- Have you ever had to go a day or more without your prescription medication?
- Do you know the physical discomfort and anxiousness of waiting to get the medication reordered?
- Have you spent hours on the phone with the doctor’s office, insurance company or pharmacy waiting for your ADHD medications to be filled?
If so, you, like me, have been trapped in the medication maze.
For years I have listened as clients told me about their challenges to be diagnosed, only to have their hopes dashed when they find themselves trapped in the ADHD medication maze. What is the ADHD medication maze? It is that tangled cycle of trying to get ADHD medications refilled. Prescriptions not relayed to local pharmacies or faxes getting lost to online medication mailing systems. Suspicious looks from pharmacists when picking up medications. Refusals by insurance companies to pay for prescribed medications. The countless dead ends, backtracking, twists and turns of getting a written prescription through the process and have it filled. The ADHD medication maze is a frustrating web where so many people with ADHD find themselves stuck not knowing which way to turn and unfortunately many give up and never get a chance to experience the possible benefits of ADHD medications.
In theory, filling medication prescriptions is supposed to be easy work. In reality, it rarely goes smoothly. Let me tell you about my own recent experience with trying to get my medications filled. I know many of you will relate.
I called to make an appointment and a month later got in to see my doctor who, after a 25-minute wait and a 10-minute appointment, prescribed me my medications. As I left the clinic, I was told a 14-day short-term prescription would be called to my local pharmacy and an email/fax would be sent to Express Scripts, my mail-order pharmacy. Okey dokey.
Not so bad. Except (you saw this coming, didn’t you?) a plan is only as good as its execution.
The following day my local pharmacy auto responder called (nice feature by the way) to let me know my short-term interim medications were ready to be picked up. I was pleasantly relieved and somewhat surprised it had been that uncomplicated. Easy peazy, I thought. I will pick them up on my way to the airport and just to be sure, allow 15 minutes extra.
You see where this is going, right?
I arrived at the pharmacy with plenty of time, trying to have faith and confidence in the system… after all they had confirmed my prescription was ready for pick up, right? I waited patiently in line for the two people before me to pick up their prescriptions and have a pharmacy consult… do dee do… no worries, plenty of time.
My turn. I stepped up, gave the pharmacist my name and they turned around to reach for my prescription. The pharmacist placed two bags on the counter, rang me up… my cost was under $10 dollars… Yay! Woo Hoo… happy dance. I even scolded myself for doubting all would work out.
Wait a minute. I had three prescriptions. “Uh hello Mr. Pharmacy Man, I’m supposed to have three medications filled today… there are only two.”
At this point I was still hopeful… wanting to trust in this “fill a pill system” and then I heard those fated words… “The doctor reordered three medications, but the XYZase is not covered by your insurance until the first of next month.”
And then, in a nanosecond, my stomach dropped, my pulse quickened and I began to see red. I was frustrated by the whole system. Frustrated because I trusted everyone to do their job. Angry with the realization that so many people get stuck in this medication maze with little support or map to find their way out…
Side note: I’ll admit it… I have a real problem with the way medications are dispensed in this country. It’s a crazy system, full of twists and turns we are expected to navigate in order to get prescriptions filled. It’s complicated by monetarily motivated insurance companies who decide what medical care I receive and what I don’t. Last time I checked, insurance companies do not have a medical license; they don’t have the training to decide whether I continue on a medication or not. My doctor with the advanced M.D. degree should be the one to decide medically what is in the best interest of my health.
So where was I… oh yes, standing at the pick-up counter at the pharmacy…
Mustering my courage and trying very hard not to be rude, I told the pharmacist that “the insurance company did not get to decide my medical care, my doctor did and I would pay for that prescription out of my own pocket if needed… thank you.” Then, I was asked to step out of the line and told my prescription would be filled as soon as possible.
So I waited… I don’t mind waiting… after all I had allowed an extra 15 minutes just in case. So I waited while the pharmacist filled other prescriptions, answered three phone calls… and a half hour later and 8 people less in line, the pharmacy assistant grabbed the coveted white bag, looked at me and said “it’s ready.”
Not trusting myself to say a word, fuming with the needless half hour wait, the senselessness of our insurance companies dictating our medical care and the realization of so many other people going through similar experiences… I paid the $25 for my medication and left.
Two weeks later, my interim medication bottles were almost empty, but my Express script online mail prescriptions were scheduled to arrive. (Insert laugh track.)
Yep… you guessed it… no white plastic bag with jingling pill bottles had yet graced my mailbox. I was a day away from my medications running out a second time that month.
Curses… here we go again! Who knew what had happened this time? So once again I was on the phone calling my mail-order pharmacy to see if they had received the refill order from my doc… nope they hadn’t received it. I called the doctor’s office again… “oops”… they had emailed my local pharmacy the short-term refill (we all know how that went), but “sorry” the email/fax with the prescription to my mail-order pharmacy hadn’t been sent. Do I need them to do it now?
People! Work with me here! I’m doing all I can… I need you to follow through. Who in their right mind would ever go through this craziness over and over again if their medication wasn’t necessary?
The fact is I know so many of you go through this confusing, exhausting medication maze… month after month, year after year. You bravely and boldly step into the process where you almost need a medical degree yourself to get prescriptions filled. It is ineffective, inefficient, and, unfortunately, it is what we are left to work with.
We cannot escape it… so if you have found yourself in the medication maze, here are some tools to sustain you when you find yourself in this labyrinth:
- Remember – you and your doctor get to decide your medical treatment.
- Your insurance company refusing to pay for a medication doesn’t mean you can’t pay for it out of your own pocket. I know some medications are costly, however, you might be surprised at how inexpensive some really are. Always ask.
- Always double and triple check to make sure emails/faxes/phone calls have been made/sent and received so the delivery of your medications goes as smoothly as possible. Specifically call the pharmacy and your medication-mailing service to confirm they received the prescription orders… if not, call your doctor’s office to make sure they were sent. Don’t assume.