Pharmacies, Algebra, and Budgets

It’s been a while since I discussed what’s up with my medical condition. That’s actually been good news. I’ve been doing pretty well, with a good deal less pain than when I still had my colon.

But because I no longer have that large intestine, there are some things that become a matter of maintenance for me that other folks don’t have to worry about. I’m currently on two medications, Imodium and Lomotil (actually generics for each), which slows down my gut motility, giving the small intestine some time to absorb some of the nutrients that would otherwise simply pass through my system. It also means that with those two medications I can be spared the caustic effects of base chemistry, which if things were left to themselves I’d have some pretty immediate problems with. The prescription directions have been the same since just after my second surgery: 1-2 tablets taken with meals and at bedtime. That’s for each of those medications.

In California, Kaiser Permanente’s system simply set me up with getting 3 months worth of medications at a time, so I would get 500 pills per 3 month period. That worked out OK.

Here in Michigan, things are not quite worked out. I haven’t yet had my introductory visit with my primary care physician here, but I’ve needed refills on the maintenance medications. I’m having some difficulties getting the clinic and pharmacy on the right page. While a physician did set me up with the same prescription directions, what the pharmacy actually delivered for one month’s worth of medication was 60 pills of each drug. That was about 8 days worth of medication.

I managed to talk to the clinic, and they put in another prescription order. This time, the pharmacy delivered 120 pills each. Now, the way I calculate that out, I basically cannot plan to take more than one pill at each indicated time; there simply aren’t enough pills in my month’s allotment to actually take 2 tablets each at each meal and at bedtime. And generally I do take 2 tablets each when I take them. I don’t always have three meals a day, but I often do, so this is putting me behind the curve. Like I mentioned before, if I don’t manage to keep my gut somewhat slowed down, I do end up with a painful situation.

When I brought up this issue with my pharmacist, there were two arguments he gave for why they only gave a fraction of the pills needed to actually meet the demands of my prescription directions: they didn’t think I needed that much medication, and the specific number of pills is provided by the prescriber, so I should take it up with them.

Now, every time I get a partial prescription, I’m still getting hit with a full month’s prescription copay charge. So this nickel-and-diming is having a distinct negative effect on my finances, not to mention any adverse effects I may run into if I run out of meds before I can get an order filled that actually provides the medication I need at the rate I’m supposed to take it. I’m hoping that I can work this out when I talk to my primary care physician early in July.

So, if there are some health care pros tuning in who can shed light on why I’m suddenly running into difficulty getting my medications here in Michigan, I’d like to hear about it.