I would just like to share and vent at the same time, something that many of you can certainly relate to when it comes to "pharmacy issues" and pain management.
First, I would like to say, that I am almost 42 years old, and had my first major spine surgery for my horribly diseased spine at the age of 18. I have had 6 invasive spine surgeries, 3 of which were fusions, most recent one was 6 weeks ago. I have been a MODEL pain management patient for the past 10 years. I am educated and aware of the intricacies that are involved with all aspects of pain management. I have learned to live with CERTAIN levels of scrutiny, as I am the first to state, that rules and regulations in reference to pain management are not only a necessity, but strongly feel that MORE needs to be done to hinder the hypochondriacs, seekers, addicts and abusers who put not only the patients, in jeopardy, but the healthcare professionals (includes pharmacists), as well as the general public. I GET all of this, and I repeat, I am willing to make any reasonable accommodations regarding this matter. However, what I am about to describe below, is absolutely unacceptable, unwarranted, illegal, unprofessional, discriminatory and downright dirty and disgusting.
I take several medications all prescribed by my reputable Pain Management Doctor. I have been with the same doctor for almost two years now, and prior to him, I was with the previous Pain Management Specialist for several years. I live in a rural area about 45 minutes north of one large city, and 65 minutes south of another large city. My spine surgeon (has been for over 10 years and 3 fusions) is in the northern city and my PM Dr is in the southern city. The CLOSEST pharmacy is 45 minutes south of me. I work from home, my bed to be specific, and do not have the luxury to just hop in my car and zip around the corner or down the street FOR ANYTHING. I go to my PM Dr every 28 or 29 days. I have NEVER once deviated from said schedule in almost a decade except for getting a 2 week supply as detailed below (still dated appropriate for fill requirements) I have used the same Walgreens Pharmacy for almost that long. It is an ordeal each month that I have to go to the PM Dr, just physically and logistically- and it takes ALL DAY just to drive to the dr, see him, go to get Rx's and get home...8 hours later, i have to start my workday on said days.
Prior to January 2011, I would go to Walgreens on my way home, wait for my prescriptions, my insurance ALWAYS went through, and I was on my pained but merry way. I am prescribed Oxycontin and Percocet normally, but for my post op meds, I am off the Percocet and taking Dilaudud. These are the only CII meds that i have been rx-ed for 2 years. The dosages have never fluxuated, my insurance has never varied, neither has my fill dates- (I ALWAYS turn my prescriptions in one or two days before I am supposed to start the new prescription- USUALLY ONE DAY BEFORE)
In January of this year, I stuck to my routine, and was startled when one of two regular pharmacists informed me that my insurance would not cover either of the CII meds until the DAY AFTER I was scheduled to run out. I am not confused, I did not mis-count, the label on my pills and the calendar do not lie. I respectfully asked why the sudden change, and told her that I would now be forced to be unmedicated for a day. She muttered something about "insurance companies across the board and new procedures" and turned away. She did not offer to call my Dr or Medco. She dismissed me. The tech who was at the register called me over and said that I COULD have them if I paid CASH for both prescriptions. I was confused, because I KNOW that Walgreens has a policy to refuse cash payments on scheduled medications that are denied as "too early to fill" by the insurance company. I did pay cash that day for my Percocet, and decided to tough it out missing one evening dose of Oxycontin, as I was NOT going to pay $900 for my Oxycontin to get it one day earlier. I was forced upon waking the next morning to drive 45+ minutes one way to get that morning dose) I called the Medco Help Desk, and spoke with a lovely woman who informed me that she really had no clue why this was happening, and that the pharmacist should have called the Pharmacist Help Line for Medco for an override. I let it go, and filed all of this in the back of my head- as I was concerned for my upcoming fusion in a few weeks, and worried about this happening again. IT DID. I only got a 2 week supply early January so that I could go back a few days before surgery to get my month supply. This time, the SAME pharmacist told me I had to wait an extra 2 days- same excuse about the insurance. Since I was having surgery, the 2 days would cancel out and I waited. Each time this happened, it has been with the same pharmacist. I have been stunned but never argued or made a scene AT ALL... I can say, that each time it happened after the first time, the tech would tell me after about 10 minutes of waiting, and this pharmacist would be looking over at me to gauge my response. I am certain of this. So, (sorry this is painfully long and detailed) during my recovery, I began researching like a mad woman. I came across at least 60 different personal blogs by 60 different pharmacists- all of whom but 2 consider chronic pain patients to be "junkies"... i am NOT exaggerating or generalizing- it was SHOCKING- and also understandable at some levels (most hate their jobs, retail, the public, their bosses and co-workers) Once thing I got from this is that it was time to change to an independent/ Mom & Pop pharmacy.
I went to my PM Dr this week, got my Rx's and also the name of the independent pharmacy they use. It is near my Dr, which is 20 minutes further from my house than Walgreens, but at this point, don't care. I was curious, as I had just researched my insurance policy- and there are NO QUANTITY limits set for either of my meds. I called ahead to Walgreens, just as a test. I was told they DID have my meds in stock. I asked for the date I could fill, since that day was day 29. I was told by Miss Walgreens that she could not fill these until TODAY- Friday 3/11- this was on Tuesday 3/8. Scripts dated 3/8. So, I went to the new pharmacy, halfway expecting to be told to come back in a few days, and Lo and Behold, when the pharmacist called my name to the counter, both my Oxycontin and Dilaudid were filled and insurance had approved both. Needless to say, I was happy, but angry at the same time. I called Medco, and got a supervisor, I explained all of this and the supervisor said she would call me back. The next day, I got a call that incensed me. First of all, they went to great lengths to research my history, and told me that NEVER EVER have they declined to EVER fill any of my meds for too early- OR FOR ANY REASON. She told me that although it differs by state, that pharmacists DO have the right to refuse a fill- but NOT under the guise of claiming a denial of claim when there was NO DENIAL EVER. I was told that based on the dates that I gave her, ALL of the prescriptions from January and February of 2011 SHOULD HAVE BEEN APPROVED AND FILLED on the date that i presented them.
I am way too busy with other aspects of my life to allow this to consume me. But it is just an UGLY reminder of the types of GARBAGE that Chronic Pain patients are subjected to.