Prescription Medications in Long Term Situations

I always have, at minimal, a week's supply of my prescription medication unless, of course, I spend a night or a week away from home and I left one of them behind. How do I plan for or what do I do in a situation where I am unable to refill my prescription for a month or maybe slightly longer?

None of my medications require refrigeration so a longtime power outage is not a problem in this regard. One of my medications needs to be taken with food but this too is not a problem. Everyone in this forum has enough food to get them by for a month at least without going to the store.

Jeanette Isabelle

I'm in exactly the same situation. I have 2, maybe 3, days of grace after the meds run out before things go bad. There are two things I do.

1) Use a mail order pharmacy where you can order a 3 month or more supply at one time instead of monthly refills. Your insurer probably has a program like this since it's cheaper that way. This will cut down on the low supply periods (<1 month reserve) from constantly to 4 months a year.

2) Have your docter order larger doses then required for that 3 month period and cut them down. Reorder when there is a 1 month supply left. This means you will always have a 1 month reserve. I'm not entirely sure of the ethics of this, but unless you are talking about the abuse prone drugs (i.e. oxycodin), I don't foresee a problem

NightHiker: Not to chew on you, but I should point out that some of the more common perscription (e.g. psychotropic drugs) don't have OTC or homeopathic equivelents. Going off these in the middle of a crises is about as much fun as sticking your arm is a blender.

Depends on the med and your doctor. Just tell him you want to have some extra ("just in case," or "leave at my parent's house" or something).

Have him fill out a second prescription. take it to your local Walgreen's, or Walmart, or Target. They all have $4 scrips for a month supply (different lists, but relatively comprehensive overall). You could just pony up the extra cost yourself.

Or, next time you're in Mexico...

That 30-day prescription limitation has been instilled by the insurance companies, it's not a law or anything.

Just tell your doctor that you would like a 30-day backup supply and ask for a separate prescription from the ins. co. one. You may have to pay full price for it, but as long as you rotate your supply, you'll always be 30 days ahead of running out, and only have to pay the full price once. Make sure your pharmacy understands that you are NOT running this through your insurance co.

Sue

Sue has a good point. Here in Canada, many work sponsored insurance companies also have the 30 day limitation depending on the meds. This makes it very tough to stockpile for those who cannot go more then a day or few without their meds. Ordering drugs online then having them shipped to Canada almost always results in the order seized by Customs.

I was thinking about that. If I had my prescriptions filled every twenty-seven days, I would have a thirty-day supply in ten months.

Jeanette Isabelle

Izzy,

You need to find a new doctor (I know that you are trying). I live in FL and most of our doctors have no problem giving you a extra refill, especially if you travel. Even when I lived in Canada it was not hard to get an extra 30 days. Most of the Insurance companies are fine with a 90 day supply (as others have mentioned) - they prefer it.

Classed substances are the exception to this but most of the meds the majority of us are using have no problem. For those classed substances the problem is somewhat greater, but the doctor should still not have a problem with extras for all but the most serious. Even the pharmacies and all the insurance companies I have had (most of them) want you to refill your prescription when you have a week left.

Respectfully,

Jerry

Another option is to have your doctor alter the prescription by upping the dosage. That's what my doctor has done. If yours upped your dosage from one a day to two a day, then voila, instant additional 30 day supply. He can change it back after that.

It also helps if you have a good relationship with your doctor. Mine has been a good friend for the past 20 years or so, so he has no qualms about doing this for me. On the other hand, my medication is not a controlled substance either so that may make a difference as well.

The current epidemic of prescription drug addiction (at least in our area) is making most doctors much more careful about how they prescribe some medications (Izzy, unfortunately our area is a pretty likely destination for some of those drugs from FL). Keep that in mind if he/she seems uncooperative at first. Be up front and honest with why you want the additional medicine (no reason not to be) and they will likely be more comfortable doing so. Simply asking, "Doc, I'd like to have an extra 30 days of medication on hand in case of [insert catastrophe hear], what do you think would be the best way to do that?" Put the ball in their court and let them come up with a solution they are comfortable with.

I do this for my wife. She's on a med that is a must have or she's a goner withinin a couple of weeks. I'm up to a three month stockpile. I need to get another scrip.

It's smart to stockpile what you can. I was paranoid enough about some of DS & DW meds before I read One Second After. Now...yeesh.

BTW, have any of you noticed that Sudafed is no longer available? The real stuff with Pseudoephedrine. DW requires it for severe allergies and it (self edit) 'makes me made' that I have to sign an electronic waiver at the counter, only purchase 1 box at a time and only allowed to do so a couple times per month.

Their website said the directions on some batches were incorrect but that was four months ago. Not a conspiracy guy but I think there is more to it than just a misprinted label.

Since drug dealers were purchasing Sudafed/Pseudoephedrine to make speed, federal law now requires tracking and limited purchases.

Pete

Yes, you can thank your local meth-makers for the Pseudoephedrine limitations. And the greedy I-didn't-know-it-was-against-the-law merchants who were selling it to them by the shipping boxful.

If you need it regularly during certain parts of the year, just buy it regularly even when you don't need it. It's the only thing for me that works and doesn't make me drowsy. Naturally.

Sue

Ack Pete. I wasn't going to go there. But its BS that because of a small percentage of tweakers (who do cause significant crime) that the vast majority of Americans who on any given day have a cold or allergies has to be burdened. And I do think regressing from on the shelf to over the counter w/ ID and signature is a burden, because it makes me the potential bad guy.

Ive watched shows on what it takes to make meth, speed, etc, and for the govt to burden the public by limiting Pseudoephedrine when they could have just as easily put that burden on not as mainstream an item as windshield wiper fluid, battery acid or phosphorus, its ridiculous.

How many times have you the reader bought Sudafed, et al for a stuffy nose or cold, in your life? Probably quite a bit.

How many times have you gone into an auto parts store to buy 5 gallons of battery acid or windshield wiper fluid? Probably never.

>>>End of Rant<<<

Mostly

There are schedule II drugs you just are NOT going to get ahead of time. My son is on one, yeah, they'll fill it 3-4 days early, but the next refull will be 30 days from that, so you remain with those 4 days grace. Yes, he has to see the MD every month

Just like the hoops you have to jump through to get on an airliner.

Just like having to be searched before you can enter a courtroom.

Just like not being able to carry a folding pocket knife with a 3" blade after having the right to do so for over 200 years.

Just like not being able to trade a packet of seeds with someone outside the U.S.

Just like having to get a passport to reenter your own country after visiting Canada or Mexico for a day.

To the people who run this country, WE are The Enemy.

"Those who surrender freedom for security will not have, nor do they deserve, either one." — Thomas Jefferson

Sue

As always, well said sue.

And once again a toe slips across the line. We're here to learn how to prepare, not to vent our spleens.

-Blast

In some cases it might be possible to very slightly extend the time interval between doses of medication.
For example if a tablet must be taken every 24 hours, I doubt that much harm would come of taking it every 25 or even 26 hours.
No good for something that must be taken at a certain time of day, but for some medicines this would give an extra dose or two every month.
After a year of so doing, about an extra months worth could be obtained.

If one was so unfortunate as to be a victim of street robbery, burglars, a house fire, or a bad auto crash, it might be tempting to claim that ones medication was lost or stolen in the incident.
To keep making such claims would be very suspicous, but just once might be tempting.

While there is much I'd like to say about gov't regs on script medications, I will content myself with noting that there are a few things you can do. One would be to see another doctor or nurse practitioner and get a separate script, filling it without insurance at a drug store you haven't used before. I see a specialist and also a nurse prac. I got scripts I need from both. It IS a non controlled substance. Don't even try fooling around with that stuff. Another would be using overseas pharmacies. Risky in some sense, but I've got a stash put away for both my wife and myself. Another would be the suggestion to refill your scripts a couple days early, and save a couple of pills every month.

Tim

Yep, Jerry is correct.

Although there are a few insurances that do not allow the 80% rule, most do, and this allows six doses saved up every month. Do that for five months and you have your month of emergency meds saved up.

They allow this on even controlled substances, and the law allows this as well, and if it is written in the law then you should have no problem if people ask you about it.

It is the cheapest way to do it (just two extra copays in a year!), unless it's one of those 4 dollar meds, then just get an extra prescription from your doc or just get the refill and tell them you are paying cash. Don't try the extra refill on a controlled substance, though, it raises red flags. For that, stick with the 80% rule, i.e. 24 days must pass in a 30 day supply.

The mail order option is actually not that great because you only have the extra meds for a couple of months, then you still have to wait the alloted time before you get more.

Another thing to think of re:Rx meds-If they are in Pill or tablet form & are Buffered(Hardened) the potency will last quite a bit longer than Non-buffered,this really applies to Pain meds for the most parts,they are Buffered so breaking them down for Intreveinious use is difficult & for longer preservation of potency in stocks.

Sorry to have to disagree:

Buffering has nothing to do with hardness (hardening) of the pill or tablet. Buffering is the addition of buffering agents/chemicals that resist changes in pH. For example in bufferd asprin, the name brand Bufferin uses MgO. Other preparations use CaCO3.


Pete

I've never had issues with medications when travelling. We have a long standing relationship with our Dr and she has always prescribed an extra month or 2’s med etc if we are travelling. Sometimes the pharmacist is not too keen to fill it but you just need to say “I’m travelling” and then its no issues.

Because we’re often remote, we also get some antibiotics and other prescription meds (for just in case), once again it has not been an issue because of the good relationship with the Dr.

I guess the moral is to develop a good relationship with a Dr who you trust, if you don’t like the Dr, then try and look for another (I know this can be difficult depending on where you live …)

That is a very important point, Aussie. Having a doctor who listens can be crucial to your health, too. And, like it or not, there are doctors out there who are nuts, who are control freaks, who just don't care, etc.

Here in the U.S., payment for meds is usually tightly linked to insurance. If someone asks for extra, the automatic answer is NO, and people think that is cast in stone. If they quiz the doctor or pharmacy, it turns out that the ins. co. will only pay for one month at a time, and that if YOU will pay for the full prescription cost, your doctor can write a separate prescription and there is no problem.

Like with most things, when someone says, "NO", ask questions. Often times, the answer is really, "No, but..." and there are exceptions to the rule.

Sue

Very good points Sue.

Even if there is cost in buying extra meds, I think it is a good investment, just like I have invested in a spare knife (… ok perhaps more than one …) or keep extra food in the pantry etc. These things cost, but I think we happily spend money on all manner of ETS equipment, and duplicates, so we should approach meds as a necessary cost in the same fashion. It seems that if you get a good Dr and can explain what you want, and if you have the money, there is no reason not to have a sufficient stock of meds, even in the US !

I think I'd rather have a 3 months of lifesaving meds in my bug out bag than a great knife, PLB and everything which shines. For those who need meds its got to be about priorities.

Hey, I just had a thought on the old axiom :
3 min without air, 3 days without water, 3 weeks without food
How about :
3 min without air, 1 day without meds, 3 days without water, 3 weeks without food ?

I have a very tight-fisted sister (aka 'cheap'). She is more concerned with her savings account total than getting prepared. Occasionally, I have to ask her, "How much would you be willing to pay for it if you really needed it and didn't have it? That's when the price REALLY goes up!"

The time that I really pounded it into her head was with storing water. She has a 155' well and no generator. Then her power went out for a day... Finally she stores some water!

Sue

I have this problem because one of my children has Cystic Fibrosis, and takes several specialty medications. Paying retail prices out-of-pocket for the three most important meds would cost me over $10,000 for a 30-day supply. So this is a prohibitively expensive option to consider.

Trying to get the doctor to write a prescription for more doses than needed is generally pointless. All prescription meds have FDA-approved dosing limits. Unless there is enough flexibility in the limits for your med, no pharmacy or insurance company will honor a script that exceeds the FDA-approved limits.

However, most pharmacies now offer 90-day refills, you just need a doctor's prescription requesting that duration. If I recall correctly, the doctor can prescribe up to a 90-day supply with 3 refills on a single order. Pharmacies and prescription plans usually allow you to get a refill once you've used 90% of your meds if refilling at a local pharmacy, 75% if using mail-order. This window slides with each refill, which you can take advantage of to build your emergency supply. You just need to be patient and diligent in pushing the limit.

There are some bumps in the road, though. One med in particular, Tobi, has been a huge problem. My son takes this in alternating 28-day cycles; 4-weeks on then 4-weeks off, at a retail cost of almost $5k per 28-day supply. Because of Tobi's 28-day on/off cycle, the insurance company said they can only send one 28-day supply at a time (two 28-day supplies would account for 112 days, exceeding the 90-day limit).

Ultimately, after months of arguments, threats, and a letter from my attorney, the best I could do consistently is get two 28-day supplies shipped out for each refill. But sometimes they screw-up and send me three 28-day supplies, other times only one. When they send one by mistake they will send the second supply immediately when I call.

Just make sure you don't get lax in maintaining your supply of meds once you build it up, and always rotate your emergency supply with the fresh refills. My mail-order plan lets me place a refill order any time, and it will be shipped as soon as its eligible. This helps make things easier if you can get the same kind of service.

Refrigeration might not be an issue for your meds, but it is for my son's. I have an Engel 12V/DC refrigerator for medicine storage hooked-up to two deep-cycle batteries and maintained 24/7 by a charger, and I have two portable generators with enough gas to run them for 3-days without resupply. The idea is the batteries would hold the meds if the power goes out when I'm away, then I'd use the small generator to keep the batteries charged (and run an adjacent fridge/freezer for food -- the larger generator would power the main fridge, furnace for heat/hot-water, and sewer holding tank pump). Once I got into my 3rd-day of gas I'd have to decide whether to continue to stay put, using the generator an hour or two each day to recharge the batteries, or move to a better location.

But I like the idea of making ice to keep things cold in 5-day coolers. The Engel can be used as a freezer, too. So I could move frozen foods and ice-packs to the Engel, and rotate frozen ice-packs to coolers to keep both meds and food from going bad. If I only need to run the generator 2 hours a day to recharge the batteries, that 3-day supply of gas becomes a 36-day supply, and I wouldn't even need to change the oil and spark-plug in the generator (only 72-hours run time).

Hi Mark_M, looks like you have really taken control of the situation. Great work, well done, you deserve to be proud.

Best wishes for your family and especially Tobi.

Here is a possible idea for refrigerating your meds: Solar Power Beer Can cooler

For Mark and others who have life-dependent needs for refrigerators...

I know I posted this before, but I believe it was in another context and may have been skipped over.

An Aussie by the name of Tom Chalko took a standard chest-type freezer, added a thermostat (uses 2 AAA batteries), and wired the freezer to turn off when the programmed refrigerator-level temperature was reached. It uses only 1/10 of kilowatt per day, running about 90 seconds per hour.

The .pdf article and wiring diagram is shown at BuildItSolar.com: 0.1kW refrigerator from a freezer

I don't know how well this would suit your requirements, if it could be adapted to a smaller freezer, etc, but it's food for thought.

Sue

Converting a freezer to a fridge by means of a different thermostat is an excellent idea as in the article linked to above.
Not however as original as the author believes, I did it years ago, and cant be the only person to have thought of this.

Although a great deal of energy is saved thus, remember that line voltage power is still required.
In any serious or long term emergency it is unlikely that grid power will be available. That means reliance on an inverter. If life depends on an inverter, then it should be duplicated.

Another option is a very high efficiency DC refrigerator, these are sold for off grid homes and use little power.
They work directly from a battery without an inverter. The battery may be charged from PV, a vehicle, or by limited generator running.

Or an absorption type where it uses a small flame. My camper fridge is like that and as long as the camper sits on the level garage floor it cools fine, doesn't work so well anywhere else but for a home fridge it would work as the flame is pretty small.

An absorbtion fridge when burning propane, or less commonly oil, has a lot to recomend it.
A continual supply of propane or other fuel is required, but the consumption is small and a large propane tank will work the fridge for months.
Although some absorbtion fridges can also be run on electricity, this can not be recomended except briefly in a moving vehicle when propane burning might be unsafe.
An RV type absorbtion fridge if electricly powered can use more KWH a day than a full sized domestic model.

My thought there was amybe somehting like a wood gassifier to provide a small amount of fuel to burn, is only a small flame like a pilot light.

for a backup....one of the commercial thermo electric 12v cooler chests with a cigarette plug or a DIY Peltier thermo electric module in a small styrofoam cooler could be run by a 12v battery with PV solar charger ...