Special ordering narcotic question

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Hulkbuster333

Hulkbuster333

Full Member
2+ Year Member
7+ Year Member
Joined
Jul 26, 2016
Messages
84
Reaction score
41
Members don't see this ad.
When a patient comes in with a narcotic prescription for something your store doesn't normally have in stock, how often are you willing to order that? Do you take into account the possibility of the patient taking back their prescription and the bottle sitting in your stock until it expires?
 
Hulkbuster333 said:
When a patient comes in with a narcotic prescription for something your store doesn't normally have in stock, how often are you willing to order that? Do you take into account the possibility of the patient taking back their prescription and the bottle sitting in your stock until it expires?
Click to expand...

Every time I've done it I end up regretting it because
A.) It becomes yet another unusual addition to stock to keep track of
B.) It's usually a sign of a pain doc that doesn't know what they're doing whose prescribing practices are based on which drug rep brings the best pizza
C.) Patients who "need" the special drugs are probably going to be very annoying, calling multiple times per day.

D.) Related to C.) They will inevitably, invariably, transfer out, leaving you with a quantity of #99.9999 left in a stock bottle
 
I don't see a problem with it. Because:
1. Your helping the patient. (Would you rather them drive from pharmacy to pharmacy praying someone has it in stock when you already know the answer)
2. One extra patient=More money for the pharmacy
3. Order one bottle and tell the patient if they want to get it again, they have to call at least 3-7 days in advance so you can order it for them.

As long as the patient calls you in advance and you can order it everyone wins! 😉
 
TheWisePharmacist said:
I don't see a problem with it. Because:
1. Your helping the patient. (Would you rather them drive from pharmacy to pharmacy praying someone has it in stock when you already know the answer)
2. One extra patient=More money for the pharmacy
3. Order one bottle and tell the patient if they want to get it again, they have to call at least 3-7 days in advance so you can order it for them.

As long as the patient calls you in advance and you can order it everyone wins! 😉
Click to expand...
Wait wait wait wait. If we're talking about something that needs to be special ordered, we can assume it's either A. a new brand name med, or B. the Brand Name of an old generic.
Assuming this, the response to your sunshine filled post is:

Oh, everyone wins, except for literally everyone else if you look at it from a societal level.
 
Lol! I think your looking "Waaaay" to far into this. The patient has a need, you as the pharmacist can fill this need, within the realms of the law and clinical practice. There could be many reasons as to why or why not the patient is being prescribed a new narcotic that isn't as common as plain Norco. Maybe nothing else has worked? Maybe the patient has an abuse problem and needs an abuse deterrent med? Maybe its a preferred drug on their formulary(least likely)? The list can go on... As long as its a legit prescription, doesn't hurt the patient, and is covered by the insurance I don't see an issue. Plus you gain a repeating customer since you already know that other pharmacies won't have this narcotic in stock. :highfive:

Also economically on a societal level its good for money to change hands as money is being circulated within the economy.
 
Last edited:
TheWisePharmacist said:
I don't see a problem with it. Because:
1. Your helping the patient.
2. One extra patient=More money
3. if they want to get it again, they have to call at least 3-7 days in advance...
Click to expand...

1. when u charge ppl money for a service, the word help is greatly exaggerated..
2. one extra investigation, one extra lawsuit, hospitalization or death, is huge loss in money. hence one extra patient is one too many....
3. addiction is defined by continuous use n dependency of a controlled substance.... by helping them to become more addicted, in west virginia, that is grounds for lawsuit... in west virginia.
 
sosoo said:
1. when u charge ppl money for a service, the word help is greatly exaggerated..
2. one extra investigation, one extra lawsuit, hospitalization or death, is huge loss in money. hence one extra patient is one too many....
3. addiction is defined by continuous use n dependency of a controlled substance.... by helping them to become more addicted, in west virginia, that is grounds for lawsuit... in west virginia.
Click to expand...

Lol! I swear it's one extreme after another.
"1. when u charge ppl money for a service, the word help is greatly exaggerated."
-Money exchange doesn't put food on your table, clothes on your back, a car to drive, gas for that car, your pharmacy education, your light bill, your gas bill, your medication, ect, ect, ect.... Please don't say silly things like this if you don't have "Objective" evidence that can be applied broadly to back this up.
"2. one extra investigation, one extra lawsuit, hospitalization or death, is huge loss in money. hence one extra patient is one too many...."
-Why did you join pharmacy? Also please don't ever start a business, because what your saying is nonsense. You don't want more patients/customers to grow your business because it slightly increases your chance of a lawsuit. I bet you don't go outside because it slightly increases your chance of skin cancer.
"3. addiction is defined by continuous use n dependency of a controlled substance.... by helping them to become more addicted, in west virginia, that is grounds for lawsuit... in west virginia."
-Well hell, if you think every person who brings in a narcotic is an addict you'll end up with 2 recurring customers, 50 lawsuits based off of discrimination, and no job.

If your still a student, you should definitely rethink your outlook on patients as well as open a business book once in a while, otherwise you won't be able to make it in pharmacy. :smack:
 
Hulkbuster333 said:
When a patient comes in with a narcotic prescription for something your store doesn't normally have in stock, how often are you willing to order that? Do you take into account the possibility of the patient taking back their prescription and the bottle sitting in your stock until it expires?
Click to expand...

In my experience, when you special order a C2 you end up frequently with a hundred count bottle expiring with #70 tabs remaining. Not always, but frequently.

You also need to decide if you want to be the go-to pharmacy in the area for narcotics that nobody else wants to order. If you're fine with that and don't mind doing a narcotic heavy business, then go ahead. If you would prefer to do fewer C2s, then that should be considered too.

In the same light, you might want to consider if it is a regular customer or a stranger.
 
TheWisePharmacist said:
Lol! I think your looking "Waaaay" to far into this. The patient has a need, you as the pharmacist can fill this need, within the realms of the law and clinical practice. There could be many reasons as to why or why not the patient is being prescribed a new narcotic that isn't as common as plain Norco. Maybe nothing else has worked? Maybe the patient has an abuse problem and needs an abuse deterrent med? Maybe its a preferred drug on their formulary(least likely)? The list can go on... As long as its a legit prescription, doesn't hurt the patient, and is covered by the insurance I don't see an issue. Plus you gain a repeating customer since you already know that other pharmacies won't have this narcotic in stock. :highfive:

Also economically on a societal level its good for money to change hands as money is being circulated within the economy.
Click to expand...
That's a nice perspective if one is just a commodity.

I happen to be a professional with the capability to think critically.
Oh well.
 
Hulkbuster333 said:
When a patient comes in with a narcotic prescription for something your store doesn't normally have in stock, how often are you willing to order that? Do you take into account the possibility of the patient taking back their prescription and the bottle sitting in your stock until it expires?
Click to expand...
If I don't already have it I don't order it unless I know it'll go out. If it's rare I just go with the sorry we don't carry this one. Drives me nuts when the safe is clogged with a bunch of crap.
 
"I happen to be a professional with the capability to think critically.
Oh well"
-Since when is writing off all patients as addicts, considered critical thinking?

*****************************
"That's a nice perspective if one is just a commodity."
-Lol! I keep forgetting we are not just pharmacists, but the morale police as well. I guess you throw out patients if they miss church on Sunday.
****************************

A few points:
1. For the argument " I don't want drugs sitting in my safe that will expire", see my comment above and if you still don't get it then look at this video because I've lost all hope in you:
2. For the argument "My pharmacy image will be ruined because I'll be the Norco center of town." Tell that to your boss when your numbers are down and your pharmacy is losing money. A better argument would be for patient safety(overdose) and fraud (illegal prescriptions). My only response to this question is to use common sense. Step therapy? Gradual increase in dosage? Patient slurred speech? Patient trouble breathing? Consistent early refills? Excessive Dosing? Legible handwriting? Corrections without initials? ect, ect, ect....I hope everyone learned something when going through school.
*******************************

This issue definitely will very from pharmacist to pharmacist, which I respect. If you want to maintain the status quo, that is perfectly fine. All I'm saying is that if you want to grow your business economically and have a high customer satisfaction rating, turning away customers is not going to help. :beat:
 
TheWisePharmacist said:
"I happen to be a professional with the capability to think critically.
Oh well"
-Since when is writing off all patients as addicts, considered critical thinking?

*****************************
"That's a nice perspective if one is just a commodity."
-Lol! I keep forgetting we are not just pharmacists, but the morale police as well. I guess you throw out patients if they miss church on Sunday.
****************************

A few points:
1. For the argument " I don't want drugs sitting in my safe that will expire", see my comment above and if you still don't get it then look at this video because I've lost all hope in you:
2. For the argument "My pharmacy image will be ruined because I'll be the Norco center of town." Tell that to your boss when your numbers are down and your pharmacy is losing money. A better argument would be for patient safety(overdose) and fraud (illegal prescriptions). My only response to this question is to use common sense. Step therapy? Gradual increase in dosage? Patient slurred speech? Patient trouble breathing? Consistent early refills? Excessive Dosing? Legible handwriting? Corrections without initials? ect, ect, ect....I hope everyone learned something when going through school.
*******************************

This issue definitely will very from pharmacist to pharmacist, which I respect. If you want to maintain the status quo, that is perfectly fine. All I'm saying is that if you want to grow your business economically and have a high customer satisfaction rating, turning away customers is not going to help. :beat:
Click to expand...


What?

Who said anything about abuse or diversion?

Did you never learn about healthcare costs?
If someone gets medication A that isn't any better than medication B, but costs 1000% more, the third party is going to recover the cost elsewhere.

This is first year stuff.
 
I'll do it for regulars. Most of the non regular customers aren't not willing to wait the 3 days for it to come in. Kinda a self-eliminating problem. Though the last time I did it my patient died before they filled the medication so not I have a whole bottle of oxy 60 sitting around
 
No:
Any cynical attempt at a money grab (like branded ANDA generics) or brand-only drugs that have no real clinical value. This would be the likes of Zenzedi, Evekeo, Zubsolv, etc. Fortunately insurances shut this crap down.

No non-preferred NDCs, like Qualitest hydrocodone/APAP

No brand NDCs when generic is available, like brand Focalin XR or brand Ritalin or brand Percocet. Most of the time it's hypochondriacs who request this crap or W/C customers. Go to CVS or Rite-Aid then

Absolutely no, never, not in a million years: "generic" Oxycontin until true ANDAs come out. No Opana either. I haven't seen Opana in 2 years and don't plan to order it ever again

Yes:
Cheap generics

As for the clutter aspects, if you move something only once and are stuck with an orphaned partial stock bottle, at least you get something to Genco out and your pharmacy won't show up on your boss's "what pharmacies didn't do CII Genco" monthly exception report
 
CetiAlphaFive said:
If someone gets medication A that isn't any better than medication B, but costs 1000% more, the third party is going to recover the cost elsewhere.
Click to expand...

-You obviously need to retake your reading comprehension classes again, because I'm talking about why a patient would need a new drug (not brand vs generic) for a condition.

TheWisePharmacist said:
There could be many reasons as to why or why not the patient is being prescribed a new narcotic that isn't as common as plain Norco. Maybe nothing else has worked? Maybe the patient has an abuse problem and needs an abuse deterrent med? Maybe its a preferred drug on their formulary(least likely)? The list can go on... As long as its a legit prescription, doesn't hurt the patient, and is covered by the insurance I don't see an issue.
Click to expand...

*Please try again. 🙂
 
msweph said:
Wow, you're not the brightest, huh?
Click to expand...

I make $65/hr working at a high volume store, so im pretty sure i know what im saying. how about u, mr Dumb n dumber?
 
I'm starting to believe the "the other pharmacy did it" or "they do it this way" patients. So much difference between us just on this board. I have 8 bottles of Opana sitting in my safe because the jackass PIC before me had no clue how to order C2's and would order everything. If I don't already have multiple patients on it i'm not ordering it.
 
sosoo said:
i highly doubt it. i make more than the PIC and ppl who been around for 15 years..
Click to expand...
You must live in a tax free state or something. I make over $10/hr than you and have been around close to 2 years now. $65 is new grad rate or I want to be a staff and take no responsibility rate.

Either way money doesn't have anything to do with how much someone knows in the company or being a staff at a "high volume" store lol For some people 2k/week is high volume for some 3k/week and for others 4k/week. Just depends.
 
msweph said:
One additional patient is too much for ya tho.
Click to expand...

not sure why u like to misinterpret what i said. the one additional patient refers to the one drug addict, the one lawsuit, and the one anal that keeps coming back for controlled substance until they get hospitalized and died. not sure how u can be a pharmacist and not understand that much. opioid abuse is an epidemic in this country. in maryland it is formally announced as a State of Emergency. so yes that one additional patient is too much. now go back to whichever cave you crawl out of and let the real pharmacists handle drug abuse.
 
msweph said:
Lolz - so because you fill an opioid script you're a drug addict? Yaaaa sounds about right.
Click to expand...

why would it not be right? or why don't u follow up on the news more? .....proposals are flying through congress, and yes the debate is filling one opioid script leads to addiction....... the proposed bill will limit that one opioid script to a small quantity to curve drug abuse.
 
6GodPharm said:
Sarcasm if you didn't get it...
Click to expand...
i was responding to multiple quotes prior. read it if u didnt get it. though i won't mind getting paid $65/hr to refill vials, clean trash.. how much easier does it get?
 
sosoo said:
i was responding to multiple quotes prior. read it if u didnt get it. though i won't mind getting paid $65/hr to refill vials, clean trash.. how much easier does it get?
Click to expand...
I wasn't hinting the sarcasm towards you it was pharmacy man user.

Buddy refilling vials and cleaning the trash is after the **** you already eat during the day lol
I help the drive thru, do the phones (dr line and reg line) do QT and fill for most of the day with my techs. When it comes to the trash and refilling vials not my duty. Some of you want to feel more like a decent human being and don't mine be my guest. I sleep just fine at night. One of us and like 4-5 of them.
 
TheWisePharmacist said:
-You obviously need to retake your reading comprehension classes again, because I'm talking about why a patient would need a new drug (not brand vs generic) for a condition.



*Please try again. 🙂
Click to expand...
There are literally zero new pain management drugs released in the past 20 years that do anything new or better.
Literally all new pain management drugs are just cash grabs by purdue and the gang.

If you don't understand that, you have a huge knowledge deficit.


Let me put it in a way so that you and other people who need smiley faces to communicate can understand:

Version A.)
Some medicine no 2 expensive.
Some medicine Big expensive.

People need a medicine.

Medicare only have so much money.

If everybody get who want it for fake allergy get BIG expensive for no clinically significant reason, then people with who need BIG expensive medicine to save their life no get it or have harder time get it because Medicare money no unlimited.
Version B.)

There's a jar full of Peter Piper Pizza tickets. There's only 6,000 tickets in it. An adult rations out the tickets.

Sally, Jimmy, and Tanya all have been putting tickets into the jar for two weeks and now share them.

Let's say Sally scraped her knee and can get an adhesive bandage for 1 ticket.
She instead completes a prior authorization with the help of the jar adult and his manager and gets a sparkly band aid for 3,500 tickets.

Jimmy then gets his usual stuff for 1,700 tickets.

Tanya then discovers she needs shoes and that they cost 2,000 tickets.

"Prefect!" thinks Tanya.

It wasn't perfect.
Jar adult said to Tanya,

"Hahaha, I'm just a non thinking commodity LOL more tickets for my quota!"
 
Yea forget about going back to college for reading comprehension classes; please start over again from grammar school. Did you even read what you just wrote??? My 5 year old cousin can write better than you. If English isn't your 1st language I apologize, but please use this when your re-write your post Google Translate . Please write your statement again in proper English.

A few points:

CetiAlphaFive said:
There are literally zero new pain management drugs released in the past 20 years that do anything new or better.
Click to expand...

-20 years?? Your ignorance is showing: Abuse-Deterrent Opioids: What You Need to Know
-To be honest I'm starting to question whether your an actual pharmacist and not some random troll pretending to be one. Normally I would say to not embarrass yourself further, but I think we are passed the point of no return. Hell I'm hoping you continue because me and my colleagues sure get a kick out of how clueless you really are. 🤣
 
TheWisePharmacist said:
Yeah, forget about going back to college for reading comprehension classes; please start over again from grammar school. Did you even read what you just wrote??? My 5 year old cousin can write better than you. If English isn't your 1st language I apologize, but please use this when your re-write your post Google Translate . Please write your statement again in proper English.

A few points:



-20 years?? Your ignorance is showing: Abuse-Deterrent Opioids: What You Need to Know
-To be honest, I'm starting to question whether you're an actual pharmacist and not some random troll pretending to be one. Normally I would say to not embarrass yourself further, but I think we are passed the point of no return. Hell, I'm hoping you continue because me and my colleagues sure get a kick out of how clueless you really are. 🤣
Click to expand...

whiguyblink.gif


I don't know how to explain the fact that I intentionally wrote it that way as a farce.
I really don't know how you don't understand or recognize writing patterns from one post to another. It's bizarre.


Thank you for your concern.

Regarding your excitement at the development of ADF pain drugs, I'm excited to hear what you think of Namenda XR.
 
🤣🤣🤣🤣
Did you just try to compare addiction dependent pain drugs(narcotics) with Namenda XR??? I'm DONE!!!:smack: Moderators if your reading this thread now, please put something in that identifies people as pharmacists. A license number or some other identifying feature, because some of these people trying to pass themselves off as pharmacists are ridiculous! LOL!!
 
Last edited:
TheWisePharmacist said:
Did you just try to compare addiction dependent pain drugs(narcotics) with Namenda XR??? I'm DONE!!!Moderators if you'rer
reading this thread now, please put something in that identifies people as pharmacists. A license number or some other identifying feature, because some of these people trying to pass themselves off as pharmacists are ridiculous! LOL!!
Click to expand...
Try to think and pay attention a little more.

We're discussing the necessity of "new" drugs.
Discussing the necessity of new drugs begets the question, "why were these meds developed?"

Why was Namenda XR developed?
Why did generic namenda IR suddenly vanish?

Why did abuse deterrent meds start coming out?


Do you have a problem with pattern recognition?
What would the next number in the following sequence be?

7, 32, 107, 332, ____
 
Last edited:
CetiAlphaFive said:
Try to think and pay attention a little more.

We're discussing the necessity of "new" drugs.
Discussing the necessity of new drugs begets the question, "why were these meds developed?"

Why was Namenda XR developed?
Why did generic namenda IR suddenly vanish?

Why did abuse deterrent meds start coming out?


Do you have a problem with pattern recognition?
What would the next number in the following sequence be?

7, 32, 107, 332, ____
Click to expand...

:troll:
 
Pharmacist can be verified if they want to be. It's a nifty feature but totally optional.

And while the tone of some posts are not exactly ideal, there is a lot of truth in them. The idea of pharmacists who buy into these new expensive opiod medications is pretty hair raising. The comparison to Namenda is apt.

Sent from my SAMSUNG-SM-G920A using SDN mobile
 
owlegrad said:
And while the tone of some posts are not exactly ideal, there is a lot of truth in them.
Click to expand...
-SOME?? I know you've been here long enough to know, this forum should be changed to the dooms day doctor network instead of the student doctor network. Maybe its bad in California, but I can tell you California doesn't represent the rest of the US. None of my friends, underclassmen, classmates, or colleagues across the US have had problems finding a job or switching jobs. Telling everyone who posts here that they will never find a job, as a pharmacist or to quit pharmacy school while they are ahead is just being plain dishonest and unhelpful. The job market is tight across all professions, so people need to stop saying that pharmacy is the worse profession on Earth and that your soul will go to hell for choosing it.


owlegrad said:
The comparison to Namenda is apt.
Click to expand...
-Am I the only one who doesn't have ADHD today? Isn't the title of this topic, "Special ordering narcotic question". Why are we talking about non controlled meds?
************************************************

I took a long hiatus from this website hoping it would improve, but I still see the same old doom and gloom and unhelpful advice being spread. There have been a few bright spots since being back, but judging by this topic, I'm starting to think its all in passing.
 
Hulkbuster333 said:
When a patient comes in with a narcotic prescription for something your store doesn't normally have in stock, how often are you willing to order that? Do you take into account the possibility of the patient taking back their prescription and the bottle sitting in your stock until it expires?
Click to expand...

I don't special order specific manufacturers for narcs (no I won't order the yellow hydrocodone for you). If it's a new patient I'll check them out on the state database to make sure they're clean also.

I will also ask if they will fill their refills here or if it's a one off....if it's an $$$ one off that would cause me left over, I recommend they get it at their usual pharmacy.

For a long time regular I will take the hit if necessary. If the prescription is logical and legit I will fill it....if for some overpriced alternative to a typical narc I will call MD to see if it can be changed and sent to us electronically or have the patient get the physical script.

Anything I order I keep the script and if the patient changes their mind and wants it back, I simply return the med to our wholesaler if I can't convince them to fill it. We are a business, yes, but I don't just refuse uncommon narcs in all spots because it is inconvenient and theres a risk I don't use all of it.

I have some vicoprofen that will probably expire, but the fill went to a patient with an acute injury and a history of liver issues that was in pain and couldn't get anyone to fill for them. I am OK taking a loss for that.
 
Last edited:
TheWisePharmacist said:
-Am I the only one who doesn't have ADHD today? Isn't the title of this topic, "Special ordering narcotic question". Why are we talking about non controlled meds?
************************************************
Click to expand...

Do you want a detailed explanation? It's comparing why Namenda XR was formulated VS why Xtampza ER was formulated. In both cases it is about money, not because one formulation is superior to another. Just because Namenda XR isn't a control doesn't mean we can't make comparisons between similar money-grabbing schemes. It's like asking why are you talking about market saturation in a thread titles "Special ordering narcotic question" 😉

It's just weird to hear a pharmacist sing the praises of new opiod medications that only exist to raise the stock price of the pharmaceutical companies.
 
owlegrad said:
Do you want a detailed explanation? It's comparing why Namenda XR was formulated VS why Xtampza ER was formulated. In both cases it is about money, not because one formulation is superior to another.
Click to expand...

To be honest I'm kinda getting bored of this subject, lets just leave it here for now(the question has already been answered). My only advice would not to be so concerned about sticking it to the insurance company that you ignore a patient in need. Not all patients situations can be treated the same. :clap:
 
TheWisePharmacist said:
To be honest I'm kinda getting bored of this subject, lets just leave it here for now(the question has already been answered). My only advice would not to be so concerned about sticking it to the insurance company that you ignore a patient in need. Not all patients situations can be treated the same. :clap:
Click to expand...
Sorry I didn't mean to bore you, I was just answering your question. I am happy to leave it here for now or forever.

Sent from my SAMSUNG-SM-G920A using SDN mobile
 
TheWisePharmacist said:
-Am I the only one who doesn't have ADHD today? Isn't the title of this topic, "Special ordering narcotic question". Why are we talking about non controlled meds?
************************************************
Click to expand...

You are not as "wise" as you think you are...
 
You must log in or register to reply here.

Similar threads

Sunshine98*
vivitrol and narcotics
Replies
7
Views
743
Sunshine98*
Sunshine98*
D
Cvs rx connect question
Replies
1
Views
2K
Old Timer
Old Timer
E
The Big Question: Pharmacy School or Career?
Replies
3
Views
2K
steveysmith54
S
S
hey , I have question to ask ?
Replies
4
Views
1K
bacillus1
bacillus1
D
CA BOP inspection question
Replies
0
Views
925
doublehh03
D
Top