Missed meds

[Flonnzilla]

How worried should I be about missed dosages? I have atripla, and I do take it everyday most cays I take it at 8am (and others at 4am, is this hourly difference a problem?), anyway I have missed I would estimate about 10 days combined in the last 2 years due to pharmacy mess ups (old pharmacy wouldn't allow me to order refills more than 5 days in advanced and took anywhere from 4-6 days to fill the prescription) but currently I am on my second day of missed dosage in a row because my new insurance isn't acceptable at my old pharmacy and my new pharmacy wants me to pay some insane amount (Ive been quoted at $253, 1,100, and 2,300).

I have a ramsell account or whatever as well so I'm only supposed to pay like a $26 cost share, and we finally figured out what was going on, but by the time we all got on the same page the people "authorized" to fix it had already left for the day, so they might get to it on Friday (fingers crossed) but it might also take til monday, which at that point would be 5 or 6 missed days in a row?  Any advice on what to do while i get this straightened out? (Sorry for the rambling I haven't slept well in 2 days and am in the middle of a panic attack over this)

[Ann]

The difference in a few hours when you're able to take them daily won't make a difference.

However, not being able to take your meds for days on end CAN make a difference - it can cause resistance issues. If I were you, I'd ring my doctor and see what he/she has to say about resuming your meds this time if it does turn out that you have to go more than two days without them. Ring ASAP.

It's absolutely criminal that insurance companies get away with causing non-compliance in hiv patients. Compliance is crucial! They should be prosecuted for medical negligence. Damn this really makes my blood boil!

Good luck Flonnzilla. We're all pulling for you. Make sure you get your doctor's take on this!

Ann

[Jeff G]

I agree with every thing Ann said but I did want to add that being forced to stop your meds for a week is a bad thing but it does not mean you automatically will become resistant .

Stopping them cold turkey for a week is much safer than missing doses regularly by not being consistent . I was on Atripla and had two treatment interruptions without harm but I still think Ann's advice is spot on and you should make every attempt to call your doctor and ASO and see if you can get some meds to get through this insurance nightmare .     

[Ann]

Thanks, Jeff. I knew I was forgetting something - and that something being to say that while missing several days can lead to resistance, it's not a certainty.

Is is a possibility though, so 'Zilla, please do contact your doctor ASAP and let him/her know what's going on.

[Jeff G]

Thanks, Jeff. I knew I was forgetting something - and that something being to say that while missing several days can lead to resistance, it's not a certainty.

Is is a possibility though, so 'Zilla, please do contact your doctor ASAP and let him/her know what's going on.

Its easy to forget something when you are enraged about what insurance company are able to do with impunity . I see red when I hear story's like this .

[Miss Philicia]

First of all, every pharmacy I've used in the past 20 years doesn't take 4-6 days to process a refill. I don't understand what's going on with your pharmacy, either the script is on file and valid or it isn't. Or is this when they have to get the doctor's reauthorization for refills -- as in he writes the script for 4 months of refills and then it must be reauthorized? Even then with my pharmacy it only takes at most 48 hours, but any lag time in this case isn't the pharmacy, or the insurance, it's your doctor's office. Anyway, just a thought.

Refill your monthly scripts 5 days in advance every month to insure you have a "reserve amount" in cases where there are delays and/or errors. Within six months you will have one entire extra month's supply and won't run into this problem. If you use large pharmacy chains most have on line refill abilities so it's very easy to do.

[Flonnzilla]

They were able to get it fixed today, so ill be able to go pick it up today for the price I am supposed to pay thankfully (about to head out now, so ill just be taking it a few hours late so only 1 full day missed).

Miss Philicia it typically had to do with what day of the week the 5 day mark fell upon, and if it was a holiday weekend or not say for example my prescription ran out on the 29th this month the earliest they would allow me to call it in would be the 24th (if I called in before that they would tell me its to soon and to call back) Since the 24th is a friday and they don't keep the meds at the pharmacy they would wait until Monday to request it from the distributor which would typically add another 1-2 days ontop of that.  On the months I needed the doctor to aurthorize a refill that would add another 2ish days ontop of that (espescially if it was a wednesday or thursday when I placed my request because he wouldn't get back to them until Friday which would then push it back to monday when they would request it from the distributor)

[Ann]

Good news!

Have you tried having a word with the head pharmacist to explain how very important compliance is with these meds, and how his practice of ordering your meds pretty much at his leisure is putting your health at significant risk?

If you approach him in a friendly and polite, but firm manner, maybe you can work something out where he gets the meds in from the supplier slightly ahead of time, when he knows you're going to be needing them.

[CJ from OZ]

My advice is to find a friend who's also POZ & on the same medication. That way in case there's ever a time you know you'll miss a dose due to reasons out of your control, your friend can at least give you a pill or two to keep you regular until you sort out all the bullshit with the pharmacy, etc.

We're all here to help one another after all, right? I would not hesitate for one second to share my medication with someone who needs it. They are all made by the same company and come from the same source after all.

Just a serving suggestion!