Sorry, this response might be kind of long, but you asked for someone who works in a Pharmacy so I figured I’d jump in.
[QUOTE=hajario]
It may be that the monthly refill requirement is an insurance thing which would bring a third party to your pitting.
I have the exact same problem and I can’t for the life of me figure out who is to blame.
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Your insurance is to blame if they only allow you one month’s supply at a retail pharmacy. I will fill a year’s worth of a medication (as long as it isn’t controlled and you have enough pills remaining) if you’re paying cash for it, your insurance keeps you coming back here every month. Many insurance companies want to encourage the use of mail order because they can more closely control the generic substitutions and keep a better eye on their own costs. The tradeoff is that you have to get your meds every month at a retail pharmacy.
The only thing your insurance controls is how many days worth of medicine you can get at a time, they have no control over what the doctor actually writes. Which is why your doc might write for a 90 days’ supply, where your insurance only covers 30, you still have 60 pills left on that prescription.
[Quote=Rilchiam]
This time, you were nice enough to tell me that Dr. F’s office had not returned your call. Call, singular. No follow-up. Do you think that I, or any other customer, brings prescriptions to you on a whim? You call once and that’s the end of it?
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Since you raise an interesting point about other customers, you must be under the impression that pharmacies only ever deal with one customer at a time, or that our priority is to follow up on what is essentially your responsibility to do. We will be more than happy to call your doctor’s office, most often fax though because most offices want a paper trail of authorizations, and then it’s in your doctor’s hands. If you think that things aren’t getting communicated well enough, you need to make sure people are keeping track of your medications. At my pharmacy, we have upwards of 3000 patients with new and refill prescriptions every week. If yours doesn’t stand out for some reason, sometimes things fall through the cracks. I personally feel that patients should take more responsibility for their medication, which it sounds like you are doing, especially when it comes to a breakdown of communication on the doctor’s end. We all know that sometimes you have to prod people to get things done. When you’re essentially 1 of 3000 people whose names and prescriptions all look the same, you need to take some responsibility for that too. Not all the responsibility, mind you, but more.
Just a simple “Well I called once and it should have been taken care of” isn’t good enough, sorry. Ideally, maybe. In the real world? People get busy and overwhelmed.
Many offices have a minimum 48 hours for refill requests to be authorized, but if there is a miscommunication at your doctor’s office and they don’t send anything back to us, you should keep calling the pharmacy to have them re-fax the doctor until they respond. After all, most pharmacies have a system by which they re-fax or re-call the doctor but only after several days with no response.
In regards to why you have to go through this every month, I’d suggest that you contact your doctor and find out why they don’t want to authorize the medication for more than a month at a time. This may be an office policy, and you may want to find a new doctor.
That’s what I would suggest. Most pharmacies will advance you at least enough pills for you to get by if they see that it’s a maintenance medication and you are a regular customer there. But also understand that the pharmacy is taking a risk that you will 1) return to their pharmacy and pay for the remainder of your pills, 2) that your doctor won’t change your prescription, and 3) that you won’t go to the doctor and get a new hard copy prescription and then take it elsewere. If any of those things don’t happen, they have just lost an unretrievable amount of money.
Some states won’t allow a 90 days supply of a CII. California, (as I found out this summer) indeed does allow for it.
Let me get this straight, did you use the automated system before when you say the pharmacy “flat out lied to you” when they said it was done? Because you also need to understand that when you get a fax-back, the prescription number you have in your hand is generated to a new prescription number, one which you may have never seen before. Call and talk to someone in the pharmacy. They will check your profile for your most recent prescriptions, regardless of the Rx number on the bottle.
This also may be why your doctor has taken so long to respond to the request. Sometimes offices will fax back, writing “no refills authorized – patient must schedule office visit before rx will be released” or somesuch. This message may have been lost to you, as much as we try to facilitate communication between patient and doctor’s office; (which I feel is also not our responsibility, if the patient is going to be pissed off at us because the doctor won’t authorize the refill, why won’t the doctor’s office just call and say “we aren’t authorizing your Dilantin, please make an appointment and then we will authorize it”?), sometimes the message gets lost. Apologies.
That’s as much as I have to offer in terms of insider advice, anything else anyone would like to know about the inner workings of the mysterious pharmacy, I’d be glad to help. 
-foxy
