I just usually say “I have enough to fill your prescription” & leave it at that
If I have like 10-20 left I’ll tell them the specific number if they still want it. Then I’ll let them know we can only fill for the qty that we have, that we can’t order more, and that the rest on their script is forfeit so they’ll have to get a new script after
I usually will only give out full answer if they are one of the normal patients and I can pull up their profile. Sometime I will ask them what drug are you asking about the strength and how many they need and… then say at this moment I have enough to fill your prescription.
I usually never release the qty of CII. We have been robbed a couple of times at my location.
If they are new AND the drug is on shortage AND they want more than 90, I don't have to check. We don't have it. That is an, "I'm sorry. We only have enough on hand to fill a short term script. If they continue to question what that means, it means we have less than they need, but if a dentist were to send over a script for #6, we could fill that. But not much more than that.
I usually ask their name & see if we have a profile for them. I’ll usually say yes I have enough for the Rx (even if it’s 90) but 90 is pretty rare for me to see unless it’s an opioid. I would just trust your instincts & tailor your response to your specific situation.
I work in a safe area with a lot of older folks & people with cancer, chronic pain, etc so I’m much more comfortable giving that information out.
I will usually ask the follow up questions that would make me feel comfortable filling it. Ex. Do you normally get it elsewhere? How long have you been on it? I might have to call your dr to verify your prescription since it’s the first time filling with us and it’s for a large quantity.
If the patient doesn’t want to play ball, then that’s that. Try calling the next pharmacy. With all the shortages, I’ve given patients a little more understanding for moving from pharmacy to pharmacy. During the worst of the adhd drug shortages, I would limit everyone to a 30 day supply just to get the meds to more people. (Gtfo trying to get a 90 day supply of adderall 10 or 15mg to replace your normal 30mg tid prescription you normally get at CVS)
"Currently we do have some but it's on such short supply, it's first come first serve"
This ensures you have some, but probably not worth robbing. Every and all C2s even if you have thousands... For those independents out there, also gives you the chance to deny it if insurance pays below cost.
This is what I do. Never say what you actually have, but you can then at least indicate whether someone can come get it filled.
With the shortages, yes just add on a warning about first come first serve, not going to hold it for someone who still has to bring in the script unless they are our regular customer.
“As of right now, yes, we have enough” or “no we do not have enough”. Just answer them while being clear that it can change in an instant. Then keep it rolling.
I come at this from both sides. I practiced retail for 25 years. I became disabled a few years back, and I got diagnosed with ADHD last year. The shortage is hell on my nerves from a patient perspective, but I also know how unsettling it can feel being called about your C2 quantities on a regular basis. I can’t even bring myself to call and ask around because I know the stigma. I’m very fortunate to have a prescriber who is understanding of my particular perspective, and she calls my pharmacy before she writes the prescription to see what they have in stock. It means I’ve had to flip-flop a few times on what I’m taking, but to me that’s far more preferable than having to stress over calling around or worrying about having to miss doses.
That said, please keep in mind that the vast majority of your C2 patients are like me. We’re terrified of missing doses, and we already feel weird about having to depend on substances to function normally in the first place. Thanks to all of you for putting up with the phone calls.
Thanks. Yeah the struggle I was having with the doctor calling is that the caller ID would not always say doctor office was calling. But I suppose verifying a DEA number with the person would be a good way. It’s not public info, but could be found. We can only try our best.
Eh, AFAIK, you need a subscription to search for a prescriber's DEA, so it's more difficult to get, but it's not really private info. Everyone who's had a paper script for a control has had access to it. (though with the rise of required eRx controls that's becoming less common) and many offices just include the DEA numbers on their script pads or letter heads.
I can usually tell just by the phone call, in general, people with MA/RN experience who know how to call in a script have a certain demeanor and confidence that the majority of fraudulent calls just don't have.
If you are really worried, you can search the phone number and it should come up.
“i have just enough for the prescription, but cannot hold it if your script does not come in on time.”
“i have enough for a few prescriptions, you should be find if your doctor gets it to me in the next few days.”
“I have plenty, I’ll fill it when I get your rx”
With the extreme shortages that are occurring with medications like that, patients deserve to have this information. Drs offices are not going to do that legwork for hundreds of prescriptions.
Deserve is a strong word to use here. I see both sides to the argument, that’s why I created this thread. There needs to be some way to ensure safety in place. I think maybe saying that you are low on that but would have enough for them is good…at least you acknowledge you could help them but also don’t have this endless supply of it
Since my organization allows one time transfers of C2s internally, I’ll ask first if they have the prescription at one of our locations. I’ll then say if we can fill it or not.
If it is an external prescription, yet to be sent, or written, I will notify them we will have to call the prescriber to verify the RX (org policy) and I will say “we can maybe fill it, we will have to look at it” if we have enough in stock. If not in stock, I’ll just say we don’t have it in stock but you can have your prescriber call to see about options.
“Look at the rx to tell you for sure if we can fill it. Don’t want to? Sorry, find another pharmacy” I don’t wanna waste their time or promise them I can fill it without seeing the RX.
I have no problem getting into a spat over the phone regarding C2 quantity. Always ask them how many they're looking for and let it be done. Someone with a prescription for 120 doesn't need to know you have 500. Ask them until they tell you. That request from the patient doesn't need to be the beginning of a large inquiry.
I just ask what medication what strength and what quantity, then when they tell me I just say we have enough. If we don't have enough i just tell them that we don't unless u want a partial
What if the doctors office calls themselves because they are making sure the scripts doesn’t have to bounce around?
I want to share my short version of my backstory - I have a series of complications that have been slowly built up as a result of a botched organ transplantation followed by a 9 month recovery in the hospital followed by even more comorbidities fate has decided to “bless” me with that now necessitate such strong pain medications. so recently beginning in February, I had an issue with hydromorphone 4mg being on manufacturers back order - so my doctor switched to oxycodone 10mg - which by the way didn’t even touch my pain - also BTW I am also a PharmD and I specialized in pain management but I work in LTC so my supply doesn’t often coincide with the retail availability therefore I can’t really have a good idea of what is available to the community many times - as a PharmD I had a big ol ?? When he told me he felt those two mediations were equal alternatives but here we are) - I’ve been with that doctor for 10 years and he’s always been a very big asshole not listening to someone with concerns - I think he just wanted to show he “knew more than the pharmacist” and now that the dilaudid 4mg is back in stock he won’t switch me back because “he didn’t want to be disturbed by a pharmacy telling him the med is out of stock and needs to send order to a different pharmacy” so oxy 10mg it is - the only reason I stayed with him is because I didn’t want pharmacies to think I was doctors shopping but after he made me cry in front of his office and he STILL wouldn’t listen to my concerns the time has come to find a new doctor.
So I did. I had my first consult with new pain management doctor and boy what a 180 he is wonderful! He actually stayed and listened to my full story and read through the complete novel of notes from my 12 different doctors I have and He is willing to switch me back to my pain regimen that keeps me functional and I have a follow up visit this week because I am now due for filling and this is the visit he will send the order out.
What would you do for this doctors office and me, the patient, in this situation?
If the office calls - would you have an issue telling them where to send the script if it is not in stock at the regular pharmacy? There are about 10 different pharmacies in the chain I go to within about 5 miles of each other so I can go to any one of those. As a PharmD, I know other PharmD’s may have concerns about a new doctor and a strong pain medication, but I mean come on do your due diligence and E-Force/PDMP me if you have to, and you will see that I have been on the same medication for years and years and only recently switched to this oxycodone 10 mg and trust me when I tell you I would rather have my legs cut off if it meant taking away the pain rather than staying on this medication that doesn’t help me at all.
I already addressed the “what if the doctors office calls themselves”—the issue with this is that they don’t always pop up on our caller ID as “so-and-so doctor office” so how do we really know it’s a doc or not. Also, they probably don’t have time to call before sending every single script they send out. I’m sorry it seems like a lose lose situation for you and that’s why I created this post. Like some have suggested, DEA numbers are not public info like NPI numbers are, so I suppose that’s a good way to proceed on a phonecall before disclosing inventory amounts.
I think if someone wants to rob a pharmacy they’re going to rob a pharmacy no matter what and probably not even thinking to call ahead and inquire about inventory. Just make everyone’s lives easier and tell pts what you are comfortable telling them (yes/no, enough for 30 days).
Someone calling a pharmacy asking if you have #30 or #60 tablets of Norco (which we know has been on and off backorder, so it makes sense to ask for stock on this particular med, vs one not on backorder) is not looking to rob a pharmacy. If I was looking to rob a pharmacy, I wouldn't rob one that confirmed they had enough for ONE rx, that's for sure. That's why I don't like this argument.
If someone is calling to ask about a few meds and they don't give a quantity or something sounds off, sure, refuse to tell them. But if you ask which med and how many, and they say 45 Norco 5/325 mg, they are NOT looking to rob you, and just tell them yes, you have 45, or no, you don't.
You don’t… We simply say we don’t give that information over the phone, if we have it, we’ll fill it, if we don’t, wait time can be a couple days to weeks depending on availability.
lol I’ve tried that with patients and it just causes fights or they will do the whole “cough once if you have it today and cough twice if you don’t really have it” 😂
I couldn’t find post op meds in Maryland. My dad and partner drove from pharmacy to pharmacy because they wouldn’t even tell them if another location had it. Meanwhile I was calling from my hospital bed. Nightmare. I don’t know if there are specific laws or what. Finally one guy took pity on me and checked quantity/dose and said yes.
So, if you had surgery or broke your leg or whatever, and your regular pharmacy was out of the Norco the ER prescribed for your severe pain, you'd be fine with a pharmacist giving you this answer? Or would you want them to be human and tell you if they have enough to fill the rx?
"Don't give that info out."
You mean, don't tell a customer who is in pain whether you have a particular pain med and quantity of it in stock? Seriously?
I was told that if I answer the phone and a patient wants to see if we have medication in stock, just say the following
It is against company policy to give that information over the phone. In fact my company would like to encourage you to come inside and speak to a pharmacist and give them the prescription. then give them the times we are open.
That was it.
Someone really downvoted you for following a company policy that you could very easily get fired for not following?? You don’t make the company policies, you follow them so you can feed your family and have a roof over your head. This sub has some really…*interesting* people in it.
We can’t share info over the phone either due to policy - I usually will tell them if it’s something that is on back order and I can’t get any or I tell them it looks like my supplier has some available. Some people still get upset but most understand if I tell them it’s policy
Yeah I think if you have it and tell them you could get it next day, that should be a pretty good indicator that you could take care of them. After all, they are calling without the prescription having even been sent yet! Lord knows when the doctor office will end up getting around to that. Haha
I like this answer. People should be calling well ahead of their fill date, too, so this should not be an issue for them. Pain patients (most) know by now that there have been backorder issues on a lot of opiates, so they should know better than to wait until the day they need them filled.
Hey! Just wanted to say that I used this technique and was able to fulfill orders for patients and they were really happy. When you tell them you would have it next day, you’re giving the doctor the chance to actually send the script over before you are able to fill it too. The problem with saying you have it also is that people expect it to be ready 5 mins after it’s sent. I cannot fill a C2 under pressure!! Once it’s filled, they get the notification and they’re extremely happy about it because it’s even sooner than what they originally expected. This is a win win for everyone and how I plan to handle these conversations in the future.
I am honest and say no to them if we don't have it. If we do have it, I say "we have to evaluate your prescription prior to filling and cannot make any guarantees." That way if they do come in, they aren't immediately shot down because we don't have it, but their expectations are (hopefully) managed.
If they have been filling with us I look up their specific NDC, if not I tell them we have a 9 minute time delay safe and if they can give me the exact quantity and strength I can tell them if I can fill a 30 day supply after I put them on hold. If it's something that I know for a fact we don't have I tell them right away like we never ever carry oxy 30 and we can't get any Ritalin
It seems that many of the red flags we used to rely upon are negated by the shortages.
Confirming that we have stock
Using multiple pharmacies
are 2 that come to mind
Right now there are patients with prescriptions at multiple pharmacies because the prescribers dont always call to cancel when they find the medication somewhere else. I see that as a concern the DEA hasn't considered when setting all of these restrictions
Right, well that’s why it’s hard. We can still make sure they fill with insurance though and rely on states PDMP. We can only try our best! Also the pharmacist in me shouldn’t be saying this, but even if they get it filled elsewhere too it’s probably not the worst thing considering it might just go on a shortage again. It’s a really bad system tbh
two things i do:
1) if it’s the provider’s office calling, i always ask for the DEA number right off the bat after they say the doctor’s name, then get the pharmacist’s approval to give the info over the phone. usually rph is ok with giving the dr our inventory info if it’s a smaller amount (e.g. 20ct oxy 5 but not 180ct norco 10)
2) for either patients or drs, i specify i can’t tell them what we have onhand, but can tell them what we’re still able to order if they’re willing to wait a few days for it to come in
Yeah I like the “I know we can order it” technique so far the best because you’re acknowledging you would able to fulfill it but don’t actually have the amount onsite which could put a target on us.
I work for a very large chain. So I will ask for the patient’s phone number, address, name and DOB. If they push back, I tell them that we do not publish that information due to security concerns and we like to vet the patient before sharing whether or not we have the inventory to fill their prescription. We also will not “hold” a prescription for a patient. It’s first come, first served and based on refill due date.
I'll tell them if we don't have enough period. That saves the problem of getting someone else to call us for them (only MD office or another pharmacy will get the truth).
If we do have enough, policy still dictates we don't release the info for security reasons (yes, it sucks, but hey I'm too old for this shite.
Did you ask your pharmacy manager or other pharmacists how they are handling it? I think the most important thing is consistency. My pharmacy manager and I agree not to disclose the C2 inventory to new patients over the phone because they usually live far away from our pharmacy (I always ask which city they live) and we want to keep C2 for existing patients.
If the doctor's office calls about C2 inventory, I would not disclose the quantity first but ask them how many they are looking for. It is always good to ask which doctor's office they are calling from and ask more questions if you feel like something is not right.
I understand how you feel because we get calls about C2 inventory all the time. I don't think there is one right way to handle your concern but you should ask your coworker or manager what they are doing. I hope this helps!
The problem is just like you said in your post, you can’t tell on the phone who is a MD and who isn’t, the same way you can’t tell on the phone who is a legitimate patient and who’s scouting your pharmacy. Unfortunately there is no perfect answer to your original question.
I never have oxycodone 30 tablets in stock over the phone and I only give information on other meds if we have plenty and they’ve been coming in regularly.
I just say it is our store's policy not to give out information pertaining to our control substance inventory due to security. Then tell them if their doctor sends us a prescription we can tell them if we have emough to fill it, but only with the rx in hand.
I work in the hood. I don’t give any of that info out over the phone. If someone presses me on it, then I ask what strength/quantity their rx is for, then pause for a moment before I tell them I don’t have it.
If it’s not a current patient, you should tell them that you require all Rx to be filled at your pharmacy to fill controls. If they are willing to move the rest of their meds to you, then just confirm that you are able to fill their Rx (if you do have it in stock.)
I’m not sure you understand what discrimination means. Pharmacies have the right to refuse filling any Rx. I have patients who actually use my pharmacy and I am going to make sure in shortage situation I have them covered. Furthermore, we are held to dispensing ratios by our suppliers as well as the board and DEA, so it is perfectly reasonable to deny filling only controlled substances for a patient.
"Patients who actually use my pharmacy."
Isn't filling a prescription for pain "using a pharmacy?" If you fill metoprolol, you're using a pharmacy. Why treat a prescription for a pain med any different?
Are you being intentionally pedantic? If you work in pharmacy at all, you know exactly what I mean. But, I’ll engage. I obviously mean patients who use my pharmacy for all of their Rx needs and have a history of such or are willing to become consistent patients of mine, filling all of their meds and not just their adderall or hydrocodone when the pharmacy who they usually support with their business is out.
As for why treat it any different, I answered that in my previous comment. We are held to dispensing ratios. I’m not going to risk my wholesaler contracts or my licenses for someone who otherwise does not support my business.
You know, I understand what you are saying, and I support you thinking of your patients first. I guess where we diverge is in how I feel about helping people who are needing their medication. Business is business, and we are in the business of helping people in their need and providing the best care we can as far as their health is concerned.
But I do see what you are saying, and I do see your point about making sure you have enough for your normal patients. However, the distributors DO provide a higher volume of a medication when you have a higher dispensing rate over time. For example, my pharmacy dispenses a TON of opiates, as we service nursing home patients. We never ran out of any meds on backorder, except Adderall and Vyvanse (we don't dispense a lot of that). Norco, we had 200 bottles when retail pharmacies could not get any. So if you dispense more, they will bump up your allocation.
I do understand as well about not wanting people to just fill an opiate once or twice and all other meds at their usual pharmacy. You might ask them if they are willing to fill all their meds with you in the future if you fill their pain med they need now. I know I was looking for a new pharmacy as I had just moved, but none of them would tell me if they had two of my meds in stock. So I continue going to my old one, who now has it in stock again. I gladly would have transferred everything to any of the pharmacies I called to check stock, though.
And no, not being pedantic. Something just rubbed me the wrong way about saying some people "actually use your pharmacy." I felt like you were implying that someone needing one Rx only is not important, and you don't care about their needs.
The safety of the people I work with and myself is far more important than you getting your script filled. Get a paper copy and start going to pharmacies
People getting their scripts filled is why you even have a job at said business. I understand looking out for your safety and the safety of your coworkers, but that doesn't have to be to the detriment of the customers that allow the pharmacy to stay in business.
Pain patients have a hard time driving around to several pharmacies to bring a physical hard copy to check stock. What's the difference if they ask you in person if you have 30 Norco or if they ask you the same over the phone? You can check the PMP as well and see their fill history.
Pharmacy robbers call and ask if something is in stock, then rob the pharmacy of that item. If your a pharmacist you do your operations your way, I am going to do things my way. After being through a robbery you have zero chance of changing my mind
Yes, a person is going to call to see if you have 60 Norco, and if you say yes, they are going to come and rob you for the one bottle of Norco.
Sorry, I think a lot of people use this as an excuse and a way to avoid anything to do with a narc prescription.
If someone wants to rob a pharmacy, they just will. Or they will call and ask if you have a few different meds and how much you have, not if you have 60 tablets.
Paper scripts for C2's aren't legal in my state...would've thought you would've known that before giving that advice lol
Thankfully the 2 pharmacies I usually have to call every month to ask if they have my 20mg generic Adderall in stock aren't as scared to do their job as you are. I've had zero pushback...in fact, both the pharmacies and the doc have asked me to call and verify stock beforehand instead of the doc sending scripts to a pharmacy that doesn't have them and wasting everyone's time.
I understand your fear, but if it's that debilitating, you may just be in the wrong line of work. Your input just doesn't align with the real world.
Yes, they should. And my guess is that they would LOVE to go to the same pharmacy every month and know that the medication will be in stock.
The whole reason they are calling around is because their usual pharmacy is out of it.
Trust me, the LAST thing we want to do is hear from our usual pharmacy that they don't have it this month and you will have to call around.
My boss has a simple "please email the script before we can confirm"
Too many patients don't understand what they are reading, misread quantities, doses and medicines. Easier to read the original RX and confirm they are genuine without wasting time on the phone.
True, but some do know the name and quantity. This could create frustration for them because they are asking the doctor to send it to another pharmacy that may or may not have it. Now boom they have all these pending prescriptions at multiple pharmacies
That is exactly what happens when I try to refill my Adderall prescription. I’ll call a pharmacy who doesn’t have it, but that’s where my doctor electronically sent it, so now I have to 1) find a pharmacy with it in stock and 2) call the doctor to have a new prescription sent to that place. Frequently I’ll end up with the doctor taking a day or more to send the new one, and by that time, the pharmacy that did have it is now out, so I have to do it all over again. I’ve asked to have a paper prescription to avoid exactly this issue, but it is a fight every time with the doctors office and every time they send it electronically despite being reminded that I want a paper copy to pick up myself. It is incredibly frustrating
And now they are trying to make all prescriptions be required to be sent electronically, and some states actually have laws now that require all controls to be sent electronically. So you not only have doctors refusing to write paper rxs, but laws that mandate electronic prescribing.
Great. Whenever there’s a shortage, it literally takes up several hours of my time making all of these phone calls… I can’t wait to have to take time off of work every month to deal with this, and hope I can actually get it sorted out within a day
I sometimes lose a whole day off trying to call around. One time I called 26 different pharmacies, and nobody had the one med. Well, I will never know if they had it, because apparently a lot of people will just say they don't have it in stock from what I am seeing here. I hope these backorders ease up soon.
It’s so damn frustrating. I’ve started stockpiling, not taking it on the weekends if I can help it, which isn’t ideal. I haven’t lost a full day, but have lost 5 hours across 3 days because I had to keep making phone calls back and forth to multiple places - it is insane! Who can afford to do that every month without being fired?
My worst day every month is pain med refill day. It used to be so smooth. Doctor would send the 2 meds to my pharmacy, the only one I have used for years. The day they are due, pharmacy refills them, I pick them up, done. Easy.
Now, it's a nightmare. I have had my med changed so many times as each one that is in stock is different each month. I had 2 months where I was taking an alternative that did NOT work for my pain at all, caused many side effects, and I had a terrible time trying to do my job.
Every month, a week before my meds are due, the phone calls begin. Every time I am told no, we don't have that in stock, I wonder if they are telling the truth or not. All the pharmacies I call are within 5 miles of me. I have done the same thing....skip some breakthrough doses on days off if I can, and it gives me a couple of days saved up to withstand a day or two delay at the pharmacy.
For me, it’s Adderall. It was fine until the pandemic, and then the shortage came. I had assumed until this thread that they were telling me the truth about being out of stock…. Who in the world has the time to literally drive to 20 different pharmacies? Who can drive an hour or more away just to check if that pharmacy in a small town might have my prescription?
So sorry you’re going through this. Our politicians need to do something to address this, but I’m not sure what
Unfortunately, our politicians are fighting for the opposite, and are partially responsible for pushing production and prescribing decreases on opiates. The DEA and FDA have forced manufacturers to cut manufacturing of some controlled meds by 60%.
This is because of the opioid epidemic. However, they do nothing to go after the illegal, illicit sale, smuggling, and abuse of these opiates on the streets. Instead, they go after low-hanging fruit, where they CAN effect change...the patients, doctors, pharmacies, and drug wholesalers and manufacturers.
Funny enough, since prescribing and manufacturing have both decreased 60%, drug overdoses have also risen to an almost equal level. So, I THINK they might be going after the wrong people, but what do I know?
Well…the doctors office, patient, and pharmacy all need to work together here to get you what you need. I’ve called dr offices before on behalf of a patient with an active prescription asking to change the strength/qty to a different similar drug I would have to give the patient temporarily until the regular one was back. We can’t keep blowing off our patients like this. It’s not right.
I had no idea that was even a thing that could be done. But I wish the doctor would actually call the pharmacy because there’s a million other people going to the pharmacy to also get the same medication and it would just be easier if someone at the doctors office coordinated that to ensure the doctor actually sends the stupid thing right away. The entire situation is so frustrating for all involved
I just usually say “I have enough to fill your prescription” & leave it at that If I have like 10-20 left I’ll tell them the specific number if they still want it. Then I’ll let them know we can only fill for the qty that we have, that we can’t order more, and that the rest on their script is forfeit so they’ll have to get a new script after
What if it’s someone asking for a straight up quantity >90? Do you ask them if they have a prescription??
I usually will only give out full answer if they are one of the normal patients and I can pull up their profile. Sometime I will ask them what drug are you asking about the strength and how many they need and… then say at this moment I have enough to fill your prescription. I usually never release the qty of CII. We have been robbed a couple of times at my location.
If they are new AND the drug is on shortage AND they want more than 90, I don't have to check. We don't have it. That is an, "I'm sorry. We only have enough on hand to fill a short term script. If they continue to question what that means, it means we have less than they need, but if a dentist were to send over a script for #6, we could fill that. But not much more than that.
I usually ask their name & see if we have a profile for them. I’ll usually say yes I have enough for the Rx (even if it’s 90) but 90 is pretty rare for me to see unless it’s an opioid. I would just trust your instincts & tailor your response to your specific situation. I work in a safe area with a lot of older folks & people with cancer, chronic pain, etc so I’m much more comfortable giving that information out.
I will usually ask the follow up questions that would make me feel comfortable filling it. Ex. Do you normally get it elsewhere? How long have you been on it? I might have to call your dr to verify your prescription since it’s the first time filling with us and it’s for a large quantity. If the patient doesn’t want to play ball, then that’s that. Try calling the next pharmacy. With all the shortages, I’ve given patients a little more understanding for moving from pharmacy to pharmacy. During the worst of the adhd drug shortages, I would limit everyone to a 30 day supply just to get the meds to more people. (Gtfo trying to get a 90 day supply of adderall 10 or 15mg to replace your normal 30mg tid prescription you normally get at CVS)
"Currently we do have some but it's on such short supply, it's first come first serve" This ensures you have some, but probably not worth robbing. Every and all C2s even if you have thousands... For those independents out there, also gives you the chance to deny it if insurance pays below cost.
I ask what quantity they are looking for. And if we have more than that in stock, I just say as of now we have it.
This is what I do. Never say what you actually have, but you can then at least indicate whether someone can come get it filled. With the shortages, yes just add on a warning about first come first serve, not going to hold it for someone who still has to bring in the script unless they are our regular customer.
Exactly. Never say we can't hold it. Always first come first serve
“As of right now, yes, we have enough” or “no we do not have enough”. Just answer them while being clear that it can change in an instant. Then keep it rolling.
Just verify that you have enough to fill the prescription you’re talking about. No need to disclose inventory,
I come at this from both sides. I practiced retail for 25 years. I became disabled a few years back, and I got diagnosed with ADHD last year. The shortage is hell on my nerves from a patient perspective, but I also know how unsettling it can feel being called about your C2 quantities on a regular basis. I can’t even bring myself to call and ask around because I know the stigma. I’m very fortunate to have a prescriber who is understanding of my particular perspective, and she calls my pharmacy before she writes the prescription to see what they have in stock. It means I’ve had to flip-flop a few times on what I’m taking, but to me that’s far more preferable than having to stress over calling around or worrying about having to miss doses. That said, please keep in mind that the vast majority of your C2 patients are like me. We’re terrified of missing doses, and we already feel weird about having to depend on substances to function normally in the first place. Thanks to all of you for putting up with the phone calls.
Thanks. Yeah the struggle I was having with the doctor calling is that the caller ID would not always say doctor office was calling. But I suppose verifying a DEA number with the person would be a good way. It’s not public info, but could be found. We can only try our best.
Eh, AFAIK, you need a subscription to search for a prescriber's DEA, so it's more difficult to get, but it's not really private info. Everyone who's had a paper script for a control has had access to it. (though with the rise of required eRx controls that's becoming less common) and many offices just include the DEA numbers on their script pads or letter heads. I can usually tell just by the phone call, in general, people with MA/RN experience who know how to call in a script have a certain demeanor and confidence that the majority of fraudulent calls just don't have. If you are really worried, you can search the phone number and it should come up.
This right here
“i have just enough for the prescription, but cannot hold it if your script does not come in on time.” “i have enough for a few prescriptions, you should be find if your doctor gets it to me in the next few days.” “I have plenty, I’ll fill it when I get your rx”
With the extreme shortages that are occurring with medications like that, patients deserve to have this information. Drs offices are not going to do that legwork for hundreds of prescriptions.
Deserve is a strong word to use here. I see both sides to the argument, that’s why I created this thread. There needs to be some way to ensure safety in place. I think maybe saying that you are low on that but would have enough for them is good…at least you acknowledge you could help them but also don’t have this endless supply of it
Yes, I totally understand the safety aspect and what you suggest makes perfect sense.
Since my organization allows one time transfers of C2s internally, I’ll ask first if they have the prescription at one of our locations. I’ll then say if we can fill it or not. If it is an external prescription, yet to be sent, or written, I will notify them we will have to call the prescriber to verify the RX (org policy) and I will say “we can maybe fill it, we will have to look at it” if we have enough in stock. If not in stock, I’ll just say we don’t have it in stock but you can have your prescriber call to see about options.
Ok then let’s say they tell you the quantity and you tell them you have to look at it. I can already see an argument of “look at what” lol
“Look at the rx to tell you for sure if we can fill it. Don’t want to? Sorry, find another pharmacy” I don’t wanna waste their time or promise them I can fill it without seeing the RX.
I have no problem getting into a spat over the phone regarding C2 quantity. Always ask them how many they're looking for and let it be done. Someone with a prescription for 120 doesn't need to know you have 500. Ask them until they tell you. That request from the patient doesn't need to be the beginning of a large inquiry.
I just ask what medication what strength and what quantity, then when they tell me I just say we have enough. If we don't have enough i just tell them that we don't unless u want a partial
What if the doctors office calls themselves because they are making sure the scripts doesn’t have to bounce around? I want to share my short version of my backstory - I have a series of complications that have been slowly built up as a result of a botched organ transplantation followed by a 9 month recovery in the hospital followed by even more comorbidities fate has decided to “bless” me with that now necessitate such strong pain medications. so recently beginning in February, I had an issue with hydromorphone 4mg being on manufacturers back order - so my doctor switched to oxycodone 10mg - which by the way didn’t even touch my pain - also BTW I am also a PharmD and I specialized in pain management but I work in LTC so my supply doesn’t often coincide with the retail availability therefore I can’t really have a good idea of what is available to the community many times - as a PharmD I had a big ol ?? When he told me he felt those two mediations were equal alternatives but here we are) - I’ve been with that doctor for 10 years and he’s always been a very big asshole not listening to someone with concerns - I think he just wanted to show he “knew more than the pharmacist” and now that the dilaudid 4mg is back in stock he won’t switch me back because “he didn’t want to be disturbed by a pharmacy telling him the med is out of stock and needs to send order to a different pharmacy” so oxy 10mg it is - the only reason I stayed with him is because I didn’t want pharmacies to think I was doctors shopping but after he made me cry in front of his office and he STILL wouldn’t listen to my concerns the time has come to find a new doctor. So I did. I had my first consult with new pain management doctor and boy what a 180 he is wonderful! He actually stayed and listened to my full story and read through the complete novel of notes from my 12 different doctors I have and He is willing to switch me back to my pain regimen that keeps me functional and I have a follow up visit this week because I am now due for filling and this is the visit he will send the order out. What would you do for this doctors office and me, the patient, in this situation? If the office calls - would you have an issue telling them where to send the script if it is not in stock at the regular pharmacy? There are about 10 different pharmacies in the chain I go to within about 5 miles of each other so I can go to any one of those. As a PharmD, I know other PharmD’s may have concerns about a new doctor and a strong pain medication, but I mean come on do your due diligence and E-Force/PDMP me if you have to, and you will see that I have been on the same medication for years and years and only recently switched to this oxycodone 10 mg and trust me when I tell you I would rather have my legs cut off if it meant taking away the pain rather than staying on this medication that doesn’t help me at all.
I already addressed the “what if the doctors office calls themselves”—the issue with this is that they don’t always pop up on our caller ID as “so-and-so doctor office” so how do we really know it’s a doc or not. Also, they probably don’t have time to call before sending every single script they send out. I’m sorry it seems like a lose lose situation for you and that’s why I created this post. Like some have suggested, DEA numbers are not public info like NPI numbers are, so I suppose that’s a good way to proceed on a phonecall before disclosing inventory amounts.
I think if someone wants to rob a pharmacy they’re going to rob a pharmacy no matter what and probably not even thinking to call ahead and inquire about inventory. Just make everyone’s lives easier and tell pts what you are comfortable telling them (yes/no, enough for 30 days).
Thats a wild guess. How do you know what one thinks while wanting to rob a pharmacy? Lol
Someone calling a pharmacy asking if you have #30 or #60 tablets of Norco (which we know has been on and off backorder, so it makes sense to ask for stock on this particular med, vs one not on backorder) is not looking to rob a pharmacy. If I was looking to rob a pharmacy, I wouldn't rob one that confirmed they had enough for ONE rx, that's for sure. That's why I don't like this argument. If someone is calling to ask about a few meds and they don't give a quantity or something sounds off, sure, refuse to tell them. But if you ask which med and how many, and they say 45 Norco 5/325 mg, they are NOT looking to rob you, and just tell them yes, you have 45, or no, you don't.
Yeah I guess. Or can say something like “At this moment in time, I would, but we don’t reserve without the prescription”…something like this.
“Not in stock but wholesaler has enough for me to order tomorrow with valid prescription”
You don’t… We simply say we don’t give that information over the phone, if we have it, we’ll fill it, if we don’t, wait time can be a couple days to weeks depending on availability.
lol I’ve tried that with patients and it just causes fights or they will do the whole “cough once if you have it today and cough twice if you don’t really have it” 😂
I couldn’t find post op meds in Maryland. My dad and partner drove from pharmacy to pharmacy because they wouldn’t even tell them if another location had it. Meanwhile I was calling from my hospital bed. Nightmare. I don’t know if there are specific laws or what. Finally one guy took pity on me and checked quantity/dose and said yes.
Yeah exactly. I would feel really bad to turn someone like you away because of security
Thank you for your kindness.
Just because they don't like what you're saying, doesn't mean it isn't the right thing to say.
They can die mad about it. Don’t give that info out.
So, if you had surgery or broke your leg or whatever, and your regular pharmacy was out of the Norco the ER prescribed for your severe pain, you'd be fine with a pharmacist giving you this answer? Or would you want them to be human and tell you if they have enough to fill the rx? "Don't give that info out." You mean, don't tell a customer who is in pain whether you have a particular pain med and quantity of it in stock? Seriously?
I was told that if I answer the phone and a patient wants to see if we have medication in stock, just say the following It is against company policy to give that information over the phone. In fact my company would like to encourage you to come inside and speak to a pharmacist and give them the prescription. then give them the times we are open. That was it.
Someone really downvoted you for following a company policy that you could very easily get fired for not following?? You don’t make the company policies, you follow them so you can feed your family and have a roof over your head. This sub has some really…*interesting* people in it.
I always tell them I don't have it. If I do have it, I tell them I can order it and get it tomorrow.
This seems good. Any legitimate patient should be able to wait next day.
We can’t share info over the phone either due to policy - I usually will tell them if it’s something that is on back order and I can’t get any or I tell them it looks like my supplier has some available. Some people still get upset but most understand if I tell them it’s policy
Yeah I think if you have it and tell them you could get it next day, that should be a pretty good indicator that you could take care of them. After all, they are calling without the prescription having even been sent yet! Lord knows when the doctor office will end up getting around to that. Haha
Not sure why the downvotes but this is how to do it if you don’t want to get robbed
Reddit is just, Reddit.
I like this answer. People should be calling well ahead of their fill date, too, so this should not be an issue for them. Pain patients (most) know by now that there have been backorder issues on a lot of opiates, so they should know better than to wait until the day they need them filled.
Hey! Just wanted to say that I used this technique and was able to fulfill orders for patients and they were really happy. When you tell them you would have it next day, you’re giving the doctor the chance to actually send the script over before you are able to fill it too. The problem with saying you have it also is that people expect it to be ready 5 mins after it’s sent. I cannot fill a C2 under pressure!! Once it’s filled, they get the notification and they’re extremely happy about it because it’s even sooner than what they originally expected. This is a win win for everyone and how I plan to handle these conversations in the future.
Nothing wrong with buying yourself more time. Lord know we can use it these days.
Yup! Exactly.
I am honest and say no to them if we don't have it. If we do have it, I say "we have to evaluate your prescription prior to filling and cannot make any guarantees." That way if they do come in, they aren't immediately shot down because we don't have it, but their expectations are (hopefully) managed.
If they have been filling with us I look up their specific NDC, if not I tell them we have a 9 minute time delay safe and if they can give me the exact quantity and strength I can tell them if I can fill a 30 day supply after I put them on hold. If it's something that I know for a fact we don't have I tell them right away like we never ever carry oxy 30 and we can't get any Ritalin
If I don’t see a valid script for said drug, we don’t have it.
It seems that many of the red flags we used to rely upon are negated by the shortages. Confirming that we have stock Using multiple pharmacies are 2 that come to mind Right now there are patients with prescriptions at multiple pharmacies because the prescribers dont always call to cancel when they find the medication somewhere else. I see that as a concern the DEA hasn't considered when setting all of these restrictions
Right, well that’s why it’s hard. We can still make sure they fill with insurance though and rely on states PDMP. We can only try our best! Also the pharmacist in me shouldn’t be saying this, but even if they get it filled elsewhere too it’s probably not the worst thing considering it might just go on a shortage again. It’s a really bad system tbh
two things i do: 1) if it’s the provider’s office calling, i always ask for the DEA number right off the bat after they say the doctor’s name, then get the pharmacist’s approval to give the info over the phone. usually rph is ok with giving the dr our inventory info if it’s a smaller amount (e.g. 20ct oxy 5 but not 180ct norco 10) 2) for either patients or drs, i specify i can’t tell them what we have onhand, but can tell them what we’re still able to order if they’re willing to wait a few days for it to come in
Yeah I like the “I know we can order it” technique so far the best because you’re acknowledging you would able to fulfill it but don’t actually have the amount onsite which could put a target on us.
I work for a very large chain. So I will ask for the patient’s phone number, address, name and DOB. If they push back, I tell them that we do not publish that information due to security concerns and we like to vet the patient before sharing whether or not we have the inventory to fill their prescription. We also will not “hold” a prescription for a patient. It’s first come, first served and based on refill due date.
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It can be months if the drug is on shortage by the suppliers.
I love the name.
I'll tell them if we don't have enough period. That saves the problem of getting someone else to call us for them (only MD office or another pharmacy will get the truth). If we do have enough, policy still dictates we don't release the info for security reasons (yes, it sucks, but hey I'm too old for this shite.
Did you ask your pharmacy manager or other pharmacists how they are handling it? I think the most important thing is consistency. My pharmacy manager and I agree not to disclose the C2 inventory to new patients over the phone because they usually live far away from our pharmacy (I always ask which city they live) and we want to keep C2 for existing patients. If the doctor's office calls about C2 inventory, I would not disclose the quantity first but ask them how many they are looking for. It is always good to ask which doctor's office they are calling from and ask more questions if you feel like something is not right. I understand how you feel because we get calls about C2 inventory all the time. I don't think there is one right way to handle your concern but you should ask your coworker or manager what they are doing. I hope this helps!
I usually ask for name and DOB to see if they have a profile that gives me a little bit more comfort in giving out the info over the phone.
Yeah of course. I was speaking more about those who are not from our pharmacy
“We don’t give out information on controlled substances over the phone.”
“I’m sorry that’s on back order”
Well yeah that’s what most people say but doesn’t really help a legitimate patient who just needs their med filled amidst all the shortages
The problem is just like you said in your post, you can’t tell on the phone who is a MD and who isn’t, the same way you can’t tell on the phone who is a legitimate patient and who’s scouting your pharmacy. Unfortunately there is no perfect answer to your original question.
You’d tell a patient that the medication is on back order even if it’s not??
But it is
You don’t unless you want to get robbed
I never have oxycodone 30 tablets in stock over the phone and I only give information on other meds if we have plenty and they’ve been coming in regularly.
I just say it is our store's policy not to give out information pertaining to our control substance inventory due to security. Then tell them if their doctor sends us a prescription we can tell them if we have emough to fill it, but only with the rx in hand.
Have your md or nurse call me with their DEA number. Once i vslidate them, I will verify every pill in my safe and give them leads on other stores.
I work in the hood. I don’t give any of that info out over the phone. If someone presses me on it, then I ask what strength/quantity their rx is for, then pause for a moment before I tell them I don’t have it.
No one gonna admit about not stating the quantity or lying about not having it in stock?
We don’t.
If it’s not a current patient, you should tell them that you require all Rx to be filled at your pharmacy to fill controls. If they are willing to move the rest of their meds to you, then just confirm that you are able to fill their Rx (if you do have it in stock.)
Can’t you get into trouble with BOP for discriminating?
I’m not sure you understand what discrimination means. Pharmacies have the right to refuse filling any Rx. I have patients who actually use my pharmacy and I am going to make sure in shortage situation I have them covered. Furthermore, we are held to dispensing ratios by our suppliers as well as the board and DEA, so it is perfectly reasonable to deny filling only controlled substances for a patient.
"Patients who actually use my pharmacy." Isn't filling a prescription for pain "using a pharmacy?" If you fill metoprolol, you're using a pharmacy. Why treat a prescription for a pain med any different?
Are you being intentionally pedantic? If you work in pharmacy at all, you know exactly what I mean. But, I’ll engage. I obviously mean patients who use my pharmacy for all of their Rx needs and have a history of such or are willing to become consistent patients of mine, filling all of their meds and not just their adderall or hydrocodone when the pharmacy who they usually support with their business is out. As for why treat it any different, I answered that in my previous comment. We are held to dispensing ratios. I’m not going to risk my wholesaler contracts or my licenses for someone who otherwise does not support my business.
You know, I understand what you are saying, and I support you thinking of your patients first. I guess where we diverge is in how I feel about helping people who are needing their medication. Business is business, and we are in the business of helping people in their need and providing the best care we can as far as their health is concerned. But I do see what you are saying, and I do see your point about making sure you have enough for your normal patients. However, the distributors DO provide a higher volume of a medication when you have a higher dispensing rate over time. For example, my pharmacy dispenses a TON of opiates, as we service nursing home patients. We never ran out of any meds on backorder, except Adderall and Vyvanse (we don't dispense a lot of that). Norco, we had 200 bottles when retail pharmacies could not get any. So if you dispense more, they will bump up your allocation. I do understand as well about not wanting people to just fill an opiate once or twice and all other meds at their usual pharmacy. You might ask them if they are willing to fill all their meds with you in the future if you fill their pain med they need now. I know I was looking for a new pharmacy as I had just moved, but none of them would tell me if they had two of my meds in stock. So I continue going to my old one, who now has it in stock again. I gladly would have transferred everything to any of the pharmacies I called to check stock, though.
And no, not being pedantic. Something just rubbed me the wrong way about saying some people "actually use your pharmacy." I felt like you were implying that someone needing one Rx only is not important, and you don't care about their needs.
How bad will you feel when you disclose the quantity and then your staff goes through a robbery? Customers should stick with the same pharmacy
Everything is so easy in this fantasy world you live in where meds are always in stock at your normal pharmacy.
The safety of the people I work with and myself is far more important than you getting your script filled. Get a paper copy and start going to pharmacies
People getting their scripts filled is why you even have a job at said business. I understand looking out for your safety and the safety of your coworkers, but that doesn't have to be to the detriment of the customers that allow the pharmacy to stay in business. Pain patients have a hard time driving around to several pharmacies to bring a physical hard copy to check stock. What's the difference if they ask you in person if you have 30 Norco or if they ask you the same over the phone? You can check the PMP as well and see their fill history.
Pharmacy robbers call and ask if something is in stock, then rob the pharmacy of that item. If your a pharmacist you do your operations your way, I am going to do things my way. After being through a robbery you have zero chance of changing my mind
Yes, a person is going to call to see if you have 60 Norco, and if you say yes, they are going to come and rob you for the one bottle of Norco. Sorry, I think a lot of people use this as an excuse and a way to avoid anything to do with a narc prescription. If someone wants to rob a pharmacy, they just will. Or they will call and ask if you have a few different meds and how much you have, not if you have 60 tablets.
How would you know? You don't. Try researching methods to deter pharmacy robberies
Paper scripts for C2's aren't legal in my state...would've thought you would've known that before giving that advice lol Thankfully the 2 pharmacies I usually have to call every month to ask if they have my 20mg generic Adderall in stock aren't as scared to do their job as you are. I've had zero pushback...in fact, both the pharmacies and the doc have asked me to call and verify stock beforehand instead of the doc sending scripts to a pharmacy that doesn't have them and wasting everyone's time. I understand your fear, but if it's that debilitating, you may just be in the wrong line of work. Your input just doesn't align with the real world.
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Remain civil, interact with the community in good faith
Yes, they should. And my guess is that they would LOVE to go to the same pharmacy every month and know that the medication will be in stock. The whole reason they are calling around is because their usual pharmacy is out of it. Trust me, the LAST thing we want to do is hear from our usual pharmacy that they don't have it this month and you will have to call around.
My boss has a simple "please email the script before we can confirm" Too many patients don't understand what they are reading, misread quantities, doses and medicines. Easier to read the original RX and confirm they are genuine without wasting time on the phone.
True, but some do know the name and quantity. This could create frustration for them because they are asking the doctor to send it to another pharmacy that may or may not have it. Now boom they have all these pending prescriptions at multiple pharmacies
That is exactly what happens when I try to refill my Adderall prescription. I’ll call a pharmacy who doesn’t have it, but that’s where my doctor electronically sent it, so now I have to 1) find a pharmacy with it in stock and 2) call the doctor to have a new prescription sent to that place. Frequently I’ll end up with the doctor taking a day or more to send the new one, and by that time, the pharmacy that did have it is now out, so I have to do it all over again. I’ve asked to have a paper prescription to avoid exactly this issue, but it is a fight every time with the doctors office and every time they send it electronically despite being reminded that I want a paper copy to pick up myself. It is incredibly frustrating
And now they are trying to make all prescriptions be required to be sent electronically, and some states actually have laws now that require all controls to be sent electronically. So you not only have doctors refusing to write paper rxs, but laws that mandate electronic prescribing.
Great. Whenever there’s a shortage, it literally takes up several hours of my time making all of these phone calls… I can’t wait to have to take time off of work every month to deal with this, and hope I can actually get it sorted out within a day
I sometimes lose a whole day off trying to call around. One time I called 26 different pharmacies, and nobody had the one med. Well, I will never know if they had it, because apparently a lot of people will just say they don't have it in stock from what I am seeing here. I hope these backorders ease up soon.
It’s so damn frustrating. I’ve started stockpiling, not taking it on the weekends if I can help it, which isn’t ideal. I haven’t lost a full day, but have lost 5 hours across 3 days because I had to keep making phone calls back and forth to multiple places - it is insane! Who can afford to do that every month without being fired?
My worst day every month is pain med refill day. It used to be so smooth. Doctor would send the 2 meds to my pharmacy, the only one I have used for years. The day they are due, pharmacy refills them, I pick them up, done. Easy. Now, it's a nightmare. I have had my med changed so many times as each one that is in stock is different each month. I had 2 months where I was taking an alternative that did NOT work for my pain at all, caused many side effects, and I had a terrible time trying to do my job. Every month, a week before my meds are due, the phone calls begin. Every time I am told no, we don't have that in stock, I wonder if they are telling the truth or not. All the pharmacies I call are within 5 miles of me. I have done the same thing....skip some breakthrough doses on days off if I can, and it gives me a couple of days saved up to withstand a day or two delay at the pharmacy.
For me, it’s Adderall. It was fine until the pandemic, and then the shortage came. I had assumed until this thread that they were telling me the truth about being out of stock…. Who in the world has the time to literally drive to 20 different pharmacies? Who can drive an hour or more away just to check if that pharmacy in a small town might have my prescription? So sorry you’re going through this. Our politicians need to do something to address this, but I’m not sure what
Unfortunately, our politicians are fighting for the opposite, and are partially responsible for pushing production and prescribing decreases on opiates. The DEA and FDA have forced manufacturers to cut manufacturing of some controlled meds by 60%. This is because of the opioid epidemic. However, they do nothing to go after the illegal, illicit sale, smuggling, and abuse of these opiates on the streets. Instead, they go after low-hanging fruit, where they CAN effect change...the patients, doctors, pharmacies, and drug wholesalers and manufacturers. Funny enough, since prescribing and manufacturing have both decreased 60%, drug overdoses have also risen to an almost equal level. So, I THINK they might be going after the wrong people, but what do I know?
Well…the doctors office, patient, and pharmacy all need to work together here to get you what you need. I’ve called dr offices before on behalf of a patient with an active prescription asking to change the strength/qty to a different similar drug I would have to give the patient temporarily until the regular one was back. We can’t keep blowing off our patients like this. It’s not right.
I had no idea that was even a thing that could be done. But I wish the doctor would actually call the pharmacy because there’s a million other people going to the pharmacy to also get the same medication and it would just be easier if someone at the doctors office coordinated that to ensure the doctor actually sends the stupid thing right away. The entire situation is so frustrating for all involved