Questions you always wanted to ask your pharmacist….but didn’t!

Fit4D Pharmacist, Sara Wortman, Pharm D, CDE, give answers and tips on getting refills, generic drugs, and more!

 

Why does it take so long for the pharmacist to fill my prescription?
Pharmacies operate on first come first serve basis.  Pretend 10 other people come before you, one of whom may have had 15 prescriptions to fill.  Even though yours may be something that seems easy and doesn’t need to be counted out and just needs a label, like a nasal spray, you still need to wait.

Example:  You wouldn’t go to McDonalds and get to jump to the front of the line because you want a chocolate shake and the person in front of you ordered food for 15 people.

You may not see all the people in front of you in line, often people drop off their prescriptions and walk away to shop or find something else they need to purchase.  Pharmacies also have physicians calling in to talk to the pharmacist, patients wanting to talk to the pharmacist, and prescriptions being faxed and e-scribed in that also need to be processed, all with various levels of priority.   While it may seem like there is often an army of people working behind the pharmacy counter, there are usually only one or two pharmacists.  Everything that goes out of the pharmacy needs to be verified, checked for accuracy, and checked against your other prescriptions for interactions, all things only a pharmacist can do.  If you think about it, there is a lot that happens between the time you drop off your prescription and when you pick it up, even when there are no problems.

Quick Tip:  To avoid long waits, going to the pharmacy at off hours is a good plan.  Off hours are generally early morning, late afternoon, and late evening hours, depending on the pharmacy’s hours of operation.

 

Say I forget to call my doctor to get a refill and  run out of my medication.  Why can you give me an emergency supply for some medications but not others?
If it’s a maintenance drug (like a pill for diabetes) that is considered necessary and stopping it abruptly could be detrimental to you, pharmacists will often dispense a 3 to 4 day supply to avoid interrupting treatment  and causing a worsening in your health condition.  It’s considered a good faith fill. Typically this happens for (but not limited to) medications taken for diabetes, cholesterol control, heart disease/high blood pressure, and other chronic disease states.  There are certain medications that pharmacists won’t be able to give an emergency supply like controlled substances such as pain medications. Keep in mind, when you fill your prescription, it will be less the days the pharmacist kindly filled in good faith.

Example:  Your doctor may call in a 30 day supply, if the pharmacist good faith filled 3 days, you will only get 27 days when you pick up the prescription for this month.

Quick tips:

  • Mark your calendar 5 days in advance of when you need to call your doctor to fill your script so you make sure you have it in time.
  • You must regularly get your prescriptions filled at a pharmacy to be provided a good faith fill.

 

Why am I allowed to fill my prescription with my local pharmacy and then, out of nowhere, I have to utilize a mail order pharmacy?
This is an insurance company policy.  Typically, this is for maintenance medications for a long-term condition or something like birth control.  It’s cheaper for the insurance company for you to get 3 months at a time at a mail order pharmacy.  In the long run, it’s often cheaper for you too!

When this happens, keep in mind, the pharmacy can’t just send the prescription to your insurance company.  You must have the doctor send it in the method appropriate for your state. Your local pharmacy can transfer prescriptions from mail order but never to a mail order pharmacy.  They require new prescriptions directly from your doctor.  If you transfer to a local pharmacy from mail order, the 90 days supply prescription is now “broken” and will require a new prescription sent or faxed to from your doctor.

Quick tip:  Have your doctor write 2 prescriptions.  One for one month and one for mail order.  This way your physician can send in the prescription to the mail order for processing and you can take the other one month prescription to your local pharmacy to have filled right away.  This way you have your medication while you are waiting for the mail order to arrive.

 

Why do you need my address?
Generally it’s because they need it to verify demographic information.  It isn’t being used in any other way than to make sure pharmacies are doing things right.  It’s not that they are selling your info but might send you targeted info from the pharmacy.

Example:  Let’s say your pharmacy only has a partial month’s supply for your diabetes pills and you don’t return to pick up the remainder of your medication once it is ready.  Your insurance already paid for it, and the pharmacy has no right to keep it.  Therefore, they might mail it to you so that it doesn’t sit on their shelves for too long.*

 

Why do you need my ID?
Not every prescription requires ID to be filled or picked up.  It depends on the state in which you live, whether the pharmacy knows you by name as a regular customer, and what kind of medication is being filled.  In general, an ID is used to verify that you are the correct person, especially if it’s a controlled substance (like pain medication).  This decreases amount of fraud and theft, and is actually meant to protect both you and the pharmacy.

What must be on the prescription?
This varies by state.  Typically, your name, date, the doctor’s signature, drug name, quantity, and directions. This can vary for controlled substances as well.

To know exactly what must be on the prescription you should check with your state rules and regulations.  For controlled substances and in many states it is required to have a diagnosis code written as well.  The diagnosis is often written as a number.  For example, 250.00 is one of the diagnosis codes for diabetes.

Quick Tips:

  • This is important to remember if you are traveling out of state and haven’t filled your prescription.  The state you travel to may have different laws about what must be on the prescription.  It is definitely best to get everything you will need filled BEFORE you travel.
  • It’s always best to double check with your doctor to ensure  that everything that is necessary to fill the prescription is written before you leave your healthcare providers office.

Why do I have to bring the actual written prescription for some drugs but not others?
It depends on the drug.  Any highly controlled substance (level C-II) must be given to the pharmacist in its originally written format from your healthcare provider.  It cannot be called, faxed, or e-scribed.

Why can’t I have name brand drugs if I want them?
Insurance companies want to save the you money.  They have a set list of medications called a formulary that they use to keep costs down.  Part of the cost of brand name drugs is due to the years and years of research and development for approval and the marketing that it takes to get the drug to market.  When the generic comes out, drug is cheaper because they didn’t put the same time and money into it the original manufacturer did.  The generic has the same therapeutic affect as the brand name medication, it legally has to.

Note:  Many patients say they are allergic to the generic drug.  It’s not that one is allergic to the generic drug itself but could be allergic to its other properties, such as the time release factor or the coating.  These things don’t have to be the same as the name brand.  Be assured the active ingredient must always be exactly the same.

Example:  Ever tried a generic Tums?  Many are awful and chalky.  They have the same affect but their taste make up is much different!

*The pharmacy will only mail medications in certain cases.  Do not expect your pharmacy to mail your medication unless you set up a process to do so.  This is not something a pharmacy is required to do.