Apr 13, 2015

doctor-pharmacy-gluten free triangle of hell

I'm on hold with the pharmacy.
Nope. Back on hold.

This is fun. I'm trying to get antibiotics for the start of an infection.
My doctor prescribed me Bactrim. It's gluten free, but it's also a brand name. My insurance is not a fan of using the brand name if there's a generic substitute.

Six months ago, I tried to get a birth control prescription. My doctor found the brand she wanted - and it was gluten free - so she just wrote it out. I didn't realize it, and when I picked my script up, it wasn't the brand version. There was no information on it being gluten free... and luckily, the pharmacy took it back. (Not a normal thing, FYI.)
What happened, as I'm sure you've figured out, is that the pharmacy did what it does and switched out my "normal" script with the generic version.
I ended up finding a different version - one that was already generic - and had my doctor write a script for that. One issue dealt with.

So back to today (or, okay, Friday. In the interest of full disclosure, I started this Friday while I was on hold, and finished it today while watching NCIS: New Orleans).

I asked my doctor to write "must be gluten free" on the script, so when they switched it to the generic version, they'd check.
Instead, she wrote "brand medically necessary. Must be gluten free". What that meant, of course, was the pharmacy couldn't switch it to the generic version. It also meant that two week's worth of pills would be around $50 (like I said, my insurance doesn't like brands). The generic is $2. So.

You know what? Let's do this as a timeline of my day.

9:15 am - doctor's appointment
9:20 am - went into the room
9:45 am - the doctor came in
10:38 am - left the doctor's office
10:45 am - realized the $50 vs $2 difference; picked up one prescription
10:49 am - sat down to wait for a shot
11:06 am - actually got my shot
11:10 am - called my doctor and left a message about the script I wanted
11:20 am - went home for lunch
12:07 pm - called my mom, updated her on what was going on.
12:54 pm - got a call from my doctor, telling me that the medicine I wanted wasn't available in the US.
12:57 pm - finally logged into the Express Scripts website and found out what they say is the generic version of Bactrim. It's something called sulfamethoxazole/trimethoprim. I couldn't find it on the gluten free drugs website.
1:18 pm - called the pharmacy to see what they subbed Bactrim out for normally. The answer? SMZ-TMP. That was staring me right in the face on the drug list. It's the same thing as the sulfamethsomehtingoranother. I hate drug names and abbreviations.
1:51 pm - called the doctor back to see if she could prescribe me Bactrim, without earmarks. Turns out, she wasn't there anymore. The receptionist said that if the pharmacy called her, she could verbally change the prescription
1:54 pm - called the pharmacy and the pharmacist that gave me my shot agreed to call the doctor. All's well that ends well.

I thought that would be a little more interesting. For the record, I didn't make up the times. I used my phone's call log. I'm a nerd like that. It's okay, I know.

So what's the takeaway from this? I learned a few things. Cue a numbered list, below.

  1. If possible, check the generic options of drugs while still at the doctor's office. Get her to write a script for that specific generic, and note that it can't be changed. 
  2. Call the pharmacy and find out what their go-to generic is. Check that against glutenfreedrugs.com. If it's safe, your doctor can write the script for the regular, brand name drug. DO NOT label "brand medically necessary". 
  3. Don't trust the internet blindly on generic versions. Use resources provided by your insurance (I use Express Scripts). 
  4. Always make doctor's appointments in the morning. 
  5. On glutenfreedrugs.com, try searching the web page for the drug in question. I searched Bactrim and found the actual drug, along with the SMZ-TMP listing which had "generic Bactrim" listed in parentheses after it. Sigh. 
  6. If you do need to get a script changed (because of a handwritten notation; I'm not sure about changing it totally), the pharmacy can call the doctor and the doctor can verbally change it. 

Oh, the real kicker? I'd gotten prescribed Bactrim last May... and it was subbed out for SMZ-TMP. All of this could have been avoided. I thought the name Bactrim sounded familiar... oh well. Live and learn.

Happy Monday, y'all.

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