Medication Frustration

20130523-192940.jpgIn the last week I’ve been to the pharmacy for different medications for myself and for family members six different times (it’s infection / allergy / asthma season in Kansas), so admittedly I’m over-exposed to this issue. But the first pharmacy run-in in the string, which took place late last week, had nothing to do with acute symptoms with relatively easy solutions. It was about antidepressant medication, which is something you just DON’T mess with.

Background info: My husband had three days worth of his antidepressant left, having run short due to an increase of his dosage a few weeks ago.

Here’s the summary of what went wrong:
-My husband forgot to mention that he was almost out of meds. Because we have a mail order insurance “service,” refills need to be ordered at least a week and a half ahead of time.
-As I tried urgently to get a refill called in, the doctor’s office insisted on leaving  messages on our house phone even though my husband repeatedly asks them to call his cell so he can get calls while at work.
-The receptionist at the doctor’s office literally never answers the office phone – it always goes to voice mail.
-Apparently, neither the doctor’s office nor the local pharmacy knows how to get new dosages approved.                                                                                                              -The local pharmacy very generously offered to sell us two days worth of medication due to the immediacy of the need – at a cost of $25 for four pills. Our normal co-pay is $8 for a month’s worth.

After this final indignity, I saw red and explained (in incredibly controlled tones, considering the provocation) that the pharmacist’s offer was completely unacceptable and that I would take matters into my own hands as they were obviously unable to handle this situation, which surely they confront on a daily basis.

I was finally able to take care of it all with calls to the mail-order insurer’s member service (which is ridiculously hard to get through to but when you do get them they’re extremely helpful and pleasant). Because it was a “code red,” meaning it was a med that can’t be just dropped, they had the pharmacist call for an override code (which, according to the member service representative is actually standard procedure), and we got a full month’s worth of antidepressant at the new dosage, and at the regular co-pay price. I wish I could say I found it amusing when, two days later, a three-month supply of the medication – at the old dosage ?!? – came in the mail from the mail order service. We still don’t know how or why that happened.

I expect the whole tragedy (certainly not a comedy) of errors will have an encore in a few weeks when we have to order refills at the new dosage.

My take on this ridiculous incident:
• If a medical doctor prescribes a different dosage, insurance companies have no business holding veto power. Who went to medical school? Who better knows the needs of the patient? Certainly not a for-profit pharmacy run by people we’ve never met.
• Doctor’s office staff and pharmacy staff should be in the business of helping patients get what they legitimately need. They should be conversant on procedures and on patients’ contact information, based on the records the patient has provided. Throwing up their hands in defeat is not acceptable. Especially when you’re talking about a medication you can’t just stop cold turkey.
• My husband is an adult. Why was I in charge of fixing this debacle? Yes, my schedule is exponentially more flexible than his. I offered to step in because it was urgent and I had more time (I have to throw in, though, the fact that I was extremely ill during these few days.) But having been, by default, my depressed husband’s personal life manager and detail wrangler for so many years, I sometimes feel resentful.

Dealing with depression and with the nightmare process of finding adequate combinations of medications is hard enough. Depressed people and their families shouldn’t be thwarted at every turn simply because they’re trying to follow their doctor’s orders.

-Amy

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2 Responses

  1. YES!!!! All this and sooooooo much more we (I, as the mom) have dealt with. It’s maddening. And SHAME on the pharmacy. They should automatically call in to insurance for you. Those things happen with great frequency. So glad you got it taken care of, but I do know the nightmare it can be to get hold of a live person at the insurance company to talk with. And don’t be suprised if they question the new dosage prescription, and tell you it’s too soon to refill and they want more than a regular co-pay. I hope it doesn’t happen, and if it does it’s not an insurmountable obstacle, just a general pain in the patootie to get it straightened out. (Oh my! Apparently I have some residual frustrations going on here … 😉 )

    Here’s to smoother days ahead between you and medication refills,

    Monica

    • I know – it’s always something. I had yet another run-in with the mail order company over the weekend, this time for one of my maintenance scripts. Honestly, I have way better things to do with my time.

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