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Old 09-20-2009, 08:48 AM   #1
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Different question about early refills..

I know that most topics about early refills tend to refer to a person using class 3 drugs like Vicodin,etc. I surely do understand that because I've been on everything from Vicodin to Oxy and during those times there were a few times where I did need to refill the meds early(usually happened the first week after a surgery, which I've had several). Also another factor in these posts is problems with insurance as well.

My question, however, is a bit different. It's about schedule 4 drugs. I know these are supposed to be nowhere near as bad as schedule 2 and 3 drugs in terms of potency and abuse factor. What are the refill guidelines like for these types of prescriptions? I'm just wondering what experiences people have had when filling these types of medicines?

Before you answer, I want to share some research on the subject I've done. I've been on Tramadol, also known as Ultram, for a while now, I've rarely needed an early refill. However, someone in my family is also on this same drug. They have gotten frequent early refills in the past from both Walgreens and Wal-mart, whom I've heard are usually strict with other medicines.

I'm going to elaborate on what I meant by early refills. I know this particular family member is probably either abusing/selling his pills, but this person has gotten numerous early refills, and when I say early I don't just mean 3-5 days early. To put it in perspective, this person would usually get a 30 day supply of meds with 3-6 refills.

He has sometimes refilled this 30 day supply on the 12-13th day out of 30. He did this many many times with Walgreens. He told me they never really said anything, and that sometimes when he was filling super early like only after 8-10 days they'd refuse to fill it, but he'd just try again on like the 13-14th day and they'd refill it it. He said this has gone on for over a year. He also said he had the same script at Wal-mart, who I know used to give ME hell about my vicodin years ago, but wal-mart filled this med on the 18th day out of 30. Keep in mind this family member(my cousin) had no insurance of any kind.

This struck me as really really strange because I had my scripts for the same med at Target, and they've only let me fill once on the 25th day out of 30..and they gave me a lot of trouble. A second time they let me fill on the 28th day out of 30, with little trouble. Which is all well and good, but that's 3-5 days early, not the sometimes 10-16 days early my cousin had gotten, and we practically live in the SAME neighborhood.

I know..I know people will say it "depends on the pharmacist" which I know is true, but then again my cousin had to of gotten his early refills from more than one pharmacist. I have trouble believing two big chain pharmacies would both be filled with nothing but extremely lenient pharmacists. So I concluded that it must be more the medicine than the pharmacist. Can schedule 4 drugs really be filled this early?

Before I end this post I want to clarify a few things: I do not clarify what this cousin of mine is doing, in terms of getting way too many early refills. I know it is wrong, I simply used it as an example in my post. I also know my cousin was not lying to me as I saw all the bottles of medication and inspected them myself. I'm just curious as to why he did not get as much hassle for a schedule 4 drug, and if anyone else has experienced similar events or if they just in general have information on the refilling policies of schedule 4 drugs or even Ultram/Tramadol in general. Thank you.

Oh and if anyone is curious I live in Chicago and my cousin in the outlying suburbs.

Last edited by eddieJ85; 09-20-2009 at 08:54 AM.

 
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Old 09-20-2009, 12:46 PM   #2
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Re: Different question about early refills..

I would think what schedule they are had a lot to do with it.

 
Old 09-20-2009, 02:08 PM   #3
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Re: Different question about early refills..

Quote:
Originally Posted by sophie56 View Post
I would think what schedule they are had a lot to do with it.
I dunno, I tried to fill one of my Lamictal prescriptions (by accident called in the 200mg script instead of 25mg) 1 week too soon and they denied me. Something seems a bit off...I can't fathom how he can do this!? Are the scripts all from the same doctor?

 
Old 09-20-2009, 04:06 PM   #4
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Re: Different question about early refills..

Based on my understanding, aside from limits on the number of the refills for certain medications in certain schedules (i.e., the # of times you can refill before you must get a new prescription), there generally aren't any laws governing the timing of refills (though it's possible that some states have implemented such laws -- I don't know of any). Insurance companies usually have early refill rules for payment purposes, but if you're not using insurance, it shouldn't be an issue. A pharmacy can set it's own rules that are more restrictive, but they usually have no incentive to do so.

 
Old 09-20-2009, 04:34 PM   #5
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Re: Different question about early refills..

I was going to vote what mark76 said about the insurance...I think it's probably insurance companies that keep count of the days..... Your cousin may not have insurance (?) ....OH...and HELLO everyone !..I'm new !

 
Old 09-20-2009, 05:11 PM   #6
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Re: Different question about early refills..

Some pharmacists think that they are some sort of prescription police, not glorified shop assistants, and relish imposing their power...... might be time to find a more obliging pharmacist.

 
Old 09-20-2009, 08:49 PM   #7
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Re: Different question about early refills..

Two factors are working in his favor....First, it's a schedule IV med, which many pharmacists don't watch that closely. But, perhaps the main reason why he gets a way with it is that he doesn't have any insurance. When a med is billed to insurance, the carrier watches the "days supply" very closely...Not because they care if you are abusing the med or not, but because they don't want to pay for it any sooner than they have to. Thus, if it's a 30 day supply, they want the med to last 30 days (or very close to it) in order to save them money. Many insurance carriers will grant early refills (by a couple days) as a courtesy. This is the case for all refills, not just controlled meds.

Conversely, when your cousin calls in his refill, it goes right through the billing system and unless a pharmacist catches it, it sails on through. Most pharmacies are so busy that the personnel don't catch the prior refill date, unless of course, insurance rejects it and then a red flag goes up. And because it's a CIV, it works in his favor even more. I suspect that he'd have much less success if it were a CIII.

However, the million dollar question is why his Doc is permitting new scripts when he's using all his refills so quickly. A particular med with 4 or 5 refills should last 5 or 6 months (first month plus the refills), not 3 or 4 months. The Doc's office should be monitoring this and catch it.

Regards,

Ex

 
Old 09-21-2009, 01:39 PM   #8
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Re: Different question about early refills..

Ya, it not going through insurance makes sense. They said my Lamictal was to soon to go through (I have insurance) and 3 days early to 5 days early max.

 
Old 09-21-2009, 02:14 PM   #9
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Re: Different question about early refills..

Quote:
Originally Posted by mark76 View Post
Based on my understanding, aside from limits on the number of the refills for certain medications in certain schedules (i.e., the # of times you can refill before you must get a new prescription), there generally aren't any laws governing the timing of refills (though it's possible that some states have implemented such laws -- I don't know of any). Insurance companies usually have early refill rules for payment purposes, but if you're not using insurance, it shouldn't be an issue. A pharmacy can set it's own rules that are more restrictive, but they usually have no incentive to do so.

Last edited by Leo123; 09-21-2009 at 02:17 PM. Reason: Already said in previous posts.

 
Old 09-21-2009, 02:16 PM   #10
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Re: Different question about early refills..

Quote:
Originally Posted by Executor View Post
Two factors are working in his favor....First, it's a schedule IV med, which many pharmacists don't watch that closely. But, perhaps the main reason why he gets a way with it is that he doesn't have any insurance. When a med is billed to insurance, the carrier watches the "days supply" very closely...Not because they care if you are abusing the med or not, but because they don't want to pay for it any sooner than they have to. Thus, if it's a 30 day supply, they want the med to last 30 days (or very close to it) in order to save them money. Many insurance carriers will grant early refills (by a couple days) as a courtesy. This is the case for all refills, not just controlled meds.

Conversely, when your cousin calls in his refill, it goes right through the billing system and unless a pharmacist catches it, it sails on through. Most pharmacies are so busy that the personnel don't catch the prior refill date, unless of course, insurance rejects it and then a red flag goes up. And because it's a CIV, it works in his favor even more. I suspect that he'd have much less success if it were a CIII.

However, the million dollar question is why his Doc is permitting new scripts when he's using all his refills so quickly. A particular med with 4 or 5 refills should last 5 or 6 months (first month plus the refills), not 3 or 4 months. The Doc's office should be monitoring this and catch it.

Regards,

Ex
This explanation along with a few other is exactly whats happening with your friends refills and I can confirm based on personal experience.

 
Old 09-21-2009, 04:34 PM   #11
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mark76 HB User
Re: Different question about early refills..

by the way, have you considered getting 90 day supplies? Some insurance companies will allow you to do this, and it's far more convenient. If your doctor is going to give you refills you anyway they might as well combine them (i.e., 90 day supply of schedule IV med instead of 30 day supply + 2 refills).

Last edited by mark76; 09-21-2009 at 04:34 PM.

 
Old 09-22-2009, 10:00 AM   #12
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Re: Different question about early refills..

Actually you can even get a 90 days supply of a schedule II med.

 
Old 09-22-2009, 06:26 PM   #13
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Re: Different question about early refills..

Quote:
Originally Posted by Leo123 View Post
Actually you can even get a 90 days supply of a schedule II med.
That's true (except for a few states that have more restrictive rules). I'm surprised, however, by how few pharmacists realize this. They think no refills for schedule II means no more than 30 days at a time for schedule II, which is not the case. Actually, insurance and issues of proper medical care aside, if a patient brought in a schedule II prescription that contained even more than a 90-day supply, it shouldn't be an issue.

 
Old 09-25-2009, 10:41 PM   #14
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Re: Different question about early refills..

Can a doctor prescribe 30mg roxicodone with refills? I didnt think that you could get refills on prescriptions like this.

 
Old 09-26-2009, 08:14 AM   #15
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Re: Different question about early refills..

Quote:
Originally Posted by demid30 View Post

Can a doctor prescribe 30mg roxicodone with refills? I didnt think that you could get refills on prescriptions like this.
Technically, no. CIIs are not permitted "refills"...i.e. circled on the script.

However, a 90 supply is possible via one of two ways:
  • Docs can provide up to 90 days of post dated scripts...Three scripts, each to follow the other with dates pre-written on them.
  • Docs can write a 90 day supply.

The DEA loosened their policy on this in December of 2008. Previously, they didn't permit post dated scripts....They had ruled that they were a "creative refill." However, many of the pain organizations and Dr groups rallied together and argued that requiring scripts each month for stable patients was unnecessarily driving up cost and creating a burden for those who were sick and/or in pain.

Regards,

Ex

 
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