Let’s level the playing field !

Pharmacy has  been been crying this for years  “we need to level the playing field”

Let’s admit it.. our health care system is really F-ed up…  and pharmacy has probably been screwed with longer than other parts of healthcare.. the PBM’s forced us to invest millions and millions of dollar in computerization.. so that we could run more efficiently as the PBM’s kept lowering their levels of reimbursement.

If fact, I read a statement from someone who claimed to be a Pharmacist that has a company that does the pharmacy auditing for the PBM’s. “… the lower the PBM’s makes your reimbursement… the faster you have to process Rxs… the faster you have to go.. the more administrative mistakes you make.. and the more money I make from the audit, catching all the administrative mistakes”

The DEA seems to have caught on to this game… last year WAGS’ & CVS paid 91 million in fines for unaccounted  doses of controlled meds.  This caused WAGS to initiate their “good faith dispensing policy”… they couldn’t call it what it really is… HOW TO JUSTIFY NOT FILLING A CONTROL MED PRESCRIPTIONS IN TEN EASY QUESTIONS ..

Rumor has it.. that CVS has taken control med Rxs out of the formula for calculating RPH’s bonuses. Don’t know if they also removed these same Rxs from the count that determines tech staffing levels. If they have reduced tech hours staffing… that means that the RPH’s have a very good reason to not deal with any control Rxs.. Those RPH’s who are opiophobic … have just been given the blessing of the corporation to not fill any control meds.

If you are a RPH reading this.. the chronic pain community is getting mad as hell … they want to sue the DEA and the major chain.. but.. no attorney is not going to take those deep pockets on.

But one of you dumb ass phobic RPH’s stepped across the line with the wrong pt..  Refuse to give a HIV + pt a flu shot and you just crossed the line of civil rights violation under the ADA. Rite Aid got fined 15 K.. and 10K went to the pt. I don’t know that only Rite Aid got fined because the pt only filed a complaint against Rite Aid and not the Pharmacists and PIC involved… and the real kicker is that for a pt to file a complaint with the ADA.. they just have to go to their website.. they don’t need an attorney..

If you are a Pharmacists reading this.. and you are hanging your hat on corporate policy and/or you are letting your biases and phobias rule your “professional discretion “.. my best guess is that you have – or will soon have a big F-ing BULLS EYE on your back..

Details on in the link below..

Can’t say that I didn’t warn you !

How to file complaints if patient is being denied having a valid

The above link is a first draft of  “how to instructions”  to help those in the chronic pain community to “level the playing field”.. and there is only a estimated 100 million in that community..

If you want the form… click on the link… it will open in Adobe … then you can either print it out.. or save it to your computer..

Feel free to send it as an attachment to your chronic pain friends… if your doc is not happy with how their legit Rxs are being denied.. give it to your doc and suggest that they give it to their pts who are being affected.

Have a question… email me:   steve@steveariens.com

LET THE GAMES BEGIN

29 Responses

  1. This problem isn’t going away. I too am a disabled chronic pain patient going on 16 years and have been to the same pharmacy for 3 years. (my previous pharmacy was Walgreens I left for reasons already stated above.) I’ve been seeing the same doctor for 5 years beginning right after I moved here from out of state.

    I have health insurance. I’ve never asked for an early refill, or any of the other things not allowed in my pain contract. In other words, I’ve been a model patient and pharmacy customer. Last time I was at the pharmacy they told me new corporate policy is to not fill prescriptions for doctors not local to them. My doctor is 24 miles away.

    Some 5 years ago the laws changed here making it much more burdensome for general practitioners to prescribe pain medicines and so most of them stopped doing it all together. Suddenly, many patients had to scramble to find a pain management doctor all at once. I felt lucky to have found one only 24 miles away considering most pain management clinics weren’t seeing new patients.

    Incidentally, I just read a news article about pain patients flying to CA from Montana to see a pain specialist. But I can’t fill my scripts from a doctor 24 miles from home.

    I have a difficult time making the trip to see my doctor every month. Traffic is horrible and I have problems with sensory overload, fatigue, and other symptoms from having multiple chronic illnesses, and pain. For me to have to make that trip twice a month simply so I can fill my prescriptions is absurd, and cruel.

    Somehow chronically ill patients have become less than OK in other peoples’ eyes. We’re supposed to be able to “tough it out”. No pain no gain, right? Wrong! We’re taking “drugs” not medicines. If we don’t get better in a “reasonable” amount of time than we must not be trying hard enough. Add in the abuse we typically receive from doctors, and pharmacists, and sometimes even families, who think we’re trying to pull one over on them on top of being on a tight fixed income, while chronically ill and in severe pain. And in not being able to get the medicines we need to have some quality of life. Patients become afraid to speak up from internalizing all the abuse, kind of like Stockholm syndrome and suicide begins to sounds like an option. Ironically, those suicides are classified as overdoses thanks to poor toxicology methods, and government agencies like the CDC that has an agenda to advance the opioid “epidemic” of 14,000 people a year or less than 1% of chronic pain patients.

    • you misunderstand the problem. the boards of pharmacies have implemented rules that controlled substance prescriptions shall not be filled for people residing 5 miles out of the area.Do that and you are subject to fines or worse losing your icense. They do not have a choice in the matter.

  2. I like some others have a pain specialist that is more than 40 miles away! Why? Because I have an implanted morphine pump and my insurance company has no one in network that has the ability to work with my pump! This has me going to an out of network doctor which is more than 40 miles away! However, I do not think it should matter how far the doctor is that you are going to …. isn’t that between me and my doctor and my insurance if I have any? If I just happen to like a particular doctor a move 25 miles away; why should anyone be forced to change doctors if they do not want to!

    I live in Florida and have been a pain patient for more than ten years but I was completely unaware at what was happening in Florida until it started being reported on the news! I however am not in the position of making sure doctors are doing the right thing or anything else such as the DEA is. I feel that the people in charge let things get way out of hand before they decided to do anything. Why would they just continue to let these pill mills exist and continue to grow in numbers for so long? Why would they let others come in from out of state and see multiple doctors and then fill all their scrip’s and return home for so long? And now why is it that the chronic pain sufferers who live in Florida are seeing our prescriptions denied or waiting days before we can find someone willing to fill our scrip’s! Why is it that our doctors are afraid to continue to prescribe a therapeutic dose for those that need more than the DEA thinks they should? Yes, look at all the pain specialists who they have went after … they too are just as afraid of writing these scripts as we are of not being able to fill them!

    This is not an issue of fairness … it is much more than that if you rely on these medications! For those of you who think you would not touch a pill …. let me break your neck and back and see how you feel afterwards about the issue!!!

  3. AMEN Donna!!!!!

  4. It really makes me sad hear pharmacists say,” the patient needs to see a doctor no more than 5 miles away from where they live, or from the pharmacy, etc.”. BUT? My son has Chronic Lyme disease and he needs to see one of the very few doctors who really understands this condition and she is nearly 50 miles away, maybe a few more. There aren’t that many Lyme specialists and this disease is epidemic proportions now days. Plus.. we live in a rural area and have to drive 30 miles to a pharmacy who will fill for him in the opposite direction. Yes we have had to explain everything about his situation but not without raised eye brows. You know there are many hairdressers, and like doctors, not all are good so we should not be red flagged because we choose a certain doctor in a certain area or pharmacy. Not filling medication because someone is over a county line is such BS. Where is our freedom here? It’s not fair and we should all have rights to the medicines we need and probably without questions. If anyone just wants to just abuse anything? We can’t stop them. It’s a choice that person made and no one else should get into trouble because of someone’s else choices. I am straight up for civil rights and human choices. This used to be a free country but more and more we are being regulated to the point of having no rights and going towards communism. Why does everything have to be in the opinion of somebody else? I also feel angry when the subject of having no health insurance comes up, the person is judged over that too and saying don’t fill their C-II because they don’t have any insurance. Yea if the medication is high dollar that may send a signal but again, we don’t know that person’s situation. I lost my health coverage while I was a legitimate pain patient and this does happen to people. It shouldn’t mean these people deserve to live in pain, because I don’t have prescription coverage? I do have coverage now but again, patients shouldn’t be judged on all this stuff. All this crap needs to stop. IF it doesn’t stop, I fear for the future of ALL Americans and EVERYONE should be worried about this.

  5. Why are prescriptions being denied in states with the monitoring programs? Why aren’t pharmacists using them to fill rather than saying we don’t have this as first response. Happened to me 6 times. Not one went to computer to check. My dx was on script. We are not asking for sympathy but medication that we are ordered after drug testing and jumping though hoops. I travel a hour to the same doctor office for past 8 years. No shame on topic being discussed but shame on those that discriminate.

    • Some chains don’t give their Rx dept access to the internet.. no internet access.. no running PMP reports.. I understand that some states have had to mandate that the chains give their Rx depts access to the internet .. so that they can run PMP reports

    • Um because they are POS evil mfers, thats why. THey are discriminating against everyone! I went to 8 stores as well and this one AHOLE tells me we dont carry this and so my dr told me to ask them next time, WHAT DO YOU CARRY THEN so my dr can give me another rx and this pos says, im not allowed to tell you that information , THE OBVIOUS giveaway that he was LYING TO ME. I cannot stand this and i hope someone does something big to stop this bs. AND FAST

  6. This is so needed & is becoming a serious problem

  7. iMO .. no you were not wrong.. from what I am hearing..all too many Pharmacists are more focused on looking for a reason to NOT FILL A CONTROL RX.. than a reason to fill it. They would rather make a mistake and not give a legit pt their needed medication.. than make a mistake and give a single dose to the “wrong pt”. Since 95% of the time the medication is for a legit pt.. so every 20 Rxs turned down.. means that 19 legit pts are being denied their medically necessary meds. We are not going to stop those that are intend on abusing some substance.. they will just switch what substance they are abusing.. I have heard of some legit pts have had to turn to street drugs to get some pain relief.. How pathetic is that ?

    • Hi Steve: Thank you for speaking up. After being treated for 15 years in NYC ( after fighting stage 3 cancer).by my doctor at Sloan, I got sick again, I moved to Fl so my wife would have the support of her family who live there as I fought the new battle. I never thought I would face the abuse I did at Walgreens and other pharmacies. My doctor set me up with a “pain” doctor in Fl. When I brought the rx to the walgreens 1 mile from our new home, they claimed they did not have the meds and would not for awhile. The doctor mentioned to me that another patient got the same rx as mine, filled the following day at that Walgreens so I would assume the pharmacy may not have been truthful.
      I was unaware of the whole problem so naively went to another Walgreens about 4 miles away who turned me down for not going to the Walgreens 1 mile from where I live. I went back to the Walgreens next to my home and was told they may be getting some in but it was for established customers. I just moved here from NY. I began to feel like I was doing something wrong, why would they not fill the rx? I was told go to a private pharmacy where I ended up having to pay cash (and filed myself with my ins). This all made me feel … dirty. Cancer sucks enough without all of this. After finding out about the fine I wonder if Walgreens isn’t striking out at us, the patients, for being punished by the DEA. Kind of like kicking the dog.

  8. Once long ago, I was in a Sams Club for #30 Ct. Valium Rx. I had 2 different. Scripts from 2 different Dr’s. I asked one be filled. The other was seen by the young grad RPh. I asked for the one to be filled. She instead deleted the Rx and called my Dr. I remarked that she called my Dr without consulting me and deleted a valid script from a board certified physician illegally. She said ” I cant help you” I said: ” What kind of establishment are you running here”? You denied me service, dishonored me and all but called me dishonest. I want to file a complaint. “We don’t take complaints”. She retorted. I walked out. The next day I called the Mgr. Of the pharmacy. He apologized and said he would have a talk with the girl. I went back to the issuing Dr, and returned to the girl 2 days later. She filled it without comment. Was I wrong?

  9. I think many have been denied service before. The reasons may or may not be germain. Expecting immediate service or not having proper id or insurance perhaps. Taking a adversarial relationship with the personel. Not driving a goog enough car or dressing disheveled. If one has proper patients and a good descent forthright manner and waits 48 hrs. For the Rx., chances are they will be served. If it is a ADA issue, it is more complex. To offer that one kindly go to a competitor for reasons of possible impropriety is ok. Although you won’t make any friends, you may not need friends of this sort. Then again don’t be a enemy of the disabled.

  10. Steve and all,

    I truly cant believe it has come to this for true chronic pain sufferers finding it hard to get their scripts filled. I’ve been a chronic pain sufferer for 25 years now and not once had a problem getting a script filled. I use the pharmacy in the same building as my pain specialist .

    When I was first diagnosed and given hydrocodone I would go through my script too fast and ran out early, this looked like abuse. When indeed my chronic pain was more than what hydrocodone could do for my pain. One time this pharmacist defaced my script writing on it do not fill till this date, but it was a new script going from Vicoden to Lorcet. Eventually I found a compassionate Pain Specialist that titrated me up to a level of relief using a long acting pain med. Till this day I’m on the same dose not requiring a increase because of tolerance to achieve better pain relief.
    _

    I can see why most pharmacist are scared to fill opioid medications even though the DEA said they have nothing to fear. What’s put in print and what truly happens seems to be two different stories.

    _

    It seems pharmacist and pain patients are stuck in the middle ,pain patients fear not getting their script filled and pharmacist fearing to fill the script. Nothing is worse than a pain sufferer finally finding a compassionate doctor willing to help then they cant get the script filled.

    _

    This needs to be resolved somehow ,we don’t need all this hassle amongst pharmacist and other entities. I thought the PMP would fix this situation but things are out of control on this situation.
    _

    As Steve stated ,fines got us here.. and fines may get us back to some sort of sanity, which is much needed at this time.
    I feel bad for pain sufferers because no one wants to suffer their life away.
    And I feel bad for pharmacist as this is their job and a way of putting food on the table.

    _

    People who abuse opioids and have become addicts have caused these problems. They need help to get their life straight ,its never too late to get these abusers the help they need.

  11. IMO.. Pharmacy/docs/chronic pain pts are in the position we are in because of greed and individual CYA.. the greed starts out with the diverters and pill mills and to some degree the DEA.. The DEA – and all governmental entities – want larger budgets, more people resulting in more “power”. The Wholesalers, docs, pharmacies/pharmacists are doing CYA.. from the greed/fines of the DEA.
    IMO.. DEA wants drugs to get to the streets.. that is job security for them. The states have spent all these millions and millions of dollars on establishing/running these PMP’s.. but.. they don’t want to give healthcare the ability to verify that driver’s licenses are valid.. against their state’s BMV’s database.. Is that CYA that the state’s don’t want to admit that their driver’s license format is not secure… CYA the state from spending money to revamp/replace their driver’s license format? How much better would the PMP reports be.. if the Pharmacists made sure they had a valid license before they put the Rx data into the PMP ?

    Fines to the wholesalers and chains.. has help put us into this spot.. something that everyone seems to ignore.. is that nearly every “addict” or “drug seeker” has some mental health issues.. they are basically trying to self-medicate the monkeys on their backs and/or demons in their head.. and our society wants to to make these mental health pts – CRIMINALS.

    Unless you have never lived with a chronic pain pt.. you are TOTALLY CLUELESS and have ZERO RIGHTS to criticism them or the medications they take.

    Reality is… all of these pts are physically/financially taxed.. and they are not going to find an attorney to take on the DEA or any corporation with deep pockets.. Even if they did.. it would take years to get to a settlement.

    We/they are at this point because of FINES and actions imposed by bureaucrats for supposedly breaking DEA rules.

    So if they chronic pain pts use the same system that put them here.. to help get them out of this hole.. so be it.

    IMO.,,, Fines got us here.. and fines may get us back to some sort of sanity.. at least in regards to the estimated 100 million chronic pain pts.

    If this whole can of worms catches the attention of a ADA focused attorney and it plays out in a different direction.. so be it.. If the ADA ends up fining a number of different player and forces them to figure out how they find a better solution.. so be it…

    There are reports of chronic paint pts committing suicide because of their inability to get their medications.. but .. the public doesn’t hear about these poor souls.. because it doesn’t fit into the DEA’s concept of the war on drugs… and it doesn’t fit into our society’s mindset – based on our puritanical roots – that these people just need to “suck it up” .. they are just “weak”..

    As a society, if we want Social Darwinism to be alive and well… let’s be up front about it..

  12. I agree with you, Red. We have a few chronic pain patients whom we know well. They sign “contracts” with local pain docs. We never deny them their meds. But if a person comes in with an Rx for oxy (with ibuprofen thrown in for good measure) from a doc 50 miles away, has no picture id and wants to pay cash, we turn them away. It is unfortunate that some folks have to wait for meds, but that is the result of reckless prescribing. If a pharmacy’s orders for oxy goes from several thousand to hundreds of thousands in 2 years then the fox is minding the henhouse. I think the DEA is just doing its job.

    • I can see it both ways, I guess. What I don’t understand about Steve’s stance is why are you putting the pressure on the pharmacy/pharmacist? Maybe on the pharmacy, perhaps, but the pharmacist can’t do precious little about controlling the order given the current circumstances enforced by the DEA and the wholesalers.

      I for one have had two 222’s rescinded because there was no ‘need’ for the medication. In both cases it was just for ADD/ADHD meds. Why? My patient came to me and asked for help. The order was placed and two kids went without because the DEA said so. It makes no sense.

      The thing I hate the most about the GFD (yep, I’m at WAG) is the fact that, if strictly followed, you aren’t allowed to say ‘we don’t have it’ or ‘we don’t fill for Dr. So-and-so.’ You are required to go through the song and dance. I’ve had people mad at me because I let them know up front that I have to call the MD, verify the script, etc. etc. Sometimes it works and they get mad and storm off. But right now in my area we are dealing with independents refusing to carry some C2s and a CVS-wide ban on over 20 doctors. We have had over 10 potentially ‘new’ patients try to get their medications filled. Right now I find myself lowering the amount of certain medications below what we ‘should’ order because I am getting sick and tired of dealing with the crazy amount of documentation that goes into every controlled prescription. Better to not order it and then not have it then to ‘get in trouble.’ I keep enough on hand for the regulars, and add on as needed for the newbies. Probably makes me a bad pharmacist but makes me a real person.

      And funny thing is, when I have followed the GFD, it the patient complains loudly enough, you get called to the carpet. I had a guy who hadn’t filled his Oxys in over a month. I get one story from his doc and one for him about why he is late. But, if you hadn’t needed the medication in a month, do you really need it? It’s gone all the way up the ladder and I got called to the phone during my shift to explain my stance to the DM. He agreed with me, I think, but I feel the need to watch my back.

    • I am a disabled chronic pain patient that goes to a state licensed pain management center. Same meds month after month. The CVS where my contract is has a larger clientele and every month it is touch and go whether I get all my meds or not. I have even had other CVS’s (even tho they can look on the computer and see my history) just flat out refuse from the onset to fill a script. This is a REAL PROBLEM. Now the state of TN is pressuring the licensed clinic to reduce their patients doses to at or under 200 mg milliequivalent to morphine. Now these are the same clinics as written in TN State Law that you have to go to if your pain treatment REQUIRES more than 200mg milliequivalents of morphine. Go figure . . . So I am losing over half my meds and they are taking me down VERY quickly even tho the law supposedly doesn’t take effect until 2015.

      Per steve: Another example of bureaucrats practicing medicine without a license.. and INTENTIONAL abuse of seniors/pts/disabled.. at some point in time a ADA focused attorney is going to go after this and someone is going to pay for all the INTENTIONAL pain and suffering that is being inflicted on these pts.

  13. How in the world will this tripe help?

    If I can’t get the drug in my pharmacy, despite my best efforts, how in the hell is that my fault? There are limits placed by the DEA, my own ordering system, and the backorders that magically appear with the producers (does anyone out there have MS Contin 15mg? I have three patients waiting and waiting…). These are things that I can’t control.

    The patient doesn’t have to come to me. There are alternatives, independents, other chains, on-site hospital pharmacies. Why are you (seemingly) so intent on harassing the retail pharmacist?

    What about the disabled pain patient prescribed something that is non-formulary? Do they have the right to sue me, personally, because their insurance requires a prior authorization?

    Are you going to make a form that pain patients can use to sue their doctors because, in the doctor’s judgement, an early refill or a drug change is unwarranted or out of the scope of practice?

    Are you going to encourage patients to file suit because their insurance will not fill medications written by non-preferred doctors.

    You rant about pharmacists needing to step up and practice pharmacy. Well, I am practicing pharmacy when I question the need for 150 Oxycodone 15mg out of the freakin’ blue. I am going to seriously question a prescription that was written 200 miles away when they come to my podunk store to fill it.

    Stop the entitlement.

    • Apparently I am failing to make myself clear… Here is quote that appeared in http://americannewsreport.com/nationalpainreport/dea-doctors-pharmacies-responsible-pain-med-denials-8822886.html in Jan 2014..
      —-
      The U.S. Drug Enforcement Administration is not trying to limit or ration access to opioid painkillers, according to a DEA spokesman who says “nothing should stand in the way” of a patient getting a legitimate prescription for pain medication filled.

      “We’re not doctors. We’re regulators and enforcers of the law. If something is prescribed for a legitimate medical purpose, we’re certainly not going to get in the way,” said DEA spokesman Rusty Payne.

      There seems to be a misunderstanding between applying what I am suggesting universally to all pts.
      Personally I have no problem and often suggest that a Rx dept develop reasonable protocol to when to decline a control Rx.

      Personally, I would be skeptical of a pt that lives/work/ or doc’s office is >5 miles from the pharmacy.
      If there is a known problem prescriber… elect not to fill any for this prescriber.. what I have been suggesting applies to those chronic pain pts who are disabled.. if the people going to a questionable prescriber.. they are not going to rock the boat and file a ADA complaint.. because they don’t want to call attention to themselves.. because they are not disabled.

      I personally got caught in WAG’s good faith policy just after they started it.. I had a sciatic nerve flare up.. doc gave me C-II for the 7-8 level pain going down my right leg.. I went to a WAG’s pharmacy – a few blocks from the doc’s office – that we had been going to for 7-8 yrs.. my wife is disabled and her annual drug cost approaches 20 K.. All of the RPH’s at this WAG’s were also graduates of Butler U.. my alma mater. Doc refused to provide ICD9.. Under what I have been talking about.. I would not have recourse… I AM NOT DISABLED.. if they did this to my wife – WHO IS DISABLED.. I could have nailed their asses to the wall. I took my C-II to a Rite Aid – actually closer to the doc’s office.. where I have known the PIC for some 30 yrs.. and got it filled with no problem.

      The one comment “we know our chronic pain pts”.. I guess that no one going forward is going to develop chronic pain and a store will never get new chronic pain pts.

      Given the statement of the DEA spokesman.. they are hands-off legit pts getting their needed medication..

      Taking that statement at face value.. if a manufacturer can’t supply a particular opiate.. because of an alleged production limits by the DEA.. then someone is lying

      If the wholesaler can’t supply the pharmacy because of some alleged purchase limitations… someone is lying

      If a RPH turns down a pt’s legit/on time opiate.. because of some nebulous reason… someone is lying.

      If you have a new chronic pain pt.. .. most of these pts are on some sort of disability.. Ask them to produce their previous pharmacy records – I would not really trust the PMP.. because of fake ID’s.. Ask them to show you their first denial from SS/Medicare .. the first denial – particularly for younger pts – comes within weeks of applying. If they are collecting on a private insurance disability policy ask them to show you their letter of determination by the insurance company that they are disabled.

      Having a store policy that you only fill opiates for pts that use you as their only pharmacy.. they don’t want to bring the other Rxs.. I can’t fill your opiate/controls alone… I would have better luck at winning the lottery than seeing a legit chronic pain pts that is only taking controls.

      Require a second ID.. that matches their driver’s license.. nearly everyone has one utility bill.

      Ask where they work… if they are wanting to pay cash.. call their employer to “verify” their drug coverage.. they don’t have their card. the employer tells you they don’t work there or their drug coverage is thru ABC insurance..

      You do your best to isolate the legit disabled pts from the bogus drug seeker/diverters.

      The legit chronic pain pts will not mind jumping thru hoops and hurdles to find a pharmacy that will provide their medication on a on-going basis..

      bogus pts.. will tell their friends and after putting obstacles in their way for 30-60 days.. and you and your staff will not be having to waste their time in dealing with bogus pts. They will try to find a much easier touch to fill their control meds.

      Pharmacists state that if they let one Rx “get thru” they soon have a line at the counter… you can use this in reverse to discourage the bogus pts from even coming in the front door.

      • Your problem, Steve, is that you are taking the stance that your issue with the GFD is the official stance of the retail pharmacist and not the aberration. 95% of prescriptions that are turned away without a reason are for >120 oxycodone with no extended relief pain medicine. Even better, written in combination with Xanax 2mg #90, which most legitimate physicians agree has absolutely no role in modern medicine anymore, because of cross-tolerance and withdrawal issues (but it sure does have street value)

        You say you would question any prescription where the patient and/or physician was more than 5 miles away from you? That’s what the GFD does. Patient is paying cash price? Yep, GFD. It does the exact same thing that you say we should do, but because one renegade pharmacist went too far, you’re assuming that it’s completely unreasonable.

        I’m sure there are plenty of people out there who have legitimate difficulty getting their pain meds. A good portion of them are likely because the wholesalers are legitimately restricting how much they will send off. But the vast majority of them – at least, in every pharmacy I’ve ever worked in – are having issues because their “pain specialist” has decided that Oxy30 q 4 h with Soma and Xanax is the best thing to start their therapy on. Coincidentally, it’s the best thing to start every other patient they see on as well.

        • Here is what a investigator reporter found in Indianapolis http://www.pharmaciststeve.com/?p=4358 .. and I experienced the back hand of the GFD personally..so from my perspective.. it is pretty imperfect.. I guess that we are glad that the GFD is not used in our court systems to determine innocents or guilty. I didn’t open this can of worms..I am just a messenger/advocate for the estimated 100 million chronic pain pts.. IMO.. the GDF policy is only part of a larger problem in pharmacy and chronic pain pts. This whole issue is just going to sort itself out in the system. Those RPH’s and companies that are during their utmost to make sure that pts with legit chronic conditions.. get what they are legally entitled to.. Won’t have a problem. Tonight I heard for a pt in Florida that had been going to the same store/doc using the same meds for years.. a new PIC came on board and decided that this pt didn’t need these/his meds… Today he told me that he moved all his Rxs to a local independent and got them filled without a problem.. Let’s see if that chain and PIC fares as well.. when the ADA complaint that he filed is resolved. His father is also friends with the local Sheriff and is going to talk abt PT ABUSE with the Sheriff.. be interesting to see how this shakes out..

          • I’m well aware of what Walgreen’s “secret checklist” entails. (Incidentally, it’s been changed significantly since that image leaked), but that’s not really an expose on pharmacist’s improperly holding back medicine. If you meant to link to the CBS expose or whatever where there were a lot of stories about how Walgreens all the sudden stopped filling their pain medicine for their MS/debilitating back pain/other condition, I’ve seen that. I’ve read every post you’ve made on the site for a long time. I like the polar opposite opinion from how I feel, it keeps me grounded sometimes. But all these stories lack definitive proof that the patients are on legitimate therapies – we don’t know anything about the patient (obviously for good reason in HIPAA). There’s nothing saying that each person interviewed didn’t put on a sad face and make up a sob story because they didn’t get what they wanted. I know that sounds incredibly jaded – but if you go back and read stuff from drugmonkey or angry pharmacist going up to a decade ago, you’ll see the same complaints – “the mean pharmacist won’t give me my pills, the doctor wrote me a script why are you questioning him?”

            You’ve been talking about cans of worms with ADA and denying prescriptions and everything – the real can of worms is removing the pharmacist’s ability to deny a script they don’t feel comfortable filling. If we get a class action suit against us for that, we’re going to be sent back to 1940 as a profession. Only, that’s going to be the impetus to completely remove us as a profession.

            IMO – a succesful ADA suit would require proof that a pharmacist didn’t fill these prescriptions because the patient was a chronic pain patient. The logical counterpoint (and the same way that every other discrimination suit is defended against) is by pointing at every single exception to that rule. All of the patients who the pharmacy DOES fill for for oxycodone. There isn’t a pharmacy alive that refuses every oxycodone prescription they receive on principle, unless the pharmacy outright doesn’t stock the medicine. And if they don’t stock the medicine (like there are plenty of pharmacies around here that do just that), is that considered discrimination as well?

          • Your story about the patient in Florida who all the sudden had his filling refused at a pharmacy after seven years is absolutely sad – but as was addressed on a previous post, neither of us have any idea what it’s like working in Florida after the DEA went crazy on them. And the morale of the story is that, even in Florida, the patient was still able to find a pharmacy that would fill all their scripts. Especially in Florida, older pharmacists know which doctors they can trust as legitimate. This new kid came in, probably was 1) terrified of filling a C2 because of the pressure from district management shrieking about the fine they paid or 2) did not have a relationship with the -legitimate- doctors around his area, and therefore couldn’t use his judgment, choosing to err on the side of caution rather than give a prescriber he’s unfamiliar with the benefit of a doubt. That’s an argument you can latch on.

            I’m not trying to bust your balls, Steve, but every time I read the posts about class action lawsuits and pharmacists denying pain medicine to long term sufferers, I feel like it’s a slap in the face to me. It would be INCREDIBLY profitable for me to fill every C2 cash script that comes in. I’m actually trying to use professional judgment when I apply my reasoning for whether I fill or not. That’s not unique of me. That’s not rare for most pharmacies. The system failed you on an occasion, and I get that. But the plural of anecdote is not “data.”

            • Reading your reply left me livid! I have been left multiple times without my medication because no Walgreens; who I have been filling with for more than ten years, seems to have my medication! How long and how often should I be left without medication? And when I get desperate enough and go to the hospital and get no help … how many return trips should I expect to make in order to get a physician fearless enough of the DEA or whoever else they may be afraid of to be sure I get the medication that I have the prescription for in my purse that I have been unable to fill! Lastly ….. how would you feel if an ER doctor called a pharmacist to be sure you could fill that prescription that you have been out of for days because no one seems to have the medication on hand or better yet … just does not feel comfortable filling for you! When the ER doctor locates your medication, and has your friend take it across the street to that pharmacy and they except it …. how would you feel when you got a call about 40 minutes after you have left the hospital and were told that they had made an error and did not have your medication? How would you then feel if you tried to explain that you were desperate for your medication at the Walgreens stores pharmacist and instead of filling that script; they called the sheriff to come visit you and caused you to be baker acted ….. after you went to the ER again … after the store was not willing to fill for you on the basis that they made an error PS. this is not hypothetical and happened to me just a few weeks ago! Wear my shoes for a few days and feel the pain and then the agony which comes with defeat!

        • Your Xanax script example is mine. The one they won’t fill. Would you care to see the hives covering my body? Fuck you

  14. Thanks Steve,

    If and when I need this its here for me and everyone , I wasn’t for sure what to do if any scripts where denied, I haven’t had that problem yet. Everything is going good here in Houston. Keep up the fight , not many pharmacist would care this much for chronic pain sufferers.
    I’ve been reading negative stories about Zohydro ER like its the worst most negative thing that could ever happen. Its only as bad as people like reporters make it, bunch of idiots.

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