Wednesday, July 13, 2011

Things that Make No Sense #1

Apparently, a pharmacy will advocate with you to your health insurance to fill an additional month's worth of pills of the right dosage, even though they will not take back medication that has been dispensed in the incorrect amounts.

In other words, it is legal, and the pharmacist will even advocate, for me to have two month-supplies of two different dosages of the same class 2 narcotic in my home, but illegal for them to accept back the first batch, or to give me any kind of exchange or refund so that I can obtain the correct dosage.

Story:  Tonight, on my way through the living room, I noticed an unfamiliar prescription bottle sitting on an end-table.

"Son, is that your new bottle of pills?" I ask my kid.

"Yes.  I mean yes, but that's my old medication."  I had just filled his pills at Walgreens the night before.  Usually we go to CVS, but I decided to try this Walgreens because... well... long story.

I had arrived 15 minutes prior to closing, but the tech said they could fill the scrip right away. I handed over the written scrip and even chatted up the pharmacy tech and we all had a grand old time. I left happier than I would have expected, having run to the pharmacy late at night at the last minute to fill my son's pills, because without them his behavior is so compulsive and erratic that I become a twisted, short-tempered and ineffective version of myself as a parent.  We all become cliched caricatures of a dysfunctional family.  It is not a good day without Vyvanse. 

So when son mentions that these are his "old" medication, I look at the pill bottle, and notice that it is his old, original dosage.  We had lowered the dosage because I was uncomfortable with how "medicated" it made him seem-- not happy, but compliant.  These pills were full strength.  Even as I was pondering how this could have happened, I was also complimenting myself on my genius 8-year-old who knew that this was the wrong pill.

I called to see if the pharmacy had made the error, but it turns out I had gone in with the old, defunct, scrip with the wrong dose.  It had somehow been left in my nightstand after we got the new, lower scrip from the psychiatrist.  I had made the error, and since the scrip was less than 90 days old, they filled it without question.

I asked if I could bring in the correct prescription and exchange the pills.  No.

But I could bring in the correct prescription and get the correct pills.  If I paid.

After getting transferred to three different parties, I found out that Walgreens would be willing to call my insurance company in the morning and advocate that they override their system so we could get the correct dosage of this narcotic stimulant drug at the copay price, instead of full price.

Oh, so it was possible I would have to pay full price for the correct dosage?  Yes.

Okay, wait.  Let's say, hypothetically, I can't afford to pay a second co-pay.  This is not a $10 kind of pill-- it's a special one.  And I sure as all holy heck can't afford the full price of that med.

So I'm stuck with an overly-high dose of a class 2, narcotic stimulant for a month.  My kid will comply, be smart, focused and probably even creative.  However, he will also be withdrawn and without a smile; he will lose the exuberance which, though it wears on me when the jokes are about farts, penises, poop or guns, is also the most happy sign of my son's intelligence, energy and sense of humor.

That, or scrape the cash together and have extra pills... to do with... as I will, I suppose?  I suppose this is one way black markets or teenage addictions are born.

You know, I know next to nothing about the current health care reforms.  I have absolutely no idea whether they will be successful.  But it is so clear that the current system does not meet the needs of patients, is full of inefficiencies and in fact creates dangerous loopholes and extra cash for the pharmaceutical companies.

For now, I have a decision to make...

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