Question on filling partial oxycodone script

[rickyroxy]

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Hello,

Another oxycodone issue I had today with customer and then followed up by my supervisor. Customer dropped off oxy 30 script at night. It was left for me to be verified with MD. I called doctor and found out that patient was given same script for #83 like 5 days before which was filled at walgreens. Apparently they had only that much in stock.... and doctor gave another script for #97 which patient brought to us. I told her that I can fill it only after she runs out of those 83 pills. She called corporate and my supervisor called me up and was trying to justify that it's ok to fill it because its just a partial of original script for 180. I told him that would be filling it early. He basically asked me to fill it regardless which I refused to do. I have my annual review tomorrow and he said we will discuss tomorrow... I am kind of worried he will bring this up and put against me for my raise. Every time something like this happens and make me not to fill any more oxycodone scripts.... I guess people have found out that they can call corporate and get whatever they want....

 

[PharmDstudent]

You're the pharmacist. End of story.

 

[psychoandy]

Do they have a rx history at your store? If you billed ins wouldnt they reject it as too soon?

I say if theyre a valuable customer do it but I'm pretty sure insurance would reject. And in my state the pt would still be able to pick up the remainder at the original store within a certain time frame...and if that was the case I would do exactly what you did and tell the rx manager that they don't know pharmacy law.

 

[Dr Wario]

As long as the script was separate and the doctor was contacted to confirm that it is ok to fill the script, it would be considered an early refill and not a partial which is completely legal. If you had suspicions about the script you could have just told him that you did not have the drug.

 

[MountainPharmD]

Hello,

Another oxycodone issue I had today with customer and then followed up by my supervisor. Customer dropped off oxy 30 script at night. It was left for me to be verified with MD. I called doctor and found out that patient was given same script for #83 like 5 days before which was filled at walgreens. Apparently they had only that much in stock.... and doctor gave another script for #97 which patient brought to us. I told her that I can fill it only after she runs out of those 83 pills. She called corporate and my supervisor called me up and was trying to justify that it's ok to fill it because its just a partial of original script for 180. I told him that would be filling it early. He basically asked me to fill it regardless which I refused to do. I have my annual review tomorrow and he said we will discuss tomorrow... I am kind of worried he will bring this up and put against me for my raise. Every time something like this happens and make me not to fill any more oxycodone scripts.... I s
e have found out that they can call corporate and get whatever they want....

Using a little common sense here would do you some good. I am failing to see why you refused to fill the prescription. You verified the prescription with the doctor. You received an
explanation as to why the patient was filling two prescriptions so close together. What exactly is your reasoning for not filling the prescription? The doctor intended for the patient to get 180 pills at one time. Because another pharmacy was not able to dispense the full 180 the patient was given a new script for the balance. You are not filling anything early. All you have done is further inconvenience the patient and make yourself look foolish. Common sense goes a long way.

 

[rickyroxy]

Using a little common sense here would do you some good. I am failing to see why you refused to fill the prescription. You verified the prescription with the doctor. You received an explanation as to why the patient was filling two prescriptions so close together. What exactly is your reasoning for not filling the prescription? The doctor intended for the patient to get 180 pills at one time. Because another pharmacy was not able to dispense the full 180 the patient was given a new script for the balance. You are not filling anything early.

I agree. But it was my professional judgement that patient has enough medication to last so many days and I agreed to fill when she runs out of those pills. There is no medical reason for her to fill that prescription today. She could have been doctor shopping and getting multiple scripts same way. She was paying cash. There was reasonable doubt to believe that it could have been used for non legitimate reasons...

 

[All4MyDaughter]

Using a little common sense here would do you some good. I am failing to see why you refused to fill the prescription. You verified the prescription with the doctor. You received an explanation as to why the patient was filling two prescriptions so close together. What exactly is your reasoning for not filling the prescription? The doctor intended for the patient to get 180 pills at one time. Because another pharmacy was not able to dispense the full 180 the patient was given a new script for the balance. You are not filling anything early. All you have done is further inconvenience the patient and make yourself look foolish. Common sense goes a long way.

I agree with this. I wouldn't have drawn a line in the sand over this one.

 

[rickyroxy]

As long as the script was separate and the doctor was contacted to confirm that it is ok to fill the script, it would be considered an early refill and not a partial which is completely legal. If you had suspicions about the script you could have just told him that you did not have the drug.

The problem is my night pharmacists are stupid. They take prescription and tell them that day pharmacist will verify with MD and we have drug in stock. So there is no way I can tell them I don't have medication.

 

[All4MyDaughter]

I agree. But it was my professional judgement that patient has enough medication to last so many days and I agreed to fill when she runs out of those pills. There is no medical reason for her to fill that prescription today. She could have been doctor shopping and getting multiple scripts same way. She was paying cash. There was reasonable doubt to believe that it could have been used for non legitimate reasons...

I think you're reaching. Assuming facts not in evidence, etc.

 

[spacecowgirl]

I would have filled it. Probably would have been denied by insurance and I wouldn't let the person pay cash, but I would have filled it. Now you know.

 

[MountainPharmD]

I agree. But it was my professional judgement that patient has enough medication to last so many days and I agreed to fill when she runs out of those pills. There is no medical reason for her to fill that prescription today.

You called and verified the prescription. You know why the patient got the prescriptions so close together and you know the Doctors intention was to give the patient 180 pills at one time. What professional judgement do you need to figure out what to do here? Its not like you caught the refill too soon by billing insurance and then confronted the patient and got the story. The patient is paying cash so they probably told you exactly why they had two scripts and exactly what happenened with the other pharmacy being short.

She could have been doctor shopping and getting multiple scripts same way. She was paying cash. There was reasonable doubt to believe that it could have been used for non legitimate reasons...

Sure she could have been a space alien, big foot or a Russian spy as well. So what? What gave you reasonable doubt to believe that the prescription could have been used for non-legitimate reasons? Nothing in your scenario indicated there were any problems other than the other pharmacy did not have enough medication to fill her original script. You called and verified it was a legit prescription with the Doc what more do you need?

 

[Chris co2012]

I would have filled it. Probably would have been denied by insurance and I wouldn't let the person pay cash, but I would have filled it. Now you know.

How do you NOT allow the patient to pay cash?

 

[PharmDstudent]

Around here, it's common practice to make patients wait until their current script runs out. I don't do it, but plenty of others do.

Once again, you're the pharmacist. It's your call.

 

[Carboxide]

It's your call, but you have no reason to believe she was doctor shopping. In fact the original doctor was well aware of the two Rx's. If she was doctor shopping, why would she go back to the same doctor??

If you want to deny her, you obviously can, but the patient deserves a better reason than "she MIGHT have been dr. shopping". Fact is, it doesn't matter if she has enough meds to last her for the next several days. If a patient had an IOU for atenolol, would you refuse to fill until a couple days before they were out? Obviously not. Patients with chronic pain need those meds in exactly the same way.

 

[Doctor M]

I see no reason why it was not filled. Unless the prescription was to tell you not to fill until a certain date, there was no reason not to fill it. I would have filled it after all verification was done.

 

[npage148]

I would not fill it until he only had a weeks left on the original rx. My rationale. There is no partial filling for CII (expect for when the drug is ordered and filled w/in 72 H). The original script was not partial filled, its qty was reduced and filled with the pt's and dr's ok. The new script is not an extension of this original script but a new rx altogether. So I would treat it like I normally would and not fill it until the orginial supply was close to out. There is no legal or ethical reason why you would have to fill it immediately and legally I think you'd be more in the wrong to fill it early. I see that this is the unpopular opinion here but that's how I'd handle it because I very rarely early fill cII except for special situations and this is not a special situation.

 

[RoyalBean]

A similar thing happened to me the other day

A doctor wrote a script for oxycontin, patient took it to a pharmacy, they had some odd amount in stock and they dispensed all they had.

Then they called the doctor and complained that they didn't get their entire script and wanted to get it all today. The doctor agreed for some reason, probably fell for the "I am going out of town" story. The doctor called the first pharamcy and verified that they did indeed only give out a partial fill. The doctor requested that the remaining script be voided at that pharmacy and had the patient pick up a script for some 42 remaining pills or something which she brought to my pharamcy.

The doctor documented what had transpired cleary in the free text of the script, and I verified the story with the first pharmacy. The doctor was clearly ok with her getting the rest of it right away.

Ideally the patient should have had enough for a long time but she wanted the rest of the script script right away. In her mind she was merely picking up what was "owed" to her at another pharmacy. I didn't even begin to try to explain why it wouldn't go through insurance to this patient, and she was happy enough to whip out some Benjamins to get the rest right away.

 

[psychoandy]

I would not fill it until he only had a weeks left on the original rx. My rationale. There is no partial filling for CII (expect for when the drug is ordered and filled w/in 72 H). The original script was not partial filled, its qty was reduced and filled with the pt's and dr's ok. The new script is not an extension of this original script but a new rx altogether. So I would treat it like I normally would and not fill it until the orginial supply was close to out. There is no legal or ethical reason why you would have to fill it immediately and legally I think you'd be more in the wrong to fill it early. I see that this is the unpopular opinion here but that's how I'd handle it because I very rarely early fill cII except for special situations and this is not a special situation.

Exactly...lets say it was within 72 hrs, MD isn't up to date on their pharmacy law, pt gets the remainder of that partial fill + more from rickyroxy's store. the fact that they're paying cash makes it even more sketchy. if you don't know who the sucker is, it's probably you.

this is also why i don't work retail...i hate playing pharmacy police

 

[MountainPharmD]

I would not fill it until he only had a weeks left on the original rx. My rationale. There is no partial filling for CII (expect for when the drug is ordered and filled w/in 72 H). The original script was not partial filled, its qty was reduced and filled with the pt's and dr's ok. The new script is not an extension of this original script but a new rx altogether. So I would treat it like I normally would and not fill it until the orginial supply was close to out. There is no legal or ethical reason why you would have to fill it immediately and legally I think you'd be more in the wrong to fill it early. I see that this is the unpopular opinion here but that's how I'd handle it because I very rarely early fill cII except for special situations and this is not a special situation.

You are missing the point. This is not some mystery situation that we are trying to guess what to do. The OP clearly states he or she called the Doctor and made sure everything was legit. The Doctors INTENT was to give the patient 180 pills at one time. It was not the Doctor or the patients fault the original pharmacy did not have the full quantity. There is no partial filling or early refills. The patient is getting the original quantity ordered by the Doctor.

For those of you having trouble with this explain to me how you could be legally wrong for filling this prescription?

 

[MountainPharmD]

this is also why i don't work retail...i hate playing pharmacy police

Then don't play pharmacy police or junior DEA agent. Take care of your patients, do your due diligence and fill prescriptions. One of the most frustrating things is having to deal with Pharmacists who make up laws and imaginary rules in order to justify not filling prescriptions.

 

[MountainPharmD]

Exactly...lets say it was within 72 hrs, MD isn't up to date on their pharmacy law, pt gets the remainder of that partial fill + more from rickyroxy's store. the fact that they're paying cash makes it even more sketchy. if you don't know who the sucker is, it's probably you.

And lets say Santa Clause is real and Unicorns exist and the patient was doing this and that. Give me a break. The scenario the OP laid out is quite clear. All proper steps were taken right up to the OP refusing to fill the prescription. The OP had no legal, ethical or moral reason not to fill the prescription. Simply stating it was thier professional judgement not to fill it does not cover it.

 

[rickyroxy]

Patients with chronic pain need those meds in exactly the same way.

😴

 

[rickyroxy]

I would not fill it until he only had a weeks left on the original rx. My rationale. There is no partial filling for CII (expect for when the drug is ordered and filled w/in 72 H). The original script was not partial filled, its qty was reduced and filled with the pt's and dr's ok. The new script is not an extension of this original script but a new rx altogether. So I would treat it like I normally would and not fill it until the orginial supply was close to out. There is no legal or ethical reason why you would have to fill it immediately and legally I think you'd be more in the wrong to fill it early. I see that this is the unpopular opinion here but that's how I'd handle it because I very rarely early fill cII except for special situations and this is not a special situation.

That's exactly what my rationale was. Atleast someone understand the difference between partial script and a new prescription.

 

[psychoandy]

Then don't play pharmacy police or junior DEA agent. Take care of your patients, do your due diligence and fill prescriptions. One of the most frustrating things is having to deal with Pharmacists who make up laws and imaginary rules in order to justify not filling prescriptions.

I wholeheartedly agree. But I also learned to never underestimate crackheads. I also find it highly amusing the RPh who are like "tell them we don't have it"...imo that's even worse than being pharmacy police because that's straight up lying rather than incorrect interpretation of the law. Then again with the recent rash of pharmacy crimes, it's probably better for business/life expectancy to lie.

And lets say Santa Clause is real and Unicorns exist and the patient was doing this and that. Give me a break. The scenario the OP laid out is quite clear. All proper steps were taken right up to the OP refusing to fill the prescription. The OP had no legal, ethical or moral reason not to fill the prescription. Simply stating it was thier professional judgement not to fill it does not cover it.

I don't think the fact pattern that OP presented is that straight up to instantly say that clearly OP should dispense. Does OP work at Wags or at another chain? Does he have access to the original store's rx records, or did the MD/pt say that's where it was originally filled? There are so many factors I would use to determine whether it was legit or not.

If OP did work at Wags, saw that the pt normally gets oxycodone 30mg #180 every month, called the original store that ran out to ensure no partial fills and that they really did run out and the rx is properly closed, and have a long history of paying for rx with cash and definitely have no insurance...then I would say dispense it. I think that is pretty good due diligence, no?

edit: wait OP is working in florida? that's another variable!

 

[rickyroxy]

Then don't play pharmacy police or junior DEA agent. Take care of your patients, do your due diligence and fill prescriptions. One of the most frustrating things is having to deal with Pharmacists who make up laws and imaginary rules in order to justify not filling prescriptions.

Until florida has prescription monitoring system in place and working efficiently, only the pharmacist is in position to block these people getting oxy 30s and 15s from 10 different pharmacies, and 15 different doctors. Every week me and my partner find atleast 1 or 2 patients doing same and we end up shredding the script. Because of these reasons only few pharmacy carry such meds. If you look up in news for last few months, you will find lots of pharmacy being robbed for oxycodone. I was robbed last week when I was floating at another 24 hour cvs. A guy walked in pharmacy around 9:30 pm with long knife and walked straight up to me and asked for oxys. I had to give him atleast 30 bottoles of oxy 30 and 15s.... He walked away with that and also cash from register...

 

[Doctor M]

Until florida has prescription monitoring system in place and working efficiently, only the pharmacist is in position to block these people getting oxy 30s and 15s from 10 different pharmacies, and 15 different doctors. Every week me and my partner find atleast 1 or 2 patients doing same and we end up shredding the script. Because of these reasons only few pharmacy carry such meds. If you look up in news for last few months, you will find lots of pharmacy being robbed for oxycodone. I was robbed last week when I was floating at another 24 hour cvs. A guy walked in pharmacy around 9:30 pm with long knife and walked straight up to me and asked for oxys. I had to give him atleast 30 bottoles of oxy 30 and 15s.... He walked away with that and also cash from register...

With a name like Rickyroxy, I'd rob you too

 

[xiphoid2010]

Until florida has prescription monitoring system in place and working efficiently, only the pharmacist is in position to block these people getting oxy 30s and 15s from 10 different pharmacies, and 15 different doctors. Every week me and my partner find atleast 1 or 2 patients doing same and we end up shredding the script. Because of these reasons only few pharmacy carry such meds. If you look up in news for last few months, you will find lots of pharmacy being robbed for oxycodone. I was robbed last week when I was floating at another 24 hour cvs. A guy walked in pharmacy around 9:30 pm with long knife and walked straight up to me and asked for oxys. I had to give him atleast 30 bottoles of oxy 30 and 15s.... He walked away with that and also cash from register...

(Shaking head)

Whatever to presumed innocent until proven guilty? Or at least probable cause for suspicion? The patient is cleared of any reasonable suspicion by the MD and patient records, you should have dispensed.

I was jaded by my walgreen internship, then by the rampant substance abusers during my VA residency, but I still keep my distaste for all the addicts out there to myself when performing my job.

 

[1ive2die]

This is why the public hates pharmacists. Although I can see the OP's thought process and intention, to the patient it just looks like the pharmacist is trying to play cop on a legit script.

 

[Sparda29]

Until florida has prescription monitoring system in place and working efficiently, only the pharmacist is in position to block these people getting oxy 30s and 15s from 10 different pharmacies, and 15 different doctors. Every week me and my partner find atleast 1 or 2 patients doing same and we end up shredding the script. Because of these reasons only few pharmacy carry such meds. If you look up in news for last few months, you will find lots of pharmacy being robbed for oxycodone. I was robbed last week when I was floating at another 24 hour cvs. A guy walked in pharmacy around 9:30 pm with long knife and walked straight up to me and asked for oxys. I had to give him atleast 30 bottoles of oxy 30 and 15s.... He walked away with that and also cash from register...

Why do you want to stop people from getting Oxy 30s and 15s from 10 different pharmacies and 15 different doctors? More profit if you just fill them. **** the DEA and their war on drugs.

 

[wezvidz]

If you billed ins wouldnt they reject it as too soon?.

HA! Somebody doesn't live in SoFl. Hoards of these folks flock to our pharmacies daily seeing if we have oxy in stock and none (average <10%) of them have insurance.

Regarding the OP's problem, I have no problem filling it after verifying everything and thoroughly documenting my due diligence on the Rx.

 

[npage148]

You are missing the point. This is not some mystery situation that we are trying to guess what to do. The OP clearly states he or she called the Doctor and made sure everything was legit. The Doctors INTENT was to give the patient 180 pills at one time. It was not the Doctor or the patients fault the original pharmacy did not have the full quantity. There is no partial filling or early refills. The patient is getting the original quantity ordered by the Doctor.

For those of you having trouble with this explain to me how you could be legally wrong for filling this prescription?

I'm not missing the point, the fact that dr doesn't understand Rx law doesn't give me the ok to break it. The second rx was a new script in the eyes of the law, not some grey area extension of the first. Legally (at least in NY) you can only fill another refill or new RX for a CS when there is less than 7 days remaining on the previous rx. So to immediately fill it is illegal (at least in NY) and unnecessary. I don't need to make some exception because the first store filled the rx for a qty less than a month supply because they were low in stock. If the patient wanted all 180 immediately they could have had the initial store partial fill and complete w/in 72 hours OR they could have waiting until the order came in

 

[MountainPharmD]

I'm not missing the point, the fact that dr doesn't understand Rx law doesn't give me the ok to break it. The second rx was a new script in the eyes of the law, not some grey area extension of the first.

What law? Please find the exact law that covers this and post it please.

Legally (at least in NY) you can only fill another refill or new RX for a CS when there is less than 7 days remaining on the previous rx. So to immediately fill it is illegal (at least in NY) and unnecessary. I don't need to make some exception because the first store filled the rx for a qty less than a month supply because they were low in stock.

The OP is not in NY so this line of reasoning doesn't matter.

If the patient wanted all 180 immediately they could have had the initial store partial fill and complete w/in 72 hours OR they could have waiting until the order came in

You are presuming to much here. The patient had a legitimate rx and went to a pharmacy and got it filled. The pharmacy could not fill the full quantity so they filled it for what they had and informed the Doctor. Maybe the patient couldn't wait 3 or 4 days for the order to come in. Who knows or cares. The Doctors original intent was to give the patient 180 pills. Therefore the Doctor wrote a new script so the patient could get the full quantity he originally intended. Whats the problem here?

 

[CUpharmD2013]

I'm not missing the point, the fact that dr doesn't understand Rx law doesn't give me the ok to break it. The second rx was a new script in the eyes of the law, not some grey area extension of the first. Legally (at least in NY) you can only fill another refill or new RX for a CS when there is less than 7 days remaining on the previous rx. So to immediately fill it is illegal (at least in NY) and unnecessary. I don't need to make some exception because the first store filled the rx for a qty less than a month supply because they were low in stock. If the patient wanted all 180 immediately they could have had the initial store partial fill and complete w/in 72 hours OR they could have waiting until the order came in

Or the original pharmacy could have found a store that had the complete #180 in stock. This is what we do at all the stores that I work at. Now I don't claim to know the situation in FL, so this type of situation may be common practice down there. I would probably make an exception for this patient in this situation if there is no prior suspicion. In this case, I would make a note in the system about this particular patient to find out if it becomes common practice for them. I would also suggest that the patient be educated that they can request the pharmacy that is in short supply to find another store within the same chain (nearby) that can fulfill the full script in the first place. Writing partial count scripts like this just creates headaches.

 

[amox]

Your decision was the correct one. If your supervisor does anything in anyway to demean your choice, or dock your pay (or give no raise), you need to go higher than him. YOU have the right to do as you see fit. Technically it is TWO SEPARATE scripts now, and too soon.

Edit --- All the stores I work at don't fill oxy's roxi's blah blah. We just simply say, sorry we don't carry this. --- This also deters robery as why would they rob you if you don't have it!

As others have argued above, he was intended to get #180 and should be entitled to that quantity, however the patient did have the choice NOT TO fill the partial and seek a location for the full quantity.

 

[Sparda29]

Your decision was the correct one. If your supervisor does anything in anyway to demean your choice, or dock your pay (or give no raise), you need to go higher than him. YOU have the right to do as you see fit. Technically it is TWO SEPARATE scripts now, and too soon.

Edit --- All the stores I work at don't fill oxy's roxi's blah blah. We just simply say, sorry we don't carry this. --- This also deters robery as why would they rob you if you don't have it!

As others have argued above, he was intended to get #180 and should be entitled to that quantity, however the patient did have the choice NOT TO fill the partial and seek a location for the full quantity.

Says the Pre-Pharmer.

 

[spacecowgirl]

You are presuming to much here. The patient had a legitimate rx and went to a pharmacy and got it filled. The pharmacy could not fill the full quantity so they filled it for what they had and informed the Doctor. Maybe the patient couldn't wait 3 or 4 days for the order to come in. Who knows or cares. The Doctors original intent was to give the patient 180 pills. Therefore the Doctor wrote a new script so the patient could get the full quantity he originally intended. Whats the problem here?

Right. Why make this more difficult for everyone?

Edit --- All the stores I work at don't fill oxy's roxi's blah blah. We just simply say, sorry we don't carry this. --- This also deters robery as why would they rob you if you don't have it!

This is a horrible practice.

People, stop criminalizing every single narc script. I don't care who's been jaded by what, it doesn't matter. I've been working in retail at some capacity for 15 years now, so it's not like I don't know what I'm talking about.

Get over yourselves. Go into law enforcement if you want to play detective.

 

[owlegrad]

Why even call the doctor if you have no intention of ever filling the script, period?

 

[Ackj]

In NY you probably wouldn't be able to fill it thanks to our "7 day rule." Assuming 180 was a 30 day supply, that's 6/day, #83 filled 5 days ago, so they'd have 53 left, which is more than a 7 day supply. Cannot dispense if the patient already has a 7 day supply or more.

Honestly, when the first pharmacy couldn't do the entire fill, they should've taken the rx and gone to another pharmacy, or they could've returned within 72 hours for the remaining quantity. Seems like a very odd situation, so trust your instincts I guess. If something smells rotten, it could be. It's not like the patient was out of meds and you deprived them and made them suffer in pain; they had an adequate quantity already. No harm in making them wait until it would clear insurance.

 

[Ackj]

The Doctors original intent was to give the patient 180 pills. Therefore the Doctor wrote a new script so the patient could get the full quantity he originally intended. Whats the problem here?

If the doctor wrote 180 scripts for 1 tablet each, could the patient go to every pharmacy they found and get them all filled? Admittedly it's an extreme example, but your reasoning doesn't sound as smooth in this case.

 

[owlegrad]

If the doctor wrote 180 scripts for 1 tablet each, could the patient go to every pharmacy they found and get them all filled? Admittedly it's an extreme example, but your reasoning doesn't sound as smooth in this case.

Other than being asinine, what exactly would be the problem in your very extreme example?

 

[npage148]

Other than being asinine, what exactly would be the problem in your very extreme example?

I see no problem based on the general consensus in this thread. The doctor can even say, yeah I do it all the time for the patient, it makes it easier when a store doesn't have all 180 in stock,

 

[Thoughtfulsinner]

Do your job; count the pills, give them to the patient. You are a pharmacist. If an MD tells you it's okay to fill, do it. There is nothing worse than a pharmacist questioning every control rx they come across.

 

[rxlea]

Do your job; count the pills, give them to the patient. You are a pharmacist. If an MD tells you it's okay to fill, do it. There is nothing worse than a pharmacist questioning every control rx they come across.

I can think of worse things...

 

[Doctor M]

Do your job; count the pills, give them to the patient. You are a pharmacist. If an MD tells you it's okay to fill, do it. There is nothing worse than a pharmacist questioning every control rx they come across.

Im not afraid to fill narcs, we fill quite a number of them. But i certainly dont fill narcotics just because a doctor says so. I fill them in good faith effort in accordance with the law and in the best interest of the patient. I guess in this case, id have to see the patient, ask questions, and investigate a little more. Too many what ifs to make a call from a forum. I know i said earlier in a post that i saw no reason not to fill it, but we dont really know every single aspect of the case. I fill narcotics on a case by case basis. Your your sound professional judgment.

 

[Hope1974]

Are you at CVS? I've seen this b4. One pharmacist didn't want to fill it because he felt it shouldn't be filled, so the DM just asked another pharmacist to fill it. Bottom line is, its YOUR license, ud be at fault if something were to happen, not the DM.

And, they can find any reason to write u up or not give u a raise.

 

[StevePerry]

Do your job; count the pills, give them to the patient. You are a pharmacist. If an MD tells you it's okay to fill, do it. There is nothing worse than a pharmacist questioning every control rx they come across.

Yeah because there are no such things as pill mills in South Florida. Every doc there is legit. Why would anyone ever question a pill mill doc's judgement? Be a good little Eichmann and just throw out the Nuremberg defense if s--- goes south...

 

[Sparda29]

Yeah because there are no such things as pill mills in South Florida. Every doc there is legit. Why would anyone ever question a pill mill doc's judgement? Be a good little Eichmann and just throw out the Nuremberg defense if s--- goes south...

So what if it's a pill mill doc?

 

[StevePerry]

So what if it's a pill mill doc?

Pill mill "doc" that is

 

[Quiksilver]

In NY you probably wouldn't be able to fill it thanks to our "7 day rule." Assuming 180 was a 30 day supply, that's 6/day, #83 filled 5 days ago, so they'd have 53 left, which is more than a 7 day supply. Cannot dispense if the patient already has a 7 day supply or more.

Honestly, when the first pharmacy couldn't do the entire fill, they should've taken the rx and gone to another pharmacy, or they could've returned within 72 hours for the remaining quantity. Seems like a very odd situation, so trust your instincts I guess. If something smells rotten, it could be. It's not like the patient was out of meds and you deprived them and made them suffer in pain; they had an adequate quantity already. No harm in making them wait until it would clear insurance.

This and the fact that the rest of the original script became null and void when you made it a partial. Thus the partial script is now its own entity since you can't legally complete the fill. Now I think the obvious problem is the pharmacy that filled the original, why didn't they parital and order the rest? To me this seems like the obvious thing to do. This is an out of stock situation and really, who gives 83 tablets as a "partial" anyways? Even when we run out of lisinopril, we don't give more then a few days supply. Why would you give 83 pills? Obviously NY has different laws that protects the pharmacy in this situation.

From a customer's standpoint why would you be upset that you can't get the other 100 pills right away? You have enough to last you half a month and you don't have to pay another copay right away. Its funny because had this been a script for lisinopril they'd be pissed for paying two copays in one month but since its Oxycontin they're pissed that they can't get enough Oxycontin to kill a rhinoceros at once. It's perfectly logical sense.

I also think its in the pharmacist's right to refuse to fill the Rx. Clearly she has enough pills to last her. You have a license to protect. Lets say the next script is filled and she kills someone on the way home from the pharmacy and ingests more then she needs, then what? Its not just the doctor's problem, its yours as well... Don't be a mindless drug monkey.

 

[PharmDstudent]

From a customer's standpoint why would you be upset that you can't get the other 100 pills right away? You have enough to last you half a month and you don't have to pay another copay right away. Its funny because had this been a script for lisinopril they'd be pissed for paying two copays in one month but since its Oxycontin they're pissed that they can't get enough Oxycontin to kill a rhinoceros at once. It's perfectly logical sense.

Some people just can't wait. Hence, the post-dated scripts that show up in the middle of the night around midnight. 😉