Oh thank god my prescription plan knows more than my doctor

[hellziggy]

hellbob's company was bought by Boston Scientific so we have a new prescription provider this year, PharmaCare. Whatever. As long as we get our drugs for just a copay it's the same difference to us.

So yesterday, I went happily skipping into Walgreens with my methylphenidate (Ritalin) prescription all fresh & shiny and autographed by my doctor. Dropped it off and came back for it a couple hours later.
Couldn't get it.

Apparently my prescription insurance is worried that it may be overprescribed. They have to have an authorization from the doctor stating why I need to take it.

Now this isn't a refill that's run out so they need a doctor's authorization. Oh no. Methylphenidte is a Schedule II controlled substance ( http://en.wikipedia.org/wiki/DEA_Schedule_1#Schedule_II_drugs ) so I figure that's why. Because it's Schedule II I can't get more than 1 month at a time. I have to have a physical prescription each time. The doctor can't call in or fax in the prescription. I can't get post-dated prescriptions from her. No. Each and every month I have to call the clinic to have her write the script. Then I have to haul ass after work to get to the clinic to pick it up before they close (It's for ADD! Of course I don't order it early enough to have them mail me the prescription!) Then I have to go to the pharmacy to drop it off and then either wait for it or remember to go back for it.
Pain in the butt.

But the best part about them now also wanting the doctor to tell them why she wrote me a prescription? (other than the fact that as a medical doctor she is waaaaaay more qualified to say what meds I need than they are?) They only want doctor authorization on methylphenidate IF THE PATIENT IS OVER 18 YEARS OLD!!!

Yes, in a country where almost all articles on ADD/ADHD are talking about how over-diagnosed and over-medicated it is in children my prescription company doesn't care if you want to give it to a kid.
But god forbid a grown woman who knows how to take care of herself wants it! An adult whose dose hasn't increased in over 4 years. An adult who has never done any illegal drug other than drinking alcohol between ages 18-20. Don't let her have that Ritalin! She might be a speed freak!
Grrr.
Fucking bureauocracy!

Comments

[allegraconbrio.livejournal.com]

That's a new one to me, I've not heard of amphetamine Rx's needing any additional authorization other than the hoop you were already jumping through (not being able to get long term Rx's and having to present the prescription in person. I have heard of that). Very annoying for you. And it does seem ridiculous. Feh. *hugs you*

[hellziggy.livejournal.com]

Too bad your company doesn't make a generic of it that you could just smuggle out to me! *hugs back*

[mle292.livejournal.com]

God, I hate insurance companies.

See, I have this friend...

[mle292.livejournal.com]

AND, another thing. See, it isn't ALWAYS that people need to pick up prescriptions for Schedule II drugs.

I know someone who takes ADD meds for a sleep disorder. His sig. other takes very similar drugs for ADD.

The person with the predisposition to have trouble with scheduling and distractions must arrange for time to pick up a physical prescription at the doctor's office. The person without such issues can call an automated phone number at the pharmacy for refills.

Yeah. Makes perfect sense.

[caitirin.livejournal.com]

GOD I hate insurance company losers!

[vanaabegra.livejournal.com]

Sounds like my shitty-ass fucktard of an pharmacom "benefits" company. Benefitting themselves is more like it.

Dr. prescribes Drug X. Drug X is Schedule IV. Pharmacom benfits cum-stains have decided you must have a DME#1 in order to get Drug X. They deny claim, once again, knowing better than the Dr. Dr. calls/fills out forms and says patient has DME option #2, give him Drug X. Pharmacom benfits cum-stains say "we give a fuck? Prescribe Drug Y or equiv, but no DME#1, then no Drug X." Drug Y is Schedule II and has many worse long-term health risks than Drug X. Fuckers.

mle292 is about 95% correct, unless she is talking about a different friend. SigO calls the automated line at the Dr's office and they mail the prescription.

[hellziggy.livejournal.com]

But hey, at least that friend looks good in a kilt! :)

[mle292.livejournal.com]

Ooops!

Okay, I was pretty close. And, I didn't know about the part with the cum-stains either.

[mr-felis.livejournal.com]

See, this is one of the million reasons a social health insurance system is better than the crappy US system. Pay more taxes, get free health care. It's a winner every time.

[scubagrrl.livejournal.com]

I'm sorry they're such morons. And the policy is stupid. I hope you get your drugs soon.