Fentanyl Citrate Powder...made Into A Compound Cream
UpdatedHello- I have had stage 4 breast cancer and a Bone Marrow Transplant, double Mastectomies, total Hysterectomy, 7 months of Chemo, 7 weeks of daily radiation, a 360 Spinal Fusion w hardware, getting another Spinal Fusion soon, Fibromyalgia, Chronic Fatigue, Nerve and Bone Pain...many other surgeries and autoimmune disorders. I have been using my Fentanly Compound Cream in a very low dose (micrograms) for over 13 years. I have now been told by my Medicare part D plan that the Fentanyl Citrate Bulk Powder lacks an Food and Drug (FDA) approved new drug application (NDA) Abbreviated New Drug Application and therefore is not eligible as a Part D benefit and is not covered under a Part D Prescription Drug Plan. The first denial was that Part D did not cover compound medications...then the lack of the FDA was considered my second denial. Can anyone help me with this situation? Has anyone run into this problem before? I am doing my own appeal now- my doctor has told me that she will not do anymore appeals that it costs her office staff to much time to help me. I also received a call from National Specialty Compound Pharmacy today and he has refused to do my compounded medications for me...he does not want to deal with anymore prior authorizations. Does anyone know of any information regarding this or how I can get my appeals through. My doctor did submit two other medications that were compounds that were also both denied. Ketoprofen and Gabapintin they are both in my formulary book..AARP Medicare RX United Healthcare has told me compounds are covered if the exact ingredients were in my formulary book. I would appreciate any input that anyone has for me. I will be sick if I can not get these Fentanyl Compounds filled soon. I can not afford to pay cash for them. Thank you in advance for your help :)))
1 Reply
Have you tried the Fentanyl patches that are available and already approved?
They are very small dose patches that are usually worn for 48, or 72 hours to manage chronic pain. The other medications are also available in other forms, such as oral pills.
This medication carries the risk of being habit forming, and may cause side effects, such as nausea, dizziness, headache, dry mouth, and constipation.
Most compounded medications aren't 'technically' approved, and many companies are balking about covering them, now.
Does anyone have any ideas that might help?
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