Mail order Pain Meds Shorted Big Time!!!

[Maggie]

UPS brought my hydrocodone today and I was shorted 160 tablets. The pharmacy acted as if I couldn't count, couldn't see three bottles and etc...etc... I hate this. They said they could not send me the amount in question since it was a narcotic but would refund me.....HA a total amount of $6.00 and everything would be O.K....

This makes me so mad. They don't understand that the doctor doesn't recognize mistakes like that. I want to know what they to do correct this since I have to depend on them for future prescribtions. Finally, I talked to a supervisor and asked her that. She said they would be sending me a form to fill out. I still don't see what that will help me explain to the doctor.

By the way, after I talked to them and investigated the box, I could see three layers of tape on it. The top layer wasn't cut but the ones underneath it was. It looked as if someone opened it and taped back over.

Good ole Walmart prescription service. :mad: Of course, it could be the UPS people as well. I just don't know.
Maggie

[Pharmacist.steve]

Save the box and file a complaint with UPS.. also file a complaint with the state board of pharmacy in both the state they operate and the state that you live in.. as well as the local offices of DEA where they operate and where you live. File a written complaint with corporate headquarters.

You could also file a complaint with the local police .. it would seem that theft was involved.

It is unlikely that a bogus patient would go to that much trouble and draw that much attention to themselves.

Forward copies of all correspondence to your doc...

[Maggie]

Thanks Steve, for that information and advise. Is it true that they cannot make up the difference or were they just using that excuse?
Maggie

[Mark N]

Steve has given you very good advice. It is my big concern with prescriptions by mail and the reason I haven't gone with the VA yet. I am sorry you are going through this but with all the correspondences to the doctor he should make sure you get the meds you need.

[Maggie]

Thanks Mark. Believe me, if I had any other way, I would take it. I'm considering selfpay for this particular med. It is the only one I would worry about. My doctor is very understanding at this point, but, if something like this happened again, I doubt he would be that kind.

[suede]

Maggie,

I'm really sorry this has happened and I can sure understand how you feel, I had much the same thing happen, though fortunately it was at the local pharmacy and not mail order but it still caused me a lot of stress,

I'm with Mark on this one, this is also the reason I have not gone with our mail order program.

"Quote"
"My doctor is very understanding at this point, but, if something like this happened again, I doubt he would be that kind".

Does this mean that you have talked with him about this and that he is willing to help you this month??

If it's possible and I was you I would go ahead and pay for this script as this med is one of the less expensive ones and could surely eliminate a lot of hassle for you.

As usual Steve had very good advice I would be sure and do as he suggested so that there won't be any question in the future about this incident and maybe they will be able to get some answers and results for you, just might be that this is something that has been happening for a while and whoever it is doing it may be under investigation and your filing reports will help catch them.

Lots of luck,
Linda

[Pharmacist.steve]

Thanks Steve, for that information and advise. Is it true that they cannot make up the difference or were they just using that excuse?
Maggie

These mail order facilities are HIGHLY AUTOMATED and should have a perpetual inventory on all drugs and most use some sort of bar code scanning to verify what is shipped against what was ordered. From what you stated they are obviously not using tamper proof tape on the package. I read a ad tonight for a automated computerized filling system and they claim a 99.99% accuracy. which means that on average one tablet/cap miscount out of every 10,000 counted.

They should have records of how much the package weighted going out the door and should be able to figure out how much a package should weight with your meds in it.

Not knowing just how this particular system works .. the package could have been weighed BEFORE sealed and someone in the shipping dept removed a bottle before it was sealed.. The shipping company should have a weight of the package in route. If more than one weigh point was encountered .. it could point to where - along the line - the package could have been opened and a bottle removed.

I would also file a complaint with your insurance company. They might be paying for meds that never reach their clients.

While the pharmacy can't just replace that much opiate without some research into the issue.

I would be amazed that you couldn't force a lot of questions to be asked by filing complaints and I would STRONGLY suggest contacting the insurance company provide a authorization over-ride on a early refill - provided that your doc would approve it.

I have little use for mail order pharmacies.... being that remote and for the most part totally detached from the patient... they have little reason to be accountable...

[Maggie]

Thanks again all. And, the informaton Steve gave is valuable in that I know they possibly can track down the discrepency.

I've not talked to my doctor about this yet, but, in the past when there was a delay in getting my meds, he was very nice. I worked with him at the hospital when I had students there. I am overly sensitive, like most of you, about having any kind of doubts cast on my motives.
Maggie

[photonut]

Maggie:
I hope you get this fixed soon. This kind of stuff can cause you all kinds of grief as you already know...Keep us posted on how its going in getting this repaired.........Allie:eek:

[BrokenBladder]

Maggie it disturbs me so much to read what happened to you. I also use a mail order pharmacy, but I was told a a long time ago by someone on this board to suck it up and take the controlled substances to the local pharmacy. I tool that advice and it would seem that things are getting desperate out there for our meds. At this point who know if it ws the mail orer company or UPS, but it doesn't really matter because you're the one who will have to face your doctor and see how he reacts and I would also let him know that you will never mail that particular medication in again. Take care sweetie and let us know how this plays out for you. I will be praying that your doctor understands.

[Maggie]

I am definitely going to get this med at a local pharmacy from now on. I'd rather pay extra. I'll keep everybody posted on the outcome.
Maggie

[Rozia]

Maggie I have a question . You said Wal mart . are you saying that they deliever and have a mail order program . If so where and how do you do it. thanks

[Maggie]

My Medicare Prescription program is with Humana and they use the Walmart mail order prescription service. I don't know if you can use them without being a member of an Insurance program or not. This particular Walmart is based in Carrolton, TX.
Maggie

[Pharmacist.steve]

Maggie I have a question . You said Wal mart . are you saying that they deliever and have a mail order program . If so where and how do you do it. thanks

Let me understand this ... Maggie and others have stated having problems with mail order ... particularly with being shorted their pain meds .. AND you want to know where they are and how you can use them ???

With mail order pharmacies there are TWO ENTITIES that handle your meds after the Pharmacist/Tech fills them .. the shipping dept at the mail order firm and the courier ( UPS/FEDEX/DHL/USPS) Hydrocodone has a STREET VALUE of $4 - $8 EACH.. Oxycodone has a street value of $0.50 - $1 PER MILLIGRAM...

Even if the mail order firm or courier finds someone "walking off" with controlled substances .. and they are caught.. it is most likely going to be handled on a very hush basis locally... The last thing large companies want is to advertise that their policies are lax enough to allow this to be permitted in the first place.. would just encourage people to apply for jobs that have alternative motives ... let along the loss of confidence & business from customers like Humana and patients individually.

When you patronize a local pharmacy ... you can "eye-ball" the meds at the Rx counter and while there may be a small mis-count... but a large number of tabs/caps missing would be obvious and should be able to be corrected before you walk away from the Rx counter.

While Maggie may have saved few dollars in using the mail order.. I just wonder how those savings are going to be relished if she has to do without her opiates for a month or more or becomes labeled as a "potential drug abuser" over this incident - which was none of her doings

[Gimpy]

Let me understand this ... Maggie and others have stated having problems with mail order ... particularly with being shorted their pain meds .. AND you want to know where they are and how you can use them ???

With mail order pharmacies there are TWO ENTITIES that handle your meds after the Pharmacist/Tech fills them .. the shipping dept at the mail order firm and the courier ( UPS/FEDEX/DHL/USPS) Hydrocodone has a STREET VALUE of $4 - $8 EACH.. Oxycodone has a street value of $0.50 - $1 PER MILLIGRAM...

Even if the mail order firm or courier finds someone "walking off" with controlled substances .. and they are caught.. it is most likely going to be handled on a very hush basis locally... The last thing large companies want is to advertise that their policies are lax enough to allow this to be permitted in the first place.. would just encourage people to apply for jobs that have alternative motives ... let along the loss of confidence & business from customers like Humana and patients individually.

When you patronize a local pharmacy ... you can "eye-ball" the meds at the Rx counter and while there may be a small mis-count... but a large number of tabs/caps missing would be obvious and should be able to be corrected before you walk away from the Rx counter.

While Maggie may have saved few dollars in using the mail order.. I just wonder how those savings are going to be relished if she has to do without her opiates for a month or more or becomes labeled as a "potential drug abuser" over this incident - which was none of her doings


Ummmmm..... maybe she wants to use it for other meds that might save her some money and have low theft appeal? A lot of people take multiple medications and need to find ways to save. No need to get out the sarcastic stick.

Gimpy

[Maggie]

Steve is right, it is a bitter pill to swallow just because you are doing what the establishment requires. I blame a lot of my prescription problems on the new medicare program.

I am not allowed to buy maintainence medications at a local pharmacy. From my understanding it isn't only a matter of saving one month's worth of meds, but it is a requirement. If that is incorrect, I would love to change my way of ordering. I was getting my medications locally but the local pharmacists said I cannot get the 90 day supply that way.

Someone needs to put out a patient's rights guide when it comes to the Medicare Part D prescription program. My medications along with three blood pressure meds, synthroid, lipitor fentanyl, are just too expensive to have someone in a big office telling me how to buy them.

I pay a premium of $80.00 a month and am now in the gap which means nothing but generics are covered.

Maggie

[Pharmacist.steve]

Some pharmacies elected to not sign the 90 supply option BECAUSE the reimbursement provided on 90 day supplies is often below their cost. Unless you are on a Medicare Advantage program .. open enrollment period for Part D starts Nov 15 for 2008.

www.communitycarerx.com is the only not-for-profit national PDP and is partially owned by the National Assoc Community Pharmacists and Nat Assoc of Chain Drug Stores... they have a 90 day program and NO MAIL ORDER SERVICE... and one of the largest coverage formulary.. that is allowed by the law..

[Maggie]

Steve, I bookmarked that web site the last time you posted it and I definitely am going to change to them come the first day of enrollment. I am paying too much for a lot of BULL.
Maggie

[Pharmacist.steve]

Steve, I bookmarked that web site the last time you posted it and I definitely am going to change to them come the first day of enrollment. I am paying too much for a lot of BULL.
Maggie

It was quoted earlier this year that they are the fourth largest PDP and had the smallest % of people dropping them at the end of 2006...

[Mark N]

Maggie, it isn't the new part D that is the problem but sorting out the companies and which one fits us better. Now you know which one not to use in your area. I hope the new one you pick works much better for you. It will be a good deal for you to get the pain meds locally even if it cost more in the short run. Steve is right about saving a few dollars isn't worth it when you didn't do anything wrong but have to do without meds for a month or get labeled as drug seeker [I hope that doesn't happen to you]; for me it is worth a few more bucks to get the meds locally.

[algosdoc]

As a physician, I agree completely with Steve's position on hydrocodone. I have had patients try to save a few $$ with 90 day supply mail order, then when they are shorted, we take the position the issue is between the patient and their pharmacy. Hydrocodone is the most abused prescription drug in America and is also the most stolen.

[curiousforever]

Steve has given you very good advice. It is my big concern with prescriptions by mail and the reason I haven't gone with the VA yet. I am sorry you are going through this but with all the correspondences to the doctor he should make sure you get the meds you need.

Exactly why I don't do the military's mail order.

I agree iwith Steve.

[neckbaby]

I don't have a choice whether to use my local pharmacy or mail order.:mad:
With the insurance plan through work we are forced to use mail order for any maintence meds.
We are allowed to fill the first three months through a local pharmacy and then have to do mail order.
At the cost of over 600.00 I can't afford to pay out of pocket at the local pharmacy.
The mail order company is such a joke as far as customer service ect. They know we don't have a choice and have to use them.
So some of us DON'T HAVE A CHOICE IN THIS MAIL ORDER CRAP.
I have a friend who is a mail carrier and it scares the crap out of him that he will be robbed some day with all these meds he has to carry in his vehicle.
Anyone with any brains knows if the meds require a signature to deliver it is something they could be robbed for.
So very frustrating.:mad:
Neckbaby

[curiousforever]

Neckbaby - I wouldn't even be able to get my pain meds at the mail order pharmacy - I think they only allow those to be monthly.

I'm fortunate that hubby is military - so even though I use a regular pharmacy (a military pharmacy doesn't have 1/2 my meds here....which then would be free) and my copays are 3 or 9...

[Maggie]

I received the forms from Walmart today to fill out. I was glad to see that these are being filed with the DEA, etc. I had planned to but now I will just take care of the local agencies.

I was extremely lost when it came to picking a plan. I looked all over the net for someone who could give me advise. It eventually came down to the final cost to me considering the medications I take. I couldn't have paid for the fentanyl patches even just during the gap.

I asked my local pharmacist which companies they had the best working relationship with thinking of the 30 day meds but they seem to be afraid to name names, so they were of no help.

I've checked with the pharmacy network that Steve mentioned and it appears I would save $1,000.00 or more a year.
Maggie

[Pharmacist.steve]

I asked my local pharmacist which companies they had the best working relationship with thinking of the 30 day meds but they seem to be afraid to name names, so they were of no help.

Pharmacists were PROHIBITED from advising patients to go to one plan over another. There was a HUGE FINE if they were caught. By our KNOW-IT-ALL government .. it was considered conflict of interest and potential "financial inducement" to influence a patient away or towards a particular program.

Of course, Wal-mart was allowed to have reps from Humana in their stores.... pushing their Medicare/Part D products... right near their prescription depts

Since I am not advising my patients/customers as to what plan may be of benefit to them... there is no potential of financial gain.. so .. I am outside of that "circle of risk"

[neckbaby]

Glad you got the forms and hope it all gets straightened out. It seems they are making you jump through all the hoops ect when you did nothing wrong.
Let us know how it goes and hopefully Something good will come of this.
But knowing Walmart :rolleyes:
Pharmacist Steve, Another one for Walmart. They seem to get all the breaks:mad: So glad we have you here to keep us on our toes and advise us.
Curious Forever. ... Yes isn't that crazy I can get three months worth of narcotics at once. When the mail order pharmacy told me I had to order my meds that way I told them I don't think that is possible. After talking to my Dr. much to my surprise it was. :eek: That is the only good thing about the mail order is I get my meds for three months at a time and don't have to go to the pharmacy every month. But I was wondering why can't I get three months worth of narcotics at my local pharmacy? :confused: Unless that has changed I never could before? :confused:
Neckbaby

[Pharmacist.steve]

I was wondering why can't I get three months worth of narcotics at my local pharmacy? Unless that has changed I never could before?

The PBM's ( Prescription Benefit Managers) won't let the local pharmacy provide 90 day supplies. They run/own the mail order pharmacies and they can make more money by encouraging patients to use their mail order component. With the Part D PDP's most of the contracts that I saw.. the local pharmacies were offered the ability to provide a 90 day supply but the reimbursement levels were below their cost of buy the drug - particularly brand names. So most all local pharmacies opted out of the 90 day programs.

What the mail order programs don't like to talk about is that most all drugs have a storage requirement of 58-85F - some like Fentanyl patches upper limit is 76F - but only the manufacturer, *********r, pharmacy is required to meet this storage requirement ... as soon as the pharmacy drops the package into the delivery service hands.... no one is bound by the temp storage requirements.

There was one asthma inhaler studied and they were losing ~50% of their potency in the heat of summer in being delivered via courier.

During the Regan years they talked about businesses merging and becoming "too big to fail".. while I think that is an impossibility .. they have none the less merged to a point where they are "too big to care"

While they said that you can't buy a member of Congress ... most seemed to be on long term leases.

IMO... Congress only cares about two classes of people .. the lower socio-economic ones that they can "buy" their votes with the promises of more entitlements and the "fat cats" that give them money to fund their campaigns in return for "favors" that will help the "fat cats" line their pockets.

If you are not a member of one of those "protected groups" ... you are pretty much on your own!!!

[Gimpy]

Regarding the 3 month mail order for narcotics:

I understand the pharmacy and insurance end of it; but..........

why can it be done that way when insurance dictates it, but we are not allowed to get 3 refills of narcotics with our local pharmacy. Does the DEA think that drug trafficers don't use mail order? How does this legally play out? I don't understand why I can't go see my pain dr. every 3 months and get 3 months worth of refills????? It is my understanding it is illegal to write narcotics for refills. Is it not? Then how is done legally through mail order? I'm sure that any person who obtains these meds under false pretense would never, ever sell 3 months of pills at a time. Whoa, I feel safer knowing the DEA has made out streets safer by this rule (obviously, not a law).

Another scratch my head law! Oh, I know, because THERE IS MONEY INVOLVED IN IT FOR THE CORPORATIONS!!!!!

Gimpy

[Pharmacist.steve]

Regarding the 3 month mail order for narcotics:

I understand the pharmacy and insurance end of it; but..........

why can it be done that way when insurance dictates it, but we are not allowed to get 3 refills of narcotics with our local pharmacy. Does the DEA think that drug trafficers don't use mail order? How does this legally play out? I don't understand why I can't go see my pain dr. every 3 months and get 3 months worth of refills????? It is my understanding it is illegal to write narcotics for refills. Is it not? Then how is done legally through mail order? I'm sure that any person who obtains these meds under false pretense would never, ever sell 3 months of pills at a time. Whoa, I feel safer knowing the DEA has made out streets safer by this rule (obviously, not a law).

Another scratch my head law! Oh, I know, because THERE IS MONEY INVOLVED IN IT FOR THE CORPORATIONS!!!!!

Gimpy

Getting a 90 days supply with one Rx is not the same as getting a 30 day supply with two refills ... the laws of this country don't have to make sense.. they just have to be obeyed.

If a doc writes for say a 60 day supply- of a CII and the patent does not want or cannot afford all 60 days worth... the pharmacist is permitted to fill it for any amount up to what it is written for .. BUT .. the balance of tabs/caps are voided and not available.

[Gimpy]

Getting a 90 days supply with one Rx is not the same as getting a 30 day supply with two refills ... the laws of this country don't have to make sense.. they just have to be obeyed.

If a doc writes for say a 60 day supply- of a CII and the patent does not want or cannot afford all 60 days worth... the pharmacist is permitted to fill it for any amount up to what it is written for .. BUT .. the balance of tabs/caps are voided and not available.

Oh, well, I see the big difference there! Totally makes sense now.

Only in America!

Gimpy

[Gimpy]

Bump - I really want to know why we cannot get 3 months of refills but we can 3 months of mail order pain meds? So if I get 90 pills a month, I can get 270 pain pills via mail order, but my dr. requires me to come in every month and I can't get 2 refills to go with my script, which would be 90 pills every 30 days. So, it's o.k. to get 270 pills but not refills or pre-dates on the script?

I don't get how one is legal and one is not?

Gimpy

[algosdoc]

The DEA has no limits on the number of tablets that can be prescribed on one script. However, no schedule II drug may be refilled, and the DEA believes writing predated scripts is an attempt by physicians to subvert the law.

[Gimpy]

The DEA has no limits on the number of tablets that can be prescribed on one script. However, no schedule II drug may be refilled, and the DEA believes writing predated scripts is an attempt by physicians to subvert the law.


But they don't believe getting mail order narcotics for a three month period is subverting the law?

I know nobody can answer these, but it really steamed me up. If the problems with mail order narcotics wasn't made aware here, I'd start getting mine the same way. It would save lots of money just avoid the monthly dr. visits.

Thanks Doc!

Gimpy

[Tbackpain1]

I just can't understand why anyone would risk their supply of meds via mail order. There are just too many opportunities for theft. I understand that some folks are forced into it by their insurance companies, but my PM doc refuses to write scripts for more than 30 days. My WC carrier wanted me to participate in Express Scripts and my doc flat out said No. They've backed off about it, but I'm sure it will come up again.

It always comes down to the bottom line, doesn't it?

Theresa

[hummer]

Dear Maggie.....
You may already be doing this, but something I have learned.....make a copy of every form you fill out, before you send it, and keep it together in a file....that way you have dates and all information, as stated, at hand.......

As you live in Texas, can you get your meds shipped through the United States Postal Service......It is a Federal offensense to tamper with anything going through that Government Agency....with very stiff penalties.....I do not know if it is the same with UPS..........

Filling out the forms, and sending them in, contributes to these people getting caught for doing this....you are leaving a paper trail that records this event, that may help show a pattern....in the culprits doing it to others, or targeting people.......

I hope you get this taken care of right away with the least amount of stress....or is that an oxymoron......HA......

Blessings to you....
Hummer

[Ragtop]

What the mail order programs don't like to talk about is that most all drugs have a storage requirement of 58-85F - some like Fentanyl patches upper limit is 76F - but only the manufacturer, *********r, pharmacy is required to meet this storage requirement ... as soon as the pharmacy drops the package into the delivery service hands.... no one is bound by the temp storage requirements.



I am surprised that you bring up patches in this discussion. I have checked
several times, and in my state (NH), I was told it is illegal to ship narcotics, period! My ins co, has tried several times to get me on a mail order plan, but each time, they come back to me and say, "you are right, we can't ship them in NH"
There must be federal laws about shipping narcotics, but does each state also have their own laws? If this is true, what a mess it is!
I'm glad that they didn't find a way to get me on the mail order plan, NO way would I trust my meds to a carrier of any kind, except me..LOL
How do the mail order programs get around these laws?

Peace
Rags

[Pharmacist.steve]

I am surprised that you bring up patches in this discussion. I have checked
several times, and in my state (NH), I was told it is illegal to ship narcotics, period! My ins co, has tried several times to get me on a mail order plan, but each time, they come back to me and say, "you are right, we can't ship them in NH"
There must be federal laws about shipping narcotics, but does each state also have their own laws? If this is true, what a mess it is!
I'm glad that they didn't find a way to get me on the mail order plan, NO way would I trust my meds to a carrier of any kind, except me..LOL
How do the mail order programs get around these laws?

Peace
Rags

At one time ... it was illegal to ship CII's by mail - at least federally... but that was repealed ... NH may have implemented a state law that still prohibits it. Pharmacy is a state regulated profession and Pharmacists are obligated to observe the most strict law when State/Fed laws are in conflict.

They get by with "all of this" is that they have convinced payors that they can save them money by making mail mandatory... they have convinced patients that they can save money by using them .. Pharmacy boards act/react to complaints ... if people aren't complaining.. the pharmacy board is not going to go looking for problems. Even if people do complain .. most pharmacy boards are poorly financed so if you have a mail order pharmacy on the east coast and sending meds to a patient on the west coast ... is the west coast pharmacy board going to send staff across the country to investigate??? Do they have any real authority on a pharmacy in another state?? unless someone has died or incapacitated .. they will most likely do a "paper investigation" .. nothing more than exchanging some letters and it goes away...