Rx? Dropped'em

[Mama_Zappa]

Without naming names (though I’m sure you can figure it out from the subject line)…

My mother-in-law spent a year taking nasty chemicals when she was diagnosed with multiple myeloma a few years back. One drug had to be provided by a specialty pharmacy. One mail-order service had the best price. But one month the stuff didn’t arrive on time. She called to raise hell, and they grudgingly overnighted it to her as otherwise it might not have gotten there in time. “But just this once - you need to order it in time!” (um, she HAD).

My husband’s insurer switched mail-order carriers to that same company. I mailed in a stack of prescriptions. 3 weeks later, NONE had arrived. Something on one of the scrips confused them - I never did find out what - and, without any notice to me, they held ALL of them, until I called. The person I spoke with said “not sure what the issue is”, she was able to expedite the order without any further action. I assume that if I hadn’t called, I’d still be waiting (this was 2 years ago).

And just this week the identical thing happened to my daughter. She mailed in 3 scrips - one of which happened to be for an ADHD medication - as in, can’t phone in a refill, has to be a paper prescription. They sent the other two, not the ADHD medication.

We called 2 days ago, they claimed the only scrip they had for that was one that had been mailed in separately, with “do not fill until some time in April” written on it (the doc’s solution to giving her a 90 day supply).

We called in again that day, saying “look, we KNOW we mailed all 3 scrips”. ::mumblemumblepleaseholdwhileItalktoapharmacist:: - and they admitted they HAD received the scrip. No explanation as to why - my assumption is that the light in their asses isn’t good enough to read by.

So it’s being shipped, “expedited”. It’ll arrive Saturday - maybe (if the post office brings it to the door, and gives us more than 30 seconds to get to the door when they knock / ring the bell). She took her last dose yesterday.

Yeah, life’s gonna be fun around here for the next couple days unless she can get hold of the doctor and get a paper scrip for 3 days worth.

Oh, and “expedited” apparently means “send via first class mail”. If they’d truly expedited it, we’d have the medication today.

[The_Vorlon]

Call the insurance company and SCREAM. Follow up with a complaint with your states insurance board. The last thing they want is light shown on the problem.

[JcWoman]

I’ve had similar problems with pharmacy management companies. I take one of the expensive arthritis meds. Because it’s expensive, they MANDATE that I can only get it from their specialty pharmacy and one time they (the company I had at the time) even yanked it out of the Safeway pharmacy where I first filled it and send me a firmly worded letter telling me what they’d done and that I could only get refills from them from now on.

One company in particular, coughahemExpresscoughScriptscough gave me the worst experience. (The one I’m with now is much better.) With that company I had to go without my meds for 4 - 6 weeks on two occasions because they couldn’t pull their heads out of their asses and didn’t care two figs about my “personal problem”.

The first time it happened because I mailed the paper script to their billing office by mistake. It was the only address on the paperwork they included with the prior shipment and I was completely stupid to not know it was the wrong address (according to them). I mistakenly thought it would be easier to straighten out over the phone rather than going back to my doctor for a new rx (doc required an office visit, and I left them too after this). The billing office first said they sent it over to the local specialty pharmacy, the local said they never got it and that was as far as I could get with phone calls. I did end up having to go back to the doc for a reprint.

I don’t remember the situation with the second time I had to go without my meds but it was similar in that it was when I had to have the rx renewed. There’s so much bureaucracy finger-pointing between the various departments that I, the customer, was not at all a priority.

[Yllaria]

@The_Vorlon

Call the insurance company and SCREAM. Follow up with a complaint with your states insurance board. The last thing they want is light shown on the problem.

If the insurance is supplied by his place of employment, be sure to scream at HR as well. We got stuck with mail-only for “maintenance medications” and after a year of everyone raising hell, it was changed to another supplier that allowed mail supply OR 90 supplies from a local pharmacy.

[Musicat]

Why don’t you have your doc call in or fax the prescription to the pharmacy, or enter it online? That was possible 20 years ago (I first introduced my GP to the call-in method ca.1992). I didn’t know paper prescriptions were still used except in extreme cases.

[nearwildheaven]

@Musicat

Why don’t you have your doc call in or fax the prescription to the pharmacy, or enter it online? That was possible 20 years ago (I first introduced my GP to the call-in method ca.1992). I didn’t know paper prescriptions were still used except in extreme cases.

Prescriptions for Schedule II drugs cannot be faxed or phoned in except for circumstances like hospice and a few others, and then the pharmacy has to have a paper copy within a varying amount of time.

I worked at a mail order place for a while after I graduated, and loved my job, but there were issues. It was over 20 years ago, and I left the company when they relocated; that was traumatic but I know now that it was for the best.

Express Scripts is ranked down there with CVS as the worst of the worst in the pharmacy world, on every level.

:mad:

[panache45]

@Musicat

Why don’t you have your doc call in or fax the prescription to the pharmacy, or enter it online? That was possible 20 years ago (I first introduced my GP to the call-in method ca.1992). I didn’t know paper prescriptions were still used except in extreme cases.

When I need a refill, and there are “No Refills Left” on the Rx, the pharmacy faxes the doctor to get a new Rx. But sometimes, for whatever reason, they get no response, even after another fax. Some doctors are “too busy” to respond to each fax. This recently happened with a medication that I REALLY cannot be without, so when I was down to my last pill, and the doctor still hadn’t responded, I called my Primary Physician and got a new Rx from her. Screw the other doctor.

And then there is the doctor who can’t refill a Rx because you haven’t been in to see him in more than 2 years. Except you can’t get an appointment for another 6 months, even though you need the medication now.

[OldOlds]

@The_Vorlon

Call the insurance company and SCREAM. Follow up with a complaint with your states insurance board. The last thing they want is light shown on the problem.

Don’t forget the state board of pharmacy. Their potency varies by state, but they are under a lot of pressure because they have failed to adequately police their respective charges, and are eager to show they aren’t just a bunch of vestigial political organs.
(because, um, they are and we’d be much better off putting pharmacy under the FDA). In fact, if they aren’t that interested in helping you, point out to them that you might raise that point with your senator.

[JcWoman]

@Musicat

Why don’t you have your doc call in or fax the prescription to the pharmacy, or enter it online? That was possible 20 years ago

I don’t know why but in the last few years some of my doctors have been implementing office policies stating that they will NOT do rx renewals by fax or phone. Not all of them, but enough to be disturbing. My current doctors have electronic (or internet, I don’t know) connections to all the popular pharmacies, so that’s very nice. The ones who refuse to use standard or modern business practices need to die a flaming death.

@OldOlds

Don’t forget the state board of pharmacy

I’ve never heard of this, is it a thing?

[OldOlds]

@JcWoman

I don’t know why but in the last few years some of my doctors have been implementing office policies stating that they will NOT do rx renewals by fax or phone. Not all of them, but enough to be disturbing. My current doctors have electronic (or internet, I don’t know) connections to all the popular pharmacies, so that’s very nice. The ones who refuse to use standard or modern business practices need to die a flaming death.

I’ve never heard of this, is it a thing?

http://www.nabp.net/boards-of-pharmacy

Sadly, while pharmaceutical manufacture and distribution is regulated by the FDA, each state has a board of pharmacy that oversees the local “retail” distribution. It’s a separate rant, but the boards of pharmacy are mostly useless. But they like to think they are important, and if you can jump on that you might get them to help. If they actually gave a shit, they generally have pretty effective powers.

[watchwolf49]

@OldOlds

Don’t forget the state board of pharmacy. Their potency varies by state, but they are under a lot of pressure because they have failed to adequately police their respective charges, and are eager to show they aren’t just a bunch of vestigial political organs.
(because, um, they are and we’d be much better off putting pharmacy under the FDA). In fact, if they aren’t that interested in helping you, point out to them that you might raise that point with your senator.

US Senators, Congresspeoples, State Senators and Assemblypeoples ALL get paid to hear you SCREAM at them … it’s in the job description … during an election year, they should be available to hear you SCREAM at them.

These companies who would put your life in danger for a few pennies profit should go to prison. I mean the pharmacies that is …

[teela_brown]

This is why I fight taking my prescriptions to a mail pharmacy. I can save a few dollars by doing so, but I can’t hang on the phone for hours trying to straighten out their goofs. I’d get in trouble at my job if I did so. And I have a couple of medications that I can’t go without for a few weeks while things get straightened out.

[MsRobyn]

Before I got a real job with insurance and everything, I had to get my meds from the VA. Once, I got a bottle with a label and no pills. To make things worse, my doc decided that I needed to be seen every three months, then go off to medical meetings or whatever when my appointments were scheduled so that I’d have to jump through hoops to get my stuff renewed. On top of that, VA providers can’t just write a prescription that you can take to Rite Aid. No, they can only write prescriptions that can be filled by the VA.

I now have real insurance where I can see a family doctor who can either send my scripts electronically to the locally-owned pharmacy, where they’re happy to see me every month, or send them in to the mail-order pharmacy, which I will utilize on a cold day in hell.

[JcWoman]

@OldOlds

nabp.net

Sadly, while pharmaceutical manufacture and distribution is regulated by the FDA, each state has a board of pharmacy that oversees the local “retail” distribution. It’s a separate rant, but the boards of pharmacy are mostly useless. But they like to think they are important, and if you can jump on that you might get them to help. If they actually gave a shit, they generally have pretty effective powers.

Thanks, I had no idea!

The other thing I’ve noticed with these mail order specialty pharmacies is that they seem to hide where they are located. They put the address of their billing office in the order paperwork instead of the address of the office that fulfilled the script. I would have no idea which states board to complain to, mine or the billing office? Or the fulfilling location which seems to be a secret?

[carrps]

A while back (5 years ago?), my company switched to Express Scripts. It didn’t apply to me, because I had Kaiser (in-house pharmacy), so I didn’t experience any issues.

But the next year, interestingly, they dropped Express Scripts.

[BigT]

And, of course, paper scripts are actually much easier to forge than an actual secure electronic-based system, where the doctor’s prescription would be signed with a digital certificate. The illusion of security is more important.

[MsRobyn]

@BigT

And, of course, paper scripts are actually much easier to forge than an actual secure electronic-based system, where the doctor’s prescription would be signed with a digital certificate. The illusion of security is more important.

No, paper scripts aren’t as easy to forge as you think. Pharmacies tend to become familiar with the doctors who prescribe their patients’ meds, and if something doesn’t seem right, they recognize it and act on it. With electronic systems, there’s no guarantee that the doctor is the one who hit “send” unless there’s a biometric signature, such as a fingerprint. My father, who is a retired pharmacist, caught more than one non-physician using the electronic prescription system.

[OldOlds]

@JcWoman

Thanks, I had no idea!

The other thing I’ve noticed with these mail order specialty pharmacies is that they seem to hide where they are located. They put the address of their billing office in the order paperwork instead of the address of the office that fulfilled the script. I would have no idea which states board to complain to, mine or the billing office? Or the fulfilling location which seems to be a secret?

A pharmacy must be licensed in each state where it distributes it’s prescriptions. So in the case of a walk-in, that’s easy (the state where it is located). However, in the case of compounding, mail-order, radiopharmacies, etc, it could be in another state. However, they must have a license to distribute into your state, so you should contact your state’s BoP.

Some states are easy to get license in, some are a nightmare. It is surprisingly common to find out that a distributing pharmacy (like a compounder or a radiopharmacy) hasn’t bothered to get a license for a state to which they are shipping. This gets them in lots of trouble because they have failed to show the proper respect to some third-cousin of the Governor who got him his job at the BoP just to keep peace within the family. I do hope my contempt for Boards of Pharmacy is clear.

All that said, they usually love a chance to feel important, and most people don’t know they exist, so they might get a little boner to help you. And if they want to, they can.

As to the lack of transparency, it could be that they have one billing office with many pharmacies, and they direct the work to the appropriate one. They probably aren’t trying to hide their location from you, but it generally isn’t something that the customer needs to know. Although, if located in an area with significant drug crime then they have a legitimate concern.

[dizzee_dee]

@panache45

When I need a refill, and there are “No Refills Left” on the Rx, the pharmacy faxes the doctor to get a new Rx. But sometimes, for whatever reason, they get no response, even after another fax. Some doctors are “too busy” to respond to each fax. This recently happened with a medication that I REALLY cannot be without, so when I was down to my last pill, and the doctor still hadn’t responded, I called my Primary Physician and got a new Rx from her. Screw the other doctor.

And then there is the doctor who can’t refill a Rx because you haven’t been in to see him in more than 2 years. Except you can’t get an appointment for another 6 months, even though you need the medication now.

This is the bane of my existence. The pharmacy faxes the request. My doc issues and signs the script, I fax it back. Usually the same day, but sometimes it takes an additional day. The fucking pharmacy tells the patient that they have tried and tried, but the doctor hasn’t responded. Because it’s easier than actually looking for the script. So the patient calls me, pissed off and loaded for bear. I get my ass handed to me by the angry patient. I call the pharmacy, “oh yes, we have it.” Then WHY did you lie to the patient and tell them you don’t have it?

[BigT]

@MsRobyn

No, paper scripts aren’t as easy to forge as you think. Pharmacies tend to become familiar with the doctors who prescribe their patients’ meds, and if something doesn’t seem right, they recognize it and act on it. With electronic systems, there’s no guarantee that the doctor is the one who hit “send” unless there’s a biometric signature, such as a fingerprint. My father, who is a retired pharmacist, caught more than one non-physician using the electronic prescription system.

So you’d put human familiarity above electronic certainty? There’s a reason why 95% of hacking is social engineering.

And of course someone else could click send. And someone else could grab from the pad and write a prescription. That’s a wash. At least, as you say, you can add biometrics as an extra precaution if you go electronic. So you can fix that problem.

I’m not saying that electronic signatures inherently make everything perfect. I’m saying they are better than these other systems. It’s far, far more secure than faxing.