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Robotics

Walgreens Turns To Prescription-Filling Robots To Free Up Pharmacists (wsj.com) 79

Posted by msmash from the moving-forward dept.
Walgreens is turning to robots to ease workloads at drugstores as it grapples with a nationwide shortage of pharmacists and pharmacist technicians. From a report: The nation's second-largest pharmacy chain is setting up a network of automated, centralized drug-filling centers that could fill a city block. Rows of yellow robotic arms bend and rotate as they sort and bottle multicolored pills, sending them down conveyor belts. The company says the setup cuts pharmacist workloads by at least 25% and will save Walgreens more than $1 billion a year. The ultimate goal: give pharmacists more time to provide medical services such as vaccinations, patient outreach and prescribing of some medications. Those services are a relatively new and growing revenue stream for drugstores, which are increasingly able to bill insurers for some clinical services.

"This frees up the capacity of our most skilled professionals," said Rina Shah, a group vice president overseeing pharmacy strategy at Walgreens. "We looked at our system and said, 'Why are we filling prescriptions the way we did in 1995?'" Covid-19 increased the demands on pharmacies as they expanded into testing and vaccinations, putting pressure on staff and creating a shortfall of pharmacists that many chains have struggled to fill. Walgreens has reduced pharmacy hours at a third of its nearly 9,000 U.S. stores, and in some markets is offering signing bonuses of up to $75,000 to fill pharmacist jobs.
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Walgreens Turns To Prescription-Filling Robots To Free Up Pharmacists More

Walgreens Turns To Prescription-Filling Robots To Free Up Pharmacists

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  • I don't get it (Score:4, Informative)

    by nospam007 ( 722110 ) * on Monday October 03, 2022 @11:42AM (#62933665)

    All the western countries just sell prepacked drugs in multiple variations, only the US manually counts pills into a yellow bottle.
    No errors, no miscounts, no substitutions...

    And some of those countries give them out for free or for minuscule amounts.

    • They're not there to count pills (Score:5, Insightful)

      by rsilvergun ( 571051 ) on Monday October 03, 2022 @12:05PM (#62933767)
      they're there to discuss drug interactions with people. In your 60s you're likely to be on several drugs and their interactions need to be carefully considered. Moreover might have 2 or 3 doctors prescribing drugs. The Pharmacist reviews them all and make sure there's not going to be an issue.

      • Re: (Score:2)

        by ljw1004 ( 764174 )

        They're not there to count pills; they're there to discuss drug interactions with people.

        My experience is that I queue for 20 minutes to get to the head of the line, show them my prescription, wait for 10 minutes while they go somewhere in the back doing who knows what, come back and talk to me for 30s, and take a further 30s to ring me up.

        So I reckon that whatever they do out there in the back must be the dominant part of what they're there for...

        • by the time they talk to you. They've looked over your prescriptions and determined what they need to tell you. If you've only got a few simple ones it's probably pretty easy. Even then it might be less of an issue with how much vertical integration there is in healthcare now (e.g. your PCP might already know all your scripts). But you still want somebody checking at the final leg of the journey or you might end up dead.

      • They also do that in countries with prepackaged drugs, they have even more time for it.

      • they're there to discuss drug interactions with people. In your 60s you're likely to be on several drugs and their interactions need to be carefully considered. Moreover might have 2 or 3 doctors prescribing drugs. The Pharmacist reviews them all and make sure there's not going to be an issue.

        Every time I go to a doctor, I check the "Pregnant" box in the questionnaire (I'm a man). Only ONE TIME in two decades of doing this has anyone noticed.

        So I'd put more faith in a computer to spot drug interactions than a doctor.

        • Re: (Score:3)

          by vux984 ( 928602 )

          Only once in 2 decades did they notice, or only once in 2 decades did they bother to react.

          A lot of those intake forms have a lot of boiler plate, and depending what you are there for they are just looking for certain flags and nothing else matters.

          I'm guessing in your particular case, even when it might matter, they see see the row of 'no' or 'n/a' and the one 'X' next to pregnant, roll their eyes at your genius attempt at being funny, and keep going, without pausing to waste their time.

          Even if, in 2022, i

          • Re: (Score:2)

            by BranMan ( 29917 )

            Might be even further out there than that - they are not allowed to question you for checking the pregnant box because you may just be *identifying* as pregnant, and if they question you they are oppressing you.

            Kind of like the character Reg in Life of Bryan

      • I didn't take it as a complaint against the idea of pharmacists, but rather having them count pills. Just prepackage the pills in reasonable quantities, and then the pharmacists only have to do something if someone is given an unreasonable prescription.

        It hardly bears mentioning that if we had a national health system we'd probably also have some system for prescriptions and avoiding bad drug interactions that wasn't so haphazard.

        • It hardly bears mentioning that if we had a national health system we'd probably also have some system for prescriptions and avoiding bad drug interactions that wasn't so haphazard.

          I'll bite. Why do you believe this? I've never actually had a bad drug interaction, and I'm still alive for over a decade missing three more or less important internal organs. Not sure where bringing government employees into the prescription business is going to improve much on that...

      • Fixed that for you...

        They're there to insert their god in between a doctor and patient. In your 20s you're likely to be concerned about unwanted pregnancy, your interactions with their god need to be carefully considered. Moreover there might be 2 or 3 religious texts to be consulted during the prescription of drugs. The Pharmacist reviews them all to make sure there's not going to be an issue with their god.

      • they're there to discuss drug interactions with people.

        You are right but how is this an argument for individual pill counting? The pharmacists are also here to discuss drug interaction in countries where the medications are sold pre-packaged... The point in discussion I think is why the pharmacy network needs to solve the pill counting problem using complicated robots when they could implement inexpensive pre-packaging. The reason I can think of is if regulations in USA mandate that pills be delivered to the unit (in principle to avoid waste and unused prescrip

      • Re: (Score:2)

        by mjwx ( 966435 )

        they're there to discuss drug interactions with people. In your 60s you're likely to be on several drugs and their interactions need to be carefully considered. Moreover might have 2 or 3 doctors prescribing drugs. The Pharmacist reviews them all and make sure there's not going to be an issue.

        In most countries we have a unified health care system where even if you've multiple doctors (lets assume you've a few specialists and a GP, rather than doctor shopping) that each doctor and the pharmacist has a full list of the medications you're on and will avoid putting you on different medications that will have bad reactions with the one's you're on. This highlights another issue in the US where doctors take a kick back to put patients on certain medications (that's flat out illegal in most countries).

      • they're there to discuss drug interactions with people.

        Nope. That's all done by computer. The pharmacist just tells the patient what the computer says, because the patient will wisely never bother to read all the crap that the computer tells them, 99% of which is irrelevant info.

  • What took them so long? Paying somebody $70/hr to move pills from Container A to Container B doesn't seem like a smart use of expensive experts.

    • Pharmacy techs are the ones that fill the rx. Pharmacist just has to sign off on it.

      • Exactly. Pharmacy techs do a bunch of the grind work, to free the pharmacist up to do work that adds value. e.g. arguing with your insurance's pharmacy benefits manager about whether or not you can get drug x and be covered, then talking to your doctor when the PBM says no.

  • nationwide shortage of pharmacists and pharmacist technicians

    Honestly, this tripe is getting old. We may have a "shortage" of workers in some areas, but it is only because people are doing other jobs instead (most likely jobs that pay more, seem more fun, are easier to transfer into mid-career, or some blend of these).

    No one should be wasting their time counting and visually inspecting pills anymore. There are more useful things out there to spend human time on.

    • Re: (Score:3)

      by tgeek ( 941867 )
      Maybe all the pharmacists and techs are busy learning to code

    • We may have a "shortage" of workers in some areas, but it is only because people are doing other jobs instead

      Well, yes, that is what 'shortage' generally means.

      If you have enough money to pay your rent, OR buy food, but not both, then you have a shortage.

      • We may have a "shortage" of workers in some areas, but it is only because people are doing other jobs instead

        Well, yes, that is what 'shortage' generally means.

        If you have enough money to pay your rent, OR buy food, but not both, then you have a shortage.

        No this is more like you have a 6 bedroom house but can't afford food situation, It's not a shortage of money it's badly allocated.

  • They're going to save $1B per year. Surely the cost of the system isn't free but I'm also sure the $1B/yr savings is factored into the cost. So when should my prescription drugs cost less?

    • As the article states: "They are going to save $1B per year." Not you or I.

    • Part of that savings is that with certain types of automated packing, insurance pays more because you're more likely to take your pills.

    • I'm thinking the pharmacist still has to sign off on every prescription regardless of whether it is filled by a robot or a pharmacy technician, but of which are much cheaper than pharmacists.

  • In hospital, automated medication dispensers have existed since at least the early 90's - These were created to reduce medication errors on the wards and reduce the pharmacy workload during peaks (morning/evening typically). These machines can also track schedules and usage, of course.
    How hard could it be to adapt this technology to the public pharmacy? For commonly dispensed meds, I would think this is a solved problem.

    • Pharmacies have automated pill machines but they are not for dispensing on a mass scale like these robots as there is a lot of interaction with the pharmacist.

    • Just the other day, I remarked that pharmacies should install vending machines that the pharmacist [not the public] could use for the most common 100 (or more) medications. Obviously, this could be linked to their IT systems so that the prescription could be sent to the machine, with minimal human interaction (and hence, minimal error).

    • The issue isn't just whether some robot exists - nothing happens until the robot is cheaper to employ than the people it replaces.

      When your wages are simultaneously not enough to live on yet more than it costs to replace you with a robot - then we have an issue because an increasing slice of the population becomes an economic liability.

  • "give pharmacists more time to provide medical services such as vaccinations, patient outreach and prescribing of some medications" Or harass them about sky wizards? See https://www.insider.com/walgre... [insider.com] and more recently https://imgur.com/gallery/7Bds... [imgur.com]
  • Why... why wasn't this done over a decade ago?

    • There is a LOT of inertia here in the form of amber vials. There's better technology by far, but people don't like change. Japan has been using strip packs since the 50s, but it's been a mostly niche product here until Amazon started using it a couple years ago. Having each individual pack say take these n pills at this date/time is way nicer than having n vials to dig through. If you're going on vacation, take a week worth of packs with you. Added bonus is that a 30 day supply of individual packs is the sa

  • Good. (Score:3)

    by AmazingRuss ( 555076 ) on Monday October 03, 2022 @12:19PM (#62933837)
    It's moronic that you have to wait 30 minutes for somebody to count pills.
  • In US, pharmacist is responsible for any dispensing, or prescription errors (yes, including PCP's prescribing wrong medication or doses). This gives large Pharma liability protection against lawsuits, thus pharmacists must carry own insurance for malpractice and are professional liable at risk of unable to purchase insurance, otherwise un-hire-able. Last decade, name of the game was to keep cutting tech hours, while buying new stores, consolidating stores, offering new services and dynamically control volum
  • Pharmacists don't fill prescriptions, Pharmacy Technicians do. Pharmacists just sign off on them and answer any questions the person filling the prescription might have. Anybody can be a Pharmacy Technician, you just have to take a short class and pass a test; even my idiot ex managed to do that.

    • Re: (Score:1)

      by Badoit ( 2618265 )
      My wife supervises training of pharmacy technicians in a UK hospital pharmacy. The 'short class' is two years of on-the-job and classroom training. There is a very high standard and students can and do flunk the course. At the end they get an accreditation qualification. They need good marks in high school in mathematics, English language, science, and one other subject.
      • My ex-wife is licensed to be a pharmacy technician for Oregon in the US. I'm guessing they have lower standards in Oregon than they do in the UK, it was more like a 3 week class of a few hours a week. There is continuing education required though, and she needs to renew every couple years. This is the same woman that flunked an English as a Second Language class, despite working a job that required she already know how to speak English.
    • And yet they cannot staff their stores. My Walgreens has cut back on hours, and the last time I went to get a prescription the pharmacy was simply closed for the day with a hastily-written note on the window, because of short staffing.
  • This all sounds great in theory but even the best AI still cannot deal with all of the individual circumstances of real life. Like for example, if I try to renew my prescription even one or two days "early", it will say that I can't renew it yet. Then when I renew it on the "correct" day, there is often a multiple-day delay before they are able to actually fill it. So I can't renew it early, but they are happy to renew it late. That means on most months I'm getting 30 days worth of medication every ~35
    • You are talking about the software that determines if you are eligible for a renewal (vs too early). That's a problem but a different one than is being discussed here which is, once it's decided that you get the script, having a machine put the pills in a bottle.
  • Most of the mail-order pharmacies have been this way for decades. For maintenance medicines (i.e. ones that people take for years or decades), there's no good reason to visit a pharmacy or have a person count pills.

    The automated pharmacies are faster, more efficient, and (most importantly) more accurate. The ones with which I've been involved had multiple mechanisms to prevent errors. Everything was bar-coded and the codes had to be scanned and within certain time limits (so you couldn't put the bottl

  • According to the pharmacists I've talked to, Walgreens already thinks they're robots.
  • I know a local hospital that has been doing that for almost 20 years. After the prescription is filled and labeled by the mechanical arm, a registered pharmacist checks the prescription.
  • CNBC was reporting this same story [cnbc.com] back in March. There doesn't seem to be any new information in the WSJ article.

  • For some time, Walgreens has offered to ship refills to the customer's home. It would be a great way to avoid the pharmacy lines if it actually worked. Twice I have attempted a refill. Both times, I received a notice that the request has been received. Then, nothing. Even weeks later, nothing. No indication that the request ever happened and no automated way to learn the status. Old fashion manual refills, albeit initiated online, work fine. This doesn't.

    I kind of expect similar results from thei

  • I live in a small, somewhat isolated area. Almost every order was sent out to a "hub" so my order was never ready on time even though specified for several days in advance, they chronically understaffed the pharmacy so they were always slammed. And don't get me started on their online ordering system losing single parts of orders on me! The robot system uses larger pill bottles than needed, thus increasing plastic use and waste, and screws on the lid a lot tighter.

    This is nothing more than automation

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