Prescription/22/dp1st/mark2nd

By ANN DONAHUE

Staff Reporter

As Y2K approaches, pharmacists throughout L.A. keep hearing the same question from customers: Should they should stock up on medicine in case computers go down and medical records are lost?

The response has been a series of conflicting recommendations from the medical community as it tries to keep patients safe while at the same time discouraging panic buying.

“I don’t think the average man in the street understands that this could reach out and touch them,” said David Breslow, executive director of United Pharmacists Network, an 800-member organization of independent L.A. County pharmacists.

While local pharmacists are advising people to stockpile reserves that will last a month or two, the recommendation at the national level is more conservative.

The American Medical Association urges patients to keep on hand a week’s supply of medication and not to wait until the last minute when it comes to refilling prescriptions.

“Patients will be counseled to get normal refills of their medications when they have a five- to seven-day supply remaining, as has always been the prudent course,” said Dr. Joseph Gutierrez, a spokesman for the AMA.

Esther Lanier, president of the Hollywood Wilshire Pharmacists Association, figures it’s better for the pharmacies themselves to take the responsibility of stocking up on medicine. As Y2K approaches, she plans to order an additional two-week’s supply to supplement drugs already on her shelves.

“We get questions about it,” she said. “Patients are telling me now that around November they would like to get another refill on their prescriptions.”

Computer systems within every pharmacy keep track of refills, billing and ordering of medicine. And in recent months, computer suppliers have assured the California Pharmacists Association that their equipment can handle any Y2K problems.

Still, Lanier is prepared to go low-tech if the need arises.

“Remember when we didn’t have computers?” she asked. “We just typed everything up and found the records for it. Computers just make the process easier. If (necessary), I’ll dispense (prescriptions) manually.”

Carlo Michelotti, chief executive of the California Pharmacists Association, is taking a prepare-for-the-worst, hope-for-the-best attitude.

For individuals, “a month in reserve is certainly the way-outside limit I would take it to,” he said. “I shudder to think about people getting a three-month supply but they’re probably going to take it home and bury it in the backyard.”

Michelotti said some L.A. pharmacies are ordering ample supplies to ward off any Y2K-related shortages. A typical pharmacy has a six-week supply in stock and some are bumping that up to eight or nine weeks, he said.

But that won’t necessarily help consumers, especially those enrolled in health maintenance organizations. Most HMOs will not allow patients to buy more than a month’s supply of prescription medicine without making them pay full price up front for the additional amount.

“Most independent pharmacists won’t get paid if we give (patients) more than a month’s supply,” said David Fong, a pharmacist in Chinatown and president of the United Pharmacists Network. “I don’t mind giving them two, three refills at a time if I can get the bill paid later.”

The worry is that Y2K concerns could turn into panic buying.

“If we encourage people to buy extra medication it could initiate an artificial shortage,” said Glenda Owens, a spokeswoman for Prescription Solutions, the pharmacy division of PacifiCare, a Los Angeles-based HMO. “It’s like panic buying before a hurricane when people get food and water for the next few weeks and the next person who comes in can’t get enough.”

Owens added, however, that pharmaceutical companies have managed to make it through short-term disruptions in the past without major impacts on consumers. And she doesn’t expect Y2K to cause any more problems than the minor interruptions that occur during hurricanes or earthquakes.

But such confidence doesn’t impress Frederick Kohun, dean of information services at Robert Morris College in Pittsburgh and an expert on Y2K health care issues.

“There’s only so much they can control,” he said. “If the system fails and it becomes a situation that’s going to be life threatening, (the pharmaceutical industry) is going to be held liable. If you have a condition that needs medication that cannot be interrupted, like a recently transplanted organ or a severe diabetic that requires insulin, I would save up a couple of weeks worth of medication.”

Despite his concerns, Breslow doesn’t think it’s necessary for individuals to hoard medicine. Instead, he recommends that patients double-check their records to see if they can receive multiple refills even if computers should fail on Jan. 1. In addition, he suggests forming a relationship with a second pharmacist in case of Y2K-related problems at a primary pharmacy.

“During the Northridge earthquake, a lot of chain drug stores were closed and the workers didn’t show up,” Breslow said. “Many independent pharmacists were in their businesses cleaning up, and they ended up filling prescriptions for those who couldn’t get them at the chain drug store. That kind of thing might happen again.”