THERE ARE EASIER WAYS FOR A PHARMACIST TO MAKE A LIVING 

A young pharmacist decided to open up a small pharmacy inside a medical building.  He ran the pharmacy on a shoestring but was able to generate approximately 75 prescriptions per day in addition to a small but adequate over-the-counter business.  It was certainly enough to give shelter and feed his family of five.  One day, he was approached by two gentlemen purporting to represent a medical provider network.  They asked him if he would provide mail order prescription services to patients belonging to the network.  The arrangement would entail the network faxing or hand-delivering the prescriptions to the pharmacy along with relevant customer information and envelopes with pre-paid postage.  His instructions were to mail out the prescriptions within 48 hours of receipt and he would be reimbursed according to a fee schedule set up by the network.  Without performing any due diligence with regard to the network, the pharmacist signed an agreement and immediately commenced filling prescriptions for them.

Over an 18-month period, the pharmacist filled approximately 7000 prescriptions for the network.  Of note was that the bulk of the prescriptions were written by three different physicians, all of whom were licensed to practice in the same state as the pharmacy but whose offices were located nowhere near the pharmacy.  However, very few of the patients resided in the state where the pharmacy and physicians were licensed. Nearly all of the prescriptions were for DEA Schedule III and IV controlled substances although the quantities prescribed were consistent with what a patient might use within a course of therapy as opposed to higher quantities which might be sold on the street.  Most of the prescriptions were restricted to two refills.  His margin of profit filling these prescriptions was nominal and significantly less than that generated from non-network prescriptions.  During the 18-month period he was working with the provider network, < 30% of the pharmacy's net profit came from filling these prescriptions.

One day, he was visited by inspectors from the state medical board informing him that at least two of the physicians he was receiving prescriptions from were writing them without performing a good-faith medical examination.  Upon hearing this and now realizing he may have been part of something that was not legal, the pharmacist immediately terminated his relationship with the network.  Unfortunately, it was too late.  Soon afterward, he was visited by inspectors from his state's Board of Pharmacy who asked for, and received, a written statement describing his relationship with the network as well as bank statements, tax records, and telephone records.  The Board later cited him for unprofessional conduct and brought him before an administrative law judge for license revocation.  Although the Board's intent was to revoke both his license AND that of his store, punishment was later negotiated down to 30-day suspensions of both and an order to hire a "preceptor" to guide him in his day-to-day operations until such time that the Board was satisfied he understood the nuances of American pharmacy law and practice (he was born and trained outside the United States).

This is a perfect example of how internet pharmacies work and eventually fail.  Had the pharmacist performed due diligence prior to signing his contract, he would have noticed that this so-called provider network was really nothing more than a handful of physicians conducting sham medical examinations over the telephone for $100 apiece and writing prescriptions for controlled substances.  In some states, administrative fines for filling these types of prescriptions can run into the tens of millions of dollars, not including license suspension or revocation.  There are easier ways for a pharmacist to make a living!