Today’s mail .. “The Pharmacy Crawl”

I live in Tampa Florida, and approximately 5 years ago was diagnosed with Ankylosing Spondylitus and degenerative disc disease.  I have suffered with back pain for the last 15 years, typically each day is painful, and I am often plagued with “flare ups”.  These flare ups are debilitating regardless of medication; however, 15 years ago they were nowhere near as frequent as they are today.

Anyway, I am writing regarding the pharmacy issue in Tampa and surrounding areas.  For a long time I just went to CVS and filled my medication without issue.  My doctor is well respected, I was a long time customer of CVS, and given my professional occupation I have health insurance and typically am dressed in a shirt and tie.  I had heard the horror stories on the news and seen some information about it on the internet, but had no idea what difficulties laid ahead.

Around two years ago the CVS rotated the pharmacists and the new pharmacist at the location where I have taken all of my prescriptions for the last 15 years would not fill my prescription medication.  After four days and approximately 40 pharmacies I went back to the CVS I had been going to with these particular medications for at least 24 consecutive months to discuss the difficulty I was having.  At that time, the new pharmacist advised me that “We don’t have that medication and haven’t had it in at least six months.”  Clearly this was a lie, I had filled the medication there all of the previous six months.

So I went back out.  I was told an array of excuses from “we aren’t accepting new patients” to “we don’t carry that medication”, and even once was told “don’t come back or I will call the police.”  I contacted one of my client’s who is a pharmacist (he works at a corporation) and he told me of an acquaintance of his that ran a local “mom n pop” pharmacy.  So I went to this local pharmacy and was told he would be happy to fill my medication, but would not accept any form of insurance for the pain medications.  I pay for my health insurance with a prescription plan for a reason, and I do not have an additional $1200 per month budgeted for medication.

However, I had a renewed hope, even if the big box stores were out, it seemed as though the local pharmacies had medication available, all I need to do was find one that accepts insurance, shouldn’t be difficult, or so I thought.  I can’t say I went to every local pharmacy in Tampa, but I went to many, and continued to stop at CVS, Walgreens, and Wal-Mart during this time.  None of the big box stores that accept insurance admitted to having the medication, and all of the local pharmacies indicated they do not accept insurance or they didn’t accept the type of insurance I have..United Health Care.  They would however, be happy to fill the medication, I just had to pay cash (no credit card, not debit card), some of them as high as $16 per pill. 

My questions is this:  Who can afford to pay cash for their medication?  I’m guessing someone that sells the medication could afford it and even earn a profit.  Unfortunately, I consume my medication as prescribed, as I assume most chronic pain patients due. These scummy little mom n pop stores charge thousands of dollars for medication, refuse to take insurance, and are all to happy to hand the pills out to anyone with cash in hand.  I called my insurance company and shared my troubles, they couldn’t believe that pharmacies were a) unable to fill the medication or order it for me, or b) were refusing to accept insurance for some of the medication, but would accept it for others.

I’m guessing it has something to do with supply.  CVS accepts insurance, so they can only pay the distributor so much for the medication.  I believe I saw some legislation limiting the number of units that could be dispensed to Florida from the distributors.  As the supply chain constricts, the prices go up.  Mom n Pop can pay the distributor more because they don’t have to take insurance.  Simple economics, sure.  The problem is,  people that are prescribed medication to manage issues with their health need to take the medication, and I’m doubting many can afford an extra $1000-$1600 per month, nor should they have to if they are paying for health insurance.  It is logical to assume however, that people that sell this medication illegally have no problem paying for it as they mark it up and make a profit. 

So, in my estimation, because of the DEA’s constriction to the Florida pharmacies, those people they need medication cannot get it, but those who sell it illegally are earning record profits (along with the scummy mom n pop pharmacies).  Congratulations to our legislative branch for making life better for the drug dealers and impossibly difficult for the patients.

I know we had the whole pill mill problem, but they have admitted they closed over 99% of them.  There are stringent guidelines that must be followed for a doctor to prescribe pain medication, for a patient to remain a patient, and even to demonstrate a valid need for medication.  Considering all the new legislation making sure that the pill mills don’t operate, isn’t it logical to assume most of the people out there trying without success to fill this medication are legitimate patients?  Further, if there are hundreds of thousands of these legitimate patients complaining that there is no medication, wouldn’t it be logical to assume the pendulum has swung too far? 

I am ashamed to live in a country where people in pain have no access to medication, unless of course they are willing to pay $16 per pill, then they can have all they want.  Maybe it’s time to cancel my insurance plan and inject that money into the medical community in a different fashion, over the counter some opportunist mom n pop pharmacist.

Sincerely,

You Pharmacists that are in the “center ring” of this dog and pony show… you know that a simple audit by the BOP or the insurance company can determine.. either by your perpetual C-II inventory or invoices that you do/did have a particular drug in inventory..  Is “lying to a pt ” .. unprofessional conduct ? You and I both know that with the increased surplus of Pharmacists that the BOP has little/no reason to protect the labor pool.. unlike a decade ago when 6000 job slots were begging to have someone fill them. Someone is going to be made an example of… could it be you ?

Someone who violates the civil rights act of 1964 is commonly referred to as a BIGOT… violating the Americans with Disability Act parallels that civil rights act.. so if you are denying legit pts their medically necessary medication.. does that make you a BIGOT ?

17 Responses

  1. They are making legitimate pain patients act like criminals. Paying cash for meds,

  2. UNREAL and sorry to hear this but seems as though they have only transferred the drug dealing from the folks on the street to the mom and pop Pharmacies, they are merely drug dealers operating under a business license and getting away with it. BULLSHIT!!!!

  3. I have had only 1 prescription filled in over a year.and it cost me 1800$ cash at winn dixie,20,000 miles on my vehicle .I pay for everything with no insurance.Someone needs to be held accountable for this disaster?

    • The scariest thing you can hear ” I am from the government and am here to help you” Ronald Reagan

  4. I don’t understand why “cash” or no insurance is such a red flag. I have not been able to get insurance for two years because of the pre-existing conditions I have with ALL of my surgeries, my spine, nerves, etc. etc. the endometriosis I have had two laser surgeries for in the past. I’m shocked more people DON’T have insurance with chronic pain. After having lost my job and not being able to afford the COBRA, and of course it does run out eventually, I wasn’t able to get healthcare till Obama care came up, but I can’t afford that! I’ve been doing the pharmacy crawl and am SICK of it. I have been seeing the same doctor for about ten years no problems, same pharmacy for five no problems till about a year ago. It’s hit or miss if they can fill my script… so tired of it. Sometimes suicide seems the best and easier option. Just make the pain STOP!!!

  5. Having been on both sides, I have had problems getting the meds to treat my neuropathic pain after having an injury to my spine. One neurologist bragged about the fact that had only one or two patients on “narcotics”. He was too dumb to say “opiates”! Then again, he tried to tell me my pain was not neuropathic pain, even though I had trauma to the nerves of the cauda equina that kept me from walking for three weeks. Direct injury was not a cause of the nerve pain I was having?! PLEASE!! As far as “narcotics” go, I am sure he gave plenty of patients Valium, Halcion, etc.! They are in the classification, as well.

    As a pain doctor, I practiced the DEA doctor/cop thing! I never thought distrust was the first thing, with which I should meet my patients. It was not ethical in a normal physician/patient relationship, where trust was one thing that is needed, in any specialty of medicine, for good patient care!

    The law has turned on the 97% of honest chronic pain patients. If it was any other specialty, there would be public acclaim for such a practitioner. I sure would like to see a cancer treatment plan that had such results. God help us all! No one else seems to care, any more. The law created, by politicians, for prevention of the selling of drugs, has been used against honest pain patients! Sadly, many will end their lives, rather than suffer the tyranny of a “benevolent” government!

  6. Paying cash is suppose to be a flag in Tennessee. I wrote to you last month in desperation after going to many pharmacies. It’s embarrassing and discrimination against the ill. I went to the cvs I usually use, Walgreen, the local hospital outpatient pharmacy, Wal-Mart all in decent areas. I have read about people crying in pain because they can’t get the medication ordered or find a reasonable doctor. I was just greater with we don’t have it, no call to doctor, no computer check. Shameful from one disabled R.N. that use to worship pharmacists.

  7. Paincare2014 to William Sarraf,

    Thank you for understanding, and thanks for answering my question as to what are pharmacist looking for in a person wanting to get a script of pain meds filled.
    I do have a RX card from AARP but it doesn’t seem to matter, pharmacist here in Houston are just plain flat out scared of losing their job and I don’t blame them for not wanting to fill a opiate, I would do the same thing if I was a pharmacist, just not fill any opioid medication script period. No cash pay patients at all no matter what.

    William I do use the pharmacy in my neighborhood ,its a nice neighborhood ,as a matter of fact its in the same building as my Pain Specialist ,he is on the 6 th floor the pharmacy is on the first floor . So what’s going on is these people that work in the pharmacy are scared and not for sure what to do. They don’t want to go to jail or lose their job so what am I and people like me to do.

    William my name is Mark and I’m not a bad person ,just a person wanting to live a somewhat normal life with this chronic pain all in my cervical and thoracic spine.
    I’ve been getting the same script filled at the same pharmacy for 5 years then this happens. So its not you and not the workers in the pharmacy its our government that’s putting the fear of God in doctors and pharmacist here in Houston and most other cities in the U.S. things have taken a turn for the worse and I don’t see anything getting better any time soon.

    Donna I’m sorry you cant live in your home in Alabama because of this out of control situation, it seems so wrong to make people suffer and uproot people from their home having to live elsewhere so you can deal with your chronic pain.

    What a mess all this is, maybe when a new president takes over this country things will change, I hope and pray.

  8. Something is lacking here. Oh, yeah… the logic. EVERY independent pharmacy refuses to take insurance and is gouging the price. NO chain pharmacy stocks narcotics. Where have all the honest pharmacists gone? They’re nothing but a bunch of liars and thieves.
    When I get some stranger asking for controlled substances one of the most important things I want to see is his insurance card. The cash customer is a definite red flag. I submit a claim for the rx and immediately know if my new friend is getting his drugs from other pharmacies and other prescribers. Maybe you need to pick a pharmacy in a better neighborhood.

    • It’s not about picking a pharmacy in a better neighborhood!
      ALMOST EVERY SINGLE pharmacy in Florida is behaving like this!!
      The big box stores, either say they don’t carry it or are out, or my personal favorite, “I don’t feel comfortable filling that”, and the mom n’ pops refuse to take any insurance, won’t take credit or debit cards, they only want cash, and their prices are insane!!

  9. This story sounds like so many others. People in FL have all faced this same problem. I don’t think there isn’t one pain patient that hasn’t experienced this at least once, if not every month. I’m fed up with it and just can’t believe that law makers honestly feel they are doing a service to the American public by scaring the crap out doctors and pharmacists so they will refuse patients that are suffering.
    I agree that the drug dealers are probably making big bucks and btw… the pharmacists asking for cash? That makes them drug dealers too!

    I so da*mn angry because I own a home in AL that I can’t live in because doctors here are scared to Rx proper meds for pain patients here. They want to do TONS of Injections that are NOT FDA approved and don’t work anyway! No problems filling prescriptions in this state but no doctors , then in other states like FL, doctors will RX but pharmacies won’t fill. Is this not a dysfunctional MESS ??

  10. I forgot to add this is the FIRST time I’ve heard a pharmacy wanting cash only for a controlled substance. Most of my experiences have been the ones who doctor shop, refill too soons, etc that demand to pay cash because they know their insurance wildeny.I always ran an INSPECT on everyone and it never failed to show why they wanted it for cash so bad and those are the ones I denied. My best one was a guy wanting Ritalin filled. He has an INSPECT report that looked like a rap sheet. I denied it and showed him the sheet. He AND his mom denied that was him even though several had been done at our store I asked him his DOB, Address and the DL in our computer matched the one he gave me.. Of course all filled generic and he claime he didn’t even take it. I didin’t give the script back. Many time I was able to keep the scripts and sent back to the docs. Hate to say many of the non legit people I dealt with were not the brightest bulbs in the box.

  11. I would think if a patient has insurance and that prescribed medication is on their approved list, the pharmacy can’t be picking and choosing which med they accept insurance and which they won’t. I’d be calling the state insurance commission and United Healthcare along with the ADA and filing a complaint. The only reason I can think they want cash only is so they can jack up the price which which isn’t that considered pricing collusion????

  12. I know the frustration of not being able to get a script filled for chronic pain.
    I did the pharmacy crawl about 3 weeks ago and it will be the last time I do that.
    I will not let pharmacist humiliate me, lie to me and down right make me angry.
    I have nothing against these pharmacist, I understand the fear of filling a opioid medication when your job is at stake. But what I don’t understand is how pharmacist gauge their customers as to who they fill for or not. Can one of you pharmacist that’s reading this please let me and other chronic pain sufferers know what it is you look for in a customer.

    As for the Mom and Pop pharmacies that accept cash only and no insurance and charge $5 for a methadone pill your nothing more than a drug dealer at the corner of your street. You all should feel ashamed of yourself.

    For the past 18 years I’ve dealt with chronic pain in my cervical spine that’s spread to my thoracic spine and I know the life of a chronic pain sufferer all to well.
    I did volunteer work for a compassionate Pain Specialist for 8 years ,he was my doctor for 12 years. I moderated our website called ,”The National Foundation for the Treatment of Pain”, I advocated for those in chronic pain and found suffering pain patients a doctor to treat their chronic pain in all states for 8 years. I had to have proof the person truly suffered before helping them.I heard of every last chronic pain condition a human can have. This was from 2002 thru 2010, then unfortunately my doctor of 12 years passed away from kidney cancer, his name is Dr. Joel Simon Hochman here in Houston. TX.
    He was the first doctor to work with me to get my chronic pain under control after suffering for 10 years. I felt I owed it to others and help them find pain relief.
    I felt this better helped me understand the lives of chronic pain sufferers, their stories and way of dealing with chronic pain was not much different than my own life.

    I will never forget this one guy that called me on the phone, the desperation in his voice saying, “are you going to help me , are you going to help me” the shear terror in his voice and story ,the desperation to find pain relief. I did help this guy after reading his MRI radiology report. Two weeks later he called me back crying on the phone saying he indeed found a doctor that was helping him, he thanked me over and over. He wanted to send me money but I said no I do this out of the kindest of my heart ,just take it easy now and enjoy life. Some people never thanked me at all that’s just the way it was.

    That was then , this is now we still have a problems finding a doctor. And when we that suffer from chronic pain do find a compassionate doctor we cant get our scripts filled. This is the lowest point our country has ever been with all the things going on. I’ve never seen or heard of such horrific things going on for those that suffer from ongoing chronic pain. This is nothing more than being terrorized and traumatized by members of our own country.

    Its frightening and disturbing enough to cause horror for all that suffer in chronic pain. I would not wish chronic pain upon anyone, I never thought our own country would make innocent people suffer in chronic pain and not intervene. How did it get to this point, what do we do to fix this.

    • When Dr. Hochman passed away, that office was immediately shut down, and the two women who worked there only helped a small percentage of Dr. Hochman’s patients to find other doctors. The rest of us were left to sink or swim, with no help whatsoever from this office.

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