04-30-2021, 03:21 PM
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Sage
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Join Date: Mar 2015
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Quote:
Originally Posted by Abby10
Per the insurance companies, Trelegy Inhalers must be billed by the number of blisters per package (#60) not the number of doses per package (#30). Therefore a 90 day supply cannot be written as a quantity of 90 but must be written as a quantity of 180. Actually the prescriber can write a 90 day Rx for this one of 3 ways -
- dispense a 90 day supply
- dispense 3 inhalers, or
- dispense #180
By writing just #90 as the quantity, the pharmacist cannot dispense more than one inhaler at a time since even 2 inhalers would be equivalent to a quantity of #120, more than the quantity written.
I know this sounds ridiculous, most pharmacists and prescribers feel the same way, but unfortunately we are at the mercy of the insurance companies who pay us, so we have to abide by their way of doing things. If not, the option is an audit, which they certainly would do on a medication as expensive as Trelegy and every dime they paid to the pharmacy would be taken back.
I'm sorry you had to leave the pharmacy so frustrated. If I had been working there, my general practice would have been to offer to call the doctor's office for you.
I hope this explanation is at least helpful.
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Just another reason why I retired at age 55.....
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