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Ask HN: What is the feasibility of completely automating a pharmacy?
8 points by noasaservice on July 20, 2022 | hide | past | favorite | 9 comments
Given the reversal of Roe V Wade, we've seen a great deal of doctor-ordered drugs refused to be vended by pharmacists due to "religious reasons". A variety of these drugs treat symptoms like lupus, Crohn's, and others. They do share a side-effect, in that they can cause a spontaneous abortion.

Combined with that, are places like CVS that put out an order to all pharmacists to withhold these drugs. https://newrepublic.com/article/167087/roe-cvs-methotrexate-abortion-pills

So I'm asking this: what is the feasibility of automating a pharmacy, to make faster, cheaper, and less biased service for what your doctor orders? Have any YC companies approached this?

(Please note: this is a feasibility of automating pharmacies. I do not wish this to be yet another tired pro/anti abortion thread. We have enough of those online. And those never provide answers - only more angry people.)



It's probably not possible legally. I think state and federal laws and regulations require that a properly trained and licensed pharmacist be involved in some way in the handling of every prescription. From a legal perspective it would be like trying to fully automate a doctor's office.


Naturally, you're completely true.

However, there doesn't seem to be a rule that each state's auto-pharm couldn't hire a small panel of pharmacists and vet them for any sort of religious garbage, and have all approvals go through them.

It would be the equivalent of having a surgical tech doing a surgery under the guise (and license) of a surgeon. And that surprises many people, but doing that is completely legal. The surgeon accepts the risk of their surg tech doing so.


Surgeons have a lot more leeway in their methods. They don't have to sign a consent form or contract for each incision they make, so the comparison isn't apt.

Even if pharmaceutical licensing isn't an issue for you, pharmaceutical supply will be as it must go through the FDA.


It is illegal in the US to vet potential employees based on religion.



The problem isn't that it isn't fast, or cheap but that it's currently in a legal limbo. So if someone orders certain medications using that automated system, it'll get logged and probably be denied to reduce legal exposure to the company.

Afterwards, law enforcement could get a court order to release those logs if the judge deems the "crime" is severe enough.

This seems more like an ethical, philosopical, or even an legal issue. I doubt it can be resolved by using automation.


You are going to have pick-pack-ship. With pharmacies, the number of SKUs are quite high (there are around 250,000+ NDC codes - National Drug Codes assigned by the FDA). Combine that with dosage regimens in prescriptions and other requirements, it is almost impossible to avoid the human from the loop.

Having said that, the issue preventing automation of this is not technical. The issue is legal and regulatory. So, perhaps "completely automating" is a misnomer.


It depends on the preexisting infrastructure. In Spain it would be easy for the prescriptions coming from the public NHS, i.e. the majority of them. Doctors prescribe in a common system (common for all the regions) that can be accessed by all the pharmacies. Pharmacists access your prescriptions using the patient Health Service Card. And patients can access the prescriptions through the Web


I recall reading that the US military has fully automated pharmacies (giant vending machine) operating in certain situations.




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