Mail order adjusting prescription quantities


#1

OK, I will admit right now I am pretty steamed but that is what I get for pushing back on the mail order pharmacy. I have a script for pen needles and they are capped at 6x a day. Insurance will cover them completely id I get them in a 90-day qty. So I had a script sent in with 4 refills from my doctor. The first time it was filled I received 6 boxes of 100 and was told that they could not short fill the script. The second refill 3 months later I received 5 boxes and was told that they could not go over the prescribed amount. Now the third refill I received 5 boxes of 90. When I called about it they said that it was because the previous fill was for 5 boxes to give me the 6th box would put me over 500. At this point, I am confused because the prescribed amount was 540 needles or 6 boxes of 90. I can not help feeling like I am being played here. I have yelled at the pharmacy but I may end up being charged for the last box even though the original script would have included it. Some days it sucks having to fight on all fronts.


#2

Agreed, it is absolutely horrible to have to fight tooth and nail every time you need your prescription items that make it possible to live another day.

Ok, now that I said that, I’m going to add that I use the Humalog Quik Pen so I need pen needles too. I reuse them, as do many people. It makes the box of pens last a lot longer. I’ll reuse anything that makes it so that I don’t have to deal with the prescription issue quite as often.


#3

It sure sounds like they shorted you. Most mail order pharmacies do boxes of 90 but maybe they had some boxes of 100 and the required math is short circuiting their tiny brains.

Full retail price OTC for 100 pen needles is somewhere between $10 and $25 (depending on whether it’s the cheap-o or BD brand) so I’ve never argued over this too much.

One thing about mail order pharmacies, is they let you refill several weeks in advance of the 3-month nominal period. I don’t think they’ll let you get 12 months of supplies in just 9 months but you can get 12 months in 11 months and then get your provider to renew your prescription. However they may then arbitrarily turn “3 refills” into “2 refills”. All funny math.

I think they also broadly realize that 4 90-day prescriptions is only 360 days so they kind of understand at some level, especially for medicine that we will die without, that we’ll need to get the new prescription renewed in less than a year after the original one. Again I don’t think you can compress 12 months into 9, but I’ve never had a problem compressing 12 months into 11.5 months.


#4

I have good insurance and they pay 100% for a 90 day script. I have run into the situation where I have been shorted and they come back and say they already filled it and I have to either wait or pay out of my pocket.


#5

I am just amazed that after they adjusted the script for the second refill that when the new box qty came out that the pharmacist filled it at the lower amount because the prescription was for 5 boxes because that is what they filled last time. But, the Original prescription now matches exactly for 6 boxes


#6

I agree they goofed it up and I see you’ve done a good job in tracing back exactly how they goofed it up and how they are repeating the mistake.

In my experience with mail order pharmacies when it comes “renew prescription time” they will forget all about your previous prescription and how they goofed it up. You could help make sure of this by getting a different brand or style of needle.

I know you want to hold them accountable and that’s not a bad thing, but also consider that the copay for a box of needles with insurance, is almost exactly the same as the OTC cost of that box without insurance. It could be less than the OTC cost of that box.


#7

Because pens and needles come in boxes that the pharmacies generally provide only as whole (“unbroken”) boxes, it’s highly unlikely a 90-day rx will be filled for an exact 90 day need. My provider won’t fill for an amount over 90 days, but will re-fill at less than 90 day intervals if the amount they provide gets used up by then.

Of course it’s a completely separate thing if your pharmacy is providing you with, say 75 days of something and then insisting that is enough for 90.


#8

Well in the end I spoke with the the customer service => Pharmacist => Doctor => insurance => Formulary benefit management => Customer Service => pharmacist. In the end they have a new script from the doc and are saying they owe me a box. Just a wast of 2 hours of my life.
The issue is that insurance will cover the cost completely only if it is 6 a day for 90 days and from their mail order pharmacy. So when I go to refill early it gets rejected until the 90 day’s is up.


#9

I broke this quagmire by buying my pen needles from Amazon.
No prescription needed. Price break when yo buy 300 or more.


#10

I’ve had that struggle with mail order pharmacy as well. Recently my script for pen needles needed to be renewed and I missed that. Told the pharmacy I’d just pay cash for a box and they said they can only sell me 10 needles without a script but since the box had 100 they couldn’t split it. It appears that my state has limited the purchase of all injection needles in an effort to combat the opioid crisis, never mind a pen needle would be very difficult to use for that purpose. But hey what do you know I can order next day delivery from Amazon for half my copay and the needles are comparable IMHO.


#11

I used syringes for over 15 years before going on a pump. I regularly recapped them after use and reused them a second and sometimes a third time without any issues.