Repeat Prescriptions.

[wing]

Like most of us here, I take a shed-load of pills - all of which need stocking up at different times, as they were mostly started at different stages of post-transplant recovery.
I seem to have a GP practice that don't want/like to prescribe too much in advance with the result that I practically have to get a prescription for one thing or another most weeks.
My medication regime has not changed in years but despite this, I'm informed that I can only have 28 days supply of pills on each prescription.
My Pharmacy has now thrown a spanner in the works by only dispensing me 25 days supply (50tabs) of Prograf the last 2 times I submitted my prescription (despite the script stating 56 tabs) as they say the rules have changed and they are now no longer allowed to split packs (and these meds come in packs of 50).
Does anyone here manage to get more than 1 months supply of meds on their prescription and if so, how did you manage it?

[Thelma]

What a nuisance!

Is it worth having a chat with a pharmacist or your GP to see if they can sort something out?

[lainiepop]

Dont know what to suggest but can relate as my doc is the same its so frustrating!! My previous docs have always prescribed 3mths worth so i dont run out. New one doesnt and it means if im going away etc i have to put in a new prescription before its due if you know what i mean!! Gonna have a word after my transplant in may and get more than one mth added i think cos fed up with it. Our surgery will be changing anyway as one doctor has unfortunately passed away and the other has left, so maybe the new ones will make some changes!!

[purplesarah]

Oh no that's awful! Will they really not budge? I would consider going to a different doctor!

My doctor knows I'm to ill to be going backwards and forwards all the time so he gives me a 5 month supply, I didn't need to ask for this - he just did it to save me time. I'm not on post-transplant drugs though - only blood pressure meds, alfa calcidol and sodium bicarb so maybe that has something to do with it?

[AmandaClare]

They are much more careful about some immunosuppressant drugs. I'm on a 2-month regime of most of my tablets but have to get the ciclosporin monthly since it's cytotoxic. My previous practice insisted I have monthly bloods too, which was a right pain, but that was the protocol. I got very cross once or twice when they prescribed an emergency supply of 5 days worth and told me to get my bloods done. I'd been on ciclosporin for 20+ years by then.

I'm surprised at your pharmacist, I'm sure they're supposed to dispense exactly what's on the script.

I'd make an appointment with your doc and explain the situation, and ask at least to get into a situation where all your drugs are 'in sync', if you know what I mean. They just don't understand how all these minor hassles nibble away at the quality of life we're supposed to have got back with our tx.

[Thumps]

I get 2-monthly scripts now but my GP did kick up a fuss (they were originally monthly) - he said that he didn't want to "overprescribe" in case my regime changed When I pointed out that my regime hadn't changed in over a year, he relented. I still have to go pretty much every month cos of the way the boxes run out, though.

Re: your pharmacist refusing to break up boxes; i've just set it up so my prescription is for the exact number in a box now. The GP was most accommodating, but I agree with the others, your pharmacist is supposed to prescribe EXACTLY the amount on the script!

[MandyV]

How annoying! At my unit they give us our immunosuppressants and they are done via home delivery so we get 3 months supply at a time (sometimes slightly more if there are just a couple of small boxes difference to a whole box). My GP is happy to supply 3 months of everything else but the pharmacy have a deal with some GP's where they can hold the repeats and dispense each month in certain cases.

Since we shouldn't be paying/script - I have an annual pre-pay certificate which works out cheaper than paying each time and others may have exemptions it may be something to bring up that there is no benefit to only giving one at a time ...

[JMan]

I changed GP's and pharmacies a couple of years ago, all I have to do now is make 1 call to the pharmacy, as long as medications
don't change. I get a months supply.

[sanela]

I too get my Prograf delivered, organized by my renal unit and my GP is happy to prescribe 3 months worth of everything else (5 different meds). When I got my transplant, I was strongly advised to keep a minimum of 2 weeks of Prograf in reserve at all times. Even when I travel I take double the quantity of meds than I need – just in case.
I can almost understand why your pharmacist doesn’t want to split the Prograf packs but, really, your gp should prescribe more than 1 month’s worth at a time. Does your renal unit have a medicine delivery system of any kind? Can your consultant help and write to your GP to give him a nudge? Is there no way that you can put a case forward to your gp so you get all the prescriptions at the same time or near enough? You might have already tried all this but perhaps stomping your feet and/or getting some tears running down your face in front of your gp (in frustration) might help.

Sanela

[wing]

Thanks for all your comments regarding this.
I know it's not a major thing compared to what some people have to put up with but it just drives me nuts and yesterday's session with the Pharmacist was just the last straw.
I've looked into this further and (as we may have guessed!) "The Government" support prescribing only 28 days worth of meds in an effort to reduce wastage and keep down costs etc. A 50 caps pack of 1mg of Tacrolimus costs £80.28p a pack so I can see that they would not want to waste any but given that I always go to the same Pharmacy for my meds what I don't get this month from a pack I could be dispensed next month (unless they think I look like I may peg out in the next 28 days!!).
Best practice also recommends that:
"Quantities of medicines on a prescription should be synchronised ie. all items should be prescribed in 28 day quantities so that they run out at the same time" - of course what this statement doesn't address is that all your meds may not have been started on the same day therefore day 28 of 1 pill will not be day 28 of another.
And apparently, the Pharmacist is within their rights to only dispense 50 pills if that is what the pack contains providing they log this so that the prescriber is not being charged for more than the Pharmacist has given - something to do with "special packaging" .
I'm afraid I've got the bit between my teeth now so I shall be writing angry letters and contacting the PCT, The Surgery and anyone else I can think of until they make this situation better for me - after all, I am the bloody patient!!

[Thelma]

If you feel like setting up a petition I'd happily sign it and pester others to do the same. As said before, these things aren't seen as a big deal by a lot of medics, but they really do "nibble away" at quality of life. It's a major feat of stock control to keep track of what I've got and the various times that I need more and what I need more of. I'm fortunate that it's all easy enough in that I order online and it's delivered, but it takes a week to arrive and that makes it more complicated again in terms of stock control.

[Unifluzie]

I have to agree with the fact it drives you nuts, i get 2 months of frusemide but rarely get enough of my laxitives its frustrating because you are constantly having to put another script in, point in fact i had to ask for my lactulose to be a larger bottle because i take 20ml twice a day but only get 350ml bottle at a time which doesnt even work out to 10 days.
I wish the docs would listen to the patients especially on kidney related items, normally we know wots going on a lot better!

[Tibbs]

I'm lucky - I get 56 days supply of all my meds, finally.

I only used to get 17 days of Sodium Bicarbonate and after months of writing on the repeat request form that I wanted more, I had to go and see the doctor, at which point he said 'of course'.

Most GPs in my area won't prescribe Myfenax, so I get that delivered in 3 month lots, which is great.

Unfortunately people who make a fuss get what they want. If I were you, I'd get a letter from my specialist to say that the meds you're on aren't likely to change in the future. Start from there and make a pain of yourself. It won't make you any friends, but if it makes your life easier, totally worth it in my opinion.

[cazpi]

My GP is great, we sat down and he synchronised my prescriptions by ordering extra of some and less of others so now they all run out together. I get 3 months of everything, and can order prescriptions online if I like, or I can email him and he'll issue one for me to collect later. If the hospital change my drugs I can add new ones to my repeat prescription over the phone.

When I used to pay for individual prescriptions (I have a prepayment card now) he would try to organise things so I didn't pay for small amounts of a drug when he coud prescribe more on the same prescription, and he would let me know which ones I could buy for less than the prescription charge (eg aspirin).

He's retiring soon, but will do one morning a week, so as long as I book in advance I will still be able to see him. I will have to get a new GP in the next few years though.

[marier]

Many moons ago I used to work for the Presciption Pricing Authority.... The chemist gets paid a fee for each item dispensed on the prescription and is also reimbursed for the exact quantity of drugs listed on the script. As for dispensing whatever the chemist feels like from the prescription, that must be an absolute NO.

If the presciption is for half a pack of 'unusual' tablets, the rule was that if he had to break into a packet of drugs to dispense, say half of them he could claim for the cost of the full packet so long as nobody else came for a prescription to use up the rest within three months. This was known as 'broken bulk'.

It might have changed now, but I very much doubt that they have been given free reign to dispense the quantity that suits them.