... appointment with my PM doctor. She changed my Opana ER 20mg pill from every 12 hours to every 8 hours. Hopefully this provides adequate pain relief that I have been longing for. I no longer even wish for "pain relief" but just to get my level down enough that I can tolerate it. Oh and if I could go a full 24 hours without crying that would be an added bonus!
She also kept me on Norco 10/325 up to 8 a day (240 monthly) although I'm thinking that I will be able to cut this down considerably by taking the Opana ER every 8 hours because the majority I take of the Norco is right between the Opana doses.
Sorry I always seem to ramble... Anyway, I have been with Express Scripts for many years with an "out-of-pocket" of only $400. With my Lupus/Arthritis medicines I usually hit the out-of-pocket about 2 weeks into the new year. After that is reached my medicines are $0 co-pay as long as I get them through the mail order after 2 months on the same medicine because it is then considered a "maintenance" drugs.
Last month when I went in for my Opana I was told that I must use mail order (it was the start of my 3rd month on it) or pay the $100.00 deductable which I did not want to do because the New Year was right around the corner and my new "out-of-pocket" would begin. The Pharmacist at Walgreens told me it was against the law to do mail order with Opana (I live in Illinois for those of you that didn't already know that). I then asked the Pharmacist if she thought it was right that Express Scripts wants to force me to do mail order on a med that is illegal to do through the mail. The Pharmacist then said, Maam I DONT make the rules I just follow them. I then explained that it would normally be free and I wouldn't mind paying but in 2 weeks at least the $100 would go towards my new "out-of-pocket".
I was not being rude to her at all, in fact although I was upset I was being very pleasant but she rudely said, This Opana costs almost $400 and you are really complaining about only paying $100 of that??? You should be lucky you don't need to pay in cash. Then she said do you really even need this Opana when you take Norco because they are both heavy pain medicines! I was SHOCKED at how she treated me! I picked up my other medicine that she had ready for me and then asked her for my script back. She went and got it, stopped and talked to one of the techs leaving me standing there for a good 10 minutes, in pain and then came back over with the script and before she would let go of it, she said, "you know I don't have to give this script back to you because once you had it to us it becomes our property and I could force you to fill it here or dispose of it and make you go back to your doctor for a new one."
Since it was already in my hand as well I quickly pulled it out of hers and said, I doubt very much that is legal and I would threaten to quit using your pharmacy except that you probably wouldn't care because you would be paid your salary if I'm a customer or not and because in 2 weeks you will no longer be in my prescription plan anyway... but I know you already know that because once it was announced 2 months ago the customer service here declined 80%, you have a wonderful day, oh and Merry Christmas! Then I went to a small local pharmacy we have in town.
I will add more detail after this post because although I promised not to be so winded I've done the opposite. LOL
Added 10 Jan 2012:
So I then went to the small Mom and Pop Pharmacy which is conveniently located next to my little one's daycare center. I just never went there because 1) Walgreens and Express Scripts went hand in hand. 2) My husband has been picking up the kids because I have not been able to do so because of pain 3) They have no drive thru :o( on and I must add 4) it is also a Hallmark store and you must walk past every item that you just MUST buy to get back to the Pharmacy!!!
I did find this local pharmacy to be very kind and helpful and to my surprise my co-pay was $9.00 less although I thought a co-pay was a co-pay anyway I also asked them if it was illegal to do mail order with Opana and they said they thought that it was but wasn't sure. They kindly offered to call them for me which I accepted. They called on a cordless phone and took care of other customers while it laid on the counter oh speaker. After about 10 minutes the phone died and they said it would need to charge. I explained that I needed to sit for a bit anyway due to my pain so I said in my SUV outside and called them from my cell phone. 20 minutes later I was finally able to speak to someone and to my surprise they told me it was completely legal to do mail order on Opana and that they do it all the time. They did need an original script and it was much safer to send it to them priority or overnight mail.
I was hesitant to believe them when Walgreens was very confident about it so they connected with a pharmacist familiar with Illinois law and she as well stated it was in fact legal as long as we followed the process to get it to them and the doctor correctly makes out the prescription for the 90 day supply. I was not sure if my doctor would be willing to do this because of the way her nurse always mentions to me how much trouble I could get her in if I were to do something wrong.... Not that I have EVER done anything wrong but I just figured they must have recently had some problems with other patients which seems to be common in Illinois. Also I could not wait 2-3 weeks to get the Opana in the mail because I only had a few days left so I went ahead and paid the $92.
So like I said today I had my appointment with my PM doctor and I talked to her about the mail order. She said I should probably check because some mail order pharmacies don't allow it and I explained most of the long ordeal with her but I also explained if she wasn't comfortable with doing it I was fine with that also and would deal with the co-pays. As I've said in other posts, she is the sweetest thing, I just wish she could move in with us! LOL Anyway she said she didn't have a problem with it but that we should wait until next month to make sure I'm finally on the right dose which I was fine with.
She did some trigger injection which actually helped this time when none of the epidural or deep tissue injections did a thing! It did last long but it did help for a few hours which made it easier for the long drive home. Anyway we discussed my surgeon problems which I know she can't say much because they are all in the same Ortho clinic as the 2 surgeon I've been to, one that did my "failed" spine surgery and the other that I went to because the surgeon thinks my pain is in my head because he just can't face the facts that his surgery not only did not work my made my leg pain much worse. I just feel like I can talk to her like a friend but she won't give me any advice about the surgeons which I also understand.
As I was leaving she gave me I month of Norco and 1 month Opana along with 3 month Norco, 3 month Opana and 3 month sleeping pill (that I started last month and has been helping me sleep some) to send in for the mail order. By the way my new prescription insurance is CVS/Caremark.
Okay I will quit apologizing for making such a long post and instead inform you that someone might be looking for the same answers and will find my post and your answers helpful!!! :o) Does that help? Post is long again... will add to it momentarily.
Added 10 Jan 2012:
After my appointment I came home and called the CVS/Caremark customer service because we had not yet used them since the switch. I verified that Opana could be done by mail order and even had her check with the pharmacist because I thought they could have different rules than what Express Scripts had. They both said absolutely it could be done. She then said instead of mailing it in I could take it into CVS and they could help me with sending it to them. She then told me that if I use CVS I will never be forced to do mail order and that it would only cost $4.00 more to do a 90 day supply and I could do it right there and not worry about these meds being left on my front porch and a child getting into them.
After an hour long conversation with CVS/CAREMARK I decided to find my way to the CVS store about 14 miles from me. I had stool softeners and Chantix (Yep I'm joining the non-smokers) called in by my reg doctor today without even knowing where it was located! LOL Before I left I called them to make sure they received the other orders and of course they didn't know who I was so it was another long phone conversation. He did however verify that I could use them instead of the mail order and in fact it would only be $4.00 more for the 90 day supply. He said to come now because they were not busy at the moment.
Once I got to the pharmacy the tech I talked to was helping one of many customers and the Pharmacist helped me instead. I explained everything now to him and wanted to verify that the co-pays were correct that CS told me and make sure that since my meds would be over the $400 that they would not charge me anymore because with the Opana 90 day supply and my few other scripts I would hit my out-of-pocket in one shot. He stopped me and said nooooo customer service told you wrong, you cannot do Opana in a 90 day with us but I can give you one month but you lose the rest of the script and will need to get a new one for next month. I said oh no that's okay because I originally only wanted one month and handed him the other script for 30 days and told him I would send the 90 day supply to the mail order like I originally planned. He said NOOO they cannot do it either because it is against the law.... OK FINALLY to my first question. Does ANYONE know if in Illinois you can do mail order for 90 day for Opana ER???? I searched and searched the web and cannot find any info on that law, although I must say I found some other very interesting reading material. So interesting that I was up all night reading it!
With the Opana script I also handed him the Norco and sleeping med scripts for the 90 days and he said he could fill those. I said it was not time yet to get the Norco so I could either sent it by mail or asked if he could hold it until it is time to fill. He said there was not a problem holding the script but asked how long until it was time and said I was allowed to fill it a few days early so that I didn't need to come back. I told him that I know I had quite a bit left probably even half a month's worth but that I didn't keep the bottle on me because I have small children. I only keep a small amount and all med bottles are locked up in my home office file cabinet. He said no problem I will check the system for you and let you know what date you can pick them up, I agreed but said I don't need them yet so please make sure you check because I don't want my doctor to get in any type of trouble.
He then told me that even if I waited there it would take 1 1/2- 2 hours for them to fill because they just got "slammed" I explained how far I lived and that the drive was painful and asked him if he could just fill the 1 month Opana because I would need it within a day or two and I would come back another day for the others and that way I could also check my Norco date on the bottle. He said he just didn't have time to even fill the Opana right now.
I then told him I would just come back for them tomorrow because I couldn't sit there that long. On my way home my hubby called to check on me as he was picking some of the kids up and I told him the ordeal I'd been through with 2 doctor appts, 2 long phone calls and then all the time spent at the pharmacy and how I still have to come back because it would take up to 2 hours!!! (although I am very against Walgreens right now, even at their busiest I think the longest wait was 45 minutes if that). My hubby then said I must be hungry and exhausted and suggested meeting me and one of my daughters that went with me, for dinner. I thought this to be a great idea so I went back into the Pharmacy and told them I would be having dinner in the area and to please call my cell phone when they are ready.
2 hours later I could barely sit at the restaurant any longer and they hadn't called yet so I decided to forget it. Not just the pain I was experiencing but our youngest ones... 3yr and 4yr olds don't do so well after that long at a restaurant especially approaching bedtime. As we were walking out CVS finally called to say they would be ready in 15 minutes. My hubby took most of the kids with him and I took 2 with me and headed to CVS again. Mind you just like the small pharmacy in my town they always have unneeded things that must be bought causing you to spend more money LOL. SO the kids shopped and I headed "slowly" and in pain to the pharmacy. This was such a loooong day for me, I used to go go go everyday and now it is an effort to get out of bed.
FINAL part of the post coming... wow if anyone actually takes the time to read all this! hehehehe
Added 10 Jan 2012:
Anyway on to question 2 FINALLY Right??? :o)
So I get back to the Pharmacy and they are still busy with people, finally it is my turn so the lady is ringing me up and $240 later (this is without the 90 days of Opana) I started looking at the bag of scripts just to verify prices to myself and although the Norco is probably one of the cheapest of all the meds I take, I noticed they did fill it. The tech was close by and I asked, did the Pharmacist check his system to make sure it was okay to fill this Norco and he said yes, I told you over the phone that everything went through okay.
Which after he said that I do remember him saying that but I guess I just thought he meant all of them were filled okay and would be ready in the 15 minutes. Anyway the Pharmacist heard me asking the tech and he walked over and asked if there was a problem, I said NO I guess not but I was just making sure that you checked your system because remember I told you that I don't want my doctor to get in any type of trouble over me filling a med early that I'm not out of. He said no it went right through the system fine and when a med comes up early it is up to me to decide if I feel it is suspicious in any way, which I don't or do I need too and then he smiled and laughed. I said NO but I was just making sure. I then paid and left the Pharmacy.
After I got home and settled the little ones down I went to the basement to add the meds to the file cabinet and it hit me again when I seen just how many a 90 day supply was! So I dug out my current bottle in there and I filled it only on 12/26. That is 16 days early!!! It has been bothering me ALL night long and I also tried researching for answers on picking up meds too early as well as info on my other question!
I just don't know what to do about this. I'm scared that the Narcotic police are going to come knocking on MY door any minute, I'm scared my PM doctor will get in trouble too, I just don't feel right and I've just been thinking and thinking for hours what I should do. Of course the first thing that comes to mind is to call the Doctor but she does not take phone calls and I can't ever talk to her assistant or her nurse that is always there during my apt. that I'm also fond of. I'm always put through to the nurse that I've had numerous problems with as I know some of you know about. I call about a question or problem with a med and she always must tell me how bad my meds are, how I better not get caught driving on even the Norco and she always compares me to her husband that also had spine surgery and never needed any of the meds I take. She don't even know me, In 6 years of seeing the PM doctor (although only the last 4 months have been for chronic pain) I've NEVER met this nurse in person. She is the nurse for 4 or 5 of the doctors there and I don't think she ever sees a patient I think she just handles all the phone calls for them and handles the refills. She has also made comments like once when I didn't know I was almost out of Norco and I called her and instantly she said, do you know if I asked the doctor to call this in or just let you pick it up when you haven't seen her in 4 weeks she can go to jail, even though I had an appointment scheduled in a few days!!! She is rude and mean and I just don't feel calling the office is an option.
I also feel too scared to wait a whole month to talk to her in person about this! I guess my question is how close is this database monitored? Wouldn't it be the pharmacy that messed up on this? What if the database really did show it was okay and it is because Walgreens is behind posting that I filled it a few weeks ago? Then they will both pop up at the same time and cause a red flag or alert the authorities.
It isn't that I want to keep it from my PM doctor because I'm sure she checks this system each month, aren't they legally made to check it? I just don't want her to see it before I can tell her about it in person because then she might think I did it on purpose. Or maybe are you allowed by the system for this to happen once?
I'm in a terrible mess that I really don't need the added stress of, like any of us do right? I was just hoping for some advice or info from anyone that knows about the Illinois laws with this and also the mail order... legal or illegal for Opana? Maybe a good website that only talks about Illinois law with Narcotics by mail?
Even if you have nothing to offer for advice, thank you soooo much for taking the time to read my BOOK!
Added 10 Jan 2012:
Called Caremark and spent 45 minutes on the phone and was told by Customer Service, Manager and one of the Pharmacists that they CAN do the 90 day. Then I called CVS that I was at last night and the same Pharmacy was working again which is strange but anyway he said NO it is a new law and he will NOT do it but that the mail order messes up all the time and will probably do it once or twice before they get in trouble and then they will stop. Why can't people just get on the same page!
Now for the bigger problem... I asked the Pharmacist again if he checked the database and he said yes and everything with the Norco was fine so he is covered on his end. I said unfortuantly, no offense but I'm more worried about me and the PM doctor being covered on our ends and I asked if I could bring the med back for a week. He said absolutly not because I left the store with it but that I don't need to worry. I sais are you sure I don't need to worry? He said he don't know what all my contract with the doctor states but that I should just go 15 days late for my next refill and then when they ask why I will be able to explain that I got it 15 days early in the past.
I told him that I plan to see her every month still even though I got 4 months scripts for the Norco. I also told him I plan to tell her but need to do it in person and if it would be okay if I wait 4 weeks to tell her. He said sure! I then asked if I have any reason at all to think that the police could come to my house over this and he laughed at me. So maybe he knows what he is talking about? I just feel a little funny about it because he is very young and probably not very experienced but I also know I should not get so worked up like this, I just don't want to screw anything up with my doctor especially cause any type of trouble!
Last night while searching for answers I found the main database and there is a link you can click about doctors and see all the details about what type of trouble they got in, some were out rageous but others went to jail for very minor things and lost their licenses. I feel bad for PM doctors they are forced to treat our pain but then have all these laws to follow and they need to know when to believe the patient, I can tell you one thing I sure wouldn't want to be a PM doctor geeez