I just had all my prescriptions refilled for the next 12 months. My insurance allows for a 90 day supply. I typed it all up being very specific as to what I need for my Lantus, my Humalog and my test strips. I faxed it to my doctorâs office with complete instructions as to where it has to be called in, etc. I spelled it all out, eliminated all the guess work for them. I even followed up with a phone call to the nurse to make sure it was going to be taken care of correctly.
I get the order today. Itâs wrong. I didnât get a three month supply of Lantus. I got half that. I specifically asked for six vials. I know how many units I require and how many are in a vial. The math has already been done. Itâs the same quantity I have been using for years. Nothing has changed. They sent three vials.
I wouldnât care about it so much if it were my cholesterol pill or something like that. Iâm not going to die if I donât have the cholesterol pill for a day or too. Not the case with the Lantus. I need that to stay alive. Get it right people!!!
I have to be right back on the phone with the doctorâs office Monday to fix it. Most annoying!!!
My experience with insulin quantities is that the doctor needs to order, âtake xx units per day.â Six vials is 6,000 units of insulin. That means that the order needs to read, âinject 67 units per day.â (6000/90 = 66.7)
If you arenât specific with the amount of units per day, I found that they will try to cut your quantity down. Itâs maddening, I know.
Good endoâs will overprescribe knowing that sometimes your needs will increase, sometimes a vial breaks, etc.
Great endoâs know that the pharmacy managers are clueless about pen priming, so if you use 10 units 3x/day, the scrip will be for 12 units 3x/day, to include 2 units per injection (at least theoreticallyâŚ) that you lose to priming.
Truly outstanding endoâs will also overprescribe knowing that itâs not just okay but good if their patients have some backup supply in the event of a natural disaster or other catastrophe that forces them to wait for their normal resupply.
Iâm a T1D and a Diabetes Educator. Thatâs extremely helpful that you typed it all out, but I would try calling the MA (Medical Assistant) when you do fax it in so you can triple check that he/she understands what you are asking. MAs are usually the ones to refill the prescriptions, and they are usually asked to do so in 1-3 month supply segments. Iâm guessing that out of habit, that thatâs what happened. Also, if your Endo doesnât already prescribe a little extra supplies, I would calculate how much you need + 2-4 weeks of extra supplies or round up just in case of an emergency. Itâs always safer to have a little extra on hand. For instance. If I need to do a new site change every 3 days, but then ask for site supplies for every 2.5 days. Hopefully this is helpful for you. Good luck. I definitely understand how frustrating ordering supplies can be!
Oh, how I can relate. Thought I was the only one with problems at pharmacies. It isnât just insulin, even the blood pressure pills I have been taking for 30 years have presented errors or problems. The âblame someone elseâ is always used. It is the insurance companyâs fault or it is the doctorâs office that is at fault. The pharmacy will never admit that they are to blame. Example: Doctor writes script for 90 day supply with refills to last 12 months. Initial dispense correct. First refill OK. Second refill, doctor must authorize. WHY??? That is 3 times filled for 3 months each and by my math, 3 x 3 equals 9 months. What happened to the last 3 months remaining on the script? I could write a BOOK about my monthly issues with refilling scripts that I take month after month, year after year, yet they canât seem to REFILL an active prescription properly.
Generally Iâve had pretty good luck, but this year I had a shocker when the charge for 4 items was over $800, when it was less than $50 the previous fill. Deductible already met.
Anyway, the CVS had upgraded their systems, (and fancy new labels were on the bottles), but it failed to pick up my insurance when it was filled. The pharmacist that filled, and cashier that rang it up didnât notice the outrageous cost. Fixed their problem, rang up again, new total = $35.
Part 2 of my response. Many docs are now using an electronic method to submit prescriptions. This has created new problems in my experience. Pharmacy fills incorrectly and then blames doctorâs office, saying that is not how the doctor submitted the prescription. How do you argue with them if you have not SEEN the actual written script? I asked for a copy of what they received and was given a piece of paper that was not credible. I watched as the pharmacist printed out something, threw it in the trash, then typed into the computer and printed out the paper given to me.
I now insist upon hand written scripts that I hand deliver to the pharmacy AFTER I have made a photo copy of it since once I turn it over to them, I have nothing to substantiate my argument when not filled properly or as written.
Part 3 of my response. First parts dealt with the pharmacy. That is not the only place for problems with prescriptions. Yes, the doctorâs office can be the source just as easily. The problem is the patient is standing at the pharmacy counter, left out of the loop completely as to what was submitted and how the pharmacy handled it, and being directed to another source for the problem. Who is at fault and how does it get fixed? Why is the patient the one needing to do the work of the doctorâs office, the pharmacy, and the insurance company? The pharmacy says, it was your doctor, call him. You call and they say it is the pharmacy. The pharmacy then says it is the insurance company, call them. They say it is not them. And there you stand, just trying to RE fill a script and you get the royal run around with nothing but finger pointing. How did they fill it properly the first time and canât seem to do it a second time?
As I said in an earlier response, . . . I want to SEE the actual prescription if at all possible so I know who is telling fibs. I am sick of the run around and the rules changing every month.
OK, 4th response and I will stop. I really could write a book about the problems I have experienced with getting prescriptions filled. One other example. Had a prescription for Novolog. First month, it was filled with one box of 5 pens. Second month, was given TWO boxes of 5 pens each and told that 1 box would not be enough for 30 days, hence the second box. Third refill, back to one box. Not only does the exact way the script was written affect how it is filled, it depends upon the pharmacist filling it, and how it is being submitted to the insurance company. Seems there is much discretion at times.
I used to get this kind of runaround when I got my prescriptions filled at a chain drugstore. Maddening! In frustration I contacted a small pharmacy run and owned by the pharmacist himself. They bend over backwards to reduce any hassle from contacts with my prescribing CDE, through insurance company, to Medicare and Part B billing. This was about 10 or 12 years ago and not a single problem in refilling Rxs. See if you can find a small pharmacy. They do try harderâŚ
Terry is spot on here. Except if it were me and I required 67 units per day for the 90 day supply, Iâd insist my rx said âinject 100 units per dayâ both so I could have a little cushion and so I can build a stockpile
I have had all the experiences and can put blame on doctor, pharmacy and insurance
One pharmacy manager REFUSED to fill my Rex for 2 vials of Lantus saying insurance would not pay even though they had been paying. Stood my ground and 20 minutes later had mt 2nd vial. 24 hours later- new pharmacy
Wish I had a pharmacist owned pharmacy near me.
When I first read your post, it set off a firestorm in me. I have had so many problems with getting my prescriptions, I went off on a real venting tirade immediately, expanding on the narrow topic you mentioned.
You were talking about how explicit your communication with the doctorâs office yet the response from them seemed to ignore your wishes and request and generically respond, dismissing your efforts to obtain exactly what you needed and requested.
I have been THERE, too. I have done precisely what you did, written out EXACTLY, what I needed and how the script needed to be written in order to pass the other powers that be; the pharmacy and the insurance company. I had also been ignored and had to jump through hoops to finally get it done properly.
I just want to apologize to the community for my rant the other day. The original post, started a cascade in me of all the hassles I go through EVERY month at the pharmacy. The fault may arise at any point along the line of people controlling meds before they reach us.
I am sorry this is such a sore point with me and hits a very sensitive nerve. Thanks to all for putting up with my venting.
This is true. My doc writes inject 80 units per day. You have to consider for needle prep and errors. I get six vials for 90.
Also make sure your insurance is not putting limits on how much can be dispensed at at time. My doctor writes to test 6-8 times a day. Some insurances limit it to 3 -4 times a day.
Also, if you can get a CGM, you will not need to test as often i think
The other week I couldnât buy a bottle of insulin. The sharp, young pharmacist found an error in their computer system and fixed it. I lucked out. There are always new hang-ups that I have never seen before. All I can recommend is to keep good written records. I donât do it, myself. But, I also have lots of problems.
Please get a stock pile of insulin for emergencies like this. My doc writes my Rx so it lists that I need WAY more insulin than I actually do. It helps, but there are still hang ups.
