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Author Topic: Pharmacy and ADAP...What idiots!  (Read 2636 times)

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Offline HollyStar

  • Member
  • Posts: 344
Pharmacy and ADAP...What idiots!
« on: January 08, 2009, 10:47:03 PM »
Hi everyone,

I saw my doctor today and I made the final decision to start meds. He thinks that I am being smart in starting now. My CD4 is 370 VL 3,300 and percentage is 33%. My first CD4 in 2001 was over 700 and I've been slowly going down hill in that department. I didn't want my CD4's to go any lower.

So he wrote me a script for Atripla and I went to the pharmacy. I couldn't get it filled because they have never even heard of ADAP. NO idea what it was. The lady made a phone call to try and figure it out but still didn't get it. I gave her all the info she needed but still, nothing. The Pharmacist mentioned how expensive they were and didn't know what to do either. This is a Rite Aid by the way, shouldn't they know this stuff? If they can't figure it out I will have to drive farther away to fill the script. I wouldn't have been surprised if they didn't know where to find the aspirin. What a bunch of dumb asses.

Alright, I just needed to vent about stupid people. It just pushed me a little to far, the last straw. My bf was being an a-hole for the last couple of days, knowing that I have been stressed about starting meds, a family blowup, blah blah blah.
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline Miss Philicia

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  • Posts: 24,111
  • celebrity poster, faker & poser
Re: Pharmacy and ADAP...What idiots!
« Reply #1 on: January 08, 2009, 11:19:09 PM »
Unless you live in an area where there are a lot of HIV patients then no, your run of the mill Rite Aid isn't going to be familiar with any of this stuff.  Perhaps your doctor can recommend another pharmacy where he sends the bulk of his patients?  I've never just walked into any random pharmacy for my meds for the past 15 years.  All of the ones I've gone to (a grand total of two pharmacies, but in two different cities) have been ones catering to a lot of HIV folks, so they totally know the routine with ADAP, etc.
"Iíve slept with enough men to know that Iím not gay"

Offline aztecan

  • Member
  • Posts: 5,398
  • 29 years positive, 57 years a pain in the butt
Re: Pharmacy and ADAP...What idiots!
« Reply #2 on: January 09, 2009, 12:02:24 AM »
Hey Holly,

I understand your frustration but also know that many pharmacists don't know the workings of the ADAP system.

I don't know how ADAP works where you live, but here, meds are shipped to the client/patient from the Department of Health Pharmacy. You can't go to a local pharmacy here and and have ADAP pay for the meds.

Do you have a case manager? If not, I think a visit to your local ASO is in order. They can help you straighten things like this out.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline HollyStar

  • Member
  • Posts: 344
Re: Pharmacy and ADAP...What idiots!
« Reply #3 on: January 09, 2009, 12:21:30 AM »
Thanks for the replies. It is frustrating. I will contact the person that signed me up for ADAP. She told me when I met with her that I would just have to take my I.D. number and group number to the pharmacy and they would be able to fill it. Maybe she had it wrong? I live in a town of about 5000 people and I'm not sure that there is a Department of Health Pharmacy. I will also contact the case manager at my clinic and see if she can help.

I am finally ready to start (ok I'm actually pretty scared) meds and I hope that someone can figure out what to do because I don't, lol. Maybe I'm the idiot, LOL.
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline mecch

  • Member
  • Posts: 11,726
  • red pill? or blue pill?
Re: Pharmacy and ADAP...What idiots!
« Reply #4 on: January 09, 2009, 04:53:17 AM »
I am finally ready to start (ok I'm actually pretty scared) meds and I hope that someone can figure out what to do because I don't, lol. Maybe I'm the idiot, LOL.
The red tape about getting your medicine is a pain.  However I would guess the major issue is your fear about starting HAART.  A lot of adjustment there, and you need support, and you did say your relationship has its problems so I hope they are purely temporary. 
I just wanted to write and say that in all likelihood, you are going to actually enjoy some aspects of being on medicine for HIV. Physically, you'll probably feel better, besides the fact that you may or may not get annoying side effects.  There are mental health benefits for you and your family. 
Hope all goes well and you work out that small town pharmacy problem.  Since you were willing to take the  perscriptions to them, maybe if you DO need to work with a pharmacy directly, if that is required or is an advantage to you, maybe you could ask them kindly to learn how to do it. They might actually become a good service for you. I dunno, maybe not. The pharmacist can't be that stupid, though. Who called?  When i took my perscription to the pharmacy in my country the pharmacist had never filled them either.  The clerk was pretty naive but when the pharmacist stepped in, it all worked out.  She even figured out a way to bill my insurance directly and she handled everything really well, given a week or two to figure it out. And the service gets even better, after a few months.

Best of luck to you.
« Last Edit: January 09, 2009, 04:55:03 AM by mecch »
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline BlueMoon

  • Member
  • Posts: 665
  • Calling from the Fun House
Re: Pharmacy and ADAP...What idiots!
« Reply #5 on: January 09, 2009, 05:20:17 AM »
Holly, I know how you feel.  I had everything set up ahead of time and it still took six weeks to get my meds after they were prescribed.  Once things were sorted out they went better.  I still have to keep on top of things and step in regularly to take care of problems.  That's just bureaucracy for you. 

Be patient and persistent, and don't get mad.  Once you get rolling, and it's time to refill, do it as early as possible so that if there is a problem you can resolve it before you run out. 

It's frustrating and daunting at first, but once you get the hang of it (and the benefit of the meds) it all works out.   
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline HollyStar

  • Member
  • Posts: 344
Re: Pharmacy and ADAP...What idiots!
« Reply #6 on: January 09, 2009, 04:01:51 PM »
Hi everyone,

Thanks for your kind replies. I will be persistent and hope I can get this figured out today. I shouldn't have let it get to me. I was already stressed and scared but I'm sure things will work out.

I sure hope that it doesn't take six weeks though, my goodness. I'm glad that I don't have lower CD4's and need to start yesterday. Thanks again for calming me down and helping me see past the fear.  :-* :-*
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline Moffie65

  • Member
  • Posts: 1,755
  • Living POZ since 1983
Re: Pharmacy and ADAP...What idiots!
« Reply #7 on: January 09, 2009, 04:02:07 PM »
Holly, it is important to understand that ADAP may not be available at a pharmacies.

HHS funds the ADAP program through the Ryan White program, and it is given to the states in one fell swoop once a year.  Then the state decides just how it is going to be handled.  For example, up until two years ago, Arizona was their own ADAP and held all the meds at the health department in one room.  Then they revised the contract and now there is one drug provider for the whole state.  The drug store they chose, was one that only has stores in Tucson, and Phoenix, so everyone else has to do their acquisions over the phone and by mail.  The case manager also helps at all turns so it works out fairly seamlessly.

I think you need to have a conversation with your CM and see if you can work out all the kinks before hand.  Anyway, there probably are a few drug stores outside of Santa Rosa that you could find.  I really have no idea how California is handling the ADAP program, but each state sets up their own way of doing things, and sometimes the case managers are doing their homework and you have to stay on top of them to get the service you deserve.

Hope this helps.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline HollyStar

  • Member
  • Posts: 344
Re: Pharmacy and ADAP...What idiots!
« Reply #8 on: January 09, 2009, 04:07:56 PM »
Thanks Tim! For some reason I thought ADAP would be kind of like other insurance but I see now that it is not. If I have to go all the way to Santa Rosa, so be it (I can do some real shopping, weeeeeee) but I really hope the ADAP lady that manages the clients and HIV surveillance can figure this out today. HIV surveillance isn't that scary! YIKES!!!
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline Moffie65

  • Member
  • Posts: 1,755
  • Living POZ since 1983
Re: Pharmacy and ADAP...What idiots!
« Reply #9 on: January 09, 2009, 04:20:00 PM »
Have another toke my friend, and all will be OK in time.  :)  :)
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline BlueMoon

  • Member
  • Posts: 665
  • Calling from the Fun House
Re: Pharmacy and ADAP...What idiots!
« Reply #10 on: January 09, 2009, 04:34:50 PM »
Have another toke my friend, and all will be OK in time.  :)  :)

Posted at exactly 4:20. 
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline Miss Philicia

  • Member
  • Posts: 24,111
  • celebrity poster, faker & poser
Re: Pharmacy and ADAP...What idiots!
« Reply #11 on: January 09, 2009, 04:48:36 PM »
I never knew that there were some states that ran a type of centralized Marxist pharmacy.  Though I go to pharmacies that cater to HIV patients, I'm not required to here in Pennsylvania.  I'm issued a card from the Dept. of Health that supposedly I could use at any pharmacy -- it's run through the computer just like an insurance card.  In fact, when I go they first bill my Medicare Pt. D card number, then they bill the ADAP card for the remainder just like they would any other secondary insurer.  The same thing was done in NYC.

The only reason I patronize the places catering to large number of HIV patients is because, speaking from years of experience, if there's ever any bureaucratic mess up they KNOW I need these meds, and they'll at the very least advance me a five day supply until whatever problem exists is sorted out.  I just don't see how there's any flexibility with these other set ups going through a central state pharmacy located hundreds of miles away.  What do you do if there's a real emergency, especially for those patients on their last option of med regimens due to multiple resistance issues?
"Iíve slept with enough men to know that Iím not gay"

Offline madbrain

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  • Posts: 1,208
  • No longer an active member
    • My personal site
Re: Pharmacy and ADAP...What idiots!
« Reply #12 on: January 09, 2009, 05:16:44 PM »
Hi,


I think you need to have a conversation with your CM and see if you can work out all the kinks before hand.  Anyway, there probably are a few drug stores outside of Santa Rosa that you could find.  I really have no idea how California is handling the ADAP program, but each state sets up their own way of doing things, and sometimes the case managers are doing their homework and you have to stay on top of them to get the service you deserve.

Hope this helps.


In California, when you sign up for ADAP, you are given an insurance card from Ramselll corp. Every single pharmacy in the state is required to accept this insurance.

Some may give you more red tape than others before they understand it, but it's the law and they cannot deny you.

http://www.publichealthrx.com/CA_ADAP.html

Offline aztecan

  • Member
  • Posts: 5,398
  • 29 years positive, 57 years a pain in the butt
Re: Pharmacy and ADAP...What idiots!
« Reply #13 on: January 09, 2009, 05:23:00 PM »
Hey Miss Philicia,

As I mentioned earlier on, if you are on ADAP, or rather, MIP (Medical Insurance Pool), which you are required to enrolled in if you are receiving meds through ADAP, the DOH pharmacy in Santa Fe mails all meds to you.
You must call in to reorder, no earlier than three weeks after you receive a shipment. If you call earlier, you are told you have to wait.
The meds are shipped via UPS and are normally on your doorstep the next day. Norvir is shipped in a Styrofoam cooler along with the blue ice packs, which you return with a handy return label included with the shipment.
All meds covered by the state formulary are handled this way, including such things as Zithromax, Bactrim, Acyclovir, Megace, etc.
You cannot fill the scripts at a local pharmacy, nor order more meds than a month's supply. The only exception would be any meds not on the state formulary, which would be covered by MIP, not ADAP.
Once you get used to it, it is very simple. But it does take some planning. If you wait until your last dose to order, you are SOL.
That is one reason I mentioned to Holly that getting together with her case manager might be a good idea.
Each state handles it differently and, if you are unfamiliar with the system, it is very easy to get lost.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline YaKaMein

  • Member
  • Posts: 368
Re: Pharmacy and ADAP...What idiots!
« Reply #14 on: January 09, 2009, 05:39:29 PM »
Hey Holly,
Not sure if Sonoma is your county but check this link:
http://www.sonoma-county.org/health/ph/hiv/resourceguide01.htm

If not, it has other resources you can contact or others here are in CA. Be persistent with your case manager to ensure this is all set up before you start the meds to avoid interruptions. Adherence will be key to success. We've all had concerns about starting treatment. Hopefully, it will be easy and gets better.

Best of luck to a easy, healthful start.

FYI, Philicia:
ADAP is centralized here in Louisiana via its 'charity' system of state hospitals and LSU Medical Centers with about 15 pharmacies through the state that facilitate dispensing the drug formulary. Once started it's an easy system. Since I'm in New Orleans, no problem to call in refills and pick up. Not sure how rural areas do it, like if any mail directly to patients  There is no ADAP participation with private pharmacies here.
09/11 Endocrine Consult
08/11 CD4 328 14.9% VL 0
 Disc'd Bactrim DEXA -3.1 Tscore
03/11 CD4 338 14.7% VL 0
11/10 CD4 300 14.3% VL 0 <20copies
07/10 CD4 336 14.0% VL 0 DEXA -2.7 Tscore
03/10 CD4 308 13.4% VL 0 Vit D normal
01/10 Began FOTO
11/09 CD4 274 13.7% VL 0 Chol 173 Trig 131
07/09 CD4 324 13.5% VL 0 DEXA -3.1 Tscore lumbar
03/09 CD4 207 10.9% VL 0
11/08 CD4 227 10.3% VL 0 Chol 176 Trig 156
04/08 CD4 228 9.5% VL 0
01/08 CD4 194 9.0% VL 0
09/07 CD4 176 8.3% VL 0
03/07 CD4 130 9.5% VL 0 Chol 261  Trig 227
12/06 CD4 109 6.4% VL 0
09/06 CD4  88 5.5% VL und desens'd rtd to Bactrim
08/06  Began Atripla
07/06 CD4  59 5.0% VL 145 Chol 117 Trig 104
06/06  Bactrim rash, X2 Dapsone
 EFV & Truvada Chol 128 Trig 131
05/06 CD4  6 (2.0%) VL 78667 only V179D mutation Dx PC MAC

Offline RapidRod

  • Member
  • Posts: 15,288
Re: Pharmacy and ADAP...What idiots!
« Reply #15 on: January 09, 2009, 06:07:08 PM »
Holly don't be surprised that when you go to the pharmacy that they don't have it in stock. A lot of pharmacies don't stock it. They can usually get it in overnight or in a couple of days. Any of the large Medical Centers with pharmacies will have it in stock.

Offline Miss Philicia

  • Member
  • Posts: 24,111
  • celebrity poster, faker & poser
Re: Pharmacy and ADAP...What idiots!
« Reply #16 on: January 09, 2009, 06:46:02 PM »
Such things are just not practical here -- we have 10,000 AIDS patients in Philadelphia, and 25,000 HIV cases.   And mind you, that's just within the city and doesn't included the larger metropolitan area or even the rest of the state.

Kind of mind boggling.

After doing some sleuthing it states on the city government AIDS Coordinating Office web site that currently medication disbursement has been centralized through CVS.  I already use Pharmacare which is a specialty division of CVS so I guess that's why I'd not heard of this, though I know when I was on Fuzeon just 2 years ago I got that from a non-CVS pharmacy but perhaps that was an exception.
« Last Edit: January 09, 2009, 06:59:01 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline HollyStar

  • Member
  • Posts: 344
Re: Pharmacy and ADAP...What idiots!
« Reply #17 on: January 09, 2009, 08:58:42 PM »
I haven't had a 'toke' in a very long time but I have been thinking about it, lol. My bf said it might help with the dreams as it already seems like I watch movies all night while sleeping. Thanks Tim.

I went to the Public Health Department today and the ADAP person won't be back until next month, however I did talk to the CM at the clinic and she made all the phone calls and has taken care of me. Thank goodness for people like her. I will be able to pick up my meds on Monday as they have to order them but at least the people there seem to know what they are doing . I have to drive an hour to get them but that is fine. Thanks everyone I really do appreciate it. :-* :-* :-*
« Last Edit: January 09, 2009, 09:02:03 PM by HollyStar »
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline Oceanbeach

  • Member
  • Posts: 3,565
Re: Pharmacy and ADAP...What idiots!
« Reply #18 on: January 09, 2009, 10:36:25 PM »
Hey Holly,

I lived next door in Lake County for 4 years while taking meds.  I learned in the first 6 months, big chain store pharmacies like Rite Aid, Longs and Safeway only get it half of the time and the customer always loses.  They have their policies and they do not go out of their way for a customer.

Ask your Case Manager for a referral to an HIV knowledgeable pharmacy.  I would suspect a family owned pharmacy such as Willits Rexall is HIV savvy.  If you do go to Santa Rosa, Creekside Pharmacy is at 96 Montgomery Drive, just off of 3rd and they are highly recommended by the HIV clinics here.  ;D  Have the best day
Michael

 


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