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Thursday, May 13, 2010


I have a terminal patient whose lovely insurance has decided to not cover her Roxanol. I am so appalled right now, I can barely speak.

Luckily, I have a little discretion in the pricing, so I was able to make it bearable, but still, I cannot help but hope that reform will eliminate such arbitrarty idiocies.


Anonymous said...

Can you get generic? Would that make a difference in cost? Why would 20 mg/mL morphine not be covered by an insurance plan? Why did we live with kowtowing to non-medical accountants for so long?

was1 said...

Love those insurance folks. I have a customer whose house burned down. Her husband is a long haul trucker and won't be able to get home for at least 3 days. Her plan refuses to pay for a replacement for her Advair so she'll probably end up in the hospital which will cost this same insurance company 100 times the cost of an advair. Nobody has the authority to override the "too soon" reject. Idjits.

Ninjamedic said...

I work for a hospice, and things like that make me sick.

How much is it? If I can help, I'd really like to.


John Woolman said...

This is probably naive given the litigious environment in which health care is delivered in the US, but could you persuade the prescriber to write a generic prescription and then make and dispense an extemporaneous preparation of morphine sulphate?

A second point is, is she also on a modified release form of morphine? If she is just on morphine sulphate solution PRN then this may not be ideal for terminal care pain relief.

I guess what I'm saying is, and you may have already done this, a chat with the prescriber, if you can get through his or her layers of flappers, may be helpful.

Big 'N Tasty RPH said...

I also don't understand why the drug seeker that goes to the ER every other day for #12 or #8 generic Percocet of any strength doesn't get his coverage revoked. He had been doing that for 5 months that I had on file. That is over $100 to the insurance every time he does that. Douche bags like that make health care expensive for the rest of us.

Pvt Jack said...

This is exactly the reason I got out of retail. I got so sick of dealing with insurance companies. I volunteer on a hospice interdisciplinary team and I'm really glad that we don't have to deal with that usually.

Burger Doodle Chicks said...

I got her taken care of, thank you all very much! Like I said, I have a bit of leeway in my pricing, so I was able to price it down where her copay would have been anyway, and fill w/ a generic. She's much more comfortable, and since it's a small town, the practitioner and I work closely enough it's almost like having home Hospice, at least from the drug availability side. (she does house calls, and she has my home number!) I think she'll be starting on Hospice this week, then we'll get the rest of her needs addressed.

I was just very frustrated, because this was an insurance with a rep for taking good care of its over-55 set, yet this one med wasn't covered??

Thanks again all, when it gets really really crazy in pharmacy, it's nice to know we're not alone.