DebinCNY asked
I have been prescribed fentanyl 75 mcg/48 hrs for years in Syracuse, NY. Last week my insurance company needed a new prior authorization (PA) and quantity limit exemption from my doctor. The insurance company has not reviewed the forms yet-they have 72 hrs to make a determination I'm told. I needed a refill on the 23rd. Since I couldn't afford to pay the $249 for the 15 patches, I bought two after struggling with withdrawal for 3 days. The pharmacist stated that he will need a new Rx from my doctor in order for me to get more patches once the ins co approves the PA. It is my understanding that under the NY laws, that my doctor cannot submit another Rx for my fentanyl for 30 days. Is that correct? Thank you.
Answer
The situation you described is a result of New York State laws unfortunately and the pharmacist is correct that you need another prescription.
Part 80 of the controlled substance law states that schedule II medications, such as Fentanyl, cannot be refilled, regardless of if you filled a quantity for less than what the prescription is written for.
In your inquiry you stated that you filled 2 patches since you couldn't afford the full 15. The 2 patches that you filled and paid for was your one fill for that prescription. Per NYS law, it cannot be refilled for the remaining 13 patches.
This really wasn't what the law was intended to do. It was intended to simply limit the refills (zero) that a prescriber can put on schedule II drugs. Due to instances like what you described with your insurance, situations like yours do happen from time to time unfortunately.
Your doctor can legally write for another prescription. The law states you can have up to a 30 day supply of fentanyl, not one prescription every 30 days.
It is important for your doctor to be aware that you only filled 2 patches. Often times, it helps if the pharmacist can communicate this to the doctor so they are aware of the situation. Once your doctor knows you only filled 2 patches and need a new prescription, hopefully they will assist you in writing another since they can confirm what happened with the pharmacy.
