PSA: Fire Your Pharmacy and Find One That Respects and Takes Care of You

cheese_greater@lemmy.world to ADHD@lemmy.world – 115 points –

K, so I see posts wayyyy to often where the OP is crying and miserable about the way their pharmacy treats them like shit and never is on top of making sure they have your meds available and/or ready for you come refill day.

If this is ever the case, you need to fire your pharmacy and find a better one. Usually, smaller mom+pop or smaller local chains will appreciate your business and help you ideally with these things without you even having to ask (or only requiring one-time orientation on what your preferences are as they relate to servics they usually do or should be offering:

  • fill your meds automatically without you having to ask

  • ensuring it is in stock without you having to worry in order for them to fill said refills

  • advise you of any complications or further steps required of you to help them make sure you're taken care of and consistent with refills

  • remind YOU about shit, not the other way around. My pharmacy might as well be my unpaid intern/executive assistant with all things medical as they pertain to my business/the privelege of getting said business I grant them

  • delivery: this is non-negotiable. If they ain't delivering, I ain't playin'. My pharmacy knows that to be my drug dealer, they gotta come to me. Cuz I ain't leaving the couch to get my drugs

  • deal with dr for you if any discrepancy or error is in the way. This is the beauty of medical practices with adjoining pharms. Ethics be damned, vertical/horizontal integration 4 the win!

That is all. Your pharmacy should feel so lucky to have a good get like AD(H)D patients, I would rather have that then a money printer if I was a pharmacy owner.

Spread the word and f all that noise. You are worthy to be waited on and catered to, controlled substance or otherwise.

Not sure if this is cogent but I take rhe 2nd rarest (prescribed/available) medication next to Desoxyn and I've never had an issue getting it filled, even in the depths of the Great Adderall Shortage although it wasn't Adderall so not sure how relevant my n=1 is this context

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To my knowledge, you cannot get stimulants delivered, and I have to call in every month for them to get filled. I’m not sure if the latter could be taken care of by the pharmacy. I have Costco pharmacy, and I really like them.

Edit: Please see the comment below, apparently you can get stimulants through mail if you use a mail-in pharmacy. So please check with your doctor/pharmacy regarding this.

I'm in the US and my (generic) Adderall XR is delivered via USPS, so it's definitely possible.

I'm fairly certain it's up to state law.

The WebMD article does indicate that the specifics vary by state, but it sounds to me that delivery of a 1 month supply is legal in all 50 states.

Because they’re schedule II drugs, you may not be able to get a bulk delivery. State regulations on prescribing these types of medications vary, so you may be able to get only a month’s worth of your ADHD medication at a time and need a new prescription for each refill. Some states also require an electronic prescription be submitted by the doctor.

https://www.webmd.com/add-adhd/adhd-med-home-delivery

TIL, I'll look into this. It would be nice to get it shipped. What pharmacy do you use, if you don't mind me asking?

Edit: Please note that apparently you can get stimulants delivered through mail.

Yeah, it's been super awesome, and I've never run into any shortages. I'm with Kaiser and they really push their patients to use their pharmacy, so I have a suspicion that's not the case for you. I've heard that many insurance companies have a preferred mail order pharmacy, so you might want to dig around with your insurance company to see if they have a preferred partner. If that doesn't work out, searching "mail order adderall" seems to turn up some possibilities, but I can't vouch for any of them. Your prescribing doctor may also have suggestions.

Got it, yeah, Kaiser is a different beast, but I'll see if I can do anything on my end. My insurance's preferred pharmacy is CVS, and I stopped using them cause they never had any Adderall during the shortage.

What State do you reside in?

I'm in Colorado.

Check this out maybe

Oh thank you, I appreciate it. I'm able to get my doctor visits be virtual, and he is allowed to prescribe 3 months at a time, so I have to see him every 3 months. I remember when I had to go in. It would be nice to get the meds delivered, I'm just worried about the shortage, but I hear it's getting better.

I don't know if they'll mail you all three months at once, it might be a monthly-type deal I would imagine.

Oh yeah, I imagine it would be monthly. I don't mind going to my pharmacy because i shop at Costco anyway, and they provide great service. But it would be nice to just "set it and forget it" with a mail0in prescription.

Right? Its the only correct option aha unless I happen to be there anyway and it coincides

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State law, but also your insurance and pharmacy benefit manager. Our pbm only allows 30 days of any Rx (pain in the ass for "round the clock" birth control) and the thing is we can pay cash and get more, but this is so hard to communicate to the pharmacies, like literally every time they just fill the 30 days and you're arguing with some poor tech holding up the line

I emigrated from the US to Canada and I was fucking amazed when my GP wrote a script for 90 days of methylphenidate... and just recently I has a three month out-of-country remote working gig and Canada was totally fine giving me a 120 day supply of my meds in advance for travel. Also, without extended insurance, my meds cost me 10$ for 30 days up here.

It's so fucking nice not living under the US Healthcare system.

Yeah, was a bit of a culture shock going the other direction. I literally didn’t go to a hospital with a broken ankle because I was uninsured. Wrapped it tight, stayed off of it, and luckily it seems to have healed properly on its own.

That happened with me one time where I went to a pharmacy in a grocery store with 3 previous months' bottles and he just wrote me a script for 180 filled right there.

I won't get into it but suffice it to say that was a weird 2 months ;) life was much harder and more perilous back then...

Edit: also like the biggest horse pill-bottle I've ever seen or retained possession of

I mean it would never scale for Costco I don't think. Smaller pharms hire a random guy who Ubers your drugs to you. Its an unimaginably beautiful thing!

I mean, that's literally against the law. I wouldn't want anyone risking their liberty for my convenience.

Edit: It's legal for a pharmacy to ship them to you. The entity has to be registered with the DEA.

I'm not in US, happily. Its definitely not, pretty sure they wouldn't be taking that risk if it were illegal (I used Über figuratively, its not literally some random Über guy...). We don't have a bunch of dumb, narc cops setting drug policy over here :)

We've definitely got pharmacy delivery in the US as well.

Not for stimulants, which is what was said

There absolutely is. I get my vyvanse prescription delivered every month in Minnesota. And I got my Adderall prescription delivered the same way before the shortage cased me to switch. Lookup a pharmacy called Capsule, they're delivery only.

My college roommate 100% had his adderall delivered to him. Might be a state to state thing

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K, I don't think you know that, you seem to be parroting the top-level commenter who already admitted explicitly he needed to actually look into it further as opposed to just saying things or how he "feels" it is. Even his initial comment sort of subtly caveats he didn't know 100%

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Anecdata here in the US, but my local mom and pop pharmacy (which I love) currently would lose $200/mo on my vyvanse because of my insurance and the whole generic vyvanse nonsense. This system sucks.

For the time being, I fill my vyvanse at Walgreens and hope they're losing $200/mo on it. I fill everything else at the mom and pop, until they let me know the situation is better.

Why is ANYONE losing money to fill scripts, I really don't understand any of this...

They're saying lots of insurance plans don't cover mom and pop shops unfortunately

That should be illegal, all this Roaming for Healthcare shite is absolute nonsense.

As someone who works at a company that analyzes the US Healthcare market.... you'd be amazed at how much shit they do that should be illegal.

Did you know that it's not uncommon in the US for drug manufacturing to pay consumers' out of pocket cost for really expensive medication? I.e. some medication would cost you 3,000/month to fill after insurance so the manufacturer offers you 3,000 dollars every month to take it.

Does that sound good? Maybe on the surface but what's actually going on is that the list price of your medication might be 12,000/mo and the manufacturer did some research and determined you're unlikely to be able to afford it so they'd be missing out on their 10,500/mo in profit from you. But gosh golly, do you know what's better than 0/mo? 7,500/mo, if they hand you a drug card that covers your out of pocket costs, they can still get the money your insurance company would cover, yay!

And you know what that sort of money printing machine encourages? Prescribing your drug to everyone!

BTW, don't feel bad for the insurers here, they're utter fucking bastards too. Everybody in this market is fucking awful, even, and especially, the fucking hospitals.

Should be, but it essentially locks in those patients to a specific pharmacy for a negotiated rate. “Okay, we will give you an extra 10% discount on prescriptions, but all of your insured have to go through us” type deal.

That is completely insane, the US is just a bunch of sketchy corporate boredrooms standing on top of each other in a smoky, murderous trenchcoat

In the US, the problem is whether your insurance works with a specific pharmacy or not. My parents go to Walgreens and their service is fairly awful - out of stock on some things, say they have our package and then can't find it after a 45 minute wait, and the 45 minute waits in general. Seems they have no idea how to staff or predict busy times properly as sometimes you go in and there's 1 person in line and 3 peple working, and other times, 15 people in line and 1 person working. I suggested they choose various other pharmacies but apparently they can't due to insurance.

If that's the case, that is beyond moronic. Fuck their system is stupid.

The US insurance system is one of the most ridiculous corporate bureaucracies and consumer ripoff scheme ever devised. It was amazing to see the blitz of corporate propaganda unleashed when the Obama admin was trying to reform it (Clintons tried, too) and the deluded people (Republicans, of course) were enraged and terrified at anything changing (I LIKE my plan!! and my favorite, "Keep the government away from my Medicare!")

I don't think I could design a more Hard-R ridiculous system if I was being waterboarded to yield it

The system here is completely broken, unless you are a C level at a hospital or some major investor/exec level at a drug or medical equipment manufacturer. The system is working super well for them. For the rest of us though, the US system is the most costly in the world both on cost to tax payers, and personal costs. Medical debt is the number one reason for bankruptcy in the US and most of the people who file have medical insurance.

America is soooooo weird in this regard, I feel for them, I really do :-(

Here I'm the UK our pharmacy (chemists) are highly qualified professionals who know what they're doing (not to suggest they aren't in the US, I just want to temper the mundane thing I'm about to say about them a bit as I'm generalising), but their job for all it's complexities and specialised stuff is this:

They dispense whatever medication is on my prescription.

That's it, that's their job, they don't get further involved. I give them my prescription, they say okay come back in 30 minutes we'll have it ready for you, and then I come back, pay the flat £9.65 fee (no matter what medication it is, it's always £9.65), and I go on my way.

That's it. They don't try to take the place of my doctor and perform their own counter-diagnosis, they don't make random decisions about whether I should have my medication or not based on prejudices etc, their job is just to grab the box of pills or whatever, stick them into a bag with my name on it and hand them to me.

It boggles my mind that over there your pharmacists are often some kinda wild weirdos that think they're able to step in to your doctor's role, or have any say in your medical care, etc. It's wild, and I'm so sorry you have to experience that ridiculousness.

I honestly don't know why your country isn't in uproar over it, considering how prevalent and deep rooted the issue seems to be. If our pharmacists all suddenly started behaving that way we'd go mental, the nationwide scandal would be huge 😅

🫂 Stay safe out there and always stand up for yourself, you're important!

Its super annoying to me when pharmacists get uppity. Its like, is there a vending machine with a little less attitude I can interface with in the alternative?!

Don't get me wrong, I generally get along with pharms famously cuz they know I know what I'm talking about and I gently but assertively refuse to play any games. Its like, I came here for x,y,z and I expect to obtain such and I'd like to know a,b,c aha. I just generally have little patience for gatekeeper and folks who attempt to impede me from doing what I need to do.

Its like, you gotta pay for that shit, I'm nobody's plaything for free, even then, I was always the shittiest of doormats 👹

I used a small old school pharmacy (it’s quite obviously only used for meds and inflating balloons cause all the items on the shelves were covered in a layer of dust) but they were meaner than the corporate locations and told me I couldn’t keep switching btwn pharmacies cause it “looked suspicious” despite that literally being the recommendations since there was a stimulant shortage in the entire nation. It’s all situation specific and most of the time I feel degraded😞

usually

Not always. Its more theres a correlation that the smaller they are, the more your chronic business means steady and necessary income for them and everybody wins

I understand outliers and you’re right but I really wish they made me feel valuable instead of being treated like a criminal for trying to hunt down my medication

Is this literally every pharm in America, I know its prolly true for all the large chains, I just can't see how every pharmacist/cy is that antipathetic to customers it relies on to stay in business and be profitable, God forbid

I currently use a Walgreens that has been quite good to me. I tried switching to a local independent pharmacy, but they said they couldn't fill my Adderall prescription because they were only getting enough for their current patients. Seems like a sign they probably have great service if you can become a customer.

So they kinda made the decision for you. And if the Walgreens is good to you, regardless of it being a big chain, that's awesome. I'm not saying "don't be a customer at a big chain" or "no Costco pharmacy", I'm saying that if a pharmacy treats you poorly and makes you do their job/worry about anything, find a better pharmacy who understands+appreciates the value of your perpetual monthly business.

So, CVS in California used to do most of that, especially filling the Rx without being asked and then telling us it was ready. But, after some reaction to the opiate crisis I can't find any place that does that. If you're Rx is on a schedule, no matter if it makes sense or how long you've been taking it abuse-free, they absolutely may refuse to help you whenever some miscommunication happens or you need it early because you're traveling or whatever.

I think the pharmacy attached to medical center is a good idea, but it was my doctor's office (the prescriber) who told me they "don't get involved with scheduled drugs" when Costco needed the prescription resent.

I gave up the treatment because the meds were never available even tho my life was so much better with them. I searched every pharmacy in my city, no one keeps methylphendate tabs on them. Now I'm once again going bareback through life.

You being serious right now, like freaking methylphenidate is too much to ask? WTF, where the heck do you live that is that incompetent?!

Imma need you to elaborate on how thats possible?

India, Dehradun, i've searched every damn pharmacy in here, nothing. Asked my therapist, she shrugged like there's just one brand available and the one store that sells it most times don't have it. So I had to wait weeks to get it. And then my therapist would have to restart the whole thing from 5 mg cuz apparently you can't continue using the 20 mg straight up idk. Did this for months and had to give up. Even looked em up in the online pharmacies. Can't say I didn't try.

Wow, that sucks. I'd be screwed without my Dexedrine, yikes. Every time I go off it things slowly start going to shit

Yeah it's like, someone took my crutches. Once you experience "normal", going back is so terrible.

What does the pharmacy say, like why don't they order more?

Maybe ask folks on r/India or whatever, maybe someone there knows something

It shows the meds, but says you can't buy methylphenidate meds from them. Or something like "not available for sale". Maybe we have some kind of ban on it or something?

Forever unavailable

Ya but ask, doesn't matter what you see or hypothesize. Or get a burner Reddit account and ask what other Indian AD(H)Ders are saying. They seem to be saying modafinil is OTC, have you tried that?

No like, nothing but inspiral is available in my city. I've asked for straight up just methylphenidate. Not even telling what brand. They just always have inspiral and they're mostly out of it. And I have to go really far for that particular store. My therapist even told me it's the only one available, she's really nice but she was dissapointed in the drugs availability too lol.

So wats wrong with Inspiral if its available in your city? How the heck does anyone else access their meds? I really don't understand how a city can be like that...this is like boonies territory I would expect that from

Just ask on Reddit if you actually want to solve this problem, I kinda feel like you have a bottomless well of "buts" for why you cant solve this problem and I gotta go aha

I don't wanna see any posts like that without someone referring them to this rebuttal PSA. There is zero excuse to still be patronizng a shitty pharmacy that makes you feel less-than.

Wasn't aware the US is insane. First I've heard on the subject /s