

Wouldn't it be prudent?

-- nothere nothere (nothere@nothere.com), June 16, 1999.

I am not saying that you should not have the a months supply of your meds. Everybody should have a supply large enough that if they can't get to the pharmacy on Tuesday it won't be a problem. If you are on long term meds, a minimum should be a month's supply better yet 3 months. Here I am thinking of things like blood pressure medication(Inderal, Capotan(sp), Hctz), things like Synthroid, heart medication(except nitroglycerin), antipsychotics ect...

However, a large percentage of the people here believe that the end of the world is comming and that the computers will stop everything(food, fuel ect...) from being delivered. You have seen the paranoia. And if no one else is saying it, I am saying it. We will deliver our products. Our patients must have it. We can not miss the deadline.

All of the pharmaceutical process that I have worked on(Lodine, Premarin, Inderal, Mepergan Fortis, OC's, Donnagel) as well as the other products that my company makes in the North American facilities can all be run without computers(except the vaccines devision). This is where their statements are probably comming from. The delivery side and reading of hand written lables should not be a problem either. For my intern days, we did place capsules and tablets into dial packs(or memory boxes) which almost every pharmacy carries. All of these things are to help the patients take their meds when they have to take them. Today for less than a dollar you can buy a 3 week(day labled) med container and they should be used for the elderly patients who sometimes forget to take their medications.

Anyway, there are some companies that will survive and still make product into the year 2000, AHP will be one of them. And yes, I am creating this message on a Y2K ready computer. If worse comes to worse, I can blow the dust off the win3.1 computer, connect it to the 12 megawatt co-gen facility(on site) and continue to make batch records, that is if the xerox machine fails. That is how prepared we are to make product.

I do not know if Mrk, Lly, Pfe, or WLA are this prepared, but then again they are the competition.

-- Ned P Zimmer (ned@nednet.com), June 16, 1999.

Lets see...80% of the raw material that the United States uses in producing pharmaceuticals comes from foreign countries... Ummm yup sure looks like there will be no problems to me too...Gotta remember to check them stock prices...

-- BiGG (supersite @acronet.net), June 16, 1999.

Ned said: "We will deliver our products. Our patients must have it. We can not miss the deadline."

Before he shuffled off this mortal coil a couple of weeks ago, I'm sure the American Airlines pilot trying to land in Little Rock had some similar thoughts: "We will deliver our passengers. Our duties demand it. We cannot miss the runway."

-- Vic (Rdrunner@internetwork.net), June 16, 1999.

Good comments Ned - thank you.

A rather long copy from Mr K's words - but they are worth reading again. All the below are "assurances" and bland words deliberately (as they said themselves) intended to calm the public - no reliable facts, numbers, contingency plans, or values to allow a person to verify anything. The question is: Do you believe them? Can you believe them? Why should you believe them? If they are wrong, what is their penalty? (What have they lost?) If they are wrong, what have you lost?

<<"The greatest risk to this supply chain is not Y2K but (rather) if people are uncomfortable with the system," John Koskinen told Newsbytes. The chair of the President's Y2K council, Koskinen spoke today at a press conference on the Y2K readiness of pharmaceutical companies and other entities involved with the nation's prescription drug supply. If frightened citizens begin trying to hoard medications, it could place a strain on pharmaceutical back-stocks, he said.

The Council, in conjunction with pharmaceutical industry leaders, patient advocates and other health care industry stakeholders, is looking for ways to foster education and outreach programs aimed at quelling consumer concerns about drug supplies, particularly in rural and underserved areas, Koskinen said.

In areas that may be served by only one or two pharmacies, it is particularly important to let citizens know that they will be able to get their life-sustaining medications, Koskinen said.>>

Particularly in the last statement - HOW does he propose to "get the medicines to the pharmacies"? He has clearly said - the pharmacies will have life-saving drugs, but has no inidication of how he intended on doing that.

To anticipate Decker's (or Poole's) questions: All that is needed is a simple count, by maker, of their total systems, their affected systems (I'm not counting critical systems - this is medicine and manufactoring and shipping, not some government agency doing nothing but counting beans) How many systems are complete, how many are complete through integrated testing, and what the sctual schedule is for the remaining. What is the status of their venders? What are their real contingency plans for power, water, sterile support supplies, regular supplies, and processing and transportation.

And I am willing to bet that these company presidents could not answer. I could be wrong - and if proven wrong (by events or by a letter from these companies, I'll admit it here) - Ned, for example, has pointed that he has backup's - hasn't tested them corporately, but he has at least thought through some contingency scenarios.

-- Robert A. Cook, PE (Kennesaw, GA) (cook.r@csaatl.com), June 16, 1999.

I don't know about your local pharmacy, but my wife who is a CVS pharmacist, and she says there will be HUGE problems.

She has the prescriptions on file, but they are only filed by date, and if the patient doesn't have the bottle, or doesn't know the date, good luck finding the script. (she does 1400+ a week, GOD help anyone wanting to find one without a date). IF they have the date, it can be found, but it'll take a while. Now, repeat this 250 times a day, and you can see how long it'll take. HUGE lines will be the norm.

Secondly, if she doesn't know the patient well, she doesn't know what other meds they're on, and there is the danger of unintentional side effects/reactions. There is less risk for those whom she remembers what they are on,(or those who remember ALL the meds they are on; many old folks can't) but for 1400 patients? Come on!

As for distribution, lotsa luck. They can't get her orders right now, let alone when it's got to be copied by hand from the last hardcopy they have, and hand picked. It'll also take alot longer to get the orders together.

This assumes that there are no delays in getting the drugs from the manufacturers...and most of the raw materials come from overseas.

Then there is the problem of patient's insurance not working. They seem to expect her to know intimately their insurance plans, and WHY something has changed. Or they expect her to know their co-pay if they don't have their card. This info isn't always in the computer. And, the system that interfaces with the insurance companies is crashing repeatedly during the day...Damn few patients have the cash to pay for the meds. It the computers aren't working, it's CASH only.

These people will riot if they can't get their meds, or if their insurance is not working, post Y2k. I fear for her safety, and will be there with a gun to protect her; that's IF the power is even up.

-- Bill (billclo@msgbox.com), June 16, 1999.

A patient advocate at the conference agreed with the industry's rosy outlook on pharmaceutical Y2K compliance. Brain tumor patient Laurene West, who has been involved with the Council's Y2K efforts from the outset, said, "Because the pharmaceutical industry has responded with such effort, I believe we will all be okay."

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

For those that can remember, Ms. West is the lady that gave the outstanding senate committee testimony on the medication issue. She will die without certian medicine.

Ms. Laurene West's testimony to the Senate Year 2000 Technology Committee

October 7, 1998 Hearing
 Washington, D.C.

http:// www.rx2000.org/data/testimony.htm

Standing here before you this morning I probably appear to be in good health. I am not. Without daily medication and a coordinated effort from the health care community, I will be a casualty of the Year 2000 . I will die.

I had a tumor removed from the center of my brain and now I require daily medication to prevent re-growth. Additionally, when I had the first of 13 surgeries on my head, I acquired a staph infection which does not respond to any known oral antibiotic. I am dependent on IV antibiotics which I can not stockpile as they expire in less than 30 days. A disruption to the supply of IV antibiotics will kill me.

I am a Registered Nurse . for more than 20 years I have worked in Critical Care areas of the hospital. Concurrently for the past 14 years, I have worked to develop and implement medical information systems. For the past two years I have worked with various health care organizations to help them prepare for the Year 2000 crisis.

I know health care. I know what impact the Year 2000 will have on healthcare

-- Brian (imager@home.com), June 16, 1999.

Here are the minutes to the meetings mentioned in the article although this latest meeting is not posted yet.

Pharmaceuticals and Medical Supplies

-- Brian (imager@home.com), June 16, 1999.

Bill,

You are right there will be a big problem in finding the "little White Pill" prescription for patient X if the patient has no ability to find out the prescription number. Most people bring in their bottles or call in the prescripton number. The computer does make it a lot easier to find the "pressure" medication when the patient forgets to bring in the bottle. For me, in the pharmacy, it was a rare thing. 50 people a day did not ask us to find their prescription, Gee if it was a refill it could have been months ago. Oh, prescriptions are are filed by number, the date just happens to be a similar.

Your wife is not totally stupid, she could ask them to: 1. go get the bottle, 2. bring in another prescription, 3. have your doctor send another prescription. If their not fixing their computer patient profile cards should be brought back into use.

You are suggesting that CVS with over 3200 pharmacies is not trying to fixing their computers? If they are not, and your wife is the "SP"(she will know what that means), she better get on the stick. She is legally responsable for the pharmacy if she is in the US.

Insurance will be a problem, CVS will have to deal with them and it is not out of line to say cash only. The patients can be reimbursed from their insurers. That is true of all programs. The insurance card does make it easier, but not all independent, take all plans. Patients will get upset, it will be tramatic for them too, but they will have to cope with y2k also. I am sure that your wife will also be human if she remembers the patients, we would never let a needed med get halted if the prescription was not in hand. It may take a few days but you are not going to take away someones, hctz, nitro, ect.

Oh yes, 1400/week is a lot. Your wife is truly on the front line. Hopefully ther is a second pharmacist in her pharmacy. It also seems like the CVS distribution system is having difficulties even without a holiday or Y2K. She may also want to call her other distributor(her non CVS one), they may be able to pick up the slack if CVS is not prepared. Lastly, if worse comes to worse, have her contact the pharmaceutical reps, they may be able to arrange a direct shipment.

80% of all supplies comes from overseas? Are you sure that is true for all companies? Are you sure that the pharmaceutical companies are not filling their wharehouses with raw materials in anticipation of potential slowdown in overseas shipments? Do you believe that everyone has just stuck their heads in the sand and are doing anything about y2k? Have you done anything to protect your job from a y2k downturn? What about your costomers, are you doing anything for them?

If you are not doing anything, then you are contributing to the problem. This is what many allarmist were saying all along. Take a stand today! Tell your company that during January and February, whether you can be paid on time or not, you will be there. My company knows this. I will be anywhere in the world that they need me to be. There are about 5,000 more employees(in my company) who will do the same to make sure that the products get to where they need to be.

Forget about ordering your meds from overseas, You do not know what type of quality you would be getting. They don't have the same requirements that we have here in the states. Also, if others are concerned about thier meds and want to get larger supplies, they should go through a US prescription mail order house in the US. Many insurance companies will relax the 30 day supply rule and let 3 months be delivered. Again Go see the Doctor and have him write the two prescriptions, one for the local Pharmacy and one for the mail order pharmacy. Also check your local insurance program(HMO ect) for variations to these programs.

-- Ned P Zimmer (ned@nednet.com), June 16, 1999.

Ned,

Will AHP hold off on billing when the claims processors go down? Don't preach to us about dedication when your paycheck is safe but cash flow halts here in the trenches and paid for inventory floats out the door---for free. Try nhin.com for a jolt!

-- Carlos (riffraff1@cybertime.net), June 16, 1999.

In spite of all the assurances, some of us are on medication for conditions that are potentially life threatening. My coumadin fits in this category...I do plan to have more than a 5 day supply...not only for the rollover, but also for the current hurricane season.

-- Mad Monk (madmonk@hawaiian.net), June 16, 1999.

Ned,

My wife is the Pharmacist in Charge, unfortunately. Extra work, no extra pay, and nebulous "bonuses" that rarely are what they say they will be.

I told my wife that late in Dec she ought to start printing out abbreviated patient profiles if she can. She will, but when you have 1400+ pts a week, it's a LOT of records to print out. :)

I doubt that CVS will be ready, although I would be VERY pleasantly suprised if they were.

She won't be able to stockpile significant amounts of drugs for her store unfortunately. Management is already telling her she has to reduce her inventory $100,000, and she is already having to owe people pills, as she runs out of a fair bit of stuff every week.

I have no solid info on the status of the drug companies, but I can't see them stockpiling raw materials or increasing production substantially. With JIT systems so prevalent nowadays, there just isn't much slack in the system. It isn't profitable to stockpile. I HOPE she can get meds as needed.

She already on many occasions, advanced patients meds until they could get the RX, or until the next business day when the insurance mess could be fixed up. However, she will have to be picky about whom to advance pills to when resupply is erratic and iffy to begin with. It'll be very interesting to say the least.

-- Bill (billclo@msgbox.com), June 16, 1999.

My friends:

Systemic is systemic. It can not be avoided. Think about the systems involved in plant-to-patient, beaker-to-belly, the labyrinth of structures required to sustain the *drip*! How many (if any) parts pieces, components, can be weakened or in failure mode to choke the supply? How many work arounds are possible? Enough I hope, but if one can not survive an extended constriction of supply with some fashion of rationing, alternative medicinal substitute, then what!!??

Why isn't some US lab issuing statements of development (forget the research, it's already been done) of things like insulin! Which *is* approx 80% imported. Even worse for insulin users is the pecking order of a **world wide scale**, since it comes from just one spot for all!! Feeling like the runt pig here!! If some lab that you know of is gearing up to produce insulin "in-country* Please, PLEASE let me know so my wife has a bit more hope for survival if TSHTF.

-- Michael (mikeymac@uswest.net), June 16, 1999.

I agree with the CVS debacle. There are always long lines and never enough help. They seem to be in emergency mode all the time. The med shelves are mostly wasted space and they are always telling me they will have the rest of the script the next day.

Ned may be willing to bet his life on these companies, I am not willing to bet mine.

-- Mike Lang (webflier@erols.com), June 16, 1999.

Last January Paid Prescriptions lost me in their Computer. I went to my local Longs Drugs for some refills and was told that I was not covered by my insurance. It took 6 weeks to get it straightened out. I had to pay over $600. I put this on my Visa card. It took several months before I was reimbursed the money. I am worried about how much cash I will have to have on hand just for meds. I am getting all Rx refills 1 week early. My Dr. is writing Rxs for more pills then I really need. I will have several month's supply on hand of all meds that are critical to my life. I take 7 different meds. I have high blood pressure and I have ulcerative colitis. I am Prednisone dependant. Without it I will die. I wonder how Pharmacist will fill RXs without power. Are they going to work with flashlights or oil lamps? What about meds that need to be refrigerated? I am afraid that a lot of people will die because of this.

-- Homeschooling Grandma (mlaymon@glenn-co.k12.ca.us), June 17, 1999.

Thanks everyone,

It is great to hear whole hearted responses to this issue of the drug supply chain. It is a long chain with many computer loops in the distributions chain. I for one know that my company can make many of product without them. We can deliver them to the front door. I also know that prescriptions can be filled without computers. That being said, the only other problem with delivering meds to the pharmacies and hospitals are the distributers. We can't have blind faith that everything in the distribution chain will be fixed but we need to have an alternative plan if they fail.

It would be easy to say that the problem is too big for me to handle, why even try. Many people say this, but just by comming to these discussion boards, everyone here is trying to do something to be prepared. Part of my personal life is to be prepared but also my professional life needs to be prepared. So the problem is "How can we eliminate the distributers computers?" The only way that I think we can get around that potential problem of the distribution chain is to use the company sales force. There are thousands of them all over the US and all that they do is deliver information to hospitals, pharmacies and doctors. They could be utilized to move product from the company to the Pharmacies. No one has come up with an Idea like this as far as I am aware. This could be one of the best "Ideas in the Workplace" for this year if y2k is worse than we expect. Without this type of solution there is one more nail in the y2k coffin which could be totally preventable.

The other problem that was brought up is payment. Well Pharemacies have to charge for their services, just like us. If y2k goes bad, you can kiss that prescription plan good by(If there are no drugs, you wont be able to use the plan either). The patients will have to pay cash or other. If this happens maybe the price will have to be lowered.

In any event, we must do something. We can't just sit around. The greatest potential of humans are when there is a problem to solve. Y2K might just be another day, but it has the potential to be a big problem. Like Gary North and the others were saying. We must do something and we must do it before it is too late. It might not be too late to fix your little corner of the world. All you need is a little faith in your ability.

About the insulin debate. Switch to Lilly's brands, they are produced in the US(Indiana, I think [very nice facilities]). About the coumadin, get a mail order prescription and order atleast the 3 month supply(US Mail order only). If you can't get any more, talk to your doctor about potential backups, Aspirin maybe(anacin). I don't think that our low molecular wt clotbuster is on the market yet.

This is the last post for me on this thread. Good luck to all with your preparations. Two year ago, the repair task was almost too much. With all of the things that have been done, it will be a much smaller problem. We have about 190 days to go, use your potential to try to solve the problems around you. If you think about it, you can only rely on yourself to fix the things around you.

Good luck, Ned

-- Ned P Zimmer (ned@nednet.com), June 17, 1999.