With 50 separate state regulatory agencies telling us what we need to put on prescription labels, it is difficult for any multistate pharmacy chain to comply. National chains may have 50 separate label formats, and often more. But even if you only have to comply with one state’s requirements, in many cases it is still difficult.
This is because of the very limited space available on small pill vials. One response is for pharmacies to standardize on pill vials that are at least 13 dram in size. We have probably all seen patients receive a 20 dram vial for what could easily be put in an 8 dram vial. And even though we all want one national oversight agency to issue the rules, it is obviously not going to happen any time soon, so we are stuck with this morass of regulations.
Now think about the changes in the last few years about the actual role of pharmacists within the pharmacy. Are they constantly in the back filling prescriptions? Or are they trying to get up front to interact with the patients more often? Yes, to everyone’s benefit they are interacting more with the patients.
So if we are most concerned with the customer’s experience, why do we still make it so difficult for them to read what is on the vial label? With the majority of prescriptions being for the elderly, who typically have poor eyesight (sorry to generalize; many younger people have poor eyesight, too), we know quite well that many of the customers cannot read much of the label. How many times have customers asked you to read part of the label to them?
Here is a prime example: First Databank and Medi-Span both provide basic auxiliary warnings for all drugs. These are printed in a 5 point font, regardless of the number of words. Can anybody really read these? They are usually reprinted on the patient information leaflets (PIL), but again in the same format, so they have very limited value. Whereas if you use the exact same warnings, but from a provider like Architext, you will have this difference:
Which do you think best serves your customers?
While it costs a touch more to use these enhanced warnings, what about the things that don’t cost you any more to print? Our local pharmacy prints the prescription number, patient name, medication name and instructions, and pharmacy phone number in relatively large print; everything else is too small for many people to read.
And while there simply is not enough room on some prescriptions to print everything in large type, on most prescriptions there is room. So how about using intelligence in your software to look at the amount of instruction for any medication and decide if you could use some of the extra room to print the medication identification in large print? Or any of the other things we print in such small type? Why print in unreadably small type when there is extra space on the label?
So far, we have only talked about the label printing, but we also need to think about the PIL printing. This is done on a laser printer, and it is expensive to keep replenishing the toner. So first, why do we print the PIL at all? Bottom line: Because the lawyers run our society. But suppose the patient doesn’t want the paper? Maybe for environmental reasons, maybe because it is a refill and he or she doesn’t need the information repeated, maybe for other reasons.
So the right thing to do would be to ask patients if they want the PIL. But we don’t do this — we print it out in advance. Why do we do this? Primarily so as not to slow down the checkout process at busy times. Yet how often does a medication not get picked up? Sure, you can return the medicine to stock, but you have to throw away the PIL that you preprinted. In some chains it is estimated that up to 10% of PILs are either thrown away or need to be changed and printed again.
How would you like to lower your toner cost by 10%?
I understand printing these in advance so as not to form a line at the register. But if you fill fewer than 150 prescriptions per day, you are not going to have much of a line at the register, even during peak times. When pharmacy technology teams evaluate new laser printers, they ask several questions, but two of the most important to them are: What is the time for the first page to print, and what is the speed of the printer? If you bought based on this, then you have laser printers that are fast enough to print at time of checkout. And you might be surprised at how many customers say that, no, they do not need the PIL. There are newer methods of providing this information digitally that many customers would prefer. I very much enjoy speaking with pharmacies about newer methods that are better for everyone.
My point is that whether it is a pill vial label or a patient information leaflet, there are better ways to use what you print in order to increase customer satisfaction. Let’s stop just following past procedures and think about what is best for our customers (and hence for our business). Or should we return to having the pharmacist stay in the back? CT
Wes Moffett is president of Printed Solutions, which specializes in helping pharmacies deploy printers and labels that improve workflow and save money. He can be reached at