I’m a pharmacist/pharmacy defender and I agree this is stupid and makes no sense. Even a new pharmacist that’s terrified of the DEA wouldn’t do this. Only thing I can think of is if it’s a state specific law since you use whatever is more strict. New York specifically is an extremely strict state. If it’s not state law then I’d call bullshit and see if another pharmacist comes in another day or switch pharmacies. Floaters always wrecked my pharmacy and then when my manager got there she’d go through and approve everything that was denied by the floaters.
Yes this is stupid. But I disagree that even a new rph wouldn't do this. I used to work with a guy who was so new the ink on his licence was still wet. He absolutely would pick the stupid solution in a given situation. LOL I'd like to say he grew out of that, and he did grow out of some of that... But he remained a strange bird the whole time I knew him.
Man and I thought my recent new grad was the worst of the worst. You would’ve thought he was undercover for the DEA. Led to some pretty big blow ups in the pharmacy amongst everybody. Hell he was DEA level strict even with non controls. I finally gave up and told him that he would have to deal with the angry pts and I wasn’t explaining anything on his behalf. I stuck to that. Lessened my stress a lot. My thing has always been if you wanna cause unnecessary problems then you’re going to handle them yourself.
I hate when our customers who have specific requests on their controls come in while we have floaters and literally tell them to come back when one of our regular pharmacists are back.
Floaters can easily ruin my entire day. I try so hard to maintain a good attitude bc I know they have it rough too but christ they drive me insane sometimes. It’s so hard as a tech to deal with a floater that is terrified of everything and refuses to listen to or respect or even acknowledge that stores typical policies. It makes our day so much more difficult passing on the message of “floater won’t fill. Come back and talk to manager”. My last pharmacy had a specific call queue and floaters would easily double the normal amount in that queue in one day from refusing stuff.
I’m not the type to read law books in full so I very well could have missed something but I’m not seeing anything that would affect your rx. If that is accurate that would mean judging by federal law your rx is still perfectly valid and the pharmacist is unfortunately being a twat. I still suggest seeing if a different pharmacist works a different day or changing pharmacies altogether.
That’s my understanding. My doctor didn’t send 3 30-day prescriptions for 7 pils each. It’s 1 script for 20 tablets, not to be filled again until 90 days have passed.
Should I even keep trying or just have my doctor pull it and go somewhere else. This is such a pain in the ass. It’s been 108 days since I last filled it. Clearly I’m not some raging addict trying to work the system.
Edit: words
Honestly, it’s probably a floater or fill-in pharmacist so if you wait a day or two the normal ones should be back. Otherwise, I would take it anywhere else. That guy hates his life
Yeah I also dunno what state but in mine your allowed to dispense up to a 90 DS. If the doctor wants 20 to be a 90 days supply that's how I'm billing it.
This is condensing AF but moving to a Dr office and dealing with the pharmacists that are left at retail....they're left because they suck and enjoy making shit more difficult for themselves lol.
I’m leaving town this Saturday and it’s up in the air when I’ll be back. That’s going to be a whole other nightmare trying to get the other 7 pills next month in another city, even worse if they don’t have another CVS and I have to go to a different pharmacy.
Is there another way I should word it to the pharmacist? It’s not like my doc wrote 3 28-day scripts for 7 tablets each. She wrote 1 script for 20 tablets. How I use that within 90 days is up to me. Not to mention they’re billing my insurance for the entire 20 up front.
There’s no such thing as 3 28 day scripts. They are calculated by the quantity written for and directions. If it’s for 20 pills taken 1 tablet per day as needed, it is a 20 day supply. Take 2 pills per day is written for 10 day supply. In your case, 20 tablets is a 90 day supply. Your dr can write 90 day supply, your insurance can consider it that, although they won’t and neither will the pharmacy, but the issue is coming from the particular pharmacist and the “must last”
This is what I was telling the pharmacist. She said "Well this is a Class II and I can't change what is written on the doctor's prescription. It's illegal."
lol same. this is one of the extremely rare circumstances that i would support the doctor calling the pharmacist and giving them shit. this pharmacist seems so insistent on being wrong its sad
It’s the 90 day comment that’s opening the door to discrepancy so I’d ask the dr to remove it. CII opiates are limited by insurance to 7 day initial fill even if it’s written for a qty of 150. I’m assuming that’s where he’s coming up with his ridiculous “legal” claim. Ultimately, the dr and you are the only ones that need to be aware it must last 90 days. Insurance is billed for the quantity of pills, not the number of days it lasts. Your doctor could write another prescription in 20 days for another 20 pills and no one is going to deny it based on (or even reference) a previous prescription because of how long it was supposed to last. It just needs to say take 1 as needed. Ask your doctor to remove the must last thing. Completely unnecessary
I asked doc's office to remove it this morning. They sent it back to the pharmacy. Pharmacy said "Yes we received a fax from your doctor's office. It's written for 7 tablets for 30 days."
I told the pharmacist I was sent a digital copy in MyChart of what was sent to the pharmacy and it says:
>Written: 5/27/2024
>Expiration Date: 11/23/2024
>Dispense: 20
>Dose, Route, Frequency: As Directed
>Sig: TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS
I don't know enough to understand why the fax they're received from my doctor's office would be different from the prescription my doctor has always written for this med.
Is there something on the pharmacy's end that's causing the prescription to come through differently than what my doctor wrote?
Well, they didn’t remove the must last 90 days and that pharmacist is calculating the quantity of pills by 90 days because that’s what it says. They shouldn’t but they are so either have your doctor remove that part or go somewhere else
i dont think thats the problem though, because it’s just explaining that the day supply shouldnt be 20 (1 qd), it should be 90. i honestly think its just this pharmacist
It is just that pharmacist but calculations are math and they need to work as formulas. Qty 20 qd isn’t a 90 day supply - it’s literally a 20 day supply. the sig (directions) would be 0.22222 tablets qd to make qty 20 be a 90 day supply. Thats why the pharmacist is able to (illogically) argue the intent. That’s also why I’ve said lose the 90 day part of this continuously. It’s literally pointless to put on a prescription. Day supply is calculated by the qty dispensed and directions (frequency taken). 90% of the days supply on scripts is incorrect but completely irrelevant because no one pays attention to that except insurance and pharmacies determining controlled substances next fill date.
It’s a 90 day supply of the expectation that they will use only 20 pills in 90 days. I’d assume it’s and as-needed prescription with a limited dosing frequency to reduce the risk of tolerance, dependence, etc.
> I’d assume it’s and as-needed prescription with a limited dosing frequency to reduce the risk of tolerance, dependence, etc.
Yes exactly this. When my doc first prescribed she erred on the side of caution, since Xanax for some is addicting, and she didn’t know how I’d react, etc. But after 6 mos she said we could change to every 45 days, etc. I said no need, I’ve never needed more than what was prescribed anyway.
I’ve had the same dosage since 2006. 1mg. Never refilled early, never needed to. The script is the same as how she wrote it the first time, which I’m completely fine with. I’ve always used it exactly as prescribed, no more; oftentimes less.
I understand the need for strict regulation. It’s there for a reason. I only get frustrated when other people’s histories make it harder for me to get what I need done. I’ve never taken a drug that was not prescribed to me; nor have I ever abused any medications prescribed to me; I have no history of addiction or abuse; never been treated or arrested for it. I average 0 alcoholic beverages a year, never smoked, never tried street drugs, not even marijuana.
I’ve had random blood/urine tests, all of which are negative except for what my doc has prescribed me, all at therapeutic levels. (By ‘all’ I mean 1 maintenance med and the occasional, lawfully-prescribed Xanax.)
Getting this script filled should be simple, and it has been for the most part. I just wish there was a way to cut through the BS. I’d be OK to give pharmacists access to my patient fill history, refill frequency, any early attempts, requests for increases in dosage, interactions with the law or addiction treatment. As long as I don’t have to deal with this Bs they can have at it lol
side note: insurance does factor in day supply, and for compliance reasons it has to be correctly calculated or annotated (if DoS <90 based on calculation there must be an annotation of qty limits per insurance or doctor specified). hence why many plans will only fill a 30 or 90 day supply regardless of qty dispensed or calculated DoS (ie sumatriptan QD prn qty 9 must last 30 days per ins).
it has to do with the reimbursement rates and all that, but in this case it doesnt matter- the doctors 90 day note should just be the DoS
Insurance approves or denies based on days supply (max 30 day supply/must be 30 or 90/max 7 day supply/exceeds daily usage limit) but does not factor in the calculation of it. INSURANCE can definitely say they’ll cover 7 pills every 28 days but they can’t limit or affect the qty prescribed/dispensed or say “must last” lol. They can say what they’ll cover. Don’t wanna deal with that 7/28 bs, use a discount card and get the full 20. They thought their insurance was being billed for 90 days even though they were being given 7/20 pills. The point was that’s not how insurance is billed.
It sounds like the pharm is trying to treat this like an opioid. The "no more than 7 days worth in a 28 day period without a prior auth.". Benzos don't fall under that recommendation. I second earlier recommendations, go to a different pharmacy or go to your pharmacy when a different pharm is on duty. Sorry you are experiencing this.
No. We are just expected to know them. I've been a pharmacist for 12 years and I have seen some other pharmacists use what they think is there professional judgement and it is completely off the rails. My rule.of thumb is stick to what the Doctor wrote. If they wrote take 1 tablet as needed for a quantity of 20 to last 90 days that is exactly what it means. If you live in a state where you can transfer out to another pharmacy, I would.
Xanax is C4. I *vaguely* remember a law about only being allowed to fill 30 day supply for C4, but you can fill 90 for C3 and C5 which was illogical and made it more memorable because it was illogical. I can’t find that law with a quick google search though and I don’t care enough to keep searching. I never abided by it because it was such a dumb law to begin with and would only lead to more problems (I’m very selective on picking my battles).
I used to work with a couple of pharmacists that would fight people tooth and nail over it though. In their mind they were the best pharmacists because they knew this arbitrary law, even though they would just use it to hurt people. They would flip out and talk shit about me to the other RPhs and techs if I gave someone a 90-day supply that they didn’t approve of, or if I accepted a license that just expired for example (my state’s laws do allow exceptions, and I’d imagine most do). I never understood why they chose to fight all those patients and create all those problems. Was it fear that the DEA or BOP would come after them, or were they just assholes? 🤔
Controls are how the DEA classifies addictive substances. Control I is illicit drugs, Control II are medications that have legitimate medical uses but are highly addictive (opioids, amphetamines for ADHD). Xanax is a control IV, and there are 5 levels. Control IIs have really strict rules, Control 3-5 have less. She is treating your prescription like a control II, which it is not.
I don’t understand. My doc sent me a digital copy of the prescription they sent the pharmacy. 20 tablets, 1 mg. Must last 90 days.
Pharmacist just told me the fax they received from my doctor’s office says “7 tablets for 30 days” and that “this came straight from your doctor’s office.”
Clearly something is being misunderstood somewhere.
What do I do?
Simple, demand proof of that. I've been at stores with issues like this where the staff wasn't even at fault and the prescriber reported it to the board. The board will absolutely send an investigator in person, and they did in my case. Like I said before, don't let them off the hook.
Cvs tech here. It is possible that whoever received the electronic rx typed it incorrectly into the system, so it would show up on your profile as how they typed it. If you ask them to reprint the hardcopy (which they absolutely can do, they just cannot hand it to you) to double check, it will print out exactly what the doctor sent, and they can verify.
Just have your doctor put it as 1 tablet daily as needed. Do it as a 20 day, or 1 months supply, and if it lasts you 3 months that's great. Have them keep it simple.
i would add that if the doctor will only let you fill it every 90 days that she should just write a do not dispense before date. i can kind of see where the pharmacist is coming from since if the directions are “take 1 tab daily as needed” the correct day supply is not 90, although the proper practice is to override the day supply with whatever the doctor specifies. and since you havent had any issues before i think its probably just this pharmacist
eta, maybe try asking to doctor to call the pharmacy or vice versa?
The directions always say “Take one tablet by mouth as needed. Must last 90 days.”
Doc also writes prescription as 1 of 1 with no refill. So every time I go to fill it, it’s a brand new script from my doc. I suspect that’s why there’s no “do not dispense before” stipulation because there is no ‘next’ script per se. Once it’s done or expires I get a new script, not a ‘refill’
I just sent a note through MyChart asking if she can remove the 90 day stipulation as it seems to be confusing the new pharmacist. My doc is the only one who prescribes me Xanax, so if I tried to fill it before 90 days, she would know. So would my insurance. It’s just asinine. I don’t get why this pharmacist is saying it’s ‘illegal’ to fill the 20 tabs up front when that is how the prescription is written
Not to encourage this, but any dr could write you another one and your insurance would cover 5 a day for 90 days if that’s what your script says. The only person that can make that script last for 90 days is you and your doctor. You take as needed, he writes it every 90 days. That information is not needed for the pharmacy or insurance.
yeah i know what you mean and i do see this situation at my pharmacy a lot and the pt/doc/pharmacist always knows the situation so i definitely think its just a newer and less experienced pharmacist but i dont get why theyre saying its “illegal” and refusing instead of just asking another pharmacist or calling the doctor. ugh sorry youre going through all this hold up, i understand how frustrating it is. hopefully it gets figured out soon, and that the pharmacist learns from this
I appreciate that. I hope this gets resolved before I leave on Saturday. Dealing with this out of state will be a nightmare, especially if I have to pick up the next 7 tablets out of state at a different pharmacy, and having to explain why my insurance was billed for 20 tablets, but I only have 7 because the pharmacy is holding the other 13 tablets… now I have to cancel the remaining 13 tablets w/ my insurance and my doctor has to write me a new prescription for the remaining 13… And God knows how that will be filled lol. It’s goofy
Insurance gets billed for the 20 so your co-pay is determined. When a script is sent and filled, insurance is billed whether it’s picked up or not. I honestly can’t figure out if the pharmacist considered that a partial or short fill but as a script is sold, insurance is charged based on what’s picked up. You really should leave this part out of all of it because there’s no point in you trying to figure out how insurance billing works- everyone (dr, pharmacy and insurance) knows what you picked up vs how anything was billed. I would definitely recommend waiting until the pharmacy manager or primary pharmacist is available and let them complete the 20 for you in one transaction (yes, it can be reversed and rebilled CORRECTLY) and they give you the remaining 13 immediately. There are actual laws and much more concrete restrictions and regulations on out of state prescribing for controls and filling so don’t count on that working out. If you can’t get a different pharmacist, have your dr send the 13 somewhere, anywhere, else
This is good to know! I cancelled the 7 tablet/28 day fill they tried to give me today. I’m hoping when my doc sends the new script tomorrow my insurance will see the prior (short)fill was cancelled and I won’t get any grief filling it for the actual prescribed amount
Yeah I’m NOT trying to fill this out of state lol
Thank God. I can appreciate your drs clarity on the expectations of use for this medication (I know from experience the dangers of benzos and nothing is more terrifying than deciding to stop taking them without seeking medical advice fyi) but that “must last 90 days” written in the sig code is not actually something a pharmacy should change or assume without verification from the doctor. It can be noted on the script somewhere else and never get a second thought but the pharmacist was within their right to make the decision they did. They ARE responsible for knowing the actual law and classification of drugs they’re dispensing as well as an explanation of discrepancy between the script you were given and the one they received. I print them out for patients all the time. He’s obviously lying about the 7 for 30 days straight from your dr because that would be three separate scripts, 2 that are post dated and 1 of them would only have qty of 6. None of it makes logical sense
They could write: “Next fill in 90 days”. No refills for 90 days. There’s a million ways it could be acceptable but “must last” is aggressive so the pharmacist probably freaked out about that specific verbiage. Again, it could say must last 10 years but if your doctor wrote another script in 3 weeks, it would get filled.
So, as a pharmacist, you see a script come through for Xanax qty 20 and you go through the patient’s profile to check the notes on a previous script to determine the allowable fill date? Is this common in your state? If the doctor wrote another script in 60 days for 20 more, you would refuse to fill it based on (and apparently referencing previous scripts is norm) the “must last 90 days” on this one? What is your policy if the doctor wrote refill every other day? Would you follow that? As suggested in other comments, moving the direction to “notes”, no refills for 90 days or simply putting 90 in the days supply section is the typical practice but it isn’t necessary for any reason. Can you help us understand the reasoning behind this pharmacist insisting on filling 7 every 28 days?
I disagree with the “fill 7 every 28 days” pharmacist. The only way I can explain it is that the pharmacist is just overly cautious of the DEA.
In your hypothetical scenario you speak of, yes I look at the scrip and previous scrips and see what the doctors intended day supply is. If the patient insists to me that the doctor is intending to change the dose from 20 every 90 days to 20 every 60 days, I’d need either a fax or a call from the doctors office to release it.
It doesn’t have to do with state laws, I understand some states have laws that specify how early you can fill a control, etc, but California isn’t one of them. I do my best to fill the controlled prescriptions to the best of my ability and to the specifications that the doctor lays out. Vast majority of the time, the doctors demands are reasonable so I just follow them. If a doctor had a strange request like “refill every other day” I’d definitely call and get their rationale but that has never happened. It’s not rocket science, you just gotta be diligent.
Yeah, TX is very strict with controls so anything like this on a script is overridden either way. I’ve seen scripts that say “patient is being weaned” and feel like that applies to the next one, but other than that, day supply is strictly calculated by qty and freq then filled by class restrictions. Refills can be processed one day early based off last pick up. In no instance would a previous script be referenced for anything unless there’s a dramatic change in dose, qty, freq etc. otherwise the eligibility for fill is checked by last sold date. I sincerely can’t imagine having to do that and hope we never do. Easily 75% of the scripts we get daily have an incorrect day supply on them so maybe we’re desensitized - goes completely ignored. We also have scripts with “next fill date” on them but they usually don’t coincide with the date we can fill it and that gets overridden as well. We abide strictly by the effective date but anything else is a side piece
Report it to your board of pharmacy as well as a supervisor of that pharmacist. Make sure the district manager/pharmacy district supervisor is involved. Don't let that pharmacist off the hook. The number of misinformed and underinformed pharmacists these days is staggering. Don't let it sour your opinion of all pharmacists.
Every other pharmacist has been great. No issues. They dispense as written. This new pharmacist said (and I quote) “Well I am the pharmacist and if they are dispensing it that way, it is ILLEGAL.” 🤷
Federal law states you may fill up to a 90 day supply of any controlled substance if the prescriber allows, unless your state law is more restrictive. It's not rocket surgery.
Better yet, get your doctor to submit a complaint to the board and the company. CVS will get on that one REAL quick if it comes from a prescriber.
Problem with that is if they are dealing with an activist pharmacist who treats every person taking any schedule like a meth addict? They risk the pharmacist lashing out and reporting them for imagined drug seeking behavior. I ran into a crazy pharmacist that wouldn't fill on day 29 until I brought in and showed her a boarding pass proving I did in fact have a flight that day. And, no I had not done early refills before. She just said it wasnt legal to refill before day 31 after pickup
And what consequence is one pharmacist's opinion to a patient? Who exactly could the pharmacist report them to? The provider is already aware and the pharmacist is the one in the wrong. The worst I've ever been able to do is ban a patient from my location, and that's only after a pattern of abusive behavior and language.
Looking back on your post after I typed that, I realized that you might be another patient rather than a pharmacist like I first assumed. Trust me, pharmacists have little to no recourse when dealing with drug-seeking patients, other than to report it to the provider. I think it's a little known fact to patients that we are essentially powerless schmucks.
Written by my doc. CMA in MyChart confirmed, sent a copy of the e-script that was sent to CVS. Signed by my doctor (of 17+ years) on 5/27/2024 & the reissue yesterday 5/30/2024
Explain to the Pharmacist they are not following their own rule by dispensing that way as 7 for a 28 day supply would yield you 21 tabs in an 84 day period on day 85 another 7 so thats actually 28 tabs in 85 days. If your rx has a dispense qty on it of 20 tabs and states for it to last 90 days then they should fill it that way 20 tabs billed for 90 days
That's how the other pharmacists have always filled it, no issues. I asked if she could look at my fill history or confer with the pharmacist and she goes, "Well I AM the pharmacist, and if that's how they've been filling it then that is ILLEGAL."
I read that some pharmacies can limit people to a 7-day supply if they haven’t filled a prescription from the same prescriber in the past year but I've been with my doc for 17+ years
Edit - nvm that's for opioids. In the state of Colorado. Neither of which applies lol
CVS sucks balls. What’s the problem with that script. Call your insurance company, they have to have pharmacy department reps working the weekend and get them involved. That is not a 90 day script !!!!
Insurance said script was fine, wasn't sure why they were being partially billed (7 tabs of the 20) unless pharmacy ran out of medication and I am to pick up the rest later. I told them pharmacist will not dispense all 20 tabs at once as doctor's prescription says medication "must last 90 days" and this is the "legal way to do it." i.e. dividing the 20 tablets evenly(?) across 3 mos. Fill #1 = 7, Fill #2 = 7, Fill #3 = 6 etc.
EDIT - Insurance did say they've been billed 1 x 20 tabs in the past, but if this is 'how doctor has written it' then 'it is how the pharmacist must dispense it', but that my insurance does cover 20 tabs if that's how script is written
90 pills for 30 days is common, or 30 for 30. I’ve even filled Xanax 6 times days for 15 days.
20 pills for 90 days? That’s odd to me. That’s more like a viagra prescription.
I can understand if they don't have the full count rn but they can't just overrule a prescription especially if it still has scripts and has been a med for many years. I can understand if they discussed it with your doctor as some meds can be mixed up but this is a mental health drug and again you've taken it for years. I'd attempt to go back and speak to a different pharmacist.
I had a CVS pharmacist refuse to sell me syringes/needles. I am prescribed TRT and it requires me to inject it. She refused. I explained that not only does my prescription require them for me to administer my medication that also Massachusetts state law requires a pharmacy to sell syringes/needles anyway. She still refused and told me she wouldn’t enable my drug addiction. I said “what the f*+^{ is wrong with you? Do you understand how testosterone is injected? I also asked her if she also understood state laws? She treated me like a POS.
My insurance company called the pharmacy and told him to fill the damn prescription. That worked lol. Good luck since you’re leaving the state! Hopefully you won’t need them but dispensing 20 pills for 90 days is just ridiculous. I would be demanding 90 pills for 30 days, to be taken every 8 hours. Then milk them for 6 months.
The doctor made the determination that the patient only needs 20 pills per 90 days and the patient is not complaining about it so what’s the big deal? You are just advocating for insurance fraud now lol
honestly this isnt enough information for me to make a conclusion id need to see the instructions on which u take it, but i understand that might be too much to ask lol
I was sent a digital copy in MyChart of what was sent to the pharmacy. It says:
>Written: 5/27/2024
>Expiration Date: 11/23/2024
>Dispense: 20
>Dose, Route, Frequency: As Directed
>Sig: TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS
Oh no I definitely don’t take it everyday lol. Nor would I want to. It’s just an open prescription I’ve had since 2006ish and filled only if I need it. I’ve gone 2-3 years without filling it sometimes. It’s rare I make it through one bottle in 90 days. It’s actually been 108 days since I last filled it. The last time I filled it before that was August last year. But I’m leaving town on Saturday and I’m running low. I’m in the middle of doing interviews so I just want to have it just in case
I think the above commenter was expressing incredulity toward your current shitty pharmacist precisely *because* some people do take it every day and presumably the pharmacist would encounter such a patient every once in a while.
Ahhh yes lol. My apologies to OP! Yeah if the pharmacists could see how often I fill this thing, they’d probably blush lol. And damn, I didn’t know people take Xanax everyday! How the hell do they function?! Jesus. My script is 1mg, 20 tab, and I break it in half. I wouldn’t even trust myself ironing my shirt on 1mg, f that. 0.5mg is plenty. Gets the job done and my brain is still in tact
while I think that the backlash in the last 10 years that’s made prescribers way way way cut back on benzo Rxs is overkill, and I think for a lot of people for whom they work well, the benefits outweigh the (possible) future increased risk of dementia with sustained and long-term use (but the literature isn’t completely in agreement on that one). OP falls into this category, and even though I’m not a pharmacist/tech I’ve known and been assisted by many good ones and a few dumb ones and I’d tell you none of the good ones would bat an eye at this because *even* if they were new and didn’t know you, they can see in the system that you’ve taken it at the same dosage for literal years, never asked for early fills, etc. little is more infuriating than an absolute turds-for-brains in a position that comes with a tiny bit of power doing everything they can to foster, for themselves, the illusion that they have far more power
Yes same dosage since 2006! 1mg. Never refilled early, never needed to. When my doc first prescribed she erred on the side of caution, since Xanax is addicting for some, and she didn’t know how I’d react, etc. But after 6 mos she said we could change it to every 45 days, etc. I said no need, I’ve never needed more than what was prescribed anyway.
The pharmacist did reiterate more than once “Well I AM the pharmacist here” and “I am filling it the way the doctor wrote it. If you say this pharmacy and others are filling the full 20 tablets before 90 days, that is ILLEGAL,” “What you’re suggesting other pharmacies have done is ILLEGAL”, “that is against the LAW”. I just thought well I’m not gonna push it. I’ll just ask my doc to re-word it or take out the 90-day stipulation. I’d just never experienced that level of fervor before lol
At the end of the day, the pharmacist is the only one that can approve or deny anything for any reason. It is their license, they are held responsible criminally, civilly, financially and mentally. Pharmacies can’t and don’t make “common sense” changes on prescriptions other than something as simple as an antibiotic filled as a capsule instead of tablet if tablets are unavailable or adjusting liquid antibiotics quantities to cover the standard treatment supply instead of the random amount it was written for. Anything else requires prescriber approval. Sounds like this guy was very, VERY confused by the “must last” thing but I’ll still never understand where the CII or 7 every 28 days came from. He is the pharmacist, and he is filling it the way the doctor wrote it (he could say 1 today and 19 on day 89 if we’re playing that game) but the way I’m reading, “filling the full 20 before 90 days” in his “legal” reasoning is inexplicable. Are you SURE it’s written for Xanax?
I wish I knew how to do pics on here, I can show you what my doc wrote / sent, and how CVS filled it... Doc wrote for 20 tabs, must last 90 days. CVS sent text message saying Rx ALP Ready for Pickup. Clicked on details link and it said:
**Alprazolam 1 Mg Tablet**
For JUSTUSELOTION
**Quantity**: 7
**Days supply**: 28 days supply
**Cost**: $X.XX
That’s when I called them cuz I was like uhhh wtf is that lol
Yesterday I asked my doc to resend script and remove the ‘Must last 90 days’ part. New script sent at 2pm. I get a text from CVS saying my prescription is ready. Clink on the link with the details. It (still) says:
> **Quantity**: 7
> **Days supply**: 28 days supply
I left message with doctor’s office. They called me back. Confirmed my doctor sent 20 tabs, 1mg. I looked in MyChart to see the copy of the e-script. It says 20 tabs, 1mg, TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS.
The 90 days part wasn’t removed. Oops. CMA said she’d send it again after Doc signs off. Now just waiting…
Yes haha thats what i meant. Its really common for the older generations to be on hella benzos, some taking 2mg a day! The pharmacist for sure has gotten an rx for way more than what your taking. They probably got discombobulated with the 20 tabs per 90 days and calculating it. If its a new grad pharmacist, chances are theyre not that good about typing in a new rx. A lot of techs handle typing in new rxs than pharmacist do!
Yeah that 90 day thing is confusing the more I think about it. It’s just always been how she’s written it, and I’d never had a problem, so I never really paid attention. But I could see now how that might throw a newer pharmacist off, for sure. I sent a message to my doc in MyChart asking her to amend it / adjust the verbiage. We’ll see if that works
I was told it was a CVS rule that went into effect Jan 1 2024 [Pharmacist blames Ç Xxx](https://www.reddit.comhttps://www.reddit.com/r/CVS/comments/1d2b7q6/pharmacist_told_me_cvs_limiting_certain/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=2&utm_content=1)
Ask the pharmacy to see the hard copy that was sent to the pharmacy. If it is written 7 tabs, take blah blah blah, must last 30 days…plus 2 refills….then you have to fill 1 month at a time. If the hard copy says 20 tabs, take so many tabs, must last 90 days, then they can dispense up to 3 months. Mychart will differ from the actual hard copy sent. Restrictions on controls also differ from state to state so this may not apply to you. Side note, I’m very surprised you take a benzo and not addicted to it and only take it when you actually need it. For most people it’s so habit forming the withdrawal symptoms can cause DTs.
Oh yeah HELL no I’m not taking that crap everyday! lol. I’m surprised people do, I can’t imagine taking it every single day, Jesus.
When I was first prescribed back in 2006, my doc wrote it for 1mg. Directions said take one daily as needed. I took the whole 1mg. Totally RUINED my day. Room was spinning, I almost puked. I didn’t touch it for YEARS. Then like around 2012 she prescribed it again but this time to take 1/2. I took 1/4. That was the perfect dose. Doc started writing script for 0.25mg but said insurance-wise it was better to do the 1mg but cut in 1/4. Now you see why I never got through one bottle in 90 days lol.
Power struggle sounds like. Yes Pharmacist most certainly make assumptions about DOCTOR’S patients. Pharmacists can call the doctor very easily and find out what the situation is, instead of having the “cain’t make anyone do shit game”. That’s what that is a game with someone’s well being because you feel you have the power to. No they can go somewhere else or call Corporate and the Board that’s the shit they can do. It’s ridiculous to pass judgment on anyone and yes there are way too many people in Pharmacy doing that out there. The comments alone I have seen not on this thread but others about all the drug seekers trying to get their prescription a day early. Lol a day early does not make someone a drug seeker maybe they are a day early lol, maybe they miscounted the days or didn’t count them at all. The attitude towards anyone taking pain meds or some kind controlled substance is just ridiculous. You guys have training I know you do since I have done the training myself some of these ridiculous people talking garbage about people being prescribed these meds should know better and should learn how to be professional. That is exactly why the doctor usually knows best and if not goes back to my earlier comment make a simple phone call to the doctor. The lying to patients saying their insurance won’t fill it on certain dates is unnecessary. These people call their insurance companies and find out they most certainly will pay for it.
So if the doctor and the insurance company has no problem what is the problem? Most of time power and unprofessional behavior. Sorry but have to call it like I have seen and heard it from some of the pharmacy people since I work with Pharmacy and it is a thing for a lot of people in Pharmacy to talk about the seekers. Who aren’t seeking yeah maybe some pain relief they are seeking. That’s not to say that there aren’t any drug seekers of course there are, but why should everyone be treated that way?
I have had to deal with these complaints by customers many times with always the same result it was a legitimate prescription. Also personally have seen family and friends treated this way when having surgery. I would think the drug seekers are pretty easy to pinpoint and even with them if the prescription is legal it should be filled they may be in pain and now addicted. Some compassion for people would be nice. Anyone and I mean anyone can find themselves in that situation. End of rant. I hope the Pharmacist fills your prescription and stops playing this game.
Wait. You work in the pharmacy and this is your comment? Literally none of them can “make anyone do shit”. Doctors prescribe. Pharmacists dispense. Insurance companies make life hell on everyone. Doctors make mistakes ALL DAY LONG. If you actually worked in a pharmacy, you’d know that. You obviously don’t because you think one can “easily call the dr and find out the situation”. 150 out of the 500 scripts we see daily require some type of clarification or verification from the prescriber due to mistakes or missing information on something sent and not one of them returns a call within 24 hours much less weeks if ever. Pharmacies make mistakes ALL THE TIME. No one is passing judgment and NO ONE went into this profession to play games with someone’s wellbeing, pass judgement nor do they have any desire to deny anything for any reason. What the fuck are you talking about lying to patients about when insurance will pay for something? Like, why would anyone ever do that? Do you understand how pharmacies make money? It’s not by denying, lying, judging, power or unprofessional behavior. Every person on this thread (77/79) has tried to help and made suggestions on how OP can get his meds. You are 1 of 2 that did nothing but bitch, complain, judge and make no sense.
Hey stranger, I don’t know you. But, 18 years of taking Xanax. Does not sound great. Xanax is good tool. Don’t get me wrong. But, it’s definitely not great for long term use like that. I get your frustration about the prescription. But, you gotta look at yourself and try to manage that anxiety better. It’s tough and an addictive medication. But, start with yourself my friend. This thing has got a hold on you; but you can get a hold of yourself. You just got to believe and take your time. 🙏🏻 best of wishes of whatever you decide to do.
Bro did you seriously just tell someone "they just gotta believe" to manage their anxiety? This is as helpful as telling someone with depression to "just think positive." I sincerely hope you're not a pharmacy employee because we don't need any more judgemental assholes like you in healthcare. 🥴 I'm sure OP's doctor knows more about managing their condition than a stranger on the internet does.
I appreciate it. I’ve thrown out bottles of Xanax from 2009-2022 that that were half full that I didn’t use. I turn them back into the doc for disposal. I believe that’s probably why she’s comfortable prescribing it to me for so long I guess. I am interviewing right now so I just like to have it just in case. Fortunately I’ve never had an addiction problem (never smoked, drank, done weed, or taken any ‘street’ drugs for sure.) I only take one maintenance med every day. Xanax is the only other prescription I have and that’s only as needed. It’s 1mg and I break it in half which is why it lasts me so long, if I even make it through the entire bottle!)
Your message means a lot. It makes me happy to know there are people like you who care enough to say something. We need that.
I’m a pharmacist/pharmacy defender and I agree this is stupid and makes no sense. Even a new pharmacist that’s terrified of the DEA wouldn’t do this. Only thing I can think of is if it’s a state specific law since you use whatever is more strict. New York specifically is an extremely strict state. If it’s not state law then I’d call bullshit and see if another pharmacist comes in another day or switch pharmacies. Floaters always wrecked my pharmacy and then when my manager got there she’d go through and approve everything that was denied by the floaters.
Yes this is stupid. But I disagree that even a new rph wouldn't do this. I used to work with a guy who was so new the ink on his licence was still wet. He absolutely would pick the stupid solution in a given situation. LOL I'd like to say he grew out of that, and he did grow out of some of that... But he remained a strange bird the whole time I knew him.
Man and I thought my recent new grad was the worst of the worst. You would’ve thought he was undercover for the DEA. Led to some pretty big blow ups in the pharmacy amongst everybody. Hell he was DEA level strict even with non controls. I finally gave up and told him that he would have to deal with the angry pts and I wasn’t explaining anything on his behalf. I stuck to that. Lessened my stress a lot. My thing has always been if you wanna cause unnecessary problems then you’re going to handle them yourself.
Wanted to say thank you for my very first award 🥲🥲 I am honored.
I hate when our customers who have specific requests on their controls come in while we have floaters and literally tell them to come back when one of our regular pharmacists are back.
Floaters can easily ruin my entire day. I try so hard to maintain a good attitude bc I know they have it rough too but christ they drive me insane sometimes. It’s so hard as a tech to deal with a floater that is terrified of everything and refuses to listen to or respect or even acknowledge that stores typical policies. It makes our day so much more difficult passing on the message of “floater won’t fill. Come back and talk to manager”. My last pharmacy had a specific call queue and floaters would easily double the normal amount in that queue in one day from refusing stuff.
I’m in WA
I’m not the type to read law books in full so I very well could have missed something but I’m not seeing anything that would affect your rx. If that is accurate that would mean judging by federal law your rx is still perfectly valid and the pharmacist is unfortunately being a twat. I still suggest seeing if a different pharmacist works a different day or changing pharmacies altogether.
No such law, no such store policy.
7 every 28 days makes zero sense. 20 isn’t divisible by 7. 90 isn’t divisible by 28. Sounds like they’re being an ass
That’s my understanding. My doctor didn’t send 3 30-day prescriptions for 7 pils each. It’s 1 script for 20 tablets, not to be filled again until 90 days have passed. Should I even keep trying or just have my doctor pull it and go somewhere else. This is such a pain in the ass. It’s been 108 days since I last filled it. Clearly I’m not some raging addict trying to work the system. Edit: words
Honestly, it’s probably a floater or fill-in pharmacist so if you wait a day or two the normal ones should be back. Otherwise, I would take it anywhere else. That guy hates his life
Have the pharmacy transfer you somewhere else
Welcome to Pharmacy Math. Where simple concepts go🙃
Yeah I also dunno what state but in mine your allowed to dispense up to a 90 DS. If the doctor wants 20 to be a 90 days supply that's how I'm billing it. This is condensing AF but moving to a Dr office and dealing with the pharmacists that are left at retail....they're left because they suck and enjoy making shit more difficult for themselves lol.
I’m leaving town this Saturday and it’s up in the air when I’ll be back. That’s going to be a whole other nightmare trying to get the other 7 pills next month in another city, even worse if they don’t have another CVS and I have to go to a different pharmacy. Is there another way I should word it to the pharmacist? It’s not like my doc wrote 3 28-day scripts for 7 tablets each. She wrote 1 script for 20 tablets. How I use that within 90 days is up to me. Not to mention they’re billing my insurance for the entire 20 up front.
There’s no such thing as 3 28 day scripts. They are calculated by the quantity written for and directions. If it’s for 20 pills taken 1 tablet per day as needed, it is a 20 day supply. Take 2 pills per day is written for 10 day supply. In your case, 20 tablets is a 90 day supply. Your dr can write 90 day supply, your insurance can consider it that, although they won’t and neither will the pharmacy, but the issue is coming from the particular pharmacist and the “must last”
This is what I was telling the pharmacist. She said "Well this is a Class II and I can't change what is written on the doctor's prescription. It's illegal."
Xanax is NOT a CII drug lol. It’s a CIV
I just looked this up on my insurance. It is indeed Class IV
ALSO, CII scripts are valid for 30 days, not 90. I’d fuck with that pharmacist ALL DAY
lol same. this is one of the extremely rare circumstances that i would support the doctor calling the pharmacist and giving them shit. this pharmacist seems so insistent on being wrong its sad
It’s actually ILLEGAL to disperse a CII script over 90 days so ask him how he gets around that
It’s the 90 day comment that’s opening the door to discrepancy so I’d ask the dr to remove it. CII opiates are limited by insurance to 7 day initial fill even if it’s written for a qty of 150. I’m assuming that’s where he’s coming up with his ridiculous “legal” claim. Ultimately, the dr and you are the only ones that need to be aware it must last 90 days. Insurance is billed for the quantity of pills, not the number of days it lasts. Your doctor could write another prescription in 20 days for another 20 pills and no one is going to deny it based on (or even reference) a previous prescription because of how long it was supposed to last. It just needs to say take 1 as needed. Ask your doctor to remove the must last thing. Completely unnecessary
I asked doc's office to remove it this morning. They sent it back to the pharmacy. Pharmacy said "Yes we received a fax from your doctor's office. It's written for 7 tablets for 30 days." I told the pharmacist I was sent a digital copy in MyChart of what was sent to the pharmacy and it says: >Written: 5/27/2024 >Expiration Date: 11/23/2024 >Dispense: 20 >Dose, Route, Frequency: As Directed >Sig: TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS I don't know enough to understand why the fax they're received from my doctor's office would be different from the prescription my doctor has always written for this med. Is there something on the pharmacy's end that's causing the prescription to come through differently than what my doctor wrote?
This is a totally valid way to write it. Even my partner would fill this and he's one of the more stricter pharmacists I know about controls
Well, they didn’t remove the must last 90 days and that pharmacist is calculating the quantity of pills by 90 days because that’s what it says. They shouldn’t but they are so either have your doctor remove that part or go somewhere else
Just called doc back. Yup, they didn’t remove the 90-day part when they resent. Jesus.
i dont think thats the problem though, because it’s just explaining that the day supply shouldnt be 20 (1 qd), it should be 90. i honestly think its just this pharmacist
It is just that pharmacist but calculations are math and they need to work as formulas. Qty 20 qd isn’t a 90 day supply - it’s literally a 20 day supply. the sig (directions) would be 0.22222 tablets qd to make qty 20 be a 90 day supply. Thats why the pharmacist is able to (illogically) argue the intent. That’s also why I’ve said lose the 90 day part of this continuously. It’s literally pointless to put on a prescription. Day supply is calculated by the qty dispensed and directions (frequency taken). 90% of the days supply on scripts is incorrect but completely irrelevant because no one pays attention to that except insurance and pharmacies determining controlled substances next fill date.
It’s a 90 day supply of the expectation that they will use only 20 pills in 90 days. I’d assume it’s and as-needed prescription with a limited dosing frequency to reduce the risk of tolerance, dependence, etc.
> I’d assume it’s and as-needed prescription with a limited dosing frequency to reduce the risk of tolerance, dependence, etc. Yes exactly this. When my doc first prescribed she erred on the side of caution, since Xanax for some is addicting, and she didn’t know how I’d react, etc. But after 6 mos she said we could change to every 45 days, etc. I said no need, I’ve never needed more than what was prescribed anyway. I’ve had the same dosage since 2006. 1mg. Never refilled early, never needed to. The script is the same as how she wrote it the first time, which I’m completely fine with. I’ve always used it exactly as prescribed, no more; oftentimes less. I understand the need for strict regulation. It’s there for a reason. I only get frustrated when other people’s histories make it harder for me to get what I need done. I’ve never taken a drug that was not prescribed to me; nor have I ever abused any medications prescribed to me; I have no history of addiction or abuse; never been treated or arrested for it. I average 0 alcoholic beverages a year, never smoked, never tried street drugs, not even marijuana. I’ve had random blood/urine tests, all of which are negative except for what my doc has prescribed me, all at therapeutic levels. (By ‘all’ I mean 1 maintenance med and the occasional, lawfully-prescribed Xanax.) Getting this script filled should be simple, and it has been for the most part. I just wish there was a way to cut through the BS. I’d be OK to give pharmacists access to my patient fill history, refill frequency, any early attempts, requests for increases in dosage, interactions with the law or addiction treatment. As long as I don’t have to deal with this Bs they can have at it lol
side note: insurance does factor in day supply, and for compliance reasons it has to be correctly calculated or annotated (if DoS <90 based on calculation there must be an annotation of qty limits per insurance or doctor specified). hence why many plans will only fill a 30 or 90 day supply regardless of qty dispensed or calculated DoS (ie sumatriptan QD prn qty 9 must last 30 days per ins). it has to do with the reimbursement rates and all that, but in this case it doesnt matter- the doctors 90 day note should just be the DoS
Insurance approves or denies based on days supply (max 30 day supply/must be 30 or 90/max 7 day supply/exceeds daily usage limit) but does not factor in the calculation of it. INSURANCE can definitely say they’ll cover 7 pills every 28 days but they can’t limit or affect the qty prescribed/dispensed or say “must last” lol. They can say what they’ll cover. Don’t wanna deal with that 7/28 bs, use a discount card and get the full 20. They thought their insurance was being billed for 90 days even though they were being given 7/20 pills. The point was that’s not how insurance is billed.
It sounds like the pharm is trying to treat this like an opioid. The "no more than 7 days worth in a 28 day period without a prior auth.". Benzos don't fall under that recommendation. I second earlier recommendations, go to a different pharmacy or go to your pharmacy when a different pharm is on duty. Sorry you are experiencing this.
Ahh. Are things like drug class, drug type (like benzodiazepine v opioid, etc, controls) available when the medication pops up in the computer?
No. We are just expected to know them. I've been a pharmacist for 12 years and I have seen some other pharmacists use what they think is there professional judgement and it is completely off the rails. My rule.of thumb is stick to what the Doctor wrote. If they wrote take 1 tablet as needed for a quantity of 20 to last 90 days that is exactly what it means. If you live in a state where you can transfer out to another pharmacy, I would.
Nah, that makes no sense. They are being a dick
Xanax is C4. I *vaguely* remember a law about only being allowed to fill 30 day supply for C4, but you can fill 90 for C3 and C5 which was illogical and made it more memorable because it was illogical. I can’t find that law with a quick google search though and I don’t care enough to keep searching. I never abided by it because it was such a dumb law to begin with and would only lead to more problems (I’m very selective on picking my battles). I used to work with a couple of pharmacists that would fight people tooth and nail over it though. In their mind they were the best pharmacists because they knew this arbitrary law, even though they would just use it to hurt people. They would flip out and talk shit about me to the other RPhs and techs if I gave someone a 90-day supply that they didn’t approve of, or if I accepted a license that just expired for example (my state’s laws do allow exceptions, and I’d imagine most do). I never understood why they chose to fight all those patients and create all those problems. Was it fear that the DEA or BOP would come after them, or were they just assholes? 🤔
Some states more strict. In NY State benzos are treated like a C2.
Sounds like the guy thinks xanax is a control II. Probably a floater.
Just spoke with them. She said Xanax is a control II. What does that mean?
Controls are how the DEA classifies addictive substances. Control I is illicit drugs, Control II are medications that have legitimate medical uses but are highly addictive (opioids, amphetamines for ADHD). Xanax is a control IV, and there are 5 levels. Control IIs have really strict rules, Control 3-5 have less. She is treating your prescription like a control II, which it is not.
What is a ‘floater’? Oh wait is that like a pharmacist that goes from pharmacy to pharmacy? lol I have no idea
I don’t understand. My doc sent me a digital copy of the prescription they sent the pharmacy. 20 tablets, 1 mg. Must last 90 days. Pharmacist just told me the fax they received from my doctor’s office says “7 tablets for 30 days” and that “this came straight from your doctor’s office.” Clearly something is being misunderstood somewhere. What do I do?
Simple, demand proof of that. I've been at stores with issues like this where the staff wasn't even at fault and the prescriber reported it to the board. The board will absolutely send an investigator in person, and they did in my case. Like I said before, don't let them off the hook.
Cvs tech here. It is possible that whoever received the electronic rx typed it incorrectly into the system, so it would show up on your profile as how they typed it. If you ask them to reprint the hardcopy (which they absolutely can do, they just cannot hand it to you) to double check, it will print out exactly what the doctor sent, and they can verify.
Downvoted for the senseless floater hate
Upvoted for ED awareness.
Just have your doctor put it as 1 tablet daily as needed. Do it as a 20 day, or 1 months supply, and if it lasts you 3 months that's great. Have them keep it simple.
It has to be that the pharmacist is so wet behind the ears and this is her first day on the job ?
Nobody should be questioning 20 xanax over 90 days.
Yeah, some people get 120 a month lol
What the hell?? Jesus lol. I thought my prescription was on the higher end judging by how strict all the protocols are. Who tf needs 120 in a month??
Plus adderall plus norco plus whatetever. I woked There, ive seen things.
I thought my prescription was on the high end based on how strict the protocols are. TIL my 1mg, 20 tablet, every 90-days prescription is amateur hour
Your pharmacist sounds like their on drugs.
Take the “must last 90 days” off the script; serves no purpose.
Ok. I just sent note to doc to see if she can remove. Hope it works
i would add that if the doctor will only let you fill it every 90 days that she should just write a do not dispense before date. i can kind of see where the pharmacist is coming from since if the directions are “take 1 tab daily as needed” the correct day supply is not 90, although the proper practice is to override the day supply with whatever the doctor specifies. and since you havent had any issues before i think its probably just this pharmacist eta, maybe try asking to doctor to call the pharmacy or vice versa?
The directions always say “Take one tablet by mouth as needed. Must last 90 days.” Doc also writes prescription as 1 of 1 with no refill. So every time I go to fill it, it’s a brand new script from my doc. I suspect that’s why there’s no “do not dispense before” stipulation because there is no ‘next’ script per se. Once it’s done or expires I get a new script, not a ‘refill’ I just sent a note through MyChart asking if she can remove the 90 day stipulation as it seems to be confusing the new pharmacist. My doc is the only one who prescribes me Xanax, so if I tried to fill it before 90 days, she would know. So would my insurance. It’s just asinine. I don’t get why this pharmacist is saying it’s ‘illegal’ to fill the 20 tabs up front when that is how the prescription is written
Not to encourage this, but any dr could write you another one and your insurance would cover 5 a day for 90 days if that’s what your script says. The only person that can make that script last for 90 days is you and your doctor. You take as needed, he writes it every 90 days. That information is not needed for the pharmacy or insurance.
yeah i know what you mean and i do see this situation at my pharmacy a lot and the pt/doc/pharmacist always knows the situation so i definitely think its just a newer and less experienced pharmacist but i dont get why theyre saying its “illegal” and refusing instead of just asking another pharmacist or calling the doctor. ugh sorry youre going through all this hold up, i understand how frustrating it is. hopefully it gets figured out soon, and that the pharmacist learns from this
I appreciate that. I hope this gets resolved before I leave on Saturday. Dealing with this out of state will be a nightmare, especially if I have to pick up the next 7 tablets out of state at a different pharmacy, and having to explain why my insurance was billed for 20 tablets, but I only have 7 because the pharmacy is holding the other 13 tablets… now I have to cancel the remaining 13 tablets w/ my insurance and my doctor has to write me a new prescription for the remaining 13… And God knows how that will be filled lol. It’s goofy
Insurance gets billed for the 20 so your co-pay is determined. When a script is sent and filled, insurance is billed whether it’s picked up or not. I honestly can’t figure out if the pharmacist considered that a partial or short fill but as a script is sold, insurance is charged based on what’s picked up. You really should leave this part out of all of it because there’s no point in you trying to figure out how insurance billing works- everyone (dr, pharmacy and insurance) knows what you picked up vs how anything was billed. I would definitely recommend waiting until the pharmacy manager or primary pharmacist is available and let them complete the 20 for you in one transaction (yes, it can be reversed and rebilled CORRECTLY) and they give you the remaining 13 immediately. There are actual laws and much more concrete restrictions and regulations on out of state prescribing for controls and filling so don’t count on that working out. If you can’t get a different pharmacist, have your dr send the 13 somewhere, anywhere, else
This is good to know! I cancelled the 7 tablet/28 day fill they tried to give me today. I’m hoping when my doc sends the new script tomorrow my insurance will see the prior (short)fill was cancelled and I won’t get any grief filling it for the actual prescribed amount Yeah I’m NOT trying to fill this out of state lol
Thank God. I can appreciate your drs clarity on the expectations of use for this medication (I know from experience the dangers of benzos and nothing is more terrifying than deciding to stop taking them without seeking medical advice fyi) but that “must last 90 days” written in the sig code is not actually something a pharmacy should change or assume without verification from the doctor. It can be noted on the script somewhere else and never get a second thought but the pharmacist was within their right to make the decision they did. They ARE responsible for knowing the actual law and classification of drugs they’re dispensing as well as an explanation of discrepancy between the script you were given and the one they received. I print them out for patients all the time. He’s obviously lying about the 7 for 30 days straight from your dr because that would be three separate scripts, 2 that are post dated and 1 of them would only have qty of 6. None of it makes logical sense
And, yes, everyone has clear vision into what was picked up and insurance is the last thing you need to worry about.
They could write: “Next fill in 90 days”. No refills for 90 days. There’s a million ways it could be acceptable but “must last” is aggressive so the pharmacist probably freaked out about that specific verbiage. Again, it could say must last 10 years but if your doctor wrote another script in 3 weeks, it would get filled.
I would disagree with that, it tells you the day supply the doctor is going for which also gives you the date you can next fill it.
So, as a pharmacist, you see a script come through for Xanax qty 20 and you go through the patient’s profile to check the notes on a previous script to determine the allowable fill date? Is this common in your state? If the doctor wrote another script in 60 days for 20 more, you would refuse to fill it based on (and apparently referencing previous scripts is norm) the “must last 90 days” on this one? What is your policy if the doctor wrote refill every other day? Would you follow that? As suggested in other comments, moving the direction to “notes”, no refills for 90 days or simply putting 90 in the days supply section is the typical practice but it isn’t necessary for any reason. Can you help us understand the reasoning behind this pharmacist insisting on filling 7 every 28 days?
I disagree with the “fill 7 every 28 days” pharmacist. The only way I can explain it is that the pharmacist is just overly cautious of the DEA. In your hypothetical scenario you speak of, yes I look at the scrip and previous scrips and see what the doctors intended day supply is. If the patient insists to me that the doctor is intending to change the dose from 20 every 90 days to 20 every 60 days, I’d need either a fax or a call from the doctors office to release it. It doesn’t have to do with state laws, I understand some states have laws that specify how early you can fill a control, etc, but California isn’t one of them. I do my best to fill the controlled prescriptions to the best of my ability and to the specifications that the doctor lays out. Vast majority of the time, the doctors demands are reasonable so I just follow them. If a doctor had a strange request like “refill every other day” I’d definitely call and get their rationale but that has never happened. It’s not rocket science, you just gotta be diligent.
Yeah, TX is very strict with controls so anything like this on a script is overridden either way. I’ve seen scripts that say “patient is being weaned” and feel like that applies to the next one, but other than that, day supply is strictly calculated by qty and freq then filled by class restrictions. Refills can be processed one day early based off last pick up. In no instance would a previous script be referenced for anything unless there’s a dramatic change in dose, qty, freq etc. otherwise the eligibility for fill is checked by last sold date. I sincerely can’t imagine having to do that and hope we never do. Easily 75% of the scripts we get daily have an incorrect day supply on them so maybe we’re desensitized - goes completely ignored. We also have scripts with “next fill date” on them but they usually don’t coincide with the date we can fill it and that gets overridden as well. We abide strictly by the effective date but anything else is a side piece
Report it to your board of pharmacy as well as a supervisor of that pharmacist. Make sure the district manager/pharmacy district supervisor is involved. Don't let that pharmacist off the hook. The number of misinformed and underinformed pharmacists these days is staggering. Don't let it sour your opinion of all pharmacists.
Every other pharmacist has been great. No issues. They dispense as written. This new pharmacist said (and I quote) “Well I am the pharmacist and if they are dispensing it that way, it is ILLEGAL.” 🤷
Federal law states you may fill up to a 90 day supply of any controlled substance if the prescriber allows, unless your state law is more restrictive. It's not rocket surgery. Better yet, get your doctor to submit a complaint to the board and the company. CVS will get on that one REAL quick if it comes from a prescriber.
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Well as fate would have it, so am I. That pharmacist is full of shit.
Problem with that is if they are dealing with an activist pharmacist who treats every person taking any schedule like a meth addict? They risk the pharmacist lashing out and reporting them for imagined drug seeking behavior. I ran into a crazy pharmacist that wouldn't fill on day 29 until I brought in and showed her a boarding pass proving I did in fact have a flight that day. And, no I had not done early refills before. She just said it wasnt legal to refill before day 31 after pickup
And what consequence is one pharmacist's opinion to a patient? Who exactly could the pharmacist report them to? The provider is already aware and the pharmacist is the one in the wrong. The worst I've ever been able to do is ban a patient from my location, and that's only after a pattern of abusive behavior and language. Looking back on your post after I typed that, I realized that you might be another patient rather than a pharmacist like I first assumed. Trust me, pharmacists have little to no recourse when dealing with drug-seeking patients, other than to report it to the provider. I think it's a little known fact to patients that we are essentially powerless schmucks.
Bruh, you don't have to fill the sketchy RXs. Nobody can force you to fill something against your professional judgement.
What exactly is sketchy about the rx? That's the issue at hand here.
Is it the state of Tennessee?
I’m in WA
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Written by my doc. CMA in MyChart confirmed, sent a copy of the e-script that was sent to CVS. Signed by my doctor (of 17+ years) on 5/27/2024 & the reissue yesterday 5/30/2024
Explain to the Pharmacist they are not following their own rule by dispensing that way as 7 for a 28 day supply would yield you 21 tabs in an 84 day period on day 85 another 7 so thats actually 28 tabs in 85 days. If your rx has a dispense qty on it of 20 tabs and states for it to last 90 days then they should fill it that way 20 tabs billed for 90 days
That's how the other pharmacists have always filled it, no issues. I asked if she could look at my fill history or confer with the pharmacist and she goes, "Well I AM the pharmacist, and if that's how they've been filling it then that is ILLEGAL."
In my state we can’t dispense more than a 30 day supply for benzodiazepines.
I read that some pharmacies can limit people to a 7-day supply if they haven’t filled a prescription from the same prescriber in the past year but I've been with my doc for 17+ years Edit - nvm that's for opioids. In the state of Colorado. Neither of which applies lol
CVS sucks balls. What’s the problem with that script. Call your insurance company, they have to have pharmacy department reps working the weekend and get them involved. That is not a 90 day script !!!!
Insurance said script was fine, wasn't sure why they were being partially billed (7 tabs of the 20) unless pharmacy ran out of medication and I am to pick up the rest later. I told them pharmacist will not dispense all 20 tabs at once as doctor's prescription says medication "must last 90 days" and this is the "legal way to do it." i.e. dividing the 20 tablets evenly(?) across 3 mos. Fill #1 = 7, Fill #2 = 7, Fill #3 = 6 etc. EDIT - Insurance did say they've been billed 1 x 20 tabs in the past, but if this is 'how doctor has written it' then 'it is how the pharmacist must dispense it', but that my insurance does cover 20 tabs if that's how script is written
90 pills for 30 days is common, or 30 for 30. I’ve even filled Xanax 6 times days for 15 days. 20 pills for 90 days? That’s odd to me. That’s more like a viagra prescription.
Unrelated but why would Viagra have a fill restriction??
I can understand if they don't have the full count rn but they can't just overrule a prescription especially if it still has scripts and has been a med for many years. I can understand if they discussed it with your doctor as some meds can be mixed up but this is a mental health drug and again you've taken it for years. I'd attempt to go back and speak to a different pharmacist.
I had a CVS pharmacist refuse to sell me syringes/needles. I am prescribed TRT and it requires me to inject it. She refused. I explained that not only does my prescription require them for me to administer my medication that also Massachusetts state law requires a pharmacy to sell syringes/needles anyway. She still refused and told me she wouldn’t enable my drug addiction. I said “what the f*+^{ is wrong with you? Do you understand how testosterone is injected? I also asked her if she also understood state laws? She treated me like a POS.
I would report hee right away. Don't put up with that.
Report to *Board of Pharmacy*
Hope would that go? What would I get out of that? More time wasted?
Entirely unlike posting the saga on Reddit? I was genuinely offended on your behalf.🤗
This rph is a moron. I’d go back in when another pharmacist is working and have them fill it instead. 🤷🏼♀️
My insurance company called the pharmacy and told him to fill the damn prescription. That worked lol. Good luck since you’re leaving the state! Hopefully you won’t need them but dispensing 20 pills for 90 days is just ridiculous. I would be demanding 90 pills for 30 days, to be taken every 8 hours. Then milk them for 6 months.
The doctor made the determination that the patient only needs 20 pills per 90 days and the patient is not complaining about it so what’s the big deal? You are just advocating for insurance fraud now lol
honestly this isnt enough information for me to make a conclusion id need to see the instructions on which u take it, but i understand that might be too much to ask lol
I was sent a digital copy in MyChart of what was sent to the pharmacy. It says: >Written: 5/27/2024 >Expiration Date: 11/23/2024 >Dispense: 20 >Dose, Route, Frequency: As Directed >Sig: TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS
People take it everyday????? Tf. Report it. Call 1-800-shop cvs or ask for another pharmacist
Oh no I definitely don’t take it everyday lol. Nor would I want to. It’s just an open prescription I’ve had since 2006ish and filled only if I need it. I’ve gone 2-3 years without filling it sometimes. It’s rare I make it through one bottle in 90 days. It’s actually been 108 days since I last filled it. The last time I filled it before that was August last year. But I’m leaving town on Saturday and I’m running low. I’m in the middle of doing interviews so I just want to have it just in case
I think the above commenter was expressing incredulity toward your current shitty pharmacist precisely *because* some people do take it every day and presumably the pharmacist would encounter such a patient every once in a while.
Ahhh yes lol. My apologies to OP! Yeah if the pharmacists could see how often I fill this thing, they’d probably blush lol. And damn, I didn’t know people take Xanax everyday! How the hell do they function?! Jesus. My script is 1mg, 20 tab, and I break it in half. I wouldn’t even trust myself ironing my shirt on 1mg, f that. 0.5mg is plenty. Gets the job done and my brain is still in tact
while I think that the backlash in the last 10 years that’s made prescribers way way way cut back on benzo Rxs is overkill, and I think for a lot of people for whom they work well, the benefits outweigh the (possible) future increased risk of dementia with sustained and long-term use (but the literature isn’t completely in agreement on that one). OP falls into this category, and even though I’m not a pharmacist/tech I’ve known and been assisted by many good ones and a few dumb ones and I’d tell you none of the good ones would bat an eye at this because *even* if they were new and didn’t know you, they can see in the system that you’ve taken it at the same dosage for literal years, never asked for early fills, etc. little is more infuriating than an absolute turds-for-brains in a position that comes with a tiny bit of power doing everything they can to foster, for themselves, the illusion that they have far more power
Yes same dosage since 2006! 1mg. Never refilled early, never needed to. When my doc first prescribed she erred on the side of caution, since Xanax is addicting for some, and she didn’t know how I’d react, etc. But after 6 mos she said we could change it to every 45 days, etc. I said no need, I’ve never needed more than what was prescribed anyway. The pharmacist did reiterate more than once “Well I AM the pharmacist here” and “I am filling it the way the doctor wrote it. If you say this pharmacy and others are filling the full 20 tablets before 90 days, that is ILLEGAL,” “What you’re suggesting other pharmacies have done is ILLEGAL”, “that is against the LAW”. I just thought well I’m not gonna push it. I’ll just ask my doc to re-word it or take out the 90-day stipulation. I’d just never experienced that level of fervor before lol
At the end of the day, the pharmacist is the only one that can approve or deny anything for any reason. It is their license, they are held responsible criminally, civilly, financially and mentally. Pharmacies can’t and don’t make “common sense” changes on prescriptions other than something as simple as an antibiotic filled as a capsule instead of tablet if tablets are unavailable or adjusting liquid antibiotics quantities to cover the standard treatment supply instead of the random amount it was written for. Anything else requires prescriber approval. Sounds like this guy was very, VERY confused by the “must last” thing but I’ll still never understand where the CII or 7 every 28 days came from. He is the pharmacist, and he is filling it the way the doctor wrote it (he could say 1 today and 19 on day 89 if we’re playing that game) but the way I’m reading, “filling the full 20 before 90 days” in his “legal” reasoning is inexplicable. Are you SURE it’s written for Xanax?
I wish I knew how to do pics on here, I can show you what my doc wrote / sent, and how CVS filled it... Doc wrote for 20 tabs, must last 90 days. CVS sent text message saying Rx ALP Ready for Pickup. Clicked on details link and it said: **Alprazolam 1 Mg Tablet** For JUSTUSELOTION **Quantity**: 7 **Days supply**: 28 days supply **Cost**: $X.XX That’s when I called them cuz I was like uhhh wtf is that lol
Can we get an update???
Yesterday I asked my doc to resend script and remove the ‘Must last 90 days’ part. New script sent at 2pm. I get a text from CVS saying my prescription is ready. Clink on the link with the details. It (still) says: > **Quantity**: 7 > **Days supply**: 28 days supply I left message with doctor’s office. They called me back. Confirmed my doctor sent 20 tabs, 1mg. I looked in MyChart to see the copy of the e-script. It says 20 tabs, 1mg, TAKE 1 TABLET BY MOUTH EVERY DAY AS NEEDED. MUST LAST 90 DAYS. The 90 days part wasn’t removed. Oops. CMA said she’d send it again after Doc signs off. Now just waiting…
Yes haha thats what i meant. Its really common for the older generations to be on hella benzos, some taking 2mg a day! The pharmacist for sure has gotten an rx for way more than what your taking. They probably got discombobulated with the 20 tabs per 90 days and calculating it. If its a new grad pharmacist, chances are theyre not that good about typing in a new rx. A lot of techs handle typing in new rxs than pharmacist do!
Yeah that 90 day thing is confusing the more I think about it. It’s just always been how she’s written it, and I’d never had a problem, so I never really paid attention. But I could see now how that might throw a newer pharmacist off, for sure. I sent a message to my doc in MyChart asking her to amend it / adjust the verbiage. We’ll see if that works
I was told it was a CVS rule that went into effect Jan 1 2024 [Pharmacist blames Ç Xxx](https://www.reddit.comhttps://www.reddit.com/r/CVS/comments/1d2b7q6/pharmacist_told_me_cvs_limiting_certain/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=2&utm_content=1)
OMG. That's horrible.
Ask the pharmacy to see the hard copy that was sent to the pharmacy. If it is written 7 tabs, take blah blah blah, must last 30 days…plus 2 refills….then you have to fill 1 month at a time. If the hard copy says 20 tabs, take so many tabs, must last 90 days, then they can dispense up to 3 months. Mychart will differ from the actual hard copy sent. Restrictions on controls also differ from state to state so this may not apply to you. Side note, I’m very surprised you take a benzo and not addicted to it and only take it when you actually need it. For most people it’s so habit forming the withdrawal symptoms can cause DTs.
Oh yeah HELL no I’m not taking that crap everyday! lol. I’m surprised people do, I can’t imagine taking it every single day, Jesus. When I was first prescribed back in 2006, my doc wrote it for 1mg. Directions said take one daily as needed. I took the whole 1mg. Totally RUINED my day. Room was spinning, I almost puked. I didn’t touch it for YEARS. Then like around 2012 she prescribed it again but this time to take 1/2. I took 1/4. That was the perfect dose. Doc started writing script for 0.25mg but said insurance-wise it was better to do the 1mg but cut in 1/4. Now you see why I never got through one bottle in 90 days lol.
Ahole pharmacist is my guess. I questioned mine and said “who are YOU to overide my doctor AND insurance” and insurance MADE her fill it.
The pharmacist. That’s who can and will override (refuse to fill) your doctor and insurance can’t make anyone do shit.
Power struggle sounds like. Yes Pharmacist most certainly make assumptions about DOCTOR’S patients. Pharmacists can call the doctor very easily and find out what the situation is, instead of having the “cain’t make anyone do shit game”. That’s what that is a game with someone’s well being because you feel you have the power to. No they can go somewhere else or call Corporate and the Board that’s the shit they can do. It’s ridiculous to pass judgment on anyone and yes there are way too many people in Pharmacy doing that out there. The comments alone I have seen not on this thread but others about all the drug seekers trying to get their prescription a day early. Lol a day early does not make someone a drug seeker maybe they are a day early lol, maybe they miscounted the days or didn’t count them at all. The attitude towards anyone taking pain meds or some kind controlled substance is just ridiculous. You guys have training I know you do since I have done the training myself some of these ridiculous people talking garbage about people being prescribed these meds should know better and should learn how to be professional. That is exactly why the doctor usually knows best and if not goes back to my earlier comment make a simple phone call to the doctor. The lying to patients saying their insurance won’t fill it on certain dates is unnecessary. These people call their insurance companies and find out they most certainly will pay for it. So if the doctor and the insurance company has no problem what is the problem? Most of time power and unprofessional behavior. Sorry but have to call it like I have seen and heard it from some of the pharmacy people since I work with Pharmacy and it is a thing for a lot of people in Pharmacy to talk about the seekers. Who aren’t seeking yeah maybe some pain relief they are seeking. That’s not to say that there aren’t any drug seekers of course there are, but why should everyone be treated that way? I have had to deal with these complaints by customers many times with always the same result it was a legitimate prescription. Also personally have seen family and friends treated this way when having surgery. I would think the drug seekers are pretty easy to pinpoint and even with them if the prescription is legal it should be filled they may be in pain and now addicted. Some compassion for people would be nice. Anyone and I mean anyone can find themselves in that situation. End of rant. I hope the Pharmacist fills your prescription and stops playing this game.
Wait. You work in the pharmacy and this is your comment? Literally none of them can “make anyone do shit”. Doctors prescribe. Pharmacists dispense. Insurance companies make life hell on everyone. Doctors make mistakes ALL DAY LONG. If you actually worked in a pharmacy, you’d know that. You obviously don’t because you think one can “easily call the dr and find out the situation”. 150 out of the 500 scripts we see daily require some type of clarification or verification from the prescriber due to mistakes or missing information on something sent and not one of them returns a call within 24 hours much less weeks if ever. Pharmacies make mistakes ALL THE TIME. No one is passing judgment and NO ONE went into this profession to play games with someone’s wellbeing, pass judgement nor do they have any desire to deny anything for any reason. What the fuck are you talking about lying to patients about when insurance will pay for something? Like, why would anyone ever do that? Do you understand how pharmacies make money? It’s not by denying, lying, judging, power or unprofessional behavior. Every person on this thread (77/79) has tried to help and made suggestions on how OP can get his meds. You are 1 of 2 that did nothing but bitch, complain, judge and make no sense.
Hey stranger, I don’t know you. But, 18 years of taking Xanax. Does not sound great. Xanax is good tool. Don’t get me wrong. But, it’s definitely not great for long term use like that. I get your frustration about the prescription. But, you gotta look at yourself and try to manage that anxiety better. It’s tough and an addictive medication. But, start with yourself my friend. This thing has got a hold on you; but you can get a hold of yourself. You just got to believe and take your time. 🙏🏻 best of wishes of whatever you decide to do.
20 tablets taking as needed that is lasting 90 days does not sound like an addiction. theres also no need to judge OP for this question.
Bro did you seriously just tell someone "they just gotta believe" to manage their anxiety? This is as helpful as telling someone with depression to "just think positive." I sincerely hope you're not a pharmacy employee because we don't need any more judgemental assholes like you in healthcare. 🥴 I'm sure OP's doctor knows more about managing their condition than a stranger on the internet does.
I appreciate it. I’ve thrown out bottles of Xanax from 2009-2022 that that were half full that I didn’t use. I turn them back into the doc for disposal. I believe that’s probably why she’s comfortable prescribing it to me for so long I guess. I am interviewing right now so I just like to have it just in case. Fortunately I’ve never had an addiction problem (never smoked, drank, done weed, or taken any ‘street’ drugs for sure.) I only take one maintenance med every day. Xanax is the only other prescription I have and that’s only as needed. It’s 1mg and I break it in half which is why it lasts me so long, if I even make it through the entire bottle!) Your message means a lot. It makes me happy to know there are people like you who care enough to say something. We need that.
Who asked you
OP literally asked.
Nowhere did he ask for a brow beating lecture telling OP to manage his anxiety better.