First, a little background. I’m on a few different medications and i’ve been on the same meds for literally years. Also, I’ve only ever filled my prescriptions at Rite Aid Pharmacy, so 100% of my prescription history is readily available to the pharmacist.
Yesterday I drove up to the rite aid that’s nearby to pick up a prescription refill that I had phoned in using their automated system earlier that morning. When I get to the pharmacy, they inform me that it’s “much too soon” to refill this particular medicine. However, it was actually a couple days past my first opportunity to refill this medication. Also, as I mentioned above, the history for this medicine, and the dates of all the refills, are easily accessible to the pharmacist.
Well after explaining the situation to the pharmacy tech (and handing her the empty bottle to show her it was not at all too soon to refill), I was greeted by the pharmacist on duty. I asked him what the issue was and he simply said that “using his professional judgment” he decided that he would not fill the prescription. I asked him why and he gave me a very vague answer along the lines of “we need to speak to your doctor first”.
I could not get the pharmacist to give me a specific answer as to why he wouldn’t fill it and needed to speak to my doctor first. All the relevant prescribing information was available in their system, which showed the same doctor prescribing all the medications as well as the timeline of all the refills.
Now, my question is, legally speaking, how can a pharmacist just arbitrarily decide that they aren’t going to fill a medical prescription for a customer? My doctor wrote me the scrips because I need them and a pharmacist, who isn’t privy to the details of my medical history, can just decide that he knows better than the doctor? It seems like this could set customers/patients up for a potential health risk as they are being denied access to the medication that their doctor has prescribed and deems necessary.
I’m not a pharmacist but I can imagine situations where I might hesitate before filling a prescription. For example, let’s say I was aware of a side-effect that was possible when this medication was taken alongside another medication I knew you were using. In those circumstance, I would wonder if the prescribing doctor might have been unaware of the side-effects or forgotten that you were taking the other medications. I would contact the doctor and ask.
That said, it seems like this would be information you are also entitled to.
pharmacists aren’t just clerks who fill prescriptions. They are highly trained professionals who are supposed to act as a final “watch dog” on the prescriptions to help patients avoid injury. For example, they are supposed to know enough to notice when a dose is wrong or when medication interactions might occur. However, they aren’t supposed to just refuse to fill a prescription-they are supposed to communicate with the doctor about the possible problem.
In your case, is the medication some type of controlled substance or substance that can be abused? It sounds like the pharmacist, for whatever reason, thinks you consumed the last batch too quickly.
I suggest calling your doctor and asking about it.
The pharmacy policies confuse me. I used to use Walgreens to fill my scripts for pain meds. I went to then for five freaking years, every single month. All of a sudden they change their policy that all narcotics had a waiting period of 24 hours before they would fill. This despite the fact that I was out of medication and my doctor will not write a script early.
After much arguing I told the pharmacist that she is well aware that my prescription is valid and the only reason to not fill is if she suspected that I had a fraudulent prescription. If that’s the case I said “go ahead and call the police, I’ll wait”. She relented and filled and I haven’t stepped into a Walgreens since.
Apparently pharmacist are going to be allowed to refuse to fill prescriptions that violate their moral standards or go against their religion or some such.
The general public holds a misconception that “doctor’s orders” are the final word. They’re not. They’re the first go ahead. Whether it’s an order to a nurse or a pharmacist, the doctor’s order (or prescription) is an instruction to the nurse or pharmacist granting physician approval for a procedure or medication. It is still up to the nurse or pharmacist to decide if the order is safe, appropriate, and valid. If it is not one of those three things, then the nurse or pharmacist is the one who can face disciplinary action or lose their license for carrying out the doctor’s order.
I agree that in your particular scenario, I’m at a loss for what the problem might have been. Something was going on that the pharmacist didn’t share with you (or that you didn’t share with us.) Completely speculating, I’m wondering if someone else tried to steal your prescription by attempting to refill it early, or if it was refilled early accidentally.
Speculative scenario A: A pill bottle thrown into the trash, I pick it up, I call the pharmacy and give them your prescription number (often through the automated refill system) and they refill it. I go pick it up, giving them your address to verify identity (I know your address because that’s where your garbage came from) and now I’ve gotten your pills for this billing/prescription cycle. You go in to get a refill, and it’s too soon. You start to argue, and now they’ve got a person who is “clearly” lying to the staff about when his last refill was, because their computer here shows he got one after the empty bottle he’s showing them. Lying is the behavior of a drug seeker.
Speculative scenario B: Someone else called in to refill their prescription, only instead of entering prescription number 923856-14530, the tech enters number 923856-14350. 923886-14350 is in fact your prescription number. Again, you go in and their system shows a refill that you never got.
In the first case, the pharmacist is unlikely to share that information with you because he feels like it’s evidence that you’re drug seeking. If he tells you how he knows that, you can change your drug-seeking strategy. In the second case, it’s unlikely he’ll share that information with you because it’s a HUGE fricking mistake that is their fault that should never happen (but does.)
I’ve had to go back to my doctor, not only for refilling too soon (I was going on vacation and wanted an ample supply) but also for refilling too late (I was using up the refills on an old Rx, but that meant I didn’t tap into the new one for a while, and that triggered a hold.)
A lot of this seems to involve computer scrutiny, not human scrutiny.
ETA: The last couple posts weren’t here when I started. Sorry to mostly repeat.
If the pharmacist was evasive the issue is almost certainly concern for prescription drug abuse. The Feds are making the pharmacies be the police force trying to slow down over-prescribing doctors as well as abusing patients.
Rite Aid HQ cares a lot more about not having the DEA up their ass than they do about pissing off any given customer. The individual pharmacists are caught in the middle, but as with any other workforce, some are more police mentality than others. They also understand that not only their job, but their entire future career, depends on not getting crosswise with the DEA.
Something changed in the OP’s scenario. Maybe the store got inspected and didn’t do so well. So now they’re under the gun. Maybe Corporate came out with new guidance and this guy is overreacting. Maybe the feds issued new guidance that chronic use of whatever med is now suspect at a lower dose than before. So even though the OP’s scrip didn’t change, the concern about it did. Maybe the OP’s doctor is under some suspicion at that pharmacy for patients other than the OP.
Sadly, there isn’t a patient’s bill of rights that requires everyone involved to tell you the truth, the whole truth, and nothing but the truth. Yet.
They don’t do it arbitrarily. They may do it mistakenly or in error or for a bad reason, but they don’t do it for no reason.
And, as others have pointed out, that is their job. Pharmacists generally know more about pharmacology than doctors do, and part of their role is to review what has been prescribed and if necessary to question it.
I understand this, I never characterized pharmacists as “pill clerks”. I understand that certain flags can make a pharmacist suspect fraudulent activity or dangerous oversights wrt prescriptions. My point is that I did not have any such “flags” whatsoever and the pharmacist still refused to fill it. I can not think of any scenario that would give this pharmacist any reasonable doubt or suspicion as to my prescription’s validity. And he gave me no explanation as to his reasoning, either.
The med in question is tramadol HCL, a Class IV controlled substance. But like I said, there was absolutely no reason given for refusing to fill it. No scrips from multiple doctors, no contraindications with any of my other meds. I don’t even understand how he could’ve possibly thought it was a fraudulent scrip, as I was only refilling a pre-existing scrip. And, this same exact medication, at the exact same dosages, has been in their system for over two years. I’m stumped.
I characterized it as “arbitrary” because there was no reason given for the decision, nor any possible reason that I could even think of. Of course I don’t think a pharmacist would just not fill a scrip for no reason, the reasoning is what I’m trying to figure out.
I don’t see any changes in Tramadol regulations recently. This is from two years ago and is presumably still in effect. But the pharmacist could have easily explained that you just need a new prescription if one of these applied:
“If your current prescription was written more than six months ago or was refilled more than five times, a new prescription will be required.”
Can’t speak to Ambivalid’s particular situation, but in the last few years it seems to me that the entire medical profession – physicians, nurses, nurse practitioners, pharmacists, all of them – have decided that nobody is ever getting any pain medication (or Xanax, or valium, or anything like that) again. Not ever. No matter how much pain they have, no matter how bad their panic attacks are, no way.
I’m not sure what country you live in but here are some statistics for the US.
" Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have also quadrupled since 1999."