what to do when a Pharmacist refuses to fill your C-II Rx that has been sent electronically

I am having pts reach out to me with what I see is a fairly disturbing pattern…  One of the basic functions of the practice of medicine is the starting, changing or stopping a pt therapy.  It use to be that if a pharmacist refused to filled a Rx – C-II in particular, the pharmacist should hand the paper Rx back to the pt.

Now with all- or nearly all – Rxs being transmitted electronically, if a Pharmacist refuses to fill a C-II… the particular C-II literally becomes a INVALID RX.  Unless the DEA has changed their rules/regulations, any chain using a central server/database… any store in the chain can pull the E-Rx C-II on the central server and fill it…

At least ten years ago, Walgreen granted their Pharmacists the permission to “black ball” any pt… for any particular reason – or no reason at all  – and the pt is “black balled” in all 9,000 stores. There is rumors that CVS has adopted the same procedure/protocol.  Each of those chains has abt 9,000+ stores, so a single pt can be black balled in a single store in each chain and they are black balled in about 25% – 30% of all the retail/community pharmacies in the country.

Any electronically sent Rx – other than C-II – can be transferred to another pharmacy either verbally by the Pharmacist or simply print out the electronic Rx data and fax it to the store that it is to be transferred to.

I think that a pt that has a pharmacist to refuse/decline to fill a electronic C-II,  should ask the Pharmacist to print out the electronic Rx data – it can’t be a valid C-II – because in order for it to be a legal  C- II hard copy is for it to be SIGNED IN INK by the prescriber.

Shouldn’t the pt be entitled to a copy of the prescribed med/strength, quantity and directions with the pharmacist’s name and license number and be signed by the Pharmacist. Ask that any notes added by Pharmacy staff on the Rx be print out as well.


In health care… it is typically quoted … “if it isn’t documented ….  IT DID NOT HAPPEN …”

If the Pharmacist refused/declines to provide a hard copy of the Rx data information.

I can’t think of any valid reason that a Pharmacist would use to not give a pt a copy of the Rx info.  What if the Pharmacist put notes of the Rx … “I’m not comfortable filling this”… “the pt appears to under the influence…”  or some other derogation comments about the pt.

It is not outside the possibility- it has happened before –  that the Rx dept staff are refusing to fill C-II… so that they can fill it after the pt has left … for diversion purposes.   Many of the opiates are “worth $1/mg ” on the street.



4 Responses

  1. That is shocking about being blackballed at major drug stores – for all their stores! So the pharmacist is having a bad day and takes it out on me…JUST ONE PERSON in the chain of pain mgmt can cause me troubles. That is scary. And it’s a chain made of many links!

  2. If that is true about diversion wouldn’t that show up on the pdmp as having been filled for that patient?

    • YEP….but if they mis-spelled the pts name transpose two letters in first and last name … the bigger risk is they bill the pt’s insurance and then the pt get denied when they get a replacement Rx … no matter where they got it filled.

      • This happens to me alll the time w/the name being mis-spelled in medical recording,,,My last name is german pronouced Willy,,, BUT it is spelled,,Wille,,,,,ALWAYS,ALWAYS,,, its either spelled Willie,Willly,,, BUT ,,never simple the right way ,Wille,,,maryw

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