Patient going to Europe

[BobA]

I have a patient going to Europe for an extended trip (unknown duration). They have a major psychiatric disorder in full remission, but it's very important that they stay on their medications. Does anyone know how I could get a patient 6 months or more of their meds? These are inexpensive, and could just be bought cheaply from the Wal Mart $4 list.

Can the patient get my Rx filled at a European pharmacy?

Thanks!

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[mlw03]

I have a patient going to Europe for an extended trip (unknown duration). They have a major psychiatric disorder in full remission, but it's very important that they stay on their medications. Does anyone know how I could get a patient 6 months or more of their meds? These are inexpensive, and could just be bought cheaply from the Wal Mart $4 list.

Can the patient get my Rx filled at a European pharmacy?

Thanks!

why can't you just write them a 6 month supply and send them to walmart with $25? i doubt a european pharmacist would fill an rx from a foreign physician.

 

[BobA]

why can't you just write them a 6 month supply and send them to walmart with $25? i doubt a european pharmacist would fill an rx from a foreign physician.

I honestly didn't know I could write for 6months at a time. Is this true?

 

[smq123]

why can't you just write them a 6 month supply and send them to walmart with $25? i doubt a european pharmacist would fill an rx from a foreign physician.

I don't think that a pharmacy is going to dispense a six month supply at one time. The most I've ever been able to get a pharmacy to dispense at a given time is 90 days. Particularly for psych meds.

I have had patients take prescriptions to other countries (Asia and Middle East) and get them filled there. If there's doubt, you could ask an attending to sign them for you, with their unrestricted license.

 

[Roguelyn]

Write two prescriptions for 3 month supplies. Unless it's a scheduled med, shouldn't be a problem to fill them. Your patient could fill at different pharmacies if he wanted to.

 

[dragonfly99]

You can only do what you can do. Write a 90 days supply and tell them to fill it before they go, and to take the refill Rx. THey could get a family member to fill it for them and mail it to them, or see a doctor once in Europe. If they have the money to go to Europe for 6 months they should be able to do that. You have to have boundaries, or patients will eat you alive. Everything is not your personal responsibility. Patients have to take some responsibility for their own health.

 

[BobA]

You can only do what you can do. Write a 90 days supply and tell them to fill it before they go, and to take the refill Rx. THey could get a family member to fill it for them and mail it to them, or see a doctor once in Europe. If they have the money to go to Europe for 6 months they should be able to do that. You have to have boundaries, or patients will eat you alive. Everything is not your personal responsibility. Patients have to take some responsibility for their own health.

This is good advice.

 

[Roguelyn]

You can only do what you can do. Write a 90 days supply and tell them to fill it before they go, and to take the refill Rx. THey could get a family member to fill it for them and mail it to them, or see a doctor once in Europe. If they have the money to go to Europe for 6 months they should be able to do that. You have to have boundaries, or patients will eat you alive. Everything is not your personal responsibility. Patients have to take some responsibility for their own health.

Man, I wish this would happen.

I like your advice the best!

 

[Droopy Snoopy]

I might ask in the pharmacy section, but AFAIK there's no hard-and-fast rule about not filling large orders of meds in special circumstances. We do it in the military for deployers all the time. I always speak to the pharmacist first though, both to put it on their radar and to ensure they have the supply in stock.

I like the two scripts idea too. But if you're worried enough about compliance to ask then putting fewer admin barriers in the way might be better.

 

[link2swim06]

You can only do what you can do. Write a 90 days supply and tell them to fill it before they go, and to take the refill Rx. THey could get a family member to fill it for them and mail it to them, or see a doctor once in Europe. If they have the money to go to Europe for 6 months they should be able to do that. You have to have boundaries, or patients will eat you alive. Everything is not your personal responsibility. Patients have to take some responsibility for their own health.

This is legal? If I had someone mail me meds from Europe I don't think the DEA/customs would be very happy about it.

 

[shopsteward]

This is legal? If I had someone mail me meds from Europe I don't think the DEA/customs would be very happy about it.

It's up to the patient to contact the embassy in the US of the country concerned in advance of travelling to find out whether the medication is legal in that country, and how much they can bring in/have sent to them. They may also need to declare it at customs. More than 3 months supply may need an import licence in advance. The patient should keep their prescription with them while abroad in order to demonstrate that the medicine is theirs and prescribed by a doctor for medical reasons.

For a local refil of the prescription the patient would need to see a doctor licensed in the country they are in. The USA embassy in the country would be able to provide a list of English-speaking doctors who could prescribe. It would cost - "free" health care in Europe is mostly only for Europeans - and is unlikely to be covered by health insurance as it is a pre-existing condition.

It might be legal for a doctor licensed abroad to give a prescription after a telephone or internet conversation, and for that prescription to be filled abroad and sent by post. But it depends on the country, so again the patient needs to ask the embassy of the country concerned.

The patient should also be concerned about informing their travel insurer about the pre-existing condition, as failure to do this might invalidate the insurance for any other issues that might arise.

 

[dynx]

i suggest not giving it another second of thought.

 

[SpecterGT260]

I'm obviously not in residency yet but I'm wondering why this is asked here and not to your attending. ?

 

[BobA]

I'm obviously not in residency yet but I'm wondering why this is asked here and not to your attending. ?

The attending had an unsatisfactory answer

 

[BobA]

FWIW - The pharmacy agreed to fill the script for 1 year.

 

[NotAProgDirector]

FWIW - The pharmacy agreed to fill the script for 1 year.

Absolutely nothing stops you from writing a prescription for more than 3 months. It's perfectly legal.

Most insurance companies will only cover a 90 day supply at a time, but in this case it looks like the patient will be paying out of pocket, so it's not an issue.