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Five Letters Re: How to Build a Deeper Supply of Prescription Medications

Dear Mr. Rawles,

Pat C.'s recent post regarding the acquisition of prescription drugs in quantity includes many good thoughts. As a pharmacist of more years than I like to admit, I feel compelled to add to a few of Pat's points.

Pat mentions FDA restrictions on quantities of several types of medications, including some "powerful antibiotics, pain drugs, and highly abused drugs". I'm unaware of FDA restrictions on dispense quantities of any drugs, except regarding a very small number of drugs with unusually high-risk of adverse reactions. These few drugs would rarely come into play in stocking for calamities. The point that I believe Pat is driving at involves the Drug Enforcement Administration (DEA) restrictions on "Controlled Substances", which, as a matter of definition include drugs with addictive potential, such as the opiate analgesics (pain relievers), many anti-anxiety agents (Valium, Xanax, etc.), and the amphetamines and related substances used for treatment of ADHD. The Federal list of these agents can be found at the DEA web site, for those who have time on their hands and are not easily bored. Many states have added a few agents to their very own 10th Amendment (my attempt at humor) replication of the Federal list, so check with your local pharmacist about specifics. You don't want to come off looking like a drug seeker! The methods suggested by Pat will attract a lot of attention if you innocently try to apply them to, say.... Tylenol #3 (acetaminophen with codeine - a Controlled Substance under Federal regs).

Also, Pat's statement, "some generics don't work as well as branded drugs" may breed confusion. Though there will be endless opinion-driven debates over this topic, the science, the FDA, and the overwhelming medical opinion at this point is that generic drugs rated as "therapeutically equivalent" to the innovator (brand name) product, can be used interchangeably without harm. Again, if you want specifics, you can Google (or, as I prefer, Scroogle) "FDA Orange Book", where you will find all of the products that are "AB rated", and thus approved (at least by the FDA) for interchange. Or, again, ask your pharmacist. Practically all commonly-available generic products are now listed as equivalent.

Okay...so I'm biased (I'm a pharmacist), but you may come off better asking your pharmacist about which tablets you can cut, than to ask your doctor. I think that I can safely say (without offending my friends that are medical doctors) that we pharmacists have a lot more time to study such things than most doctors!

Just my 2 cents worth! As always, thanks for all you do to help us live fuller live! - SH in GA

Dear Mr. Rawles:
Regarding yesterday's article "How to Build a Deeper Supply of Prescription Medications", I would like to suggest an alternative source for low cost prescriptions. When I was without medical insurance, I purchased prescription medications from AllDayChemist.com. This company is located in India. My experience was very good. My prescription cost $12/pill in the US, and $4/pill from India. The quality was fine, the service was great. They charged a flat fee of $25 to ship the package by air. Once I was comfortable with the quality and service, I started ordering larger quantities to amortize the shipping cost.

Best Regards, "+P+"

Hi Jim,

Just a note on how I got around this. I take a medication for GERD (a symptom of which is painful heartburn). I take one pill a day and my medical insurance will cover 100 pills at a time, and won't let me get any refills before the 100 days is almost up. Around here, all pharmacy computers are linked to insurance companies, so there's no way anyone could do what Pat C suggests in her article, unless it was ordinary OTC drugs. Anyway, I only pay $2 for prescription drugs, and a lot more otherwise, so I was heavily motivated to figure something out. So what I did was I told my doctor that 1 pill/day isn't always enough, depending on what I'm eating, and asked if she could raise it to two pills per day? (Sometimes this is true anyway). She did, and now every time I go I get twice as many pills. As long as I remember to go get refills every 100 days, I'll be able to build up a nice supply. This doesn't work for a lot of drugs, as dosage is critical in some things, but it worked in this case. GERD is one of those things where you just keep upping the dosage until it goes away (to a point, and I'm well below that point).

BTW, I cautiously asked my doctor about prescriptions for other types of medications, such as antibiotics, just to have on hand in a medical kit. In a word, she said "no". - RL in Ontario

James,
I can tell you as a retail pharmacist for a chain store that we do have linked data bases from state to state, but it is only within the chain itself.
A couple of thing you might want to considered when getting your physician to write that six month prescription is to have him write for a total quantity of ______# of tablets (fill in the blank with the total number of tablets you will need for that six months of medication). This will avoid problems with pharmacists who are limited by state law to dispensing only what the doctor writes for. In other words if your Dr, writes for 30 tablets they can only fill for that 30.

As far as tablet splitting, some good points were brought up. I'd just like to make sure every one understands that if a tablet is not scored do not try to split it. Pharmaceutical sales people have told me that manufacturers do not guarantee an "even mix" in unscored tablets.

Also don't forget to take advantage of any special transfer offers (such as $25.00 gift cards) that are being offered for transferring prescriptions between companies and the $4 prescriptions being offered by Wal-Mart, Krogers and Rite Aid. Many companies will also match these prices if you ask. (But you must ask.) - D. S. in Georgia

Mr. Rawles;
Many insurance companies allow you to purchase a 90-Day supply of prescriptions by mail at a cost that is normally much less then three individual 1-Month prescriptions. We have been participating in this program for years and have saved several thousands of dollars. - CaBuckeye

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