GSK – 1 / TAP – 0 and what patients will do for their pain pills

Lets just say that I love generic Coreg. Seriously, just absolutely love it. If I could have sex with the bottle I would. Why?

• Its a generic that right when it hit the market was affordable. None of this $20 less than trade name crap. I’m talking bargain-basement cheaper than vicodin. I bought a years supply of it because what is the price going to do? Drop to free? Plus I hate switching generic manufacturers on people.
  • Its a godsend to Medicare part D patients in keeping them out of the Coverage Gap. Seriously, I had a little old lady in her coverage gap almost do cartwheels when she found out that a month supply of her Coreg wasn’t the usual 150-200 bucks, but a whopping $9.95.
    However my glee was immediately kicked square in the nuts by one doctor in town. We have a patient who has been on Coreg since it came out. He has MediCare part D, and fortunately he is not on many other things so I believe he is just now getting into the coverage gap. Now Coreg-CR has been out for 3 months or so. The patient has been on Coreg all this time. I send the refill request all gleefully waiting to fill it with shiny new generic, and guess what comes back:
    Coreg-CR 20mg 1 cap qd #30 DAW-1
    I hate drug reps. I really do hate drug reps. Now you know why. If the Dr though that Coreg CR was a superior product, why did he happen to wait until a week after the generic comes out to switch him? Why wasn’t he switched over while Coreg was still trade name (and during the three months Coreg-CR was out)? I guess Coreg just suddenly became an inferior product once the magical patent wore off (when it was perfectly fine for him for years). Maybe I should ask the blonde GSK rep that is sucking his cock if she had anything to do with it. Seriously, now he is going to be in the coverage gap for sure, and up shit creek without a paddle. Thank you Dr for totally financially fucking over my patient because of some talking pair of tits who obviously has more intelligence than you do. Ironically my boss and I were talking about throwing away all of those Coreg-CR DAW-1 forms about 5 min prior.
    Pisses me off to no end how some doctors who view themselves as so intelligent can be so absolutely fucking retarded. When will they actually think for themselves and stop listening to real-life paid advertisements? I think the drug-reps should have prescriptive authority, obviously they must know more then this doctor. And to think I defended Avandia in the past! That cheating whore!
    On a happier note, we’ve had doctors who just now find out that Coreg went generic (probably because the GSK reps have been out in full force), call me and ask how much it is (for which I say “basically free”) and it makes their day. Now good doctors (meaning ones that have free thought) are going just as crazy over this as I am since now their patents get a good product for an affordable price (like it should be). Plus it makes the patient happy, me happy (I don’t want that expensive trade name shit sitting on my shelves), and the doctor look like a hero. Win-Win-Win situation. Every pharmacist loves to tell patients that their once-expensive drug is now cheap-as-dirt, and to be honest I give full credit to the doctor if the patient asks. Do I get thanks for this? Yeah, I do, and it makes my job worth the shit I write about on here.
    Onward with the second part of this entry, what patients will do for their pain pills.
    Do patients think that us pharmacists don’t talk with each other? I mean seriously. I know pretty much every pharmacist in my town (or at least in my area) and if they don’t know me personally, they know my boss personally (who has been in the area for 30 years. Before Walgreens came and overtook all the Independents). I mean you see them at the pharmacy association meetings, you go drinking with them, you ask them what person code to put in new-insurance-x, you call them looking to see if they have a broken bottle of Meridia (ugh, hate) they want to offload, etc. For the students out there, the pharmacy world is extremely small. When the medicare part D shit hit the fan, we would all band together (even the chains) to help each other out. I may rag on the chains, but when the shit hits the fan we all pull together for each other. In the meantime we rag and play jokes on each other. Good times.
    But I digress in my 2-martini to the wind state.
    We had a patient who wanted his pain pills refilled 2 weeks early (gee, surprise). The doctor flat out told us to tell him to go fuck himself, he had a contract for 1 refill a month regardless if God himself came down and took them (that would be an excuse I hadn’t heard before). He asked if he could use the phone, which of course I let him. He called a fucking pharmacy down the road (another independent no less) to see if he could get his pain pills refilled there! I just sat there and shook my head in total disbelief at this guy. So of course 30 seconds after he hung up I got a phone call from that pharmacy. We sat there and chatted a bit about how things were going, and if they were busy, and how this guy had the balls to call him using our phone. Then I told him he wanted his narc’s 2 weeks early and he had a contract. Talk about pooping in the poor crackheads punchbowl. Needless to say he left a very sad panda, and I had something else to write on here other than how much I hate drug reps.

Comments #

Comment by Enrico on 2007-09-18 21:47:59 -0700 #

You know, I was here a while back, even left a comment or two, and damn if I didn’t put your feed in my newsreader. But here I am back again, laughing my ass off for the last 30 minutes reading prior posts. Feed added, good times ahead.
I don’t regret NOT going into pharmacy, but I sure do love the profession. Especially from your POV.
(Oh, and I love the crayon/notebook CSS layout)

Comment by RJS on 2007-09-18 22:27:47 -0700 #

I can’t tell you the number of new assholes I’ve torn when that name-brand-only shit comes down the pipes. Dispense as written, my ass.
I get on the phone and get that shit changed. Or if it’s someone who I know will grab the bull by the balls themselves, I give them the information they need to get the cheaper drug and send them on their way.
Because it’s much funnier when they come back with a new script and a look of triumph on their faces. And usually you don’t see that shitty behavior out of that particular doctor again.
Unless someone’s got fucking Alzheimers, they usually know or can feel if they haven’t taken their beta blocker, so this improved compliance bullshit is just that: bullshit. I love battling doctors the way our accountant loves battling the IRS. I’ve been told it’s a thing of beauty.
—
What’re your thoughts on this new generic famciclovir that’s probably going to disappear like clopidogrel did?

Comment by Ann on 2007-09-19 07:42:31 -0700 #

I am one of those drug reps that you hate see walking through the door but I have to ask a serious question. Do you think that generic Coreg is equivalent in efficacy/tolerability to the branded Coreg? Also, since there will be 14 potential manufacturers of generic Coreg, will they all have the same effect? Hasn’t there been alot of difference with the generics for metformin? Maybe not? I would like serious responses because if generic Coreg is as good as the branded then that will be great for your customers. They will be getting the best beta blocker at an affordable price. How about the patients that switch from branded Coreg or Coreg CR to the generic? Do you see any problems in regard to potential decompensation of their CHF? I know post MI and HTN patients will be different but the CHF patient is a little more vulnerable. Also, how about the patient who has the same co-pay or a little higher for branded or generic- would you recommend that they switch to generic? This personally happened to me when I got a script filled. I have the same co-pay and I was given a generic without being asked. Wasn’t happy about it so asked for the branded that the doctor wrote on the script.
Thanks for your serious reply.

Comment by Kay Geers on 2007-09-19 07:55:42 -0700 #

You crack me up almost every day. Thanks,
Kay

Comment by rph3664 on 2007-09-19 08:38:31 -0700 #

So, carvedilol is practically given away? Wow. I remember that generic citalopram plunged in price as well when it went generic.
Don’t get me started on sotalol, which in the early 00’s was still frightfully expensive for the patient due to its ripoff AWP.
I’ve never heard of drug reps giving doctors blowjobs. If anyone here has, please enlighten me about it.

Comment by AngryNatalie on 2007-09-19 09:42:07 -0700 #

your state lets you transfer narcs? must be one of those crazy rogue states that lets you put refills on benzo’s too…

Comment by Carol on 2007-09-19 19:47:24 -0700 #

Just curious…what is a DAW-1? I’m from Canada….I would also like to put my 2 cents worth in for the DSI (drug seeking individual). I do relief work and it just makes my day when I catch someone with a second rx (often forged) at a second pharmacy the day after I served them somewhere else!

Comment by Drugmonkey on 2007-09-19 23:52:52 -0700 #

“If I could have sex with the bottle I would.”
You just haven’t tried hard enough my friend.

Comment by BlueTech on 2007-09-20 10:14:10 -0700 #

I’m working the evening shift, and Mr. Accident-prone walks in. He doesn’t have this neckbrace this time, so my urge to burst out laughing isn’t quite as strong. He gives me a script for MS Contin #30 bid, dated today. He wants it under workers’ comp. OK, sure, no prob. I accidently bill it under his other insurance (medicaid, of course), and it comes up that he filled 28 days worth at CVS down the road…a week ago. Different doctor, too. I call CVS to see if he’s picked it up, and sure enough, he waited for it there. CVS tells me he’s got quite a track record there…so I call both doctors (both pain-management specialists) and inform them of what just happened. They didn’t know (of course), and surprise! He got dilaudid beetween these two dosings of MS, from two other doctors! I went on to call his W-Comp adjustor, who promptly put a freeze on his claims. We ended up giving himn the RX back, but he won’t be able to fill it anywhere unless he pays cash…good luck, as it’s DAW-1.
BlueTech:1, Dumbass narc-addict:0.