Walgreens' recent acquisition and immediate closure of three independent community pharmacies in the St. Louis area has raised questions about the privacy of customers' prescription records.

Some former customers of the three sold pharmacies — the Williams Pharmacy in University City, the Clarkson Square Pharmacy in Chesterfield and Prescription Plus in the Central West End — have complained that, as part of the Nov. 30 sale, their medical files were transferred to Walgreen Co. without their consent, violating their privacy.

Other former customers of the sold pharmacies say they encountered difficulty and delays in arranging for Walgreens to transfer their prescription records to another pharmacy of their choice.

"I was greatly inconvenienced and surprised by the way this happened," said Ruth Kraus, a former customer of Prescription Plus. "I was under the misimpression that medical or confidential information could not be transferred without my consent. This transaction was obviously well orchestrated — and not with consumers' particular needs in mind."

A Walgreens official countered that the company followed all applicable laws regarding the transfer of records. The prescription records made the acquisitions valuable in the first place, giving Walgreens access to new customers while eliminating local competitors.

Michael Polzin, a Walgreens vice president, said the transferred patient records are assets of the purchased pharmacies.

"It is HIPAA information, and HIPAA regulations allow for this type of transfer," Polzin said.

The federal Health Insurance Portability and Accountability Act, or HIPAA, was enacted in part to protect patient privacy by maintaining the confidentiality of medical records. Federal law permits pharmacies to transfer customers' prescriptions to other qualified pharmacists. Such transfers are made routinely, not only in pharmacy sales, but when a customer needs to fill a prescription at a different pharmacy when traveling away from home.

Missouri law does not require patient notification before a pharmacy sale or transfer of records. But some states, including Illinois and Iowa, do require notice. Under Illinois law, customers must receive 15 days notice before a pharmacy sale, including notice of where the customer's records will be maintained. Iowa requires 30 days notice to consumers.

Pharmacy experts were not surprised by Walgreens' takeover of the customer accounts. If the records were not transferred, it could inconvenience even more patients, who might have to return to their doctors to get prescriptions rewritten, said Kent Schafermeyer, a professor and administrator at St. Louis College of Pharmacy.

"This is done all the time," Schafermeyer said of the records transfers. "If a pharmacy just closed and did not pass its prescription info along, it would create great hardships for these patients. If the patients prefer to go somewhere else, they can call Walgreens now and ask them to send their records to the pharmacy of their choice."

Some patients encountered delays in making those kind of transfers, however. They complained that Walgreens seemed unprepared to handle the volume of new prescriptions it acquired through its purchase of the three St. Louis-area pharmacies.

Carol Fichtelman of Clayton, a former longtime customer of Williams Pharmacy in University City, said that four or five days after the Nov. 30 sale, she received a letter from Williams Pharmacy advising her of the transfer of her prescription records to Walgreens.

By that time, Fichtelman said, she had already been to Walgreens to fill a prescription and had to wait about 24 hours because the drugstore did not have enough Lipitor, a common statin medicine, in stock.

"I would have really been upset had it been my high blood pressure medicine," she said. "I just think the way it was handled doesn't give me confidence in pharmacies."

Mindy Kammer, the manager of MD Pharmacy, an independent drugstore in University City, said that in the days following the Nov. 30 sale, Walgreens was slow to respond to phone calls from her technicians to facilitate customer requests to have their prescription records sent to MD Pharmacy.

"Walgreens was overwhelmed," Kammer said. "Customers were calling us, saying, 'Why are we being switched to Walgreens?' It was bedlam. We were sitting here with hundreds of pieces of paper from patients, waiting for Walgreens to return phone calls."

Polzin explained that any delays by Walgreens were attributable to "the volume of requests" that its nearby pharmacies were receiving.

Ron Fitzwater, chief executive of the Missouri Pharmacy Association, said that although Walgreens' recent purchase of the three community pharmacies was routine, it was more rapidly executed than most drugstore sales, perhaps because of increasing competition among retail pharmacies.

"The patient records go back and forth," he said. "That information moves throughout the health care system, as long as it's going to another provider who's HIPAA-compliant."

Brett Williams, who sold the three pharmacies to Walgreens, said he wished it would have been possible to give advance notice of the sale to his customers, but the presale negotiations were private.

"The contract (with Walgreens) prevented me from contacting my customers," Williams said. "No matter how you do it, there's going to be chaos for the first couple of weeks. I certainly sympathize with those customers."

But some of his former patrons remain irritated. When Kraus called her pharmacy on Dec. 1, she said, a recorded message told her the phone number had changed and referred her to a new number. When she dialed it, a voice message answered, "Thank you for calling your 24-hour Walgreens."

Six days after the pharmacies were sold and closed down, Kraus said, she received an envelope from the formerly independent Prescription Plus pharmacy in the Central West End. Postmarked Dec. 2, it announced the sale and informed her that "we have chosen to entrust your records to Walgreens." Also enclosed was a Walgreens marketing brochure.

"We felt that our loyalty supporting a local independent pharmacy was misplaced," Kraus said. "There's an ugly taste left over from this particular transaction."