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Need Advice About Medication

Lindsay630

By Lindsay630
in Coping with Celiac Disease

Recommended Posts

Lindsay630 Rookie
Lindsay630
Posted

Hi Everyone,

I haven't been on in a while, but need your help now....I was given a RX for Zofran from my PCP. She wrote on the RX Please only substitute IF no gluten components, pt has Celiac. Well I went to pick up RX and the generic has gluten. So I assume they have the original (non Generic), they do BUT it is $800.00 That is for about 1 months worth! NO WAY can I afford that. I called my insurance and the representative told me I was acting like a spoiled brat and should just take what they will give me "you will be Fine". I still filed the appeal, but it will take 6-8 weeks for them to make a decision. What makes me the most angry is that it isn't even an MD that reviews the appeal its a Pharmacy Tech! Yea they know more than an MD right? Has anyone ever dealt with this? Any advice? Thanks so much for any and all help!

Lindsay

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ravenwoodglass Mentor
ravenwoodglass
Posted

Call your doctors office. Many times another med can be substituted and also on occasion an office will have sample packets that they can give you.

Takala Enthusiast
Takala
Posted

Call the doctor's office is right. The doctor's are trying to fob this off on the patients and letting them wrangle with the pharmacies and the insurance companies, but it is their job to write the prescription in a way that it is clear that the script has to be filled without it containing the allergen.

Your insurance is trying to rip you off. Don't let them. You must contact the doctor's office immediately.

You can also file a complaint with your state's attorney general's office about the insurance company refusing to fill a script as written by your doctor.

That's right, I said "allergen." That is the word I use I use when dealing with dimb bulbs in the pharmacy technician world. I tell them I am allergic to wheat, rye, barley, AND the proteins and starches made from such, and I cannot take anything with that in it. This is because the word "allergy" is understood, while they may not recognize the significance of "gluten intolerance" or "celiac." Or they may pretend to not recognize it. If they do not know, THEY need to let me talk to the pharmacist and ask, or they need to contact the manufacturer and find out.

While technically, I comprehend that I do not have an "allergy," but an auto immune reaction, for the intents of how they are perceiving the ingredients, that's how they have to look at it. Pharmacy techs may not realize or care that my auto immune reaction is not an upset stomach, but neurological reactions and a flare up that may make it impossible for me to drive.

The last time I went to get a script filled the idiotic pharmacy technician at the drop off had no idea what I was talking about, and was pulling this "uh, I think you'll be fine" routine, so I asked her to let me consult the pharmacist as this was an allergy and we had to check with the manufacturer. The PHARMACIST does not know for sure and tries the same routine, at which point I said we need to contact the manufacturer, who is it, she says she doesn't know and opens the package and there is NO manufacturer nor country of origin listed. (at this point I am getting annoyed, and you don't want to see that. I don't get mad, but I am not a pushover.) She says she will get the tech to give me the name of the product distributor. The snotty little tech finally gets the name of the distributor, and I call them on the cell phone because they cannot be bothered- they refuse to do this. The product distributor tells me they need the official store number of the store. I try asking the counter clerk, who can see me doing this, and get told to go away as they are too busy. Nice customer service, eh ? I give the store's address to the distributor, and he finds the manufacturer (finally) and gives me their number. He also checks the ingredient list on this particular item, and says he thinks I am fine, but that I should call the manufacturer and make sure.

I call the number for the name of the manufacturer. Which is in a different time zone, and I get an answering machine saying they are closed until the next day.

At this point I don't want to get a script filled with this store, and I am going to go home and try this the next day at a different place closer to where I live as I don't want to ***** around with these idiots who are selling Rx drugs that they don't even have labeled on the box as to the country of origin and the manufacturer, and who are acting annoyed that I need to know this because they won't look. And I will be able to get to my computer and look it up faster now that I have not only the product name, but manufacturer and point of origin.

It goes better at the second store.

This was not the fault of the doctor, he wrote it as "fill this in a form that does not have the allergens" and said to call him if the pharmacy balked, but it was later in the day.

Loey Rising Star
Loey
Posted

Hi Everyone,

I haven't been on in a while, but need your help now....I was given a RX for Zofran from my PCP. She wrote on the RX Please only substitute IF no gluten components, pt has Celiac. Well I went to pick up RX and the generic has gluten. So I assume they have the original (non Generic), they do BUT it is $800.00 That is for about 1 months worth! NO WAY can I afford that. I called my insurance and the representative told me I was acting like a spoiled brat and should just take what they will give me "you will be Fine". I still filed the appeal, but it will take 6-8 weeks for them to make a decision. What makes me the most angry is that it isn't even an MD that reviews the appeal its a Pharmacy Tech! Yea they know more than an MD right? Has anyone ever dealt with this? Any advice? Thanks so much for any and all help!

Lindsay

Sometimes the pharmaceutical companies that make the product will give it to you. It would be worth checking into. I know AstraZeneca does that when a patient can't afford to pay for their prescription.

Loey

SGWhiskers Collaborator
SGWhiskers
Posted

I agree, talk to the doctor's office and get some samples to start you out. Usually there are more than one manufacturer of generics and you can shop around from pharmacy to pharmacy to see which ones don't have gluten. I know it is a pain, but I've been able to locate gluten-free versions of generics that way. I actually was lucky enough to have my regular pharmacy do the research for me one time. If you are stuck with one pharmacy chain, you could have them order a generic version that is gluten-free if you two can work together to find it.

I also like the idea of just subbing in another medication if possible.

The insurance company is ethically wrong and I've been in your situation before. Fortunately, my pharmacist and I were able to find generic alternatives with some research. It may be that the alternative you come up with is an injectable or something that will cost the insurance company more to fill in the long run. I kind of hope so.

Oh, also check different forms of the medication. I had one med I took that had one of my allergens in the liquid and tablet form, but not the pediatric chewable. I was given a script for a large dose of the pediatric chewable instead.

Also, have your doctor call the insurance company directly. I got that same med approved because the doc knew how to work within the insuranc system. Otherwise, they wanted me to pay for all of it out of pocket.

K8ling Enthusiast
K8ling
Posted

My zofran is generic and is gluten-free... I haven't had a problem with it.

Lindsay630 Rookie
Lindsay630
Posted
  • Author

Thanks everyone. After over 3 hours on the phone, my insurance company approved it! I can't believe they finally caved. I got a representative who understood celiac. I am so disappointed in the US healthcare system. Thanks again for all of your advice.

Lindsay

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