tag:blogger.com,1999:blog-10776815.post2462440210181626270..comments2024-01-31T08:27:22.773-08:00Comments on Your Pharmacist May Hate You: Why The Fucking Flexeril Isn't Covered Anymore. Unknownnoreply@blogger.comBlogger18125tag:blogger.com,1999:blog-10776815.post-81521463587690061872016-01-29T13:24:47.169-08:002016-01-29T13:24:47.169-08:00I just had to say this, as a former PA who has to ...I just had to say this, as a former PA who has to take a muscle relaxer for a genetic disorder (Ehlers-Danlos syndrome) which can cause intense muscle spasms as a result of joints that are hypermobile and frequently (almost daily) cause sprains and strains. I am not elderly, being in my late 40s, and I cannot fathom an insurance company that would suggest that an NSAID can perform similarly to a muscle relaxer. This is just idiotic. What made the substitution even worse is that I cannot take NSAIDs. Now, I know what an NSAID is and which drugs qualify as them and the difference between the NSAID and a muscle relaxer. However, your average senior citizen is just going to pick up that prescription and not question the substitution. If he has a bleeding disorder or other condition that precludes NSAID use, then this substitution could prove deadly. It should always be the patient's doctor who decides what drugs are best for the patient. Of course, we understand why we cannot fill orders for excessive amounts, especially in the case of controlled substances. But this issue just makes no sense to me at all. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-37382276592487289102015-07-21T17:47:34.816-07:002015-07-21T17:47:34.816-07:00I would laugh too if someone dares waste my time o...I would laugh too if someone dares waste my time on a PA to save a few bucks. I wont even fill out PA's for schedule 2 ADHD meds for adults. In the rare case I write them you can pay for it yourself if you want it that badly Justa Dudehttps://www.blogger.com/profile/02753773176520974822noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-20531266788521208412015-07-21T17:44:09.344-07:002015-07-21T17:44:09.344-07:00Walgreens has the highest cash price of any pharma...Walgreens has the highest cash price of any pharmacy i have ever seen. Their strategy seems obvious thoughJusta Dudehttps://www.blogger.com/profile/02753773176520974822noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-76846996181898074122015-07-21T17:38:16.074-07:002015-07-21T17:38:16.074-07:00Boy the MedD's not paying for benzos didn'...Boy the MedD's not paying for benzos didn't last long. You get the elderly jumping on your car and beating it with canes and that gets people's attentionJusta Dudehttps://www.blogger.com/profile/02753773176520974822noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-46533613968702969112015-07-21T17:31:53.513-07:002015-07-21T17:31:53.513-07:00I would laugh too if someone dares waste my time o...I would laugh too if someone dares waste my time on a PA to save a few bucks. I wont even fill out PA's for schedule 2 ADHD meds for adults. In the rare case I write them you can pay for it yourself if you want it that badly Justa Dudehttps://www.blogger.com/profile/02753773176520974822noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-67378462883886543652015-07-21T17:28:15.473-07:002015-07-21T17:28:15.473-07:00Jeezus considering what i see given to oldsters fl...Jeezus considering what i see given to oldsters flexeril is the least of the worries. I do finally now know from drug monkey why some cheap generics are requiring prior authorization. I refuse to do them however. They can cough up ten or 20 bucks if they want the med. My time and my nurse time is more valuable than you saving ten bucks. A big FU to to all those who hassle their doctor for PA's to save a few bucks.Justa Dudehttps://www.blogger.com/profile/02753773176520974822noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-24157116764220748202015-05-17T14:25:00.137-07:002015-05-17T14:25:00.137-07:00If that's the case Walgreens is ripping you of...If that's the case Walgreens is ripping you off my friend. That stuff wholesales for less than twenty bucks for a thousand tabletsDrugMonkey, Master of Pharmacyhttps://www.blogger.com/profile/17626504777714043799noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-74790006899910213392015-05-17T14:22:15.149-07:002015-05-17T14:22:15.149-07:00My workers comp insurance refused to cover the fle...My workers comp insurance refused to cover the flexeril prescription (generic), but wouldn't say why!<br />But, it isn't cheap.<br />Walgreen's pharmacy said it would cost $255- for 90 tablets! -<br /><br />- HelgaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-16030824363830556632014-09-27T21:17:43.781-07:002014-09-27T21:17:43.781-07:00Flexaril maybe didn't generate the kind of mon...Flexaril maybe didn't generate the kind of money Lyrica C-V does. Soma was cheap and effective. Now a C-IV. Anyway, cyclobenaprine doesn't mix with psueudoephedrine. Rather do vals. They are scheduled, but you're gonna have to try hard to get addicted. I wouldn't wanna be THAT SEDATED ANYWAY. Kim Lawsonhttps://www.blogger.com/profile/03929870702801564522noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-29073999923178385752014-09-07T06:52:57.365-07:002014-09-07T06:52:57.365-07:00Holy shit . . . Med D covers benzos now? I have b...Holy shit . . . Med D covers benzos now? I have been away from retail for longer than I thought!<br /><br />Also, dead on about counseling at the point of sale. Good luck with that, guys. It's the same reason MD's hand out Zpak's like M&Ms. Bronchitis? Zpak. Nevermind it's viral. Nevermind we are increasing resistance. Patient's need to <i>feel</i> like they got something for their time & money at the MD's office.<br /><br />Just you try to talk them out of that. You lose a lot of credibility when you are dispensing medical advice across from the 'As Seen on TV!' endcap.RxSeRPhnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-88547576615655095552014-09-03T00:23:31.796-07:002014-09-03T00:23:31.796-07:00I have another theory about these kinds of insuran...I have another theory about these kinds of insurance rejects that require PAs for excessively cheap drugs: since they occur with drugs that are both cheap AND popular (zolpidem, cyclobenzaprine, fluticasone nasal spray), the insurance company saves $$$$ over a broad margin (the old, "take 2 cents out of every bank account in America and you'll be a billionaire!" kind of trick).<br /><br />You also might notice that it occurs with cheap generics that still have ridiculously high AWPs (like ondansetron), as if the insurance company can't figure out a MAC based on real drug costs like they do for everything else.<br /><br /> But then that would compel everyone to realize that drug prices are based on fiction...shhh!!!Lucky13https://www.blogger.com/profile/01844084899307585088noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-19978893403841058732014-08-22T14:45:28.436-07:002014-08-22T14:45:28.436-07:00The post is what I have been thinking all along in...The post is what I have been thinking all along in regards to these new PAs. <br /><br />Your response, DM, to the comments, is all that and more.<br /><br />I still find it hysterical that no one gives a crap until you hit that magical age of 65. Then, it's all about Beers criteria this and 'what if someone falls' that. Did your pharmacy get the fax from Humana two years ago about medications they would no longer cover for the 'elderly' because they were on the Beers List? Fricking cowards, but at least it was a nice heads up. Were you as shocked as I was when the MedDs starting covering benzos? Enough cranky old people who can't sleep can bring a PBM to its knees faster than any pharmacist group.<br /><br />Chances are if you've been on Flexeril for umpteen bajillion years, you're good. Turning 65 is not going to make it a bad thing. Just speaking from experience, as I have had several patients turn that magical number and now cannot get a medication that has helped them in the past unless they cash or have a discount card. red_No_4noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-61915241488937661602014-08-19T22:00:53.153-07:002014-08-19T22:00:53.153-07:00Dear APhA nerds,
You're good kids, you reall...Dear APhA nerds, <br /><br />You're good kids, you really are, and I know your heart's in the right place, but before you start trying to impress us with your *cough* "doctor" *cough cough* of pharmacy brainpower, perhaps you should spend some time in an actual drugstore that fills actual prescriptions. It's obvious from your words you haven't.<br /><br />You want to influence prescribing behavior in order to promote quality. That's great. It really is. But here's the thing, and I can't emphasize this enough, YOU HAVE TO DO THAT SOMEWHERE ELSE OTHER THAN THE POINT OF SALE!! Because number one, pharmacies are chaos, spend some time in one and it'll take you about 5 seconds to figure that out. If you wanna take a crack at calling Dr. Dumbass to initiate a prior auth while your other 4 phone lines are ringing, and grandpa's at the counter asking what's taking so long, and grandma wants her shingles vaccine, and great grandpa wants his purple pills refilled and crackhead is having a fit because you won't give him him his early norco and crackhead's girlfriend just called in a fake rx and your technician's trying to figure out the insurance card from Blue Cross of Buttfuckistan that actually gets billed to Express Scripts, go ahead, be my guest. <br /><br />You probably have a better idea though, you're gonna break out those counselling chops from pharmacy practice lab and go over there and talk to grandpa yourself. <br /><br />Bully for you. I'll direct your attention though, to the words "100 percent failure rate" in the comments above. And it doesn't take a *cough* "doctor" to understand why that is. <br /><br />Because Einstein, when you go over there and tell grandpa that maybe the Flexeril might not be the best thing for his spasy muscles, you are now offering him a choice between what some dude who gives out dog food coupons with every flu shot says might not be optimal, and........nothing. Do you really think someone is going to walk away from the counter with nothing? Seriously? If they could make do with noting they wouldn't have gone to the (real) doctor in the first place. <br /><br />"So, Mr. Smith. There's a bunch of eggheads that say this med might make you too drowsy, I mean, you might be likely to go home and sleep off this day that you feel like crap. We can't have that, so I'm going to call your doctor, and maybe in 2 or 3 days they'll get back to me with an answer when you're already starting to feel a little better" You'd have to be.....pretty dumb to take that deal. Yes? <br /><br />So some free advice, "doctor." Get your head out of your textbook and think about how things work in the real world for a minute or two. Realize that medicine is not a cookbook, that guidelines are not laws. If they were, we could just do away with doctors and their pesky professional judgement altogether and practice medicine with algorithms. Despite your guidelines, there will be cases in which a course of Flexeril will do quite nicely where other (preferred by the textbook) meds fail. That's how things work in the real world. That's why we have (real) doctors whose job it it to examine people, not pages, and make a judgement. <br /><br />So if you want to start an educational initiative on why Flexeril is over used, knock yourself out. Write up a CE, do an in-service, come up with an app that ties in with electronic medical records that makes sure prescribers have all the relevant information they need about their choices. But don't try to influence prescribing behavior at the point of sale. Anyone who's actually filled a prescription knows why.DrugMonkey, Master of Pharmacyhttps://www.blogger.com/profile/17626504777714043799noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-61333164292449177142014-08-19T18:45:19.953-07:002014-08-19T18:45:19.953-07:00At what point do we as pharmacists stop filling th...At what point do we as pharmacists stop filling the flexeril for the elderly patientregardless of who pays for it? The reason behind the pa required rejection strongarm tactics is because as a whole pharmacists are not stepping up and managing/ educating patients. Pharmacist want to be paid and treated like members of the healthcare team, but ever increasingly act like automatic dispensing machines. <br /><br />What role do you play in your patients Heath? Are you a dispenser or a pharmacist? Don't blame the insurance companies for quality related alerts. Remember that healthcare costs are much more than the cost of the medication. Kennychttps://www.blogger.com/profile/16748113025876337690noreply@blogger.comtag:blogger.com,1999:blog-10776815.post-68723863446907962892014-08-16T16:49:00.301-07:002014-08-16T16:49:00.301-07:00I don't think you're right or wrong on thi...I don't think you're right or wrong on this one! Not because I have a valid stance to support it, but because it's the natural progression from the last three comments.<br /><br />Corresponding with this topic, though is the supreme annoyance I get from every single Humana Med B vs. Med D determination claim, that says a prior authorization is required for any acute treatment medication in existence written for a dialysis patient. PA required for Amoxicillin? Not a big deal, one might say, amoxicillin is a 2 dollar drug. But Ms. "I DONT HAVE A COPAY I PAY ZERO DOLLARS FOR EVERYTHING" does not agree with that, and insists you get her dentist to complete the prior authorization required for the medication. Her dentist, as you would expect, laughs and hangs up the phone.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-53643305386213160522014-08-16T12:55:46.617-07:002014-08-16T12:55:46.617-07:00I think you are both right and wrong on this one! ...I think you are both right and wrong on this one! I think the elderly patient needs to be empowered by our knowledge of why a certain medication is considered high risk, so that they can make an informed decision about their healthcare. To just fill the prescription at a discount without informing them of the potential for the cascade of fall, broken hip, and impending death due to complications of that situation, we as pharmacists are doing our elderly patients an injustice. You are so right about the non-transparency of the star ratings in the fact that most patients are still going to choose to take the high risk meds and pay cash which will not reflect on the star ratings, but adverse effects will still occur. I try everyday to talk my elderly patients out of taking zolpidem or temazepam, with a 100% failure rate. Most of the time it doesn't matter what we tell them, they will still choose to take their dangerous drug cocktails and prescribers will continue to prescribe them. The star ratings are a joke in this sense, but I ask, why are we just now trying to measure outcomes, shouldn't our healthcare system have been concerned about this all along?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-21606047217287684282014-08-16T08:39:36.996-07:002014-08-16T08:39:36.996-07:00You're wrong on this one! wtf are they suppose...You're wrong on this one! wtf are they supposed to do when they have a quality initiative. I mean, I imagine we could sell Norco otc at a price that would have it flying out the door, but we don't. Seriously, I know Norco could be priced at $10 for 20 and without having to do any pesky checking or counseling, oh how sweet the profits would be (gross margins for the pharmacy exceeding 20% with no hassle). All those regulations. <br /><br />Or what about the tramadol above where you are going to bother to mention the pill limit. If you are going to have a license to dispense "dangerous drugs" in California, then it should mean something (like maybe you should think twice about just selling grandpa his flexeril at 5 bucks). <br /><br />Just a rant; just like yours, but have you ever considered that flexeril isn't even that great a medicine - just cheap (I bet Norco would score better head to head).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10776815.post-56747845808495209142014-08-15T20:38:12.227-07:002014-08-15T20:38:12.227-07:00You are so right on about this one!
You are so right on about this one!<br />Anonymousnoreply@blogger.com