Encounter at Walmart Pharmacy
 

Recently had a "prescription" filled as I do often for a 90 day supply of "Trelegy Inhaler" which administers single does (30) from each inhaler. I have been getting this inhaler for the last 2 years with no problem until this week

I had requested a 90 day supply ( 3 inhalers / 30 does each inhaler) as I have done many times before but now after going over to TRY and correct the problem was told I need to change prescription on "quanity" from 90 to 180 in order to get "3" inhalers.

I told the lady at counter (after calling I went over there) that I wanted THREE..... not ONE inhalers since I was getting it for 90 days and the fact that I had always gotten 3 at a time (90 day supply) every other time but she REFUSED to give me more than "one" even as I had called Dr back to again tell them I wanted 3 NOT ONE !!

She told me to call Dr back and request 180 in "quantity" instead of 90 which made absolutely no sense and until now have never had a problem getting it filled for 90 day period.

It ceases to amaze me as much as I argued with her how stupid this was and have since switched pharmacy's and will no longer get my prescriptions filled at Walmart. Also the fact that my wife was supposed to get 90 pills one time and got home and there were only 30.... but after returning they did make up the difference.

Just want people to be aware of watching what's going on as Walmart among other GIANT retailers are not to be taken for granted. I still cannot understand how I was told to change my "quantity" for 90 to 180 when there are only 90 individual does!!

Has common sense completely gone out the window?

Were you dealing with a pharmacist? I would think they must have the ability to so simple math to become a pharmacist. You got someone who can not multiply 30 times 3. I would have asked to speak to a manager who can do simple math.

Which Walmart was this math challenged person working at?

In the army they called them 90 day wonders. Now we get them from online schools; supposedly people ready to be a pharmaceutical assistant. Short stint of school on computer, no real contact with people. Good idea, not good in practice.

yes, either that or a language barrier

Have you checked with your insurance company to see if they have changed requirements on how rx just be written to get a 90 day supply? My pharmacy is really good about telling me exactly how it needs to be written. Did you speak to pharmacist and ask why?

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.

Just another reason why I retired at age 55.....:1rotfl::1rotfl::1rotfl:

Re: common sense.
So many of us go through the same thing. I assume are on medicare. The medicare preferred suppliers are a very mass huge retailer, the one you mention.
Two grocery stores that sell drugs and a drug store that sells groceries. Your prescription, generic? Who knows where it is made? Who checks that it is what it says it is? You are betting your health on a long chain of????????

Welcome to mass medicine. On medicare, even your doctor is told what he/she can charge and they are told they must see 4 patients an hour. That is 15 minutes each

I went through hell with medicare. I went to publix they were polite an helpful. They told me turned down by medicare. I called medicare about an hour on the phone. They too were helpful concerned etc. I was told the issue was a prescription I had for a similar product item. It was due to expire in three weeks and I should put this in again it three weeks. Ok I told Publix that. They waited the three weeks put it in again and it was again denied by medicare. Medicare told me Publix was putting it in wrong and they told me I should go to another preferred supplier. Ok so I went to Walgreens. Stated in another post not a grocery selling drugs but a drug store selling groceries. They too were very nice. Got yet another prescription from my doctor, this one to Walgreens. Yet another week delay. Walgreens, reminder you do not talk to the bureaucrat who deals with medicare. Walgreens told me denied by medicare. I called the manufacturer and they gave me the names of mail order suppliers. Yup another prescription from my doctor. Yup another week delay. And that is how it took THREE MONTHS to get a product that the medicare book says is covered.
Surely, most people who are not as stubborn as I am give up.

Really???? They tell physicians that??? And you came to this conclusion how????
Bottom line, you are clueless about what you're talking about, Medicare has no such requirement.
Also, Medicare does not dictate what a doctor can charge, only what they will reimburse. That's why concierge physicians do not participate in Medicare. (or any other insurance for that matter)

Yeah, that's because you're a lot smarter than me. I finally retired the first of this month - April Fools' Day - so appropriate for someone who now keeps asking herself why did I wait so long?!? :rolleyes:

My math surmising was incorrect. I don't understand the blister pack stuff so I apologize to the pharmacy person at Walmart. Sorry.

Completely off subject but about the vagaries of medical insurance.
I get my medical insurance for my trips to US and it is valid for 90 days. I cannot extend it due to previous medical condition.
I can however fly back to UK, never leave airport, board another plane back to US. and my insurance is good for another 90 days!:shrug:

Errors
 

What we have here is a problem in communication . Not a fault of Medicare or Walmart . Or you . Just plain stupidity to of regulations.

We must have similar prescription drug plans. I (supposedly) can get 90 days (3 months) of medication for 2 copays. I get my prescriptions filled at Publix and had the same problem getting an inhaler. Even though the prescription was for 90 days (3 inhalers) I was only able to get 1. I did question the pharmacist and she said some government regulations changed and they were no longer able to dispense more than one at a time. And, that’s OK with me IF the only charge me once for the 3 inhalers.

Walgreens has been hell last few months too, one pharmacist is so rude and horrible I know 3 that have changed because of her. I plan on it too.

A 90-day supply is just that. If an MDI, metered dose inhaler, gives you 90 doses, you get one. If it only gives you 30, you get three. Ask to speak to the pharmacist. Sounds like a misunderstanding.

My insurance company will only let me fill 30 day supply of meds locally. For 90 day supply I must use mail order. Check out requirements for your insurance company.

Agree. The post makes no sense and is obviously misinformed. How can medicare dictate how many patients a dr has to see. So, i guess the poster talks fast when they go to the dr so they dont go over their 15 minute visit. Lol

I agree, it's poor math and their right to make a decision. Had the same problem with Navy pharmacy. I now use escripts have to pay postage, but it's great, and meds come to mailbox. (escripts = Express Scripts)

What you see on a printed pharmacy list, whether medicare, military, ect. is changed almost as soon as the printed list is published.

I also use Trelegy. Walgreen on Bernard Road.They never give me a hard time. They are all very nice. Maybe you should try them.They let me choose whether I a want 1 months supply or 3 months. Hope this helps.

I also use Trelegy. Walgreen on Bernsed. Road.They never give me a hard time. They are all very nice. Maybe you should try them.They let me choose whether I a want 1 months supply or 3 months. Hope this helps.

as a retired pharmacist, I can't count the number of times I took abuse because I had to follow the law or the insurance company's policies. for some reason, people think a pharmacist should disobey the law just because they are inconvenienced. it's something I thankfully left 8 years ago and never miss it. Believe me, all the pharmacist and technicians want is to fill a prescription and dispense it promptly. in retail, they are expected to do so many a day. We hated when there was a problem with quantity, or formulary, or that it was too early to fill, etc. not only did it slow things down but we were sure to endure the brunt of the patient's abuse even if it was an error in prescribing. to talk about the technicians as "90 day wonders" is the type of disrespect that was dealt with on a daily basis when our hands were tied by how it's submitted to insurance. Frankly, having a health care system dictated by insurance companies and employers is archaic, but that's for another discussion.

One should always check their dosages I check them actually before I even leave the pharmacy.

You know where it's made, because the manufacturer's name is right on your prescription label. For Walgreens' labels it's directly under the name of the medication itself.

For instance, my current batch of generic levothyroxine is manufactured by Amneal, and is manufactured in the USA.

It took me less than 4 minutes to check the bottle in my bathroom medicine cabinet, scan the wikipedia entry for the manufacturer's name, discover that they have plants in 3 different countries, then do a google search for "amneal levothyroxine country of origin" and see that this particular drug is made in the USA.

Trelegy is a combination of inhaled corticosteroid, long acting beta-agonist and anticholinergic. It is NOT a "controlled substance". However, the pharmacist still cannot change the amount dispensed without contacting the physician

Sometimes it is an individual store that causes illogical & frustrating scenarios. I have had similar situations w the cvs near my house. Switched to rite aid & all problems disappeared. I was just fed up & switched chains but i think i would have been fine just switching stores.

Just like the OP, your math actually does make sense. It's the insurance companies that often don't, but unfortunately they dictate the rules and the provider either follows them or doesn't get paid.


Good summary of the situation. It seems the pharmacy failed to communicate properly to the patient. Again, the extra step to me would have been to offer to contact the physician's office for the patient rather than leave the patient frustrated in trying to understand a situation that is difficult to explain due to nonsensical insurance regulations.

The only way a patient can choose whether they want a one month supply or a 3 month supply is if the doctor wrote the prescription for a 3 month supply to begin with.

Upon patient request, a pharmacist can dispense less than what the doctor ordered, but never more than. If you brought in a prescription for a one month supply and the pharmacist filled it for 3 months, one of 2 things happened. The pharmacist either broke the law, or more likely, he/she called your physician and got a 3 month prescription for you. If it was the latter, please be sure to thank them. :)

it may be problems disappeared because to transfer the prescription they may have called your doctor. since the new pharmacy knew what you wanted, the pharmacist could have told them how to write it.

Great clarification

I used to go to Wallgreens and that place is a horror. I switched to Walmart and never been happier. My prescriptions are ready on time every month without fail.

We agree. DH kids them by asking, "What took you so long?"

You can often learn things from others.

Often the lesson is not to be as they are.

I am happy that I get a 90 day refill of my medication that gets sent to my mailbox with no problems!!!

I recently needed a medication that was sent by my doctor to Walgreens. When I got to Walgreens, I was informed my medication was not approved by insurance and would cost $346.00 WOW!!! Called the insurance company and they said they would approve it in 24 hours and the cost would be $46.00. That was reasonable.

I went back the next day and Walgreens informed me my cost was $0.

Makes me wonder who's warming a chair. :smiley: