So There’s This Conversation With My Pharmacist….


This article is reprinted with permission from FWD/Forward, Feminists with Disabilities for a Way Forward. 

…that I am really tired of having.

For the most part, I am pretty fortunate when it comes to actually
dealing with the process of getting medications. I don’t take any
OMGADDICTIVEADDICTIVE medications which would require people to place
hoops in front of me to jump through every time I need my meds. My
pharmacy is usually very together and I rarely have any problems with
them. Since I am currently surviving about half on samples and half on
prescriptions paid for in cash, I don’t actually have to go into the
pharmacy that often.

Except for this one medication.

Just the one.

Can you guess what it is?

Here’s how the conversation starts:

Me: Hi, I’m here to pick up a prescription for Smith?

Pharmacist/Pharmacy Tech: Ok, great.

(Whoever is helping me goes to grab it from the back. When they
bring it to the front, I can clearly see that it’s not the right
package.)

Me: Oh, uhm, Dr. Redacted called in a three month supply? That looks like a one month package.

Pharmacist/Pharmacy Tech: Oh, well, the discount plan only pays for one at a time.

Me (confused): I’m not in a discount plan? I always pay cash. For a three month supply.

Pharmacist/Pharmacy Tech: But the discount plan only pays for one month at a time.

Me: I have been getting this prescription at this pharmacy for a
very long time. I always. Pay. Cash. For a three month supply. Every
time! I swear!

Pharmacist/Pharmacy Tech: Oh, you’re not on the discount plan? Sorry. But the insurance still only pays for one at a time.

Me (gritting my teeth): I don’t have insurance. (I come in every
three months to pick up this prescription, I pay in cash for a three
month supply, and every time, we have this exact same conversation. In
fact, the last time this happened, you were the person who helped me.)

Pharmacist/Pharmacy Tech: Oh, ok. Sorry. Well, do you want this?

Me: No, I want a three month supply.

Pharmacist/Pharmacy Tech: Oh, well, I’m going to have to put it back
into stock…and then redo the prescription…are you sure? It’s very
expensive to get a three month supply.

Me: Yes, I’ll wait, thank you. (No, I would not like a month
supply, my need for this medication is not going to suddenly stop in a
month, therefore, I would like three months, so that I can come into
the pharmacy once, NOW, rather than three times.)

Now, what sort of prescription could possibly require this much
fuss? Could it be expensive (it is, a bit)? Could it be dangerous (no,
not really)? Could it be…birth control?! Yup, that’s right,
it’s birth control. And the conversation gets better. The pharmacist
checks off the new package with a three month supply, the tech brings
it up to the counter to ring it up, and this happens:

Tech: Most people use those green cards1?

[She is not, in this case, referring to a US Permanent
Resident card, but rather to the cards issued to people in the
FamilyPACT program, which provides reproductive health services for low
income Californians. I would note, among other things, that this
program at one point paid a bonus to low income folks who got
sterilized. I don’t think they do this anymore, but they definitely pay
for/encourage sterilization. Oh, and it gets better; once you are
sterilized, the program refuses to pay for reproductive wellcare like
Pap smears.
]

 

Me: Oh, I don’t qualify for that.

Tech: Have you considered applying for one?

Me: I don’t qualify for that program.

Tech: Oh, why not?

Me: … *eyebrow*

Tech: Ok, well, $235.87!

So, here’s the thing. This sounds like a kind of minor annoyance.
And, in the grand scheme of things, it is. Way worse things happen to
people with disabilities than this. Way worse things happen to people
with disabilities in pharmacies than this. I am really not complaining that much. If this is the worst thing that happens to me in the pharmacy, so be it.

But, for me, this is an endeavor which basically turns the
silverware drawer upside down. Spoons? I’m out. For days. The pharmacy
is a loud place. It’s bright. It is filled with smells which make me
anxious, and loud noises, and noxious magazines which tell me about how
I can take a diet pill and trim inches and pounds off my tummy.

This prolonged social interaction agitates me every single time.
There’s usually a line. People are glaring at me because I am taking so
long. People are rolling their eyes because I insist on having my
prescription filled properly. I am trying to control myself, because
it’s not the tech’s fault, it’s probably some glitch in their system,
but I want to lunge over the counter, throttle someone, and liberate a
year’s supply of BC from the back room before fleeing out the side
door. I start to hyperventilate. I fidget. I feel like I am exploding
inside.

And, every single time, I ask if it’s possible to put a flag in the
system so that they know that I will pay in cash for a three month
supply. So that a 40 minute ordeal every three months could be turned
into a five minute in and out trip every three months. Every time,
someone says “uh huh, we will look into that,” and then, the next time
I come in, this happens again.

This is a pretty minor thing, in the grand scheme of things, but
it’s yet another tiny little facet of the American health care system
which is broken. While I’m waiting for my correctly prepared
prescription, I watch people go through the line. People with MediCal
or Medicare or CMSP or any number of other welfare programs get to the
counter, hear that a prescription has been denied, and shuffle away
without it. People with private insurance get told that the
authorization for a prescription hasn’t come through, or it’s been
denied, and they look at the prescription and the price on the
register, and they walk away without it. I can tell that the people who
know they will have to pay cash, like me, arrive at the counter and
weigh their options; pick up the prescription today, put off grocery
shopping another week?

I’ve actually had the pharmacist refuse to fill this prescription in
the past until I’ve paid for it. And, you know, I think that they think
they are doing me some sort of budgeting-related favour by trying to
get me to take a month’s supply. But it’s not like I’m not going to
need it next month. And the month after. And the month after that. The
way I budget, I would rather pay a large lump sum every three months
than get dinged every month. Every three months I see a collision of
class issues in the pharmacy. The haves and have nots. The assumptions
that get made by the pharmacy staff. The callous and routine denial of
prescription benefits to people who need them. And every three months I
think there was to be a better way to do this.

Comparatively, I’m lucky. I can at least afford to pay for my
prescriptions most of the time. There are a lot of us out there who
cannot.

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  • valkyrieofbi

    Can you get your prescription by mail-order and avoid the social situation entirely?

     

    Can you use another pharmacy that might be less uniformly incompetent?

     

    Or maybe you can bring a written note the next time you go that says something like, "Please fill my prescription for a 90-day supply, as written. I understand that it will cost me about $235.87. I’ll be paying cash, as I always do. No arguments, please." Then you can verbally remind the tech that you have had this conversation many times, and you’re using this note to save time and energy, then say "So, it’ll be about 20 minutes, right? I’ll be back," and turn on your heel and leave. The interaction will be so surprising the tech may be inspired to finally put a note in your account.

  • quill2006

    Strange, my old insurance would only let my family obtain long-term prescriptions in 3 month supplies!
    I have to say that perhaps it might make sense to switch pharmacies, if there is more than one near you. This one is obviously frustrating.

     

    Your point is certainly valid; filling prescriptions in the US is an exercise in frustration for all concerned. Just as with everything else in our medical system, we’re paying for not having universal health care because the doctors and pharmacists have to deal with getting everything approved by one of the thousand different insurance plans their customers use, and those of us who pay cash pay extra for the privilege of not being on insurance, because we can’t negotiate a reduced rate. I’m not going to argue that universal health care would be a panacea, but it would certainly reduce the cost of data processing and office staff for doctors and pharmacists.

     

    On a connected note, have you looked at what types of birth control is available at some "big box" stores for a very reduced rate? They offer certain prescriptions for very cheap as an enticement to get people to switch all their prescriptions there, but there’s no actual requirement that you have other prescriptions to get the low price.

     

    If there’s a similar brand that your doctor thinks might work for you that costs $7-$9 a month, you might give it a try. Obviously, certain brands work better for certain people, but I was lucky enough to be on one that I found was offered at Sam’s Club, where I’m already a member, for $9 a pack (and they let me buy a 3-month supply). I was paying $67 a month for the same stuff at a different pharmacy.

  • se-smith

    Well meaning suggestions for "solutions" are not actually terribly helpful, especially when they suggest doing things that I can’t do/don’t want to do/have already tried. Can we assume, as a collective, that I’ve already gone to considerable effort to make this less of a pain in the behind, and that the scenario described above is as good as it’s going to get?

     

    This piece is not a request for people to tell me what to do, but rather an indictment of the way the system as a whole is run. People should not be forced to wait for 40 minutes every time they refill a routine prescription when they’re already called in a refill, no matter what the prescription is. 

  • frolicnaked

    I went to the pharmacy yesterday to get them to try to fill a scrip for a diaphragm. I didn’t expect them to have it in stock. However, I also didn’t expect to spend every bit of an hour inside, explaining that no, I shouldn’t have to go to a medical supply company to get this and to get an answer other than, “We don’t do that here.”

    (This already is one of the most competent pharmacies in my area of town.)

    And yes, I understand and agree that I’m lucky in that this scrip is a long-term thing. Provided I can actually get the device, I won’t have to deal with this particular hassle for a long time.

    But I also have cyclic chronic pain. I’m glad I was at the pharmacy yesterday because today, there’d be no way I’d be able to have that discussion.

  • momtfh

    I saw this on FWD. Good to see it here, too!

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