I almost fell over at the pharmacy when I paid for the adderall my doctor prescribed. Perhaps because I always request brand name prescriptions, and there was a generic available....

So anyway, once the doc and I establish the correct dose, will he be able to write a 90 day with 3 refill? That is what is required of my insurance company for benefits on maintainence drugs.

I know it's controlled so I'm not sure...

I have that some Q around lamictal. I have a 6 month script 30 at a time that I mailed in for my insurance, and they tell me it should be 90 day supply plus 3 refills. Now I might go up... so I don't know if doc could/would write another one the way my insurance requires.

mostly I'm concerned about the adderall rules for prescribing... I know someone here is in the know.

Its my understanding that you must provide the pharmacy with a new RX sheet each time you need another month's worth. I am not sure if this is nationwide or not, but I do not remember anybody here managing to get anything like a RX for a stimulant of any type that included refills. As far as I know, since its required to produce a new RX each time you need the meds, there is no way to write a RX with refills included.

I do know that some people are able to get several months worth of RX sheets at once, because although they are now covered for a few months, they still need to produce that sheet each month. This is illegal in my state, however.

I figured it would be something like that... but I wonder if he could write 90 days at a time. The only thing is that my insursance company requires us to use the mail service pharmacy for maintainence drugs. So I wonder how this will work. If I go to the pharmacy for it (generic or XR formula) more than 3 times I get charged full price. Maybe they have an exception for these types of pills

Its my understanding that you must provide the pharmacy with a new RX sheet each time you need another month's worth.
That is what my doctor told me when writing mine. and it has to be hand delivered, you cant fax it to them either.

so, no mail in?

Hmmm I THINK mail may be possible. I know my insurance company offered me that option but I am not sure whether it applied to all my meds or just some of them, like my Lamictal, for example.

You're Dr can mail a prescription to you, but your Dr can't mail a prescription to the pharmacy, as far as I know. I'm pretty sure the prescription must be hand delivered to the pharamacy.

This has been my experience over the years. Every now and then I am unable to make it to my scheduled Dr's appointment, and due to how far his office is from where I live, he used to mail me the prescription in the mail when this would occur.

I never asked if he could send it to the pharmacy, so I am not completely sure if thats out of the question or not, but it would seem like something that would not be allowed simply based on how much red tape there is with these kind of medications.

Whoopsie! I think what I was trying to say was that for insurance coverage you may be able to mail in some form of evidence of the RXes existing. DUH DUH DUH! :foot:

I am having a DUH day in general. Many apologies!

You're Dr can mail a prescription to you, but your Dr can't mail a prescription to the pharmacy, as far as I know. I'm pretty sure the prescription must be hand delivered to the pharamacy.

This has been my experience over the years. Every now and then I am unable to make it to my scheduled Dr's appointment, and due to how far his office is from where I live, he used to mail me the prescription in the mail when this would occur.

I never asked if he could send it to the pharmacy, so I am not completely sure if thats out of the question or not, but it would seem like something that would not be allowed simply based on how much red tape there is with these kind of medications.
I don't actually mean 'mail' to walgreens or anything. but the insurance company i have contacts a company to manage prescriptions. So I have to mail my prescriptions into this company called Medco. They request a 90 day script with 3 refills for maintenance drugs. So if I go to walgreens with monthly scripts for maintainence drugs more than 3 times instead of using the 'by mail' method, I have to pay full price. : (

just figured it out...

just talked to walgreens. sounds like no refills. but he mentioned that the doc could write the script for 90 days then I could mail in. so confused. I'll find out monday I guess.

So if I go to walgreens with monthly scripts for maintainence drugs more than 3 times instead of using the 'by mail' method, I have to pay full price. : (I have not had insurance since I was 18. Having paid out of pocket for my prescriptions all these years I have learned that individual pharmacies are permitted by law to charge what ever they choose for prescription drugs.

Folks who use insurance mostly seem indiferent to this fact due to their copay being the same no matter where they go to get it filled. However, people without insurance (the poor, and elderly usually) are being taken advantage of in the most cruel way, as are the insurance companies who pay for the other part of the prescription copays (and then pass this off to those with insurance via higher premiums).

Anyhoot, below is an example of how bad the problem is where I currently live (and I have found this exact situatuation to exist in every city I have lived in throughout other states). A prescription for 400 tablets of the 5mg Dexedrine is my normal prescription. Here's some the price quotes for the brand name Dexedrine 5mg tablets (from lowest to highest) from last summer:

Kmart pharmacy $210
Walgreens pharmacy $475
CVS pharmacy $490

I usually get the generic versions, but last year I decided to get back on the brand name to re-evaluate things. I was saddended that pharmacies are still allowed to do this, because I worry about the elderly who go into their local Walgreens, or CVS, or Right-Aid (the three worst when it comes to price gouging IMO), and they would never suspect that the price of their prescription may be literally hundreds of dollars cheaper at the pharmacy down the block.

Anyhoot, sorry to ramble on here, but I wanted you to know that if you ever have to pay full price for a prescription, or if you find the fact that Walgreens price gouging is immoral (which it is), then I would suggest that you call around town and get some price quotes from the different pharmacies in your area. I strongly encourage anyone to try supporting the pharmacies in your area who are selling their drugs at lower prices. By doing so, you are supporting pharmacies who are concerned about their patients more than they are concerned about their patients wallets. ;)

It is legal to order schedule II prescriptions by mail. However, I would have thought that there might be a distinction between mail order pharmacies and retail outlets in terms of the rules. But then again, the following contradicts this:

http://www.avma.org/onlnews/javma/nov05/051115e.asp

DEA clarifies rules on schedule II controlled substances

The Drug Enforcement Administration has issued a clarification of requirements for prescribing schedule II controlled substances—those controlled substances that have the highest potential for abuse that also have an approved medical use.

The essential requirement is that medical practitioners, including veterinarians, prescribe schedule II controlled substances for a legitimate medical purpose, such as the treatment of pain, in the usual course of professional practice.

Also, practitioners may not authorize refills of schedule II controlled substances or write multiple prescriptions on the same day with instructions to fill on different dates. Practitioners must exercise the utmost care in determining whether to see a patient each time they issue a prescription for a schedule II controlled substance or whether seeing the patient at less frequent intervals is consistent with sound medical practice.

In instances when a practitioner who regularly sees such a patient does not see the patient, the practitioner may mail the prescription to the patient or the pharmacy. Practitioners may fax a prescription to a pharmacy to facilitate filling if the pharmacist reviews the original written, signed prescription before dispensing the drug.

Practitioners must ensure that their prescribing of controlled substances occurs in a manner consistent with effective controls against diversion and misuse, taking into account the nature of the drug.

Some states impose limits on the amount of a schedule II controlled substance that a practitioner may prescribe. These limitations apply in addition to the requirements of federal law.

The "no refills" rule I believe is federally regulated. This is also true of the necessity to produce the original prescription. The maximum 30 day quantity rule in many states is a state rule, not a federal rule. In my state, it is possible to bypass this partially by filling one's prescription through a mail-order pharmacy (up to a 90 day quantity in this case).

Howdy!

I would consult with your insurance company and ask them what their policy is on Schedule II controlled substances. As the DEA restricts and prohibits refills on Schedule II drugs...which includes Adderall. So your insurance company probably has a policy regarding how to handle Adderall as a maintenace drug. See below.

DEA website in regards to Schedule II controlled substance

Question: Can controlled substance prescriptions be refilled?

Answer: Prescriptions for Schedule II controlled substances cannot be refilled. A new prescription must be issued. Prescriptions for Schedule III and IV controlled substances may be refilled up to five (5) times in six (6) months. Prescriptions for Schedule V controlled substances may be refilled as authorized by the practitioner.
http://www.deadiversion.usdoj.gov/faq/general.htm#3
Question: What information is required on a prescription for a controlled substance?

Answer – A prescription for a controlled substance must include the following information:



Date of issue,
Patient’s name and address,
Practitioner’s name, address and DEA registration number,
Drug name,
Drug strength,
Dosage form,
Quantity prescribed,
Directions for use,
Number of refills (if any) authorized, and
Manual signature of prescriber.
A prescription must be written in ink or indelible pencil or typewritten and must be manually signed by the practitioner. An individual may be designated by the practitioner to prepare the prescriptions for his/her signature. The practitioner is responsible for making sure that the prescription conforms in all essential respects to the law and regulation.

Prescriptions for Schedule II controlled substances must be written and be signed by the practitioner. In emergency situations, a prescription for a Schedule II controlled substance may be telephoned to the pharmacy and the prescriber must follow up with a written prescription being sent to the pharmacy within seven days. Prescriptions for Schedule III through V controlled substances may by written, oral or transmitted by fax.
http://www.deadiversion.usdoj.gov/faq/general.htm#2

(a) Schedule II substances
Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in schedule II, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.), may be dispensed without the written prescription of a practitioner, except that in emergency situations, as prescribed by the Secretary by regulation after consultation with the Attorney General, such drug may be dispensed upon oral prescription in accordance with section 503(b) of that Act (21 U.S.C. 353(b)). Prescriptions shall be retained in conformity with the requirements

thanks for the info guys. I found some of this stuff out on google, but i'm one of those people who can't quite 'definitively' be convinced of black and white print that I'm getting the answer I want. I'm hoping that tomorrow, I can go into the dr. office, convince him that I'm cool with 20 or 25 xr and then get a 90 days supply, mail it ito medco and have them ship me 30 days at a time. If not, I'll probably throw a tantrum. j/k thanks again guys. you're helpful and kind.

Hey balanced.... I used to have Medco, up until last year when I turned 25 and had to go off of my Dad's insurance. :(

Anyways, I was DEFINITELY able to get 90 days supplies of Adderall/Dex. All you do is mail it in and they would ship it with UPS and when it got to your door, an adult over 18 had to sign for it. It was really, really convenient. :)

Balanced,

My company uses Medco for prescriptions as well. Maintenance medications must be filled by mail else I have to pay the entire cost (I can get the prescription filled at a regular pharmacy for the first 3 months, called the 'grace period'). Also If you don't get a generic when one exists, my copay is 80$ instead of 0$ in my case.

Anyway, my prescription plan has a list of medication considered to be 'maintenance medications' and Adderall/Adderall XR is not on the list. They do have a disclaimer that says that the list is not necessarily complete though.

Contact your HR representative at your company, or contact Medco directly. They'll be able to answer that.

Your doctor will NOT be able to prescribe you a 90-day supply of Adderall or Adderall XR.

I haven't been charged to date for my prescriptions.

btw, Your company may be able to provide you with a login and password on your prescription plan provider's website. We both have the same provider (though not necessarily the same plan) For me, Adderall and Strattera are not under the "maintenance medication" rules. But something like "Nasonex" (a nasal spray of some sort) is. That's what their website indicates for me. Might be the same for you. Ask your HR person

"The essential requirement is that medical practitioners, including veterinarians, prescribe schedule II controlled substances for a legitimate medical purpose, such as the treatment of pain, in the usual course of professional practice."


I had to cut, recopy that bold it and look at it again to make sure I read it right.

Has this become an issue I am unaware of? Are domestic pets securing Schedule II substances illicitly now? And if so why? Cramming for finals??

:eyebrow: :eyebrow: :eyebrow:

Our tax dollars at work folks !!!

"The essential requirement is that medical practitioners, including veterinarians, prescribe schedule II controlled substances for a legitimate medical purpose, such as the treatment of pain, in the usual course of professional practice."


I had to cut, recopy that bold it and look at it again to make sure I read it right.

Has this become an issue I am unaware of? Are domestic pets securing Schedule II substances illicitly now? And if so why? Cramming for finals??

:eyebrow: :eyebrow: :eyebrow:

Our tax dollars at work folks !!!:rolleyes: Don't be so ignorant. Schedule II drugs are mainly compromised of pain medications (Hydrocodone, Codeine, Morphine, etc.). Stimulants (such as Cocaine and Amphetamines) compromise like the other 10% of the list;)

Veterinary applications mainly consist of Ketamine-like drugs for pain reduction (which are abused by humans who take the pills intended for Max the dog and his broken paw;) )

In Illinois as with Indiana you have three days(72) hours to fill the prescription from the date on the handwritten script. Also, The doctor must write the quantity in both numerics and alpha (#60 sixty). If these are left out in error they cannot call the doctor to correct the mistake. The script must be rewritten. also, if you get a prescrition more than three days prior to the refill day. The doctor may adjust the date to correspond to the refill date. This is beside the DEA's rules on CII's. There are also issue with filling a CII from a MD from a different states. These I think are state specific. I do not recall the exact rules for IN and IL as I have not worked in the pharmacy for almost 8 years. Well thats my two cents. Goodnight all.

Quote::rolleyes: Don't be so ignorant. Schedule II drugs are mainly compromised of pain medications (Hydrocodone, Codeine, Morphine, etc.). Stimulants (such as Cocaine and Amphetamines) compromise like the other 10% of the list;)

Don't for get most of the barbituate group. eg. Seconal.

Sorry figured out the way to do quotes after the fact

I don't know what this is worth, but my rheumatologist decided I should take Adderall, but he can't prescribe it in my doctor network, so I had to go to a psychopharmacologist.

I walked into his office, told him my rheumatogist said I have CFS and need Adderall. He didn't ask me any questions or anything, just said okay and wrote me a prescription. I didn't even look at it, took it to my friendly neighborhood CVS, and dropped it off. Went back a few hours later to pick it up and the kid behind the counter (not the pharmacist but probably the pharm tech or an intern from a nearby school of pharmacology) said, here you go, miss, you should have enough for 2 months there.

And sure enough, my initial dosage was 5mg twice a day, and my bottle had 120 5 mg pills in it, and the instructions said "5 mg, up to 2x a day."

It did say "Refills require authorization" on it though.

:rolleyes: Don't be so ignorant. Schedule II drugs are mainly compromised of pain medications (Hydrocodone, Codeine, Morphine, etc.). Stimulants (such as Cocaine and Amphetamines) compromise like the other 10% of the list;)

Veterinary applications mainly consist of Ketamine-like drugs for pain reduction (which are abused by humans who take the pills intended for Max the dog and his broken paw;) )
C H I L L

Joke. It was one.

C H I L L

Joke. It was one.Sorry. Shouldn't have been so impulsive like that - but you know how it is with ADHD - I couldn't tell if you were joking or just ignorant (and I don't mean that in a bad way like you're stupid or anything, I mean ignorant = somebody needed to tell you about pain pills and barbituates).;)

I guess I need to fix my sarcasm detector.;) No hard feelings or anything, right?:p

Nope...it's all good

Yeah that's the problem with forums and online chat.... It's sometimes hard to tell the intended "tone" (sarcastic :rolleyes:, joking :D, smart aleck :p...... who knows? ;))

:)

Just thought I'd provide an update to this topic if anyone is still interested.

I saw my doctor on Friday and got a new prescription, and I asked him if I had to fill it right away (because I don't need it yet, I still have tons left from the last prescription). He said it has to be filled within 30 days.

I filled a prescription at my local CVS about 3 weeks ago. Because I don't trust my doctor's word, I took my prescription right to CVS, still not sure if I had to fill it right away to avoid any "issues." I didn't even consider that there might be a problem getting more less than a month after I filled my last prescription, even though when I was using birth control pills they wouldn't even let me refill those within 30 days.

So 3 weeks after my last prescription I walk in and hand them the new one. No problem at all. They said as long as I have a valid,signed prescription, I could come in once a week and fill one. And they reiterated that the prescription would be good for 30 days.

So it seems the only rule in my area is that you can't get a prescription for more than one month's worth. Then again, I'm just north of Boston, Ma. We're pretty liberal around here!

I too have insurance that covers 3 rx's local then Medco 90 day supply for mail order. Might even work for the same company. With my plan, you can actually refill CII medications, which adderall is, indefinitely at the local pharmacy without penalty. (even though it is a maintenance medication.)

For mail order, you must get a prescription for a 90 day supply, then mail it to medco. There are no refills. Every 90 days, you must mail a new RX in.

For local pharmacy, you must use a new, written RX every 30 days. Some docs will write 3 rx's at once, but they CAN NOT post date the prescription! They may write something like "Fill after xx date", but the actual date of writing must be included. The pharmacy here told me that CII meds actually have a longer expiration date than normal meds because of the no refills thing. I don't remember what that time length was. This is for my state (expirations), but I know that the no refills thing and no post dating is a federal law.

I actually prefer to use medco because they have the Mallincrokdt dex, as compared to the Barr which is all that is available locally. The Barr stuff (both Adderall and Dex) gives me an upset stomach (gas/gurgling) within 10 minutes of taking it.

My doc has me trying Adderall again, so I'm suffering through the Barr stuff until we see how it works. (Adderall IR in the AM, then Dex IR afternoon)

I almost fell over at the pharmacy when I paid for the adderall my doctor prescribed. Perhaps because I always request brand name prescriptions, and there was a generic available....

So anyway, once the doc and I establish the correct dose, will he be able to write a 90 day with 3 refill? That is what is required of my insurance company for benefits on maintainence drugs.

I know it's controlled so I'm not sure...

I have that some Q around lamictal. I have a 6 month script 30 at a time that I mailed in for my insurance, and they tell me it should be 90 day supply plus 3 refills. Now I might go up... so I don't know if doc could/would write another one the way my insurance requires.

mostly I'm concerned about the adderall rules for prescribing... I know someone here is in the know. See if your doc can write you a prescription for double your dose. You know if you take 10mgs 2x daily have him write it for 20mgs 2x daily(that's what I take) and just break them in half and take your normal dose and that way you will have a two months supply. It won't help with insurance issues but it will cut the cost.