Pharmacy just ticked me off

[tinasmom]

I just went to pick up Nicole's prescription for Lamictal and they tried to switch it to a generic. They told me that the insurance company was denying the Brand name. I then told them that there is an order from the doctor on file that states Brand Name only Medically Necessary. They then told me that it has to be renewed every year. I told them that she has been getting this prescription for 2 years now with no problem. When I told them that the State Law does not require the doctor to renew this every year, they argued with me. I have looked up the law and this is how it reads:



450.13 Using drug product equivalent in dispensing
prescriptions. (1) DRUG PRODUCT OR EQUIVALENT TO BE USED.
Except as provided in sub. (2), a pharmacist shall dispense every
prescription using either the drug product prescribed or its drug
product equivalent, if its drug product equivalent is lower in price
to the consumer than the drug product prescribed, and shall inform
the consumer of the options available in dispensing the prescription.
In this section, “drug product equivalent” means a drug product
that is designated the therapeutic equivalent of another drug
product by the federal food and drug administration.
(2) EXCEPTION. A prescriber may indicate, by writing on the
face of the prescription order or, with respect to a prescription
order transmitted electronically, by designating in electronic format
the phrase “No substitutions” or words of similar meaning or
the initials “N.S.”, that no substitution of the drug product prescribed
may be made under sub. (1). If such indication is made,
the pharmacist shall dispense the prescription with the specific
drug product prescribed. No preprinted statement regarding drug
product substitution may appear on the face of the prescription
order.


I will be supplying a copy of this statute to the pharmacy and my insurance company. I guess they will find out that they just upset the wrong person.

 

[Meetz1064]

Oh, Laura.......

I am soooo sorry that the pharmacy is being a bunch of TWITS. Hopefully they'll do the right thing now......

 

[epileric]

Good luck with that. Remember you can always go somewhere else if they don't want to treat you well enough to keep your business (and let them know that).

I'm sure you can find someone with comparable prices.

 

[tinasmom]

It appears to me that the main problem is with my insurance company as they were denying the name brand. There used to be a wonderful pharmacist that worked at the pharmacy but she has now gone to another pharmacy. She actually understood the importance of Nicole not being switched from the Brand Name as there was a possibility of a break through seizure.

 

[marion]

I know exactly what you mean!!!

After my first prescription for lamictal was filled I figured everything was all set. But no, the next month the insurance company wouldn't okay it. I was shocked when I was ready with the copay and they said that'll be $1124. Well, it took me three days, and 7 million hours on the phone with the insurance company, the doctor's office (they wanted all new paperwork and the doctor had to send them multiple times before they'd acknowledge receipt), and the pharmacist, who was very helpful and guided me through this mess. If finally came through and things have been good since then, and I learned a lot about how to deal with those *xxxxx* insurance companies. Hang in there.

 

[CallMeSam]

My pharmacy tried to do this too, but even a doctor order couldn't get them to stop. My doctor finaly ended up switching me to once a day lamictal (which he says works just as well, we'll see) that there is no generic for yet.
Hope this goes better for you!