Woman denied insulin because no pharmacist was present

Youve probably heard about this situation that occured yesterday. A members daughter who has type 1 went to her local pharmacy to get her insulin script filled. The whole town was snowed in and the pharmacist who lived in another town was snowed in so therefore was not at the pharmacy. The woman was told that she could not have her perscription filled for insulin as there was no pharmacist available. I think that this is a law that a pharmacist must be present when perscriptions are dispensed.

I think that the law should be changed when it comes to insulin. The need for insulin is not optional for someone with type 1. Its pretty much like needing water. Would someone deny a person water if they had none to drink?
Someone mentioned that certain insulins are available over the counter without a script but my concern is if the person didnt have the financial capability to pay for these insulins that they will be turned away if there is no pharmacist to dispense their prescribed insulin that is covered by insurance.

I want to do some research into this and find out exactly what the laws are governing the dispensing of insulin and see how to get this changed. That is barbaric to have someone with d be told that they cant get their insulin Thankfully the pharmacist is available today and the woman is going to be able to get her perscription filled

 

Every state sets their laws on how its governed to dispensing of medications, in this case insulin.

 

The insulins available without a prescription are NPH and regular and are very inexpensive, probably less than a copay for either Log, Apidra or Lantus. While we all know they may not be ideal for our specific need, they would certainly suffice in a case like this and to the best of my knowledge would not cause anymore financial hardship than paying the copay for prescription insulin.

 

Through my research so far NPH is about $30/vial while regular is $50/vial. Im not sure of what her copay is but mine is $15. Although fortunately we pay nothing for diabetes supplies. I realize that anyone could use these insulins if they had to to stay alive. My concern is that someone may not have the money to purchase insulin in the event that a pharmacist is not available

 

That's exactly what I thought...

 

I dont know, maybe Im poorer then I thought but these days $50 is not inexpensive to me and if I didnt have that money with me would it be reasonable for a pharmacy to turn me away empty handed?

 

There are many life-saving drugs for lots of situations and all of them will be refused if they are a by-prescription-only drug and a pharmacist is not on hand. It is for the protection of everyone. If someone can get to a pharmacy, they can get to an Emergency Room where they can be treated with insulin, IV if necessary, if they do not have any other means to get insulin. Insulin is not "unique"

 

Well if its a blizard and the pharmacy is 5 minutes away and the hospital is an hour away then I see that as a problem.

 

I agree....


I live in Iowa. We have a pharmacy that is within walking distance to our home. BUT its only open if we're lucky 12 hours a week. The next closes place would be the Hospital 30 minutes away. In a snow storm/blizzard, there is no way, I would be able to get to a hospital. Our roads here, are not safe to travel on.

Hopefully this can be used as a lesson to each and everyone of us. To make sure we have enough insulin for what ever weather/storm happens to arise.

All though some insulin can be purchased without a script, there are laws that protect the Pharmacy/Pharmacist from dispensing ANY insulin no matter if it needs a script or not when the Pharmacist is not present.

 

I would say that is the main lesson from that incident. We need to be prepare, who knows what can happen.

 

Unfortunately, yes. It's not in their best interests to hand out prescription medications without a pharmacist present, let alone hand out medications for free. When I worked at CVS, if the pharmacist was not present, we couldn't even open the pharmacy area at all. They alone had the key to unlock the pharmacy gate, and so if they weren't there, we couldn't get to the Regular insulin or any other drug, regardless of the situation.

Like another poster mentioned, the ER would otherwise be the best bet, even at an hour away. I would risk it if I were in the same situation. It would be great if I didn't have to jump through fifteen hoops to get the insulin I need to live and if it were free to everyone who needs it, but it doesn't work that way and it isn't likely to change.

 

This is exactly right and the laws are there to protect the patient as much as the pharmacy. I wouldn't want a minimum wage employee filling prescriptions that could lead to a life or death situation.

Keep at least a week's supply of any critical medication always with you, more if you live in extreme areas that warrant such, and in emergency situations go to the ER.

 

Agreed.. I didn't want to play devil's advocate, but I always have backup insulin.... whether it's extra Apidra for my pump, or Lantus in case something happens to my pump, in the worst case I'd be okay if I couldn't refill my RX for some reason out of my control (like walgreens not having any Apidra - which has happened 2 of the 3 times I've refilled my RX). I even have some Levemir in my fridge, and that stuff didn't work well for me, but it would still be better than "nothing" in an emergency.

 

The laws are there to protect both the pharmacy/pharmacist and the consumer. I have to respectfully disagree on this one, sorry. I believe pharmacy's/pharmacists are required to carry some sort of liability/malpractice insurance the same as a doctor is. The insurance policy most likely does not cover a mistake made by a clerk or a tech. The only way I can see that it would be possible to dispense insulin without a pharmacist present would be to no longer require a prescription. If you take away the requirement for an rx, the insurance companies will no longer cover the insulin. I know a bottle of novolog/humalog/apidra/lantus is much more than $50. I know that without insurance, I would have a VERY hard time paying for insulin. I think it was a bad situation all around and an unfortunate situation. None of us know how Beth's daughter ended up in that predicament, but maybe it could have been prevented. We all can certainly learn from this. Please don't get upset that I have an opinion that differs from yours Becky, if you can find a way to prevent this from happening again then I will back you 100%, but as it sits now these are the facts as I see them

ETA: Insulin is a unique medication seeing how it is the only thing we have to keep our CWD's alive. I'm sure there are other medicine's that are life-sustaining but they are also unique in their usage. JMO

 

Common sense should prevail here. Isn't this woman's prescription on file? Isn't she a regular customer of this pharmacy? Without insulin in two days you may die or be in very bad shape. State police or police, ambulance.... in the case of emergency life saving meds can be brought in via snowmobile. Pharma tech should be able to look up the woman and see if her prescription is on file and simply ask for identification. Laws need to be changed.

 

I can see why a pharmacist would need to be present to explain new medication, check for dangerous prescription combinations, etc, however....

This was a prescription REFILL, right? How long has the child had diabetes? I can't imagine they do anything besides hand the insulin over, knowing she has plenty of experience using it and doesn't need anything explained to her. And especially because it's a life or death medication, I think they should have made an exception to their policy.

But yes, let this be a lesson to the rest of us to always have back-up insulin in case of emergencies.

 

I dont' believe it was a child - it was an adult child of a poster here.

here is the law - or part of it.
http://law.justia.com/nebraska/codes/s71index/s7101147000.html
http://law.justia.com/nebraska/codes/s71index/s7101147033.html

You can't just have anyone handing out prescriptions - even if they don't require an rx they still are covered by the dispensing laws in that state. They don't fall into the realm of OTC drugs.

 

Here is a story that was on our local news. I found it interesting.

DES MOINES, Iowa -- The Iowa Department of Public Safety said Tuesday that state troopers answered more than 811 calls for help during the last snowstorm.

Iowa State Patrol


Troopers answered 156 calls on Sunday, 574 calls on Monday and 81 more calls by 9 a.m. on Tuesday.

Officials said the Iowa State Patrol was asked by Trinity Hospital in Fort Dodge to transport an emergency blood supply needed for a patient.

Troopers were able to get the needed blood to the hospital with help from DOT snowplows. The supply was needed for an open heart surgery patient.

?There are a number of services that troopers provide during bad weather from responding to crashes to assisting those who are injured. I?m proud that our troopers were able to help save many lives, including the life of a surgical patient in Fort Dodge," said Col. Patrick Hoye, chief of the Iowa State Patrol.

In addition to the troopers' work outside, call center staff answer thousands of phone calls and coordinated efforts inside.

The call center received 523 calls on Sunday, 2,167 calls on Monday and 502 calls by Tuesday morning.

Officials said that two troopers' cars were involved in crashes during the storm. Both troopers were out of their vehicles investigating other crashes when their vehicles were hit, officials said. The troopers were not hurt.


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Thats correct, it was an adult with type 1. I absolutely understand why a pharmacist should be present when dispensing MOST medications. But a person can survive without their antidepressants or Viagra. But a person cant live very long without any type of insulin. I know that regular and NPH is sold over the counter but its also possible that these are locked in the medication room when the pharmacist is not there leaving no kinds of insulin accessable.

I also am aware that the hospital would have insulin but during a blizard when people are warned to stay off the roads because of white out conditions it would be good to know that one could get ahold of something that literally keeps them alive. I know thats difficult to think of sometimes, it is for me. I still feel that the laws need to be changed. One can get Motrin over the counter but can still get a perscription from a doctor so that it can be covered by insurance as are alot of medications sold OTC and by perscription. If insulin is going to be sold OTC it should be in a refrigerator that is open to all customers and not locked away when the pharmacist isnt there

 

Insulin should NEVER be kept where anyone can just get it. Just keep in mind that there are many bad people in this world and we unfortunately suffer the restrictions because of them. A person intent on murdering someone else need only to get a vial of insulin and a syringe, and a quick stick and that person is dead from hypoglycemia.

The law doesn't need to be changed - its there to protect everyone. And again I would argue that insulin is not the only medication that is required to stay alive. I would argue the adult was at fault for not having sufficient backup and in the event of the emergency, the paramedics can be called to address this situation, whether it is a "non-emergency" ride to the ER or transportation of medication from a called-in prescription from a Dr.