Big Problem at Pharmacy---Advice Please

[Eva 14]

I've been going to the same pharmacy for 2 and a half years. It is a big chain pharmacy and really my only choice in this town. I don't have alternatives, so I'm stuck with this pharmacy.

I have a GREAT pain doctor, but the pharmacist at "my" pharmacy is driving me crazy! (She is NOT the Pharmacist in Charge, but she works there almost as much as the "head" pharmacist does. For all I know, there are TWO pharmacists in charge there). She has been rude to me on more than one occasion. I am always nice as can be, even when I'm furious inside.

My pain doctor sees me every 4-8 weeks, so I fill my scripts every 28 days. My insurance is fine with this. Until today, the pharmacy was fine with it.

Due to my doctor's schedule, I've been given prescriptions a week or so early on a few occasions. Back when this happened, I asked the pharmacist when it was okay to fill them. I was told "24 or 25 days". And I did just that---NO PROBLEMS. Plus, my pharmacy sometimes is out of my meds and it takes them 10 DAYS to get them, so it's a good thing I have a small stockpile.

TODAY, I went to the pharmacy straight from my doctor's appointment. It had been 25 days since I'd last filled my scripts. The pharmacist practically verbally attacked me. She said, "We can't fill your prescriptions this early! You must either have a month's stockpile (about 2 weeks, actually) OR you've taken it all, and THAT would be a BIG PROBLEM!

I was in HORRIBLE pain and totally stunned, since I'd filled scripts early before and all was fine. I told the pharmacist, "You can call my DOCTOR, you can do whatever you need".

She ignored me and said I was "WAY EARLY" and she wasn't going to let me fill my meds for another FIVE DAYS!!!! Insane! She was wanting me to come in every 30 days when my doctor gives me my scripts every 28 DAYS.

Again, I told her she could call my doctor. She then lorded it over me that "SHE" makes the final decision about my meds, NOT my doctor!!!! Oh, really??? She doesn't know a THING about the excruciating chronic pain that I suffer from.

When I complained, she told me, "We're getting AUDITED a lot more that we used to". (I don't know if that's BS or what?)

I finally said, "Okay, I will pick my prescriptions up on Friday, since it will be 28 days since my last fill". She finally agreed to this. But I am worried about her in the future trying to claim that my scripts are for "30 days" when they actually are for 28 days.

I told her I was in horrible pain and it's hard for me to get out of the house, and that's why I was there---I'd just seen my doctor. NO apology that I'd have to come back in 3 days. NO sympathy for my pain.

Has anyone else had a similar problem? At what day are you allowed to pick up your C-II scripts---25, 26, 27? Lastly, is there ANYTHING that my doctor can do to help with this situation? I hate the idea of being rigidly locked into every 28 days, if the pharmacy will even do that for me. People need a BIT of flexibility.

Thanks for any support or advice. I NEVER in a million years would have thought that a PHARMACIST would have more power over my meds than my DOCTOR. And has anyone else heard this stuff about pharmacies being "audited"?

Thanks,
Eva

[tortoisegirl]

Not to side with the pharmacy, but I can see how they cannot fill it early if its a 28 day script. I don't have this issue because I have to pick up one from my doctor monthly (either call and pick up if I am doing ok and have been in recently, or make an appointment). He writes for 30 days. I've gone in to get it anywhere between 27 and 32 days depending on our schedules, and filled it at the pharmacy that day. There have been a couple times I've been far past the 30 days by the time I got it, either due to doctor or pharmacy problems. Thankfully I keep an extra couple weeks (I stockpiled at the beginning by not starting the med right away, and then I try to fill a day early on average to get more).

I think as long as they will fill on day 28, that is the best you can do. I believe the vast majority of narcotic dependent pain patients are made to wait this out. I do think the 28 days schedule goes much more smoothly because they you don't have the weekend issue (why I end up coming in early or late most of the time, that or my doctor isn't in on the day), but it confuses some people. Plus, with insurance, you end up getting shorted a bit by paying every 28 days not 30. Its hard to believe you don't have alternatives--wow. I think in the since that you can't get the meds unless the pharmacist fills them they have the final say, but not really. I think in certain cases they are allowed by law to substitute and such?

I've had no apology when they didn't have a med I had requested and neither did any other local pharmacy so I had to wait, or they wouldn't fill it because my doctor forgot to write his DEA number and it was a weekend, etc...in cases like that I would have been SOL if I had no stockpile. Sadly I think they are within their rights and it sucks. We have to be our own advocate and we are at everyone's mercy for these meds we are now physically dependent on. I can see why they don't want you to fill early because they over time you do build extra, but the accusatory tone sure isn't helpful. She probably didn't see the 28 days at first so 5 days (30-25) early sounded like a lot, when it was really 3 (28-25).

I have to remind myself how overworked they are when I get attitude at the pharmacy and try to be extra polite. They deal with a lot of angry customers and getting angry back never helps. I'm sure Steve will have an answer, but I do believe that they can get audited. I don't know if they are getting more now though. I know my prescribing doctor uses the DEA "excuse" as to why my dose can't be escalated even though my relief has decreased and my pain is out of control...he says they are keeping a close eye on things, new laws coming into effect soon, etc. I think some of it is just their fear. They have a lot more on the line than we do actually. Worst case we end up in withdrawal and go to the hospital, but worst case they lose their livelihood and may have trouble finding even a much lesser paying job out of the field.

Hope you can have a smooth pick up soon. I would call 10 days before your scheduled pick up (if that is really their lead time--that is ridiculous--I've never heard more than 4) and ask them to set aside your amount if they can't consistently have it and can't do a recurring order for it. Best wishes.

[alex44]

Sorry this happend to you.

These people tend to get the "GOD" complex , just like doctors do. I asked my doc. about the meds I was on (Ms-Contin) and how they seemed to take forever and also were upsetting my stomach. She took the time to explain that there are three differant fillers they can use, and to ask the Pharmacist to order a differant brand. I have since learned that Mallencroft often has less of the active ingrediant, and has been known to cause stomack(sp) upset. Well, when I went to the pharmacist, I TOLD her the Doc. had given me this information and could she please get another brand for me. She gave me the "Look" like I was a drug seeker, I have only been stable on this dose for thirteen years, but told me to call one or two days ahead of time and rhey could get it the next day. Ten days is BS. I would talk directly to the head pharmacist and the store manager, about her attitude if nothing else besides the long lead time. I am not sure how the twenty eight day thing will work out but NO ONE has the right to be rude or obnoxious. I am on Medicaid, I can get my prescriptions filled right there at the clinic. or anywhere else but then I might have a small co-pay - might be worth it. the other point being , we pay their saleries, in my case medicaid, which means she is a public employee ( Iwill Not use Public Servant , IMHO, that is demeaning). I wish you all the luck in the world, You MIGHT also want to talk to your Doc. In these days, one unfortuneately needs to tread carefully.
Good Luck
Blessings
Alex44

[Mark N]

Sorry too hear that you went through this as if we aren't in enough pain when at the pharmacy. I haven't been treated like that but have been told I can't get it filled at that time and have to wait for another day or two. Unfortunately your pharmacist attitude is one that SIL pharmacist takes with her customers. She thinks she knows more than the doctor and tells them so. They see enough drug seekers and if they aren't careful it comes out on other customers.

Can you pick which pharmacist waits on you? That is the only idea I have since you are limited where you can go.

[hummer]

I hope your next visit is better...and something can be worked out...if you are both afraid or stressed...there is more potential for conflict....

Blessings to you...and to all Beings.........

[Kira]

They are pretty strict about the date here, and always have been. I think the format of C-II prescriptions varies a bit by states, but here there is a "Fill on or after" spot and my doctor puts the date there. She always dates them 30 days apart, and that's when I can pick them up, period. If there is a reason that my doctor wants me to be able to pick up extra meds or earlier meds (ie changes after a hospital stay), then she will just put the correct "Fill on or after" date on the new script. If the pharmacy wonders about it, they can call her... and they did, once, with no problems.

This is with the C-II meds. I do sometimes pick up other non-controlled substance prescriptions a little bit early... insurance tends to be willing to fill the regular stuff a few days early with no hassles.

[Diandra]

hi eva....lots of good advice. the only thing i can add....are your scripts covered by insurance? in my experience, they are the ones who dictate when an opiate can be filled. i would call them and ask them first, then i would call the pharmacy and ask to speak to the owner and explain your dilemma (25,26 days never having been a problem in the past and what a hardship it is to come back a day or two later). also, my best advocate on the legality of medical issues had been the attorney general in my state. the AG is there for consumer issues and this most certainly is one. call the AG's number and ask for the person who handles a health related consumer issue. one time a new doc who i was not satisfied with would not give me my medical records and all it took was one call to the AG's office. The AG's assistant called the doctor and told him the CT law and I had the records fedex'ed the next day. also, one time my health insurance was blocking an IV treatment my doc scripted and the AG's office told me to call my employer who provided the health insurance and tell them. Again, I had the IV treatment within days.

This pharmacist is not being professional at all. Get the facts and the law behind you and that should more than enough ammunition. I wish you the best. I hate bullies, especially those that abuse their power! Take care, Diandra

[Pharmacist.steve]

By state law there is legally only one PIC (Pharmacist in Charge) at each store.. and a Pharmacist cannot be a PIC at more than one store - PERIOD !.. IF it was the insurance that is denying.. ask her to print out the screen with the insurance company's rejection sent back to the pharmacy. They could be getting audited by the insurance company because the doc is writing for 28 days instead of 30 days supply. Actually 28 days make sense for eliminating weekend request and running out... insurance companies like to work in 30 days or 90 days supply. Normally insurance companies will pay for the next refill when 75% -80% of the previous supply would have been taken. All too many Pharmacists are opiophobic and IMO ..she is one. I am sure that if you go to the State Board of Pharmacy website for the state you are in .. there is a complaint form.. The only way that you are going to get her attention is to contact the company's corporate headquarters and the state board...otherwise.. she is going to treat everyone in the same manner. I would not bother with the management at the store level.. IMO .. either they are in agreement with her attitude or prefer to ignore her demeanor

[ray]

Hi, around my home, the pharmacies, want an opioid filled on the day 30, not before, but the dr.s here don't write 28 day scripts, just 30 day. here most of the time I can get the opioid filled 5 days ahead and no one says anything but i don't. I get it the day on one of a three day period, like the 5,6 or 7th every month. usually the 6th. but when ever, as long as one of those three days. If I started getting it filled 5 or 6 days early every time sooner or later someone would say something and what would happen I don't know, but i like to do things the correct way. I get my script from my doc on the 20th and then hold it till the 6th to fill it that way I always have the script plenty of time before i need to get it filled so if somethng happens I still have time to get the script plenty of time before the 6th. It has taken years for me to get into this position, but if you are long term chronic pain I suggest you figgure a way to set up a situation like mine for a time cushion to elevate problems. best wishes, and good luck

[Pharmacist.steve]

Personally, I prefer for a chronic pain pt to have 1-2 wks backup supply... you never know what mother nature is going to throw at you... hurricane, ice storm, tornado, snow storm, flooding... or when there is going to be a supply problem. If the Pharmacist can give you a 100% guarantee that none of these issues will interrupt you getting your meds on the day needed - which they can't - then there shouldn't be a problem in making the pt wait until the last day. Rules work most of the time.. it is when those unanticipated circumstances get in the way of the rules.. IMO.. a Pharmacist that doesn't take into account all possible circumstances that could throw a patient into withdrawal.. could be subject to the patient filing a complaint with the state pharmacy board for unprofessional conduct.

[Eva 14]

Thanks for your advice---everyone.

My insurance approves my meds at day 24, so insurance isn't the problem.

The Pharmacist in Charge has never treated me badly, but the two pharmacist's work schedules are rather unpredictable.

A couple months ago, it took 11 DAYS for the pharmacy to get one of my pain meds, so I would think that the pharmacist would understand why I wouldn't want to wait until the "last minute" to fill my scripts.

My doctor writes my scripts for every 28 days. If I then fill them every 28 days, that must be okay? It's fine with my doctor AND my insurance. Hopefully, it will be fine with the pharmacist. It is she alone who wants me to wait till the last minute to fill them.

If I'd been thinking more quickly, I would have said, "But it routinely takes 10 DAYS for orders to come in; don't you think it's a good idea for me to have 2 weeks extra meds on hand?" But she probably wouldn't have cared. She's VERY familiar with the occasional stock shortages.

Oh well, at least I was able to pick up my meds on Friday. All I can do is hope for the best in the future.

Eva

[Pharmacist.steve]

Some chain pharmacies only grant the PIC the authority to sign a DEA 222 form or order via the electronic CSOS system.. the only way a pharmacy can get CII inventory from *********r... and some restrict ordering to once a week... so if the PIC is off on vacation and didn't order ahead before he/she left... you have a 7-10 day wait to get a CII order in... Generally the chains are more interested in how many times the inventory turns as opposed to having a product on hand 100% of the time when needed.

[ray]

Hi again, my insurance covers like yours, however its the federal laws on narcotics, in my case that controls the day of pick up. In an instance where its not narcotic, some insurance co.s have restrictive dates on some of the super high dollar items, and even quit paying as much as they do at times. I recently had my insurer change a 4 dollar script back to a $80 dollar script because they did not want to pay for it any more. Just Like That!. if you have a script that is good on day 25 then try like you are to build up a back up like steve says. My dr. told me on day one I needed to get a backup of narcotic meds built up for emergencies & I asked how do i do that & he said it is hard to do sometimes just try to get it done. It is getting harder & harder to do that with narcotic meds now of days & if the uninformed powers that are control freaks find out they will say you are an addict and hording meds, or selling meds or whtever runs through their simple minds. Instead of keeping yourself prepared for an emergency that could cause you possible suicide from the pain and withdrawal that would accompany the long outage, of meds. At one time I had a two week delay in getting my narcotic meds, as the office is a hundred miles from my home & I don't drive. It seems the person who wrote down my call for renewal lost it, I called again & found they had no record of my call but took it again, & lost it again, i called a third time and got ahold of an administrator and raised cain, they had it mailed out that same day, & when I got it it was 2 weeks late!. Fortunately I had enough with cutting way back on my meds to not run out, and slowly brought my meds date back to where it was to stay a couple weeks ahead. Which would be nearly impossible now. With the new computer monitoring of every script there is no way to get a buffer on narcotic meds now where I am. I can call in 10 days ahead & they won't write the script until the exact day of the month at the dr. office. So im lucky to have been doing this for years in that respect. best wishes, ray

[goldenmain]

Here in FL we are having huge pharmacy problems. Usually they will fill in 27 days or whatever your insurance will cover. The problem here now is... Pharmacies are refusing precriptions for anyone! even to fill doctors prescriptions that are in good standing with our state medical board. When is it that a pharmacy will not accept a legitimate doctors prescription or know more than a doctor? This is nuts! These pharmacists know that on your information insert attached to your prescription bag says- "do not stop taking this medication abruptly unless told by your doctor". Many patients have been with the same pharmacy for years. Many patients have tried to switch to another pain med(that may not work as well) just to try get some pain meds for the month. Unfortunately this war on drugs, trying to stop addicts is having a huge effect on legitimate pain patients. Even a woman with malignant cancer was denied her pain meds this week. It made the news. Something needs to be done about this problem. The pendulum is swinging too far to the right. Pain patients are going to fight back here. DEA and legislators are going way too far with everything in our country. It's a shame, needless suffering.

[Pharmacist.steve]

What you described is called UNPROFESSIONAL CONDUCT... here is the list of all state boards of pharmacy Only registered and activated users can see links., Click Here To Register...
You should find a complaint form for each state. Generally, these boards do not take kindly to Pharmacists refusing to fill valid Rxs
If the boards refuse to act... then you need to file a complaint with the AG's office against the board for failing to do their primary charge... protecting public health/safety.
If the AG's office fails to take actions, I would consider finding an attorney because what you have described.. IMO .. is patient/senior abuse.
There are few reasons why a Pharmacist can legally refuse to fill a Rx... basically all revolve around patient safety (allergy, drug interaction, too high a dose, too early refill) a Pharmacist being opiophobic is not a valid reason to refuse to fill a Rx.