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Caremark - Refusing to Fill Prescriptions

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Sara of Pasco WA (8/24/04):
I have had to be on some pretty expensive and potent medications for Reflex Sympathetic Dystrophy, a very painful condition. The doctor wrote me a prescription with one refill for a pain med. They, although the prescription is due to reach me by 09/04/2004, state because of the amount of the pills the doctor has prescribed, they will not refill it for another month. They stated she is giving me too many doses. This is always for a 3-month supply and she prescribes 540 pills.

They told me today that at this rate that means I would be taking 10 pills a day which disqualifies the script. They said that two pharmacists did the numbers and this is what they came up with, stating that I should have at least a month's supply left yet. If it's a three-months supply and it is written for 540 at an average of 30 days a month, this comes to 6 pills a day, which is just what the doctor had ordered.

I have had them refuse to fill prescriptions and return them to me. They call the doctor continuously and harrass her about the medications she has me on. It seems to me that when a person has a disease that is barely controlled by any meds, this company automatically takes it upon themselves as to whether they will will the prescription or not. Meanwhile I suffer.

They noted that I had gotten a prescription filled at a pharmacy other than them, I told them I had no choice as that was when they denied my meds and sent all my prescriptions back to me. I am forced to use this Caremark mail order due to my husband's insurance plan. At this point I am stuck ... I cannot get a prescription at a pharmacy as they deny it stating any chronic long-term medications MUST be filled by them. I could get the medications if I wanted to pay full price, but I am totally disabled and do not have the money to do so. I haven't worked in over two years.

In talking to them today I told them that they were taking away the very thing that keeps me at least within a tolerable pain level. I told them that a life lived like this is not worth living. It has been two months since I have even left the house due to the pain, left leg being totally numb and paraysis of my foot. I have a constant, aching, burning pain. I average maybe four hours of sleep a night and that is broken sleep. I can't stand anything to touch my left leg or foot, it is a painful sensation and causes my leg to spasm.

The pharmacy cares little about this. They make the ultimate dicision as to whether I will get my medication or not, even though the doctor goes to bat for me. I at this point feel as if I no longer have any option except to suffer the pain ... and what kind of life is that? Even with medication I don't have a good quality of life.

One giant, rich company calls the shots as to whether I will be a bit eased of pain or not. It all lies in Caremark's hands and there is noting I can do about it. Once again the little man loses. I only know that I can't and won't tolerate this pain much longer. I won't tolerate being made to feel like an addict. I have been an upstanding RN for many years, I don't even so much as drink. Now I am reduced to this.

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