Kelly asked
I feel that pharmacists are biased against people who are on controlled substances. I have recently moved to a new state and am seeing a new practitioner. I'm on a mood stabilizer, 2 antidepressants, a benzodiazepine as needed and 10mg of Adderall. In NJ, where I lived before, I had 5 different residences in the last 10 years and subsequently utilized the services of 9 different CVS pharmacies in that time period. I have been on .5 Klonopin for 20 years prn and 10mg Adderall for 1.5 years. I never overlapped prescriptions (not sure you can now anyway), and I take my medication as prescribed. This new pharmacy is giving me much difficulty in filling the Klonopin and Adderall stating the insurance declined it and they need authorization. I offered to purchase the medications with cash as I don't want to be without them due to my psychiatric conditions and potential withdrawal effects. They said it is illegal in NY state to dispense controlled medications for cash payment if the patient is insured. Tomorrow is day 3 that they have the script and I fear they will continue to tell me it's not authorized. I understand the risk pharmacists are taking with controlled medications, but in my file you can clearly see I fill every 30 days and at the same milligram. Is the pharmacist acting with bias against me? Does the pharmacist think I am a drug abuser? Is that the reason for their condescending tone and impoliteness against me? How do I remedy it so I can get the medication I so need for my condition?
Answer
I'm certainly sorry to hear of the problems you have experienced, both in regard to trouble filling your prescriptions and how you have been treated at your pharmacy.
Pharmacists have the legal obligation to deter drug abuse and diversion. As such, they are trained to lookout for certain "red flags", such as:
- Filling controlled substance prescriptions at multiple pharmacies
- Getting prescriptions from multiple doctors.
- Going to a new pharmacy.
- Going to a pharmacy outside of the area the prescription was written.
If a pharmacist gets a prescription that raises any "red flags", they are going to look into it and possibly question you regarding it. This does unfortunately come off at times as combative or derogatory to the patient. Patients deserve to be treated with respect and if you feel you are not being treated well at your new pharmacy, it may be prudent to look into others.
Nevertheless, a few things you mentioned in your inquiry (e.g. using 9 different pharmacies, moving to a new location) would certainly be red flags and would necessitate the pharmacist investigating the medical necessity/legitimacy of your prescription(s).
We can't comment on your specific situation as we don't have all the details, but it is imporatnt to find out why your prescriptions are being rejected.
- Are they being rejected from the insurance company?
- Are they being rejected by the pharmacy or pharmacist?
- Were they cancelled by your doctor?
If it is the insurance company, there is a reason why the prescription is being rejected. It could be a non-covered drug and need a "prior authorization" from the doctor. It could be that your fill is coming back "too soon" to fill. It could be rejected for a "therapeutic duplication", meaning that a similar drug was filled too recently. Ask your pharmacy what the specific rejection is and if there is anything you can do to expedite the process. Often times involving the doctor helps, especially if the drug isn't being covered.
It is vitally important you know why your prescription is being rejected. Only then will you have a better understanding of the situation and what to do. If you wish, please reach back out to us when you have more information on why your prescription is being rejected and perhaps we can provide you with some steps to remedy the situation.
In terms of being illegal to fill a controlled substance prescription for "cash" if you have insurance, that depends on the state laws where you live. In certain states, if you have a government funded insurance such as Medicaid, it may be illegal to pay cash for a prescription if it is being rejected for a certain reason.
We wish you luck!
