But you do engage in behavior that LOOKS like drug-seeking - namely trying to get more drugs than your pharmacist is allowed to give and/or your doctor is willing to prescribe. And then you complain because they don’t just risk their entire business to do everything the way you want so as to minimize your inconvenience.
I’ve been through the same problem with Mom. I understand what a PITA it can be. I understand that doctors aren’t always willing to prescribe an adequate level of medication, in part because of the DEA regs and tracking.
The scrips I deal with can’t be handled over the phone or automated systems - they require an actual, physical prescription with an actual, physical signature, each and every month. Try getting one of those at noon on Sunday when the facility has once again let her meds run out without telling anyone and she’s already a day behind on a physically-addicting medication.
What I don’t get is why you’re throwing hissy fits about the pharmacist.
Yes, exactly. That’s how it works. So what’s your problem, again?
Your doctor, for whatever reasons, has written you a prescription for 30 pills, with 12 refills. One prescription, these days, unless it specifically states otherwise, is considered to be for one month, so your doc wrote enough refills for one year. Your doctor, for whatever reasons, has refused to give you more than 30 pills per month.
The pharmacist is filling the prescription according to the doctor’s orders, and the various regulations, rules, and laws that govern drug dispensing.
Why are you bitching about the pharmacy instead of your physician?
The pharmacist isn’t doing any such thing. Obviously your physician is perfectly happy with how the pharmacist is filling her orders, or she’d rewrite the orders to make it more clear.
You’re just pissy because you’re not getting your way. That’s MHO.
Butalbital/APAP/Caffeine Tablets are not a federally controlled drug, however in some states they are controlled. I can’t speak of Florida, but here in Georgia it would be controlled. Since it isn’t federally controlled, there is no dealing with the DEA on this script. However, they might have to deal with your state’s Drug and Narcotics agency.
However, that shouldn’t make a difference if the doctor actually wrote
This would be a five day prescription as written, and the pharmacist should be able to fill it every 5 days. Now, it is possible that your insurance wouldn’t be willing to pay except every 30 days, but you should be able to pay cash for the script.
I know I wouldn’t have any trouble filling your script as you have explained it, and in Georgia, there would be no laws or rules broken by my filling it.
I forgot to mention that this is normally no “assuming” that a script is for a certain days supply. Day supply is normally figured out by the frequency and number of tablets. However, if your doctor wrote “for 30 days” on the script, that would make the pharmacy not fill early, and is something that is normally not put on the prescription label. Do you know what your doctor actually wrote on the prescription itself?
In both your posts above, you have demonstrated the ability to have read my complaint and your comprehension of the problem. I’m grateful to you for that.
My doctor has written the prescription exactly as you have isolated it above: one tablet by mouth every four hours as needed; not to exceed six tablets in any 24 hour period As you point out, and I pointed out up front, thirty tablets could conceivably be used in a one week period. My complaint is simply that INSTEAD of contacting my doctor for a refill authorization, the pharmacist insists on informing me that the prescription cannot be refilled while I insist that it can. If a call to the doctor is required, why in the hell can a note not be added to my computer profile to simply make the call, get the authorization, contact the insurance company and get on with it instead of making me appear in person to repeat a conversation/explanation/argument the pharmacist and I have had several times in the past? All the jumping through hoops could be eliminated and I could have what I need and what my doctor has prescribed without the two to three day delay that often results while I explain once again what, when, where, how, and why I need the damned medication. That’s it; it’s as simple as that and it is the delay involved that irritates me especially in view of the fact that my doctor has never failed to authorize an “early” refill and the insurance company has never failed to pay for it, minus my co-pay. It seems straightforward to me; it isn’t a matter of the pharmacy accommodating me; it is a matter of the pharmacy providing a degree of service to a regular, long-term customer.
Thanks again for having seen the problem for what it is and not what some people think it is.
Well, if you have authorized refills left, there shouldn’t be a reason for needing to contact the doctor at all. However, as I said, I don’t know Florida law, and in pharmacy state laws can very wildly. But in Georgia, the state I work in, and know the laws of, there would be no problems at all of filling your script after 5 days. I don’t know why they would be having a trouble filling it. I don’t think you should be having any trouble with getting this filled at all.
You’re welcome, most people seem to assume there is a normal 30 day assumption at pharmacies, while it is true most maintenance medications are filled for 30 or 90 days, pain medication normally isn’t, and there shouldn’t be an assumption at all.
One thing I would say is a possibility however, the computer system at the pharmacy I work at automatically calculates the day supply based on the sig, however we do occasionally need to change it since some insurances won’t pay based on the actual day supply, and the easiest way to fix it is to just change it. For example, an albuterol inhaler which if used as often as allowed would last about 17 days, but some insurances will only allow us to fill as a 30 day supply. If someone had to change the day supply on your script to allow it through insurance, and the person refilling it just looked at the day supply to see it was too soon, they might have an issue filling it. However, once pressed, they should look at the actual paper prescription and see that it is not too soon. You might have to pay cash if your insurance won’t pay, but there is no reason you shouldn’t get your medication… (unless something crazy in Florida law contradicts what I’ve said).
I have the reverse problem, my Dr wrote me a script for a low dosage sleeping aid, 30 tabs initially, after we agreed it was effective, 90 tabs. Thing was, in both instance, it was with 4 refills. There is no conceivable way I could use 90 tabs that quickly. In fact, I couldn’t use 90 tabs in a year, even if I gave a couple to my husband from time to time. So when I did go to refill it I was told it had expired and I had to get a new script, even though there were still 3 refills left on the thing!
Went back to the Dr, explained, back to the pharmacy, got my tabs - 90, 4 refills. Someone didn’t get what I was saying or I don’t know what. Not that it matters in my instance, I just don’t bother or need a refill, in 18 months I’ll go back to the Dr and try again to see if she’ll give me a script for 30 tabs with a couple of refills only. Sometimes they just do what they do, habitually, without really thinking about it sometimes.
I use Walgreen Pharmacy and have, about six months ago, changed the particular store I use. In the store I had to leave behind, the pharmacy department automatically contacted the doctor and the insurance company in situations like I’ve described; they had added that requirement to my computer profile OR they had come to know me well enough to know it was SOP. The store I am now using can’t be bothered to modify my profile; maybe they enjoy tormenting me. Whatever. I have seen the pharmacist at my current store look at the original paper prescription they have on file, scratch his head and say, “Well, you’re right” or words to that effect. What really irritates me is the necessity of them doing that over and over again when it would be easy enough to avoid doing it at all. Well, my irritation level goes quite high when I have to actually drive to that pharmacy and insist they look they look the damn prescription up instead of doing it automatically, if they feel they must. Doing it their way just makes extra work for them as well as for me.
Sorry, I didn’t realize that the doctor was both able able and willing to authorize the early refill. In that case, yes, the pharmacist should just make the call instead of arguing with you. I thought you had to actually go see the doctor to get a refill, which made it sound like something the doctor should fix. Ideally, the pharmacist should do exactly what you expect, and put a note in your computer saying to make the call, and do so without even talking to you about it, but that’s too much to expect from most retail pharmacies. (It shouldn’t be, but it is.) But even if you have to have the conversation every time about how they have to make the call, they shouldn’t refuse to do so and argue with you about it. That’s just terrible service.
So now, that you’ve convinced me that the pharmacist really is being unreasonable, I suppose I should answer the original question, to wit: what the hell makes the pharmacist think she has the right to override your physicians instructions? The answer is that retail pharmacy is apparently a miserable, soul-sucking profession that makes highly skilled and educated people into chattel working long hours doing mundane, repetitive tasks with little autonomy or authority. We should probably count ourselves lucky they don’t give us all arsenic.
You were probably prescribed Ambien (Zolpidem) or Lunesta (Eszopiclone). Both of these are federally scheduled drugs, as such, the prescription expires in six months, and are limited to no more then five refills. Just because your doctor writes you a 90 day supply (I assume, one at bedtime is the normal dose of these, but wouldn’t put in the system unless I saw the actual script), doesn’t change any of this. Only things I can suggest are to get a refill right before it expires, and to also make sure you contact your doctor a week or so before you are out of pills.
I learned a long time ago when working in pharmacy, the chain you go to doesn’t really matter (besides specials and such). What really matters is the people who actually work in the pharmacy. If you were happy with one pharmacy, but unhappy with the other, that is most likely totally due to the phamacists and techs who work there.
However, part of your problem might just be because you go to Walgreens… They have started in the past two years or so something they call “POWER”. So far they are only doing this is Florida and Arizona, but basically, it is where they eliminate the staff at the local stores, and do everything centrally. This of course leads to the local stores not having the staff and time to do what needs to be done, and the people at the central fill locations don’t care, and don’t look any deeper into prescriptions. (Don’t get me started on POWER, I’ve never worked in Florida, but from the scuttlebutt in the profession, it is the worse thing ever! No one in pharmacy likes POWER, except the people who own stock and don’t actually work in a pharmacy)
The pharmacist has the total right to question the physicians instructions, however in this case, they aren’t questioning it, they are totally ignoring it. If the prescription was as black and white as the OP has said, there is no reason he should be having any trouble.
As for pharmacy turning into a “soul-sucking profession that makes highly skilled and educated people into chattel working long hours doing mundane, repetitive tasks with little autonomy or authority”, I do have to agree with you in a lot of ways… However, it isn’t “retail” pharmacy that does this, it is “chain” pharmacy that does this. The chains keep cutting tech hours while insisting on greater workload. The chains only look at the number of scripts we fill in a shift, they never look at the how, or why, or how much trouble the scripts might be. Plus, they keep lowering the prices on prescriptions to the point they can’t make any money on the actual filling process anymore. $4 prescriptions are the worst thing to happen to pharmacy since the drive thru!
As I mentioned, I became acquainted with a couple of pharmacists at the mail order pharmacy I delivered for and both those guys would all but foam at the mouth at the merest hint of working in retail pharmacy. Both had done so in the past and both considered it a fate worse than death. One of them in particular would become absolutely rabid on the subject----I used to worry that he would have a heart attack during one of his tirades. Your information explains a lot----I had forgotten the reactions I used to witness.
That sounds annoying as hell. Your pharmacist sounds like a dick. My initial response would’ve been, “Your plan probably has qll (quantity level limits to prevent overuse, but you probably knew that) and/or prior authorization applied to that drug,” and it sounds like they do, but from what you said upthread, it sounds like your pharmacist is mostly a jackass.
I used to work for a pharmacy benefits manager that specialized in those programs, and we implemented a patient profile with our network pharmacies for that reason. It was probably more work for the pharmacist, but it seemed to reduce aggravation on both sides.