Fentanyl Patches And Problems With Insurance And Pharmacies (Page 2)
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I have been on fentanyl / Duragesic since 2005 when i was not longer able to take oral opioids as my stomach lining was eroding since then the first couple years while i was continuing care under one pain management office i had little problem filling them other than then not having them in stock and i had to wait one day. Since i move to PA and then back to FL and now again back to PA i have been having non stop issues between the medicare insurance and prior authorizations some periods every month and now my pharmacist tells me that the script was written out to be taken orally .. has anyone else had issues with just about every darn excuse they can give you sometimes having to go through withdrawal for weeks on end? I am just wondering and if so who can you turn to in order to get results i am tired of being prejudiced against filling these scripts out and without them. I am useless literally unable to move out of bed due to such pain i even decreased the amount i am taking because i have to go through withdrawal so often it is insane might as well smoke cannabis at this point it would be easier to get, but that causes me to have seizures so i am sort of stuck between a rock and a hard place so tired of the BS

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Not to quibble, but just to put it out there, there is NO need to wait five years. The statute of limitations says you cannot wait TOO LONG, but you can sue as soon as you believe you were injured due to someone else's negligence. Since I assume you mean to say you want to sue Medicare, that means suing the government and for that, you first must file a "claim", and after 6 months you can convert the claim into a legal suit. If you want to sue the insurance company, there are ways to do that as well. But they do require you first give them a chance to rectify the situation and to do that, you file an administrative claim with them. OR an "appeal" of their decision, depending on what transpired. You can accuse them of "patient abandonment" I would think. OR "Deceptive trade/practices" b/c they are deceiving patients about their benefits, or arbitrarily denying you coverage, which is wrong - and for which you can also sue.

Good luck.

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I hear your suffering and I understand it because I suffer from severe chronic pain and I also have been humiliated to tears many times trying to get my medicine. Every disc in my spine is damaged. I understand how it feels to examine your own quality of life and wanting to give up when you are so aware that the pain controls your entire life. I have never allowed a doctor or a pharmacy to allow me to run out of pain meds. If I did I would literally be crying and moaning in pain, unresponsive to others, and regretting being alive, too. I know how you feel. I know how bad it is during the times I tried to decide that I don't want to take pain meds. My pent-up rage boiled over when I saw myself before I got hurt. I was an athlete. I was lean, strong and had tons of energy. All of that was taken from me. It hurts to be awake, it hurts to sleep, it hurts to exist.
The way that I've always dealt with managing my suffering, reducing it so that I can relate to other humans, is to pay cash. If I had not paid cash for these years of severe chronic pain I would've taken my life, too. Sometimes I've had money for only one thing: either food or meds. I choose the meds because without them I wouldn't be able to eat anyhow for the extreme vomiting that's caused me two umbilical hernias already. The pain is so bad that I will vomit for days until someone gets me some Phenergan suppositories.
I think that my life is worth living, but only medicated, because if I'm not medicated I can't think. If I am medicated I can spend time with my adult kids and work on politics. Surely you also must have some value to offer to the world. Always seek the pain relief so that you can think. If you can think, life is worth living.

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finally, i have had a long talk with insurance company,, hey maybe the read these message board too..since last year they now allow the patient to do their own prior authentication which takes away the added days on end of waiting to get approval.. i am good to go so far now i have not had an issue for the past 8 months with filling them.. THANK Heaven!! thanks for caring..

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Prescriptions have to be written a certain way, with certain codes. Your dr should be aware of this. Find out exactly what the rx needs to have written on it and when you get your rx read it to be sure all the info is there and correct. It is much easier to have a mistake correct while you're still in the drs office than after you leave.

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Fentagirl, this is an awesome reply. This is a tremendous help for us when there is nowhere else to turn. Thank you.

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Fentanyl is very expensive and even generics are so at every and any available opportunity Ins. Will kick it out. Five months is unacceptable, also with a family history, and your current thoughts on living need to be adressed
When the ins
Company I have heard that I had any trouble obtaining my patches, they directed me to go to the E
R. This is serious stuff to just quit, and they soon realized they would call both my Dr. And pharmacy because paying for an er.visit every two days was not cosy effective in the least, bottom lines get attention. They advised so complied , wasteful as it was. Ot made things easier that I had my script in hand. I would look for pain management office more willing to see you sooner than 5 mos. Due to the schedule.of Fentanyl and it's abuse potential you must be seen, or at the least go in to pick up and hand carry your script in monthly as it cannot be phoned in and requires extra paperwork by law. Please don't consider death over living esp. In this trying time for you. Get help however you can!! Please let us know you are okay
Hang in there!!!

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I empathize completely and understand exactly your frustration.
Wishing you well ... please let us know if you are okay?

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The problem COULD be if your doctor marks that ONLY Duragesic, the original brand name, can be used. I use Mylan Fentanyl patches and have never had a problem obtaining them and having Medicare pay for them.

I do not use standard Medicare, but us Medicare Advantage which pays a lot more than standard Medicare.

I hope by now your situation has been cleared up, if not, you can always try to sue if you can wait five years.

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Hello I feel sympathy for your pain and suffering and maybe could help you obtain the "duragesic brand 100 mcg" limited supply only. Its better then nothing at all. I just simply need to know what state are you located?

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Thank you David for your response..
yes it helps but now due to 3 deaths in my family in a 8 day period i missed my pain management appointment and all the arrangements and services and no one called to remind me of the appointment, so in the nightmare of all this, i missed my appointment and I am faced with finding something else to help with my pain as the pain management office will not fill my script until i have been seen and can not find a way to see me for 5 months, SO i have come to the end of my rope now and want off these blasted patches 5 months is a death sentence and even if i managed to get through the time frame, I would not be able to get out of my bed to make the hour ride to see the doctor at that point. i am done with the games,, they put me on these narcotics and told me there was nothing more to do other than manage the pain.. i had been through every possible remedy and surgery is no longer an option as the surgeries caused more complications after 5 years, I did not ask for it but i have to kiss butt to get them every darn month and I seriously dont want to fight every month to stay on something i never wanted to be on in the first place... when I am at the point where death is a better option, then maybe it is time to go with it .. i do know starving myself is the best way, as my grandmother did that after she had several falls and broke her hip a number of times, as it shuts down the brain from sending messages that your in pain .. just have to shut myself in a room and stop getting up and with this pain . that will not be hard to do at this point. otherwise i loose my dignity and have to kiss butt every month to keep me on something i wish i never was on in the first place.. before someone is placed on this they should tell people that these sort of problems will result. like they may have trouble maintaining the drug due to insurance regulations and that the withdrawal is something you will wish you never had to endure. i would have told them at the time to stuff it as that is not what i want to deal with. i have been managed care and not changed medication dosage for 8 years other than to cut back as a result of the games (either the pharmacies dont have it on stock, the insurance requires prior authorizations or now this mess and i will not get into relocating to a new area and the nightmare that causes) and not wanting to deal with the withdrawal as part of my daily routine, i have to admit the drug is a great relief from the pain level i deal with every d ay and allows me to function as best as anything can possibly allow, yet the red tape and nightmares i have been presented with the past 2 years was not something i signed up for 8 years ago when i was placed on this medication..prior to that i was on lortabs for 8 years and never had this sort of problem obtaining those, although they ate through my stomach lining and now taking oral medications tend to be a constant issue as my stomach is very sensitive,, shame of the system..it is time for a change at this point.. what type of change is depending on what happens in the next week. as i am going through withdrawal and will not endure the pain once i have gotten through the withdrawal. i will be a vegetable and life is senseless without the ability to function and unfortunately the patches allow me to function when i am on them.. when i am not .. life is not worth living simple and plain.. so time is of the essence. God bless and I hope your mother is never subjected to this sort of handling of her medications or anyone else for that matter..

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@ ladagosta,

Sorry to hear about the complications you've been facing with insurance companies and pharmacies. Although I can't necessarily relate to what you're going through right now, I do understand how frustrating prior authorizations things can be since my mom was running into similar problems earlier this year. From your description I really get the sense that they have little clue how to even go about their customer services, like having a one time authorization for all your records already on file and things of that nature, taken care of with a few clicks on the computer. The process should be as simple as transferring patient information from one computer to another, keeping it simple for everyone. But we know theses companies like to make things more complicated than they probably should be. If only they knew they'd be doing themselves a favor as well. It seems as though very few people on the other end understand the urgency of prior authorizations. Either that or they've been in the corporate office too long too care.

Regarding the availability of Duragesic, have you considered asking your doctor about the generic Fentanyl transdermal patches instead? Sometimes pharmacies just don't have a particular brand in stock, but if you inquire about other brands or generics, it'll at least increase the odds of getting your script filled on a regular or more frequent basis.

I hope this helps!

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I am curious if i am the only one who seems to have difficulty obtaining duragesic for one reason (excuse) or another seems like too much trouble, but without the medication I can not function.

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