This is legal correct?

[SClENCE]

We switched PIC who says no discount cards of any type on any controlled substance.

So we can legally tell a suboxone person that we will no longer use their manufacture coupon on file that we have been using for the past year, correct? Still offering to fill it, just flat out refusing to use the manufacture coupon anymore?

Sometimes doctors even give patients coupons that we refuse to use

I don't see where there would be an issue with it but not really sure

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[WVUPharm2007]

Its probably legal. Its just incredibly petty and stupid. If you aren't comfortable with filing the script, don't fill it. Don't pull some cowardly passive-aggressive nonsense like this. Suboxone is used by people to get off of opiates and it is very expensive. You are putting up a barrier to recovery. Sure, some people just use it as a withdrawal bridge, but others don't and its pretty unethical to judge all of them as one.

 

[zelman]

Patients avoiding using insurance is a red flag, so this is actually reasonable for "discount cards" that don't trigger "too soon" rejections. But coupons that are billed along with insurance seems a little overboard.

 

[PharmNerdMatt]

Legal, yes.
Against your corporate policy - Probably
Stupid and pointless - Definately.

 

[npage148]

I refuse to use discount cards for spiriva You gave yourself COPD, you get to deal with the copay!

 

[SClENCE]

It's not my decision and I personally would just tell them to take it elsewhere if I didn't want to fill it. I was just curious as to what will happen when someone complains because it's bound to happen.

This PIC will gladly tell a patient that she is not comfortable filling their prescription and send them off. I think this rule is to eliminate the ones that he is comfortable filling for but simply doesn't want to (which for Suboxone is all of them).

 

[josh6718]

Our district already has this in place store wide (for controls). Keep in mind though, the state I live in has one of the highest % of prescription drug overdoses in addition to already being in the top 10 states for the number of opioid/narcotic pain prescriptions.

Did people complain? Sure, but on the other hand, I also don't have a problem with price matching for some of our patients for their blood pressure/diabetes meds, etc who can't afford it. I also spend a decent amount of my own time helping insured patients with affording medications from Humalog to Advair- usually reducing their copays in half if not more.

This to me is much more rewarding than trying to run 6 different discount cards to find someone the cheapest price I can get for 240 oxycodone or 'greenstone' alprazolam.

 

[PikminOC]

I refuse to use discount cards for spiriva You gave yourself COPD, you get to deal with the copay!

 

[PharmNerdMatt]

Our district already has this in place store wide (for controls). Keep in mind though, the state I live in has one of the highest % of prescription drug overdoses in addition to already being in the top 10 states for the number of opioid/narcotic pain prescriptions.

Did people complain? Sure, but on the other hand, I also don't have a problem with price matching for some of our patients for their blood pressure/diabetes meds, etc who can't afford it. I also spend a decent amount of my own time helping insured patients with affording medications from Humalog to Advair- usually reducing their copays in half if not more.

This to me is much more rewarding than trying to run 6 different discount cards to find someone the cheapest price I can get for 240 oxycodone or 'greenstone' alprazolam.

Does your district's policy apply to manufacturer coupons as well (drug specific) or only to the generic, catch all discount cards that they mass mail to people?

 

[josh6718]

Does your district's policy apply to manufacturer coupons as well (drug specific) or only to the generic, catch all discount cards that they mass mail to people?

Only to the generic discount cards that I'm sure everyone has seen. Typically they have something along the lines of "Save up to 80% and "Never expires".

I wish they would also include on those advertising for those cards that:

"No they can't be co-used with insurance"
"99% of the time your insurance pays more than this card will."
"If you copay with insurance is more, using this card will not be applied to your deductible"

 

[farmadiazepine]

Its probably legal. Its just incredibly petty and stupid. If you aren't comfortable with filing the script, don't fill it. Don't pull some cowardly passive-aggressive nonsense like this. Suboxone is used by people to get off of opiates and it is very expensive. You are putting up a barrier to recovery. Sure, some people just use it as a withdrawal bridge, but others don't and its pretty unethical to judge all of them as one.

Perfectly said.

That PIC needs to take the stick out his or her as* and grow a pair.

 

[genesis09]

I have no issue with the manufacturer co-pay cards. I don't like the discount cards though. All the policies I heard about ban the discount cards not manufacturer co-pay cards.

 

[sosoo]

i knew a PIC who refuse discount cards for all scripts.. reasons? he feels that it hurts his CVS store profits.

 

[maria1oh]

I have been to pharmacies that don't even carry suboxone in stock. Just don't order it.

Refusing to honor discounts on controls is getting more common.

 

[kvl1027]

Discount cards and Manufacturer Co-Pay cards are two completely different things. I wouldn't take any generic discount card, because they are nothing more than data mining tools that wind up costing me money. But a manufacture sponsored coupon, what a dick. Especially for someone who is trying to recover from addiction. Just a prick if you ask me, but not illegal. It may be a violation of certain 3rd party provider agreements.

 

[PikminOC]

Discount cards and Manufacturer Co-Pay cards are two completely different things. I wouldn't take any generic discount card, because they are nothing more than data mining tools that wind up costing me money. But a manufacture sponsored coupon, what a dick. Especially for someone who is trying to recover from addiction. Just a prick if you ask me, but not illegal. It may be a violation of certain 3rd party provider agreements.

Tell me about the data mining. How specific does it get?

 

[doublehh03]

OP, are you sure you are wording the question right?

I know a lot of stores don't accept the "discount" insurance cards anymore for any medication period b/c they dont' get anything back (esp. when audited).

But I have never seen anyone deny a "manufacture" coupon/card like for suboxone or vyvanse or androgel or something like that.

 

[kvl1027]

Tell me about the data mining. How specific does it get?

As far as I know, nothing that would warrant a HIPAA violation. Prescribing statistics mostly from what I have heard. If I was a drug company, knowing what docs are writing for in specific regions and for specific patient populations would be highly valuable. If I knew that you were writing for a lot of statins and I was selling Crestor, I'd would know exactly who to visit in a certain region.

The worst part is that my pharmacy has been charged to use some of these cards, so they do nothing but discount meds at my expense. It's like I'm paying to give them information instead of them paying me for the information. Brilliant really, but a racket.

 

[SClENCE]

OP, are you sure you are wording the question right?

I know a lot of stores don't accept the "discount" insurance cards anymore for any medication period b/c they dont' get anything back (esp. when audited).

But I have never seen anyone deny a "manufacture" coupon/card like for suboxone or vyvanse or androgel or something like that.

He/she has made it clear that we are not to accept discount cards OR manufacture coupons. The main reason is that we are yet to see a single patient being tapered off of Suboxone though the pharmacist obviously doesn't want to add incentive to fill any type of control. I think the rule is mainly targeted at Suboxone patients though the rule is uniform for all controls.

I personally don't see Suboxone as something a patient should be on for life and the pharmacist feels strongly about this as well... though we have people that have been on it for 10+ years. Though Suboxone isn't a "bad" drug... he/she feels that it should only be used to taper people off. By feeding an addiction with Suboxone the patient is just as much of an addict as when they were "using"... the only advantage being that Suboxone is safer and the Suboxone clinic profits.

 

[ZakMeister]

I refuse to use discount cards for spiriva You gave yourself COPD, you get to deal with the copay!

Would you/pharmacy lose any money if you used the discount card? Wouldn't you be reimbursed?

 

[ZakMeister]

He/she has made it clear that we are not to accept discount cards OR manufacture coupons. The main reason is that we are yet to see a single patient being tapered off of Suboxone though the pharmacist obviously doesn't want to add incentive to fill any type of control. I think the rule is mainly targeted at Suboxone patients though the rule is uniform for all controls.

I personally don't see Suboxone as something a patient should be on for life and the pharmacist feels strongly about this as well... though we have people that have been on it for 10+ years. Though Suboxone isn't a "bad" drug... he/she feels that it should only be used to taper people off. By feeding an addiction with Suboxone the patient is just as much of an addict as when they were "using"... the only advantage being that Suboxone is safer and the Suboxone clinic profits.

How do pharmacies lose money or profit by allowing discount cards? Doesn't the issuer cover the remainder?

 

[SClENCE]

It's not about the money

 

[zelman]

How do pharmacies lose money or profit by allowing discount cards? Doesn't the issuer cover the remainder?

No.

 

[PharmacistReb]

I refuse to use discount cards for spiriva You gave yourself COPD, you get to deal with the copay!

Yeah, 9 out of 10 with COPD are former smokers. But then there's 10 percent that have industrial-related respiratory problems or other reasons for developing COPD. They worked in a mine or a factory and were around noxious chemicals for the entirety of their professional life. They come in to see you looking to save money and you tell them to get lost because "you gave yourself COPD".

What's your policy on someone who's found a manufacturer voucher or 12-month discount on their HIV medications? You tell them to get lost? What about someone who's been eating cheeseburgers their entire life and they bring in a Crestor discount card? You tell them to get lost? What about someone who's been eating 24 ounce Mountain Dews and eating greasy food their entire life and they bring in a discount card for Invokana? You tell them to get lost?

You're also the guy in a separate thread who said you would never, under any circumstance, give someone 5 lisinopril in the event of mail order not shipping out someone's meds on time.

You seem like a wonderful pharmacist. You undoubtedly care about people.

 

[npage148]

I ask them how they got hiv and I'll decide if it's a coupon worthy reason.

 

[PharmacistReb]

I ask them how they got hiv and I'll decide if it's a coupon worthy reason.

Can't tell if you're making an attempt at sarcasm or some form of dark humor or if you're being serious. Either way --> Fail

 

[PharmacistReb]

Your argument is patently absurd as most of the chronic medications people take as they age are self-induced in some way or another. Genetics and aging do not coincide with everything you dispense. You, too, should probably stand on your nonsensical principle and turn away all coupons due to the potential for the self-induced morbidity.

 

[SClENCE]

Yeah, 9 out of 10 with COPD are former smokers. But then there's 10 percent that have industrial-related respiratory problems or other reasons for developing COPD. They worked in a mine or a factory and were around noxious chemicals for the entirety of their professional life. They come in to see you looking to save money and you tell them to get lost because "you gave yourself COPD".

What's your policy on someone who's found a manufacturer voucher or 12-month discount on their HIV medications? You tell them to get lost? What about someone who's been eating cheeseburgers their entire life and they bring in a Crestor discount card? You tell them to get lost? What about someone who's been eating 24 ounce Mountain Dews and eating greasy food their entire life and they bring in a discount card for Invokana? You tell them to get lost?

You're also the guy in a separate thread who said you would never, under any circumstance, give someone 5 lisinopril in the event of mail order not shipping out someone's meds on time.

You seem like a wonderful pharmacist. You undoubtedly care about people.

Some people really can't detect sarcasm^

 

[Wheresmyaricept]

He/she has made it clear that we are not to accept discount cards OR manufacture coupons. The main reason is that we are yet to see a single patient being tapered off of Suboxone though the pharmacist obviously doesn't want to add incentive to fill any type of control. I think the rule is mainly targeted at Suboxone patients though the rule is uniform for all controls.

I personally don't see Suboxone as something a patient should be on for life and the pharmacist feels strongly about this as well... though we have people that have been on it for 10+ years. Though Suboxone isn't a "bad" drug... he/she feels that it should only be used to taper people off. By feeding an addiction with Suboxone the patient is just as much of an addict as when they were "using"... the only advantage being that Suboxone is safer and the Suboxone clinic profits.

You get reimbursement from manufacturer coupons. And actually, you are reimbursed by SOME (very few) generic discount cards. I can't remember which ones off the top of my heads. But the PIC is incorrect about manufacturer's coupons.

This is stupid. The drugs that get the most discount are drugs that already have a huge markup. In fact, you'll probably still make more money off these people using discount cards than the ones you are getting reimbursed for by insurance. Look up how much a bottle of simvastatin or lisinopril costs the pharmacy to order, and then see how much the cash price for a 30 day supply is. It's a rip off. In addition, it's a customer service disaster. The customer will shop around for cheaper drug prices and transfer to a different pharmacy. So now you're making no profit on their scripts. And then your supervisor will question why your script count is going down and customer service scores are low.

I understand the PICs intentions, but the bottom line is that it's probably a handful of people and at most a few hundred dollars a month. In a chain pharmacy, that's a laughable number. If anything you're just inconveniencing the customer. If you're worried about 500 dollars a month, then there's bigger issues going on that should be addressed.

 

[SClENCE]

You get reimbursement from manufacturer coupons. And actually, you are reimbursed by SOME (very few) generic discount cards. I can't remember which ones off the top of my heads. But the PIC is incorrect about manufacturer's coupons.

This is stupid. The drugs that get the most discount are drugs that already have a huge markup. In fact, you'll probably still make more money off these people using discount cards than the ones you are getting reimbursed for by insurance. Look up how much a bottle of simvastatin or lisinopril costs the pharmacy to order, and then see how much the cash price for a 30 day supply is. It's a rip off. In addition, it's a customer service disaster. The customer will shop around for cheaper drug prices and transfer to a different pharmacy. So now you're making no profit on their scripts. And then your supervisor will question why your script count is going down and customer service scores are low.

I understand the PICs intentions, but the bottom line is that it's probably a handful of people and at most a few hundred dollars a month. In a chain pharmacy, that's a laughable number. If anything you're just inconveniencing the customer. If you're worried about 500 dollars a month, then there's bigger issues going on that should be addressed.

You're missing the point. As I'v already stated the policy is not about the money and has NOTHING to do with the profit of the pharmacy. The pharmacist WANTS the patient to shop around and go to a different pharmacy. Plus C2's don't even count towards script count and most patients paying cash for their narcotics are not filling other meds anyways.