Perscription Medications...how do we handle these?

Ok, Let me start this thread with the notice that I am talking about actual prescribed medications.

Since insurance companies and doctors will only allow us to receive a certain amount of medications how is everyone stocking up, if at all?

Now with the facts that we are usually allowed to get 30 days worth, and hopefully nothing that will last more then 30 days will happen, what do you have prepared IF it does go longer then 30 days?

Maybe when you only have 3 days of medicince left something big happens. Natural disaster, man-made situation, but either way you and your family need to bug out...what do you do with only 3 days of stuff left?

I am wondering.....

Thanks
DTT

You sit down with your prescribing doctor and pose this very question. There are MDs who prescribe prescription drugs for people who indeed travel 'back of beyond' and may need , ie cipriol as an immediate medical tool. You simply have to work out a logical rotation for efficacy and assure your M.D. of the reasoning.

The problem I have found in the past, are the insurance companies, not the doctors.

Most of my prescriptions are for 3-6 months but the insurance will only 'approve' 30 days worth.

Probably because if I croak in 35 days, why would they want to waste money with a full 90 days paid for

Yes, it's the insurance companies. There's no law against having extra prescription drugs on hand. The doctors have no problem with it.

All you have to do is talk to your doctor about what you want to do. He/she will give you an EXTRA prescription for the medication(s), the only catch is that you have to pay for them yourself, the full price. And if you're on something expensive, that could be $100-200 for a 30-day supply.

Some meds are relatively cheap. I did this for my Mom's prescriptions, and most of them were relatively inexpensive.

Sue

My thyroid is actually cheaper if I purchase 90 days at a time...but my others I am sure, are not.

I heard of a guy that was 6 months ahead. He did not take any
controlled substances, so I do not think this it was illegal.

Think creatively.
Generally, every time something changes, you can get a few
days to a few weeks ahead. Any of these changes, offer
opportunities for you to get ahead: change Pharmacies,
change prescriptions, change doctors.

If you keep close track, you can keep getting
your meds at 24 days (or whatever) so you are
progressively farther ahead each month ( each 24 days).

If you tell your pharmacist that you are going on
vacation, he can probably get the Insurance Co to
authorize an early purchase. Then, most likely,
24 days later you can fill again. You might get
away with 2 vacations a year.

Most insurance companies (did) like you to order 3 months
supply through the mail. Saves them and you money.
To your advantage, get a written prescription for this,
and send it in right away. But, you still need to fill
locally, because the mail could take a long time, right?

When you get a new prescription, fill it immediately,
but take the old meds till they run out. Of course,
you must use good judgment on this one.

To save money and give you flexibility, ask your doctor
to prescribe generics. Sometimes generics are so cheap
that you need not buy them using your insurance.

Some people get a full year, written prescription, for
every drug, with generics enabled. It can save hassle,
but does not really help your question, directly.

Some discounted drugs are so cheap that you do not need
the Insurance Company. See below on Costco, Target, etc.

Lately Costco offered good deep discounts for 100-days worth
on some drugs. It might be good to get 100-day option enabled
on your written prescription. I would think that Insurance
companies would like this, but no matter, they are real cheap.
You dont have to join Costco, to use their pharmacy;
have some cash, no Credit Cards(?), no checks(?).

Wall-mart and Target give dirt cheap prices, on some drugs,
so you do not need the insurance company.

Whenever your doctor changes your prescription,
ask for some short term Samples, but fill the written
prescription immediately; this puts you ahead.

I started by pulling one or two doses out of each prescription as it was refilled until I had the target amount (7 days worth).

The beginning of this year when we filled the first prescription of the year for each med I rotated the old stash out and replaced it with 7 days worth of the new.

It takes some time but once you've got the amount you need rotating it is easy.

Fortunately, we don't have that many prescriptions.... yet.

Ask your doctor about it. Then, pull this list from Wal-Mart:

http://www.walmart.com/catalog/catalog.gsp?cat=546834

and ask if he'll write a scrip for what you/he think you'll need. At $4 each, they're dirt cheap, and no need to tell your insurance co.

Something everyone here forgot to mention, make sure you write down (preferably while at the physician's office) the route, dose, indication and time you'll need to take these drugs. For example, Keflex is great for skin infections, but not so good if you've been chugging dirty water and have diarrhea. And, are you on the 750mg, 5-day dose, or the 500mg, 7-10 day dose? You'll need to do more than just walk to your pharmacy and fill them up- you NEED to have enough basic medical knowledge to use the drugs effectively.

That being said, if you're bold, ask your physician if there's a book you can buy that will help tell you this stuff if you forget. Some pharm representatives will "give" these types of books to the doctor if he asks, so you might get lucky and get a $200 book for free 9. Otherwise, you might be able to Google each drug and pull the info directly from the manufacturer.

Some good resources I've used in the field or hospital:
-Sanford Guide to Antimicrobial Therapy
-Epocrates (Epocrates.com, free for PDA)
-Physician's Pharmacopia (pricey, HUGE book)
-Some basic pharm texts are better than others, available at book stores by the nursing/weight loss/self-help medical section.
-Some pocket reference books for EMS professionals have real basic pharm info in the back. Also at book stores.

Good luck!

As a prescribing g physician, these would be my comments (In the US):

1: It is not illegal to have meds on hand, IF PRESCRIBED (even controlled
Substances, though be prepared to explain to someone why you have a large quantity) keep in mind in Canada and much of Europe, codeine is available over the counter with a signature.

2: Most physicians will prescribe extended amounts of meds for patients they are familiar
with.

3: Most cost effective sources will be Costco and Wal-Mart (if drug is on the “$4 list”).

4: Build up a supply, then rotate out the oldest

5: Many drugs that don’t have a generic equivalent do have generic therapeutic substitutions (“same as, only different”)

6: References for First-aid supply needs:
Wilderness Medical Society: Practice Guidelines for Emergency Care, Fifth Ed.
William Forgery, M.D.

Wilderness Medicine, 5th Edition - Text with DVD by Paul S. Auer Bach, MD

7: General drug refences:
Epocrates –online
PDR – really just a collection of selected drug package inserts, good for trade
drugs, worthless for generics
Facts and Comparisons – probably best single source, groups drugs in classes,
gives off label uses, and compares prices (wholesale, not retail) – often available at the public library (many hospital and university libraries give public access with a simple request)
Sanford Guide to Antimicrobial Therapy- issued yearly, obviously antibiotics only

We need insulin on a daily basis for a type II diabetic for whom the oral meds are ineffective. Our insurance encourages mail order of 3 month supply for the price of 2 months co-pay. Two months after your last order, you are allowed to refill. We do this all the time, and thus have built up and keep a minimum 3 month supply on hand in the fridge. The prescription is valid for one year. Just watch expiration dates and use on a first in first out basis. When traveling on vacation, we take a supply for at least twice the length of time of the projected time away from home. Also having a couple of spare original prescriptions with you when traveling is a good idea.

Do you also have Glucagon-injections for hypoglycemia? If so, how much are you allowed to have?

No, not yet. So far, hypoglycemia has not been a problem. Frequent blood testing (several times a day) and careful control of dose/food so far have been the approach. Also, ALWAYS keep glucose tablets handy and in reach. So far, so good.

Well one of my drugs is not on any list, but I will start to do mail order 3 months ahead program. Then I will take alot of the suggestions mentioned here, especially the one where I find the re-fill cut off date and order on that day to maximize the amount I can get.

Thanks for the help everyone!!

When I get a script from my MD, if it is something that I need a stockpile of, then I ask him to write double the dose. Instead of a 30 day supply, I now have a 60 day supply.

I mostly do this with broad spectrum anti-biotics. This leaves me with a extra dosage series (usually 7-10 days) which I carry with me onboard ship. If I have a bacterial infection while I am on the boat, I can take the dosage series, as prescribed, versus having to get off the boat, go to a Dr, get the same anti-biotics, then wait (lose work) for the anti-biotics to do their thing, killing the little bugs, before I can get a Dr's release to go back to work.

Where I am required to take a pill/capsule each 12 hours, my MD writes out 2 pills/capsules each 12 hours. This makes my insurance company happy and allows me to keep those prescription drugs on hand, in sufficient numbers, to handle most emergencies.

The same thing is true of an emergency at home, where the Dr's offices and/or pharmacies are closed.

1) If you forget to take your pills at the right time,
no worries, take them, but do not get back on the regular
schedule. Let this be your new schedule.

Example: you normally take your pills at 7 am, but you
forget until noon. You take your pills at noon from now on.
Then you forget to take at noon and realize it at 3 pm, so
now take them at 3 pm etc.

2) If you take tablets that are Not Time Release, you could
take a portion of a tablet, like 3/4 or 1/2.

This may be reflected in lab tests or other symptoms.

Example: you take blood pressure meds, and one of them is
a Tablet at 10mg (very low level); with your blood pressure
up, ask the doctor if maybe 20mg might get it down. You can
then go back to taking the full 10mg, splitting a 20 when
needed. BTW, re prices, 20mg, 50mg, are not a whole lot more
expensive than 10mg. [Your blood pressure can go up, if you
take less meds, or take more salt, before an office visit.]

Get Super Organized so you have your meds separated by type.
Each type, ordered by age. You should not have to search
through a bag of pill bottles!

Many times during disasters, we often get asked to refill a patient's regular prescriptions, including for controlled substances. In such case having the original of the printout the pharmacies usually provide that documents the prescription or the the most recent labeled Rx bottle along with any medical records you may have and good ID will help you get what you need from our physicians.

Jeff

For maintenance type of prescriptions, that is the best way. I mail order 4 medications. My insurance requires 90 day prescriptions for mail order. Usually you can re-order after about 60 days. If you are diligent, it is not too hard to get ahead by as much as two weeks per re-fill. Eventually you could end up with an extra 30 day + supply.

Those are my thoughts also....

If you can't get more than a 30 day prescription because of your insurance company or the pharmacy then perhaps your doctor can prescribe a double dose tablet that you can divide in half with a pill cutter.

Tim

That's the way we do it. That, and maybe skipping a pill every so often, allows us to acrue a pretty large stock of pills...

Not sure if this was posted already....if so...sorry....

Being in Florida, and having been through the year of....what was it 4,5 or 6 hurricanes......anyway.....a number of the insurance companies came to the realization that maybe allowing our patient's to get their prescription a bit earlier whe a storm is in their area may just be a good thing.....I don't know if they still 'allow' this. But you may want to look into it.
CJ