For numerous years the DEA has “forced/persuaded” the pharmacy wholesalers to RATION controlled substances that a community pharmacy can purchase.  That rationing is based on a PERCENT of all the Rx meds that a particular pharmacy purchases… I have seen rates of 15%-20% being thrown out as the limit of controls that a pharmacy can purchase.

Several of the statements/press releases that has been put out by Amazon over the past 1-2 weeks… have had some vague statements as to what they are intending to do.  One of their statements was to push the issue that they believe that they can sell pts medications for less than their insurance copay.

They also said that they would inventory “common prescribed medications”… since controlled substances are typically 15%-20% of all prescriptions – will they be considered “commonly prescribed medications ” Just think of all the potential headaches of dealing with the DEA that they would avoid if they don’t dispense controlled meds ?

Just like pain clinics wants to only do ESI’s on pts so that they are not dealing with controlled substances.

If people start having their non-controlled meds filled at the Amazon mail order pharmacy, that means that the local community pharmacist will be purchasing fewer non-controlled Rx meds and most likely the DEA will reduce their ability to purchase the amount of controlled substances as they have in the past.

Could this produce a larger “out of stock” issue by local pharmacies for controlled substances and/or if the local pharmacies are even able to retain enough overall Rx business to remain profitable enough to remain in business.

The vast majority of controlled substances are prescribed to pts who are dealing with subjective diseases (Pain, Anxiety, Depression, Mental Health & ADD/ADHD). The total number of pts that could be affected could be a HUGE NUMBER.

As fewer and fewer controlled meds being distributed by pharma wholesalers, will this just encourage the DEA to cut pharma production quotas on controlled meds even that much more ?

Could this end up causing a whole lot of collateral damage to those pts with a valid medical need for controlled substances that NO ONE WILL CARE ABOUT ?

UPDATE

We do not deliver Schedule II controlled medications, which includes most opioids. Learn more at amazon.com/pharmacy.

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Hello Steven

I was very impressed with the article that I just read .  I am having that problem with a Walgreens store located in Indialantic Florida 32903 Highway A1A and Paradise Boulevard. I have been using that Walgreens store where I have been filling my chronic pain medicine hydromorphone (4 mg) for the past 4 months and before that I was with them for years  The pharmacist would not fill my prescription based on the fact that it was increased from 4 mg to 8 mg 3 times a day 90 tablets.  I had to wait 4 days until I found another Pharmacy to fill my prescription and therefore was without my pain medication.  The reason other pharmacies did not want to fill it is because on record I am a patient using Walgreens pharmacy. and I should not be using different pharmacies.   I just went to the doctor and have the same prescription that’s why I  hope you might be able to help me. It is due to be filled on the 27th of this month.

  Here is my response to this pt:

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I have always had a concern about mail order pharmacies.. first of all… all medications have temp storage requirement typically in the mid-50’s to mid-70’s. These storage requirements have to be met by the pharma, wholesaler & the pharmacy.  But, when a pharmacy hands off a packaging of Rx meds to a delivery service… NO ONE has a obligation to maintain those storage requirement.   Normally, if a pharma, wholesaler, pharmacy allows Rx meds to be outside of the required temp range for > 24 hrs the product is consider adulterated and NO LONGER SALEABLE.

From this article and others that I have read, Amazon appears to be “pushing ” paying cash for Rxs.  If this Amazon pharmacy has a contract with your health insurance and you pay cash… it won’t applied to your deductible and highly possible if you submit your cash receipts to your insurance company they will not reimburse you and apply to your deductible because Amazon pharmacy has a contract to bill the insurance for the pt.

Encouraging pts to PAY CASH the Amazon pharmacy will not have to deal with the BS from insurance companies in getting a Rx claim thru the system and with a charge card .. Amazon will get their money in – at most – a couple of days instead of having to wait 2-3 weeks for the insurance company to pay and then reconcile their payment against what was billed and won’t get docked with those unpredictable DIR fees.

If this Amazon pharmacy functions like most mail order pharmacies, filled Rxs may not reach the pt for up to TWO WEEKS and what does their statement mean that they “will offer commonly prescribed medications“… Does that mean NO CONTROLLED MEDS ?  The DEA states that it is RED FLAG for a pt to pay cash for a controlled substance if they have insurance.

Amazon opens online pharmacy, shaking up another industry

https://www.foxbusiness.com/retail/amazon-opens-online-pharmacy-shaking-up-another-industry

The company opened an online pharmacy Tuesday, giving Amazon shoppers the chance to buy their medication and order refills on their phones and have it delivered to their doorsteps in a couple of days, just like a book or toilet paper.

The move propels Amazon into a new business, potentially shaking up the pharmacy industry as it has done to everything from book sellers to toy stores and grocers. Big chains like CVS and Walgreens rely on their pharmacies to bring them a steady flow of shoppers who stop by frequently to pick up their medications.

Amazon said it will offer commonly prescribed medications starting Tuesday, including creams, pills, as well as medications that need to stay cold, like insulin.

Shoppers have to set up a profile on Amazon’s website and have doctors send prescriptions to the Seattle-based e-commerce giant.
ONLINE SHOPPING SURGE COULD LEAD TO HOLIDAY DELIVERY DELAYSMost insurance is accepted, Amazon said. But Prime members who don’t have insurance can also buy generic or brand name drugs from Amazon for a discount.Amazon has eyed the health care industry for some time. Two years ago, it spent $750 million to buy online pharmacy PillPack, which organizes medication in packets by what time and day they need to be taken. Amazon said that PillPack will continue, focusing on shipping medication to people with chronic conditions.

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And something that not many doctors are talking about lately is one of those that apparently is a symptom caused by some vaccines. And it is that although within the study impotence is not taken into account as a determining factor within vaccines, the trend seems to indicate the opposite. That is why at UK Meds they take this problem very seriously and try to deal with it by offering the most effective product against this problem, being one of the best sellers in the United Kingdom.

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Click on the link below to listen to a 32 minute pod cast that details how a ultra fast metabolizer intractable chronic pain pt was forced to decrease his dose OVER 75% and he ended up committing suicide… evening behind a young wife with FOUR KIDS.

http://standandfight.buzzsprout.com/359756/2002150-stand-and-fight-podcast-darleen-h-palmer-pain-managment-vs-addiction

In this episode Darleen shares the story of her husband Adam. He caught a rare disease from a tick called Rocky mountain spotted fever which left him dependent on pain meds to function. The problem became dealing with the insurance companies and his struggle to find common ground with them. In the end her husband took his own life. Now she is her to tell his story and to help other families in need. She is now a single mother of 4. Sometimes we don’t think about the 1% who live with an insane amount of pain on a daily basis. They need medication just to function. Myself being a recovering addict i always fight for everyone to be drug free but this conversation helped me with the other patients who actually need it. A voice clip of the husband’s suicide goodbye message is on this podcast so if you are vulnerable or feel you might be triggered please don’t listen or listen with a friend.

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https://youtu.be/5WZCh3TeTa0

RSD/CRPS is a condition that needs much attention. Charles saw this dire need and wanted to contribute to get that need filled. Charles has talked to many, heard scores of stories and researched the condition; with this knowledge, his heart was moved to get involved and become an advocate for the condition through the love of his mother and the heartfelt for the countless others suffering. This moving piece takes us on a journey that will impact the perspective of how we view healthcare and the caregivers of those suffering daily. We walk with Charles as he helps his mother through her own treatment and life changes. We will also meet others fighting to stay alive from this deadly disease. We will fight to help this project move the health care system to figure out ways to help those who need the funding or the health care coverage to get the needed treatment to allow them to live. We will expose what at times seems like Guinea pig-type of treatments that at times can do more harm than good. This is a story that needs to be told and this documentary will open the eyes of many around the world that never knew of this condition and bring hope to those with CRPS. For more info on Charles and his work visit. To work or book Charles visit http://charlesmattocks.com PLEASE SUBSCRIBE TO THE CHANNEL AS WE ARE LOOKING AT DOING ANOTHER FILM BASED ON CRPS AND RARE DISEASE, GET THE LATEST UPDATES. All rights and music belong to our company.

https://www.youtube.com/watch?v=5WZCh3TeTa0

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I have Kaiser SoCal but prior to the last two years I had a private dr in Texas and took pain medication, 6 mg of Xanax & ambien for 7 years. No overdose no narcan required. I moved back to Ca after surviving a brutal attack now having anxiety so bad I am having psychogenic blackouts and the ambulance is coming to my job. Kaiser refuses to give me more than 2mg of Xanax even though it’s become physically dangerous s they also refuse to properly diagnose the blackouts as well as the very obvious adhd I’ve always had. If it involves controlled medication you won’t get diagnosed , they also lie on your chart and black ball you from all care of you switch DRs. I have fought them like crazy for proper care and they refuse to do anything stating I refused their treatment plan which is a lie. I already take gabapentin and have tried hydroxozine which is a joke for anxiety at my level, increased gabapentin is not going to stop the severe stress skyrocketing my cortisol and me passing out. I can’t believe there aren’t major groups fighting Kaiser for their horrific treatment.

I realize that not all readers of my blog read all the comments… but this is not the first time that I have received a similar comment – or email – from a pt that has health insurance from Kaiser Permanente telling about similar denial of care from them.

Kaiser Permanente is considered a HMO

Health Maintenance Organization (HMO)

and the definition of a HMO:

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

HMOs often provide integrated care and focus on prevention and wellness.

Does the care that this pt is claiming to be receiving has a focus on PREVENTION & WELLNESS ?

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