Sunday, October 18, 2009

Another Testimony Citing the Evils of the Pharmaceuticals and Insurance Companies

I am going to document my recent encounters with the pharmacy, my insurance, and my doctor's office for venting purposes and also in case I need to provide a true account someday in a court of law, as a defense on why I either murdered someone in the aforementioned groups, or why the aforementioned groups should pay me damages.

I have been newly diagnosed with multiple sclerosis. Around the time of diagnosis, I was given a prescription for a drug called Provigil. It is an anti narcoleptic medication but also used in patients who suffer from neurological disorders, to help treat their fatigue.

I will not bore you with the details about my fatigue before I started taking this medication. I will just tell you that once I was on it, I felt that I had reentered the land of the living. When I filled my prescription, I was forewarned by the pharmacist, that they could fill it this time but next time would need authorization from my insurance company. You can decide for yourself whether that is fair. But I knew that there could be a problem. It is an expensive drug.

So, when I got down to about six pills, I called in my prescription. Two days later, I called the pharmacy, just to make sure there were no problems, and to make sure that my prescription would be there waiting for me later that afternoon.

“Oh,” the pharmacy aid or whatever she's called said, “Your insurance denied this.”

“Um, Okay, Why didn't you guys call me and let me know?” I asked.

Now her snotty voice came on. I think they practice this, and it proves the point that many, many people do not like their jobs, or at any rate, the part of their jobs which involves dealing with the public. “We just got the fax, yesterday.”

I decided not to point out that seeing how it was now today, and I was calling her, someone could in fact have called me. I just asked her what the solution to this obvious problem was.

She said that my insurance company had said I must try this other medication for sixty days. And then if it didn't work, they may...or may not allow me to have my Provigil. She said that my doctor had received this same fax, and so he would call in the prescription for this other drug.

“Fine, I said, “but just in case there's any problem with that new prescription, how much would it cost me out of pocket, to buy a few of my Provigil pills to get me through?

Provigil isn't a pill,” she stated.

“What?,” Ok, deep breaths, “Provigil.” I said again, enunciating.

“Oh, Provigil.”

Great, now that after fifteen minutes we're on the same flipping page. Anyway, I bought six pills at the whopping price of $44.

The next day, I called my doctor's office and was informed that my doctor would be out of town for a week but that some other doctor could call me in that prescription.

Great. I was also assured that this alternate medication would really work quite comparably but was just much cheaper.

So, I go to pick up my new prescription, and ask the pharmacist, just because I like to take polls, if this would in fact, work the same. He told me no. No. They are not even in the same ballpark. Lovely.

I get home and begin to read the info about this drug. It is to help with my neuron function and help me exercise. Ok, no. I need to be able to stay awake. But, I think, maybe they know something I don't. I'll just call my insurance company and ask them nicely to explain, what the f- they think they're doing, but of course in much nicer terms.

So, I call my insurance. They must have been pissing a lot of people off that day, because I was on hold for a while. Finally, I talk to someone and she is very nice and she tells me to just have my doctor call their pre-authorization line and explain why I need to be on Provigil, that it is for fatigue. She said that they (the insurance company) probably didn't know that.

Yay! We're getting somewhere. So, I call my doctor's office. The nurse gets on the phone and has such a rude attitude about talking to me, that I decide to ask her if we could just be nice to each other. I then explain what my insurance company had told me.

“You want me to call them today?” she asks, as if I'm really putting her out.

No, just whenever you feel like getting around to it, I think, sarcastically. But I say, “Well, I'm pretty low on my medication and so, yeah, that would be nice.

We get off the phone and five minutes later she calls me back. She announces that she just got off with my insurance company and they said, “ABSOLUTELY NOT.”

Whose side are you on, lady? Then she asks me who I talked to. I don't know and so she says, “Yes, well, no one over there even remembers talking to you.”

Well maybe they have ms too, I want to say, but instead I just quietly wait for her to get to her point. I also decide that she and I are in a full blown fight. Now that my insurance company has convinced this nurse that I was on the wrong stuff to begin with, she attempts to convince me. She says, “You know, this is what your doctor prescribed you.”

“No it's not. My doctor prescribed Provigil. My insurance company then said I have to take this Amantacrap stuff and some on call doctor called that in!” I'm losing my cool a little bit by now.

“You have, what, ms? No, not ms, right? What do you have?”

“Uh, yeah. I have ms.” I say, breathing deeply and slowly.

Ok, well, Amantacrap is often given to people w/ ms for fatigue.” she says.

“The bottle says 'may cause drowsiness!'” I exclaim.

“Well, everybody's body is different.”

I don't bother to tell her that just in case my body is one of the bodies that gets drowsy from this Amantacrap, then um, what's the point in taking it.

Maybe sensing my frustration, she says, “It's too bad you don't live closer. You could come and get some samples of the Provigil.”

Lady, I would drive across country to get some samples. I will be there Monday.

Anyway, bottom line, I have to try this stuff and fail, before someone can call the insurance company again on my behalf. I admit, that after reading through all the information about Amantacrap, I might now be biased on how it works. It says to not operate a vehicle or doing anything else requiring alertness until I know that I am able to do so while taking this medication. It also says 'many' people do not have such and such side effects. 'Many'? It's supposed to say 'most'. I know. I read these things. This is like the new drug that's out and I don't know what it's called or what it's for, I've just heard the commercial say, 'May cause suicide'. Not, 'May cause suicidal thoughts.' Just, 'May cause suicide'. I guess the thought part of suicide gets bypassed.

And what happens when these idiots start messing with psych patient's drugs? Like the guy taking anti-psychotics or the schizophrenic. Can you just imagine his phone call to the insurance company? “Yeah, you know how you denied my anti-voice drug? Well, the voices are back, and they're telling me to kill YOU!”

My solution is that everybody working for either an insurance company or a pharmaceutical outfit needs to either have suffered a serious illness themselves or have a close family member who has. That should be the top job requirement. And as for the nurses – don't go into a profession just because it's a guaranteed job in a tough economy. If you don't like people, why don't you do medical coding. Yep, if I was in charge of the health care bill, that's where I'd start.

1 comment:

  1. Wow! That is all I can say because I am speechless! I am so sorry to hear that you are going through all of this and so sorry to hear that the people that are supposed to be helping are doing nothing but interfere with your progress. I wish you were closer so I could give you a hug- but please know that my thoughts and prayers are with you and I'm sending you a big virtual hug!