Another Avoidable Death Due to Prescription Drug Pricing Travesty

It is a travesty when a life-saving medication has a price-tag that is out of reach. What’s worst is that your pharmacy and your insurance do not collaborate towards helping you obtain them by requesting extra paperwork while your health is at risk. This was the case of 19-year-old Yarushka Rivera a Massachusetts woman who died of a seizure because she was unable to get prior authorization to renew a prescription for her medication. Now her family sues Walgreens alleging its negligence caused their daughter’s death.

Rivera’s family went to Walgreens to fill her prescriptions of Topamax a medication that helped her manage her life-threatening seizures. Her family didn’t have any issues getting her medication from the pharmacy in the past, but a month after Rivera turned 19, the pharmacy informed them that her insurance wouldn’t cover the cost of the medication without receiving a doctor’s pre-authorization for insurance coverage.

At this point, the pharmacy gave the family two options: to pay $399.99 out of pocket to get the medication or wait for the pharmacist to contact the doctor for a pre-authorization form. Since they couldn’t afford to pay for the medication, they decide to wait.

They went to the pharmacy five separate times to follow up on their request, and each time the pharmacy would say they would notify the doctor. Throughout the time that the family waited for the authorization, Rivera suffered three seizures, the third which was fatal and led to her death.

She should not be dead. 

This is a travesty on two levels. First, the cost of the generic version of this prescription through is between $2.40 and $28.80 depending on the version of the drug, evidenced as follows:

Drug Name Our Price**
Topiramate Tablet 50 Mg (Generic Topamax) $2.40
Topiramate Tablet 100 Mg (Generic Topamax) $3.60
Topiramate Tablet 25 Mg (Generic Topamax) $1.50
Topiramate Sprinkle Cap 15 Mg (Generic Topamax) $17.10
Topiramate Sprinkle Cap 25 Mg (Generic Topamax) $28.80

*Generic drug prices as of 6/11/18 for a 30-day supply.

Our supply side business model proves that this drug didn’t cost anywhere near the list price she and her insurance were being forced to pay and clearly couldn’t afford. Surely Walgreens gets better wholesale prices than us, considering that they own 20% of AmerisourceBergen one of the three largest wholesalers in the world –  why couldn’t this patient get a similar price to ours?

It does not seem to be clear if she was ordering the brand or generic version of this prescription, and if it was the brand I presume for good reason – because if not, there is no excuse for a drug that wholesales for less than $1 a capsule, and less than $0.12 a tablet, to be marked up so egregiously. Even if she was prescribed the brand, why didn’t the pharmacy offer her a generic supply for 30-days until they worked out the paperwork issue? Surely the side effects would have been less severe than DEATH.


The second part of this travesty is that like Rivera, thousands of Americans come across these preauthorization forms to get the medicines they need to maintain their health.

At we believe that a pharmacist’s duties go beyond the dispensing of medication as they play a vital role in the well-being of their patients. Pharmacists take an Oath, similar to the Hippocratic oath. Pharmacies – corporations – should take an oath too.

We understand that the pharmacy process can be confusing at times that’s why we coordinate care directly with the doctor. No pharmacy should put this on the patient… period. There is NO excuse.

This problem is like a slow-moving freight train and Americans are a deer in the headlights. When people have to choose to handle paperwork they don’t understand, pay for things they can’t afford at absurd egregiously marked up prices, and/or DIE… we have failed as a society. IT IS COMPLETELY AVOIDABLE. At what point are we any different than animals that eat their offspring with business practices that kill our children.

Regardless of the outcome of the lawsuit, pharmacies, especially fortune 100 corporations who can afford to manage thousands of retail stores and employees have an obligation to pick up the phone. Would the child of a Walgreen’s executive have had the same experience? I think not.


This week we concluded filming across South Florida of multiple new commercials airing throughout 2018 on cable networking including CNN, Fox News, History Channel, and local networks ABC, CBS, NBC, CW and FOX.

This campaign will be the cornerstone of a broader engagement strategy. Each part of the strategy will be announced with rapid succession on a weekly basis following the television launch.

Stay tuned. launches Public Awareness Campaign for Pharmacy Safety

I’ve spent the last two years watching, mesmerized, as countless reporters wrote about “health tech” companies without spotting nuance-issues with the healthcare perspective of the businesses being reported on. I’ve found some recurring trends where the story’s focused on technology or size of the investment, and overlooked patient care – which is what should be the core focus of any healthcare provider.

This phenomenon has prompted us to design a multi-part series where our licensed pharmacy staff answers common pharmacology questions, with one of our pick lines in the background.

Our customers can now follow’s social media (Facebook, Twitter, and Instagram) and get useful clinical information about their own pharmacology experiences from the convenience of their feeds, or on our YouTube Channel “Frequently Asked Questions” playlist here.

Yep, we’re letting consumers use their senses (not just their pocketbook) when making a decision on what pharmacy they choose to service their prescriptions through.

What our customers will find unique about is how seriously we take the practice of pharmacy. Here are some examples of how we compare to other alternatives out there:

Example One: A well-funded pharmacy discount drug card start-up had a keg in the background of the shot at their headquarters during a primetime TV spot debuting the service.

Why this matters: With substance abuse on the rise in America we should be doing anything and everything to curtail any form of substance abuse. Mixing drugs and alcohol is a fundamental no-no in pharmacy, and considering the service provides discounts on controlled medications, it would make sense to have some self-awareness.

Example Two: Another, dispensing Pharmacy competitor doesn’t require its pharmacy staff to wear scrubs, and uses unlicensed pharmacy technicians in their process to keep costs down.

Why this matters: Customers should know where the pharmacy starts and stops. Making pharmacy easy and affordable shouldn’t invoke eliminating the nuances of practicing healthcare. Healthcare should be clean and safe. If your lawyer showed up to court in a tracksuit… would you be worried? If you’re in a fast-paced environment you don’t want your staff wearing baggy clothing that can get caught in any high-speed equipment. It’s about safety and professionalism.

Example Three: A popular, well-funded, mail-order pharmacy start-up opens pharmacy’s that invoke a “Brooklyn VC Renaissance” office design in old industrial buildings.

Why this matters: It’s cool to be hip and trendy, but, it’s even cooler to be low cost, high output, and high accuracy. Customers don’t care about design awards. They care about speed to delivery, accurate fulfillment, and affordability. We invoked the Amazon Fulfillment Center design characteristics when we built in order to give our customers a “prime” experience.

Example Four: Pharmacy’s and discount cards posting images on social media of computer screens and paperwork in their office. This one transcends pharmacy, almost monthly some big wig gets shellacked because something confidential on their desk, like a password on a post-it note, was on a photo posted on social media.

Why this matters: HIPAA. Period. If a customer sees their pharmacy doing this, it should be cause for caution. All public photos should have black screens, and no paper in them, period.

The big picture

One would think these novel ideas would come as no-brainers. But, with everyone striving for uniqueness to garner media attention, they forget that in some businesses: boring is better.

The difference

You see, at we only employ licensed pharmacy technicians and pharmacists. The customer will ONLY interact with this staff regarding their healthcare. If a customer asks even myself for a price quote, I’m going to hand that off to one of our highly trained, skilled, licensed professionals. Because that’s the process. We don’t deviate. It’s boring, but it’s the best process.

Furthermore, our licensed staff are clearly identifiable. They are in Branded scrubs. They know they do a benevolent job. Outside of work, they are brand ambassadors, and inside of our facility they are “savings specialists”. Whether they are on the phone with a patient, a doctors office, or operating a robot… they are performing an action that has resulted in savings for a customer.

You don’t send a football player on the field in tennis shoes. They wear cleats. There is a reason: performance. At we take our job seriously. That’s our Modus Operandi. We play to win. We dress the part.

And we play in a state-of-the-art facility. 12.500 sq. ft. of specially designed contact center space, and 12,500 sq. ft. Of specially designed robotic dispensing space. It’s a very big, very secure, high-tech licensed pharmacy. The floors are a specially painted concrete, conveyor, there is a tremendous amount of light, there are sterile glove dispensers, and hand sanitizer and hand wash stations available every few dozen feet. Our facility was designed from day one to be able to safely dispense millions of prescriptions at a fast clip.

And to make sure your privacy is protected we do not allow cell phones in work areas. It’s inconvenient for our staff, especially in today’s connected society. But, our team takes our patients privacy serious. That’s why what limited paper that we use is shredded constantly and recycled daily. Speaking of which we clean the facility every day, all day.

And Our recycling and trash? Under lock and key until pickup. We monitor the temperature and have sensors every dozen feet. It’s a bit cold but optimal for drug storage. It’s not what’s best for us – it’s what’s best for our patients.

Have a question?

If you have questions that you’d like our pharmacy staff to answer in our new series, feel free to email me your idea to