Can someone help explain? "Not approved for bipolar"

So... I'm having pharmacy issues. The pharmacy (not my insurance) refuses to fill my Rexulti prescription. They're arguing that Rexulti "is only for major depressive disorder and schizophrenia", so they refuse to fill it. So because I have a bipolar Dx attached to the Rexulti Rx, it's going to get rejected every time.

My pdoc says there are ways around it, such as telling the pharmacy that "going off the med will destabilize the patient" and such.

Can someone explain to me why my pharmacy can't fill the prescription? I mean, I don't see how anyone could abuse an antipsychotic to "get high"! Unless they're trying to "protect" me from taking a med unnecessarily. However, they're not my doctor and plenty of Rx's are used for off label!!! So maybe I'm just missing something here?

My pdoc has been giving me free samples while we work this out, so I'm okay for now.

That's nuts! Why on earth should they have any say in it?! It's not as if they've caught some huge interaction that was missed. Like you say, off-label happens all the time!

I hope it gets ironed out quickly for you. I think they've overstepped their bounds.

Call and make sure your insurance approved it. then try a different pharmacy.

I think the pharmacist is trying to "protect" you.
However, just as you have mentioned, usually a doctor can prescribe for "off label" purposes.

I never give my pharmacy my diagnoses. I've never heard of pharmacies requesting diagnoses.

Your doctor can call the pharmacist and discuss this. That's how my pharmacist and doc work out misunderstandings, etc. They get on the phone with one another and sort it out.

I hope this gets resolved soon!

WC

What a crock of ****! I hope you get this worked out soon

Thanks guys!

I did some "research" and apparently I can file a case against the pharmacy by contacting the pharmacy board for my state for refusing to fill a valid prescription, although they recommend that I talk to the pharmacist first to see if that can be settled. And I can contact the Medical Licensing Board if they're trying to play "doctor".

Has anyone done this before? I have to pick up a clonazepam prescription today anyways.

I've never done it. They filled my Rexulti with insurance authorization. Good for you!!! Now you can get this straightened out.

You are very bright and very resourceful!
While I commend your willingness to stand up for yourself I'm encouraging you to ask your pdoc to talk with the pharmacist. It's your pdoc's script, he has a stake in this, too. It's a lot easier and a lot faster than filing complaints.

In all honesty I do think the pharmacist thinks s/he is looking out for you, not needlessly exposing you to atypical antipsychotics, which is a movement that's increasing with both pharmacists and doctors.

In trying to "protect" you, the pharmacist is missing some key info, info your pdoc can supply in an intelligent conversation between 2 professionals.

The reason I am suggesting this is: I think getting the pdoc and the pharmacist together will me much easier on you in the long run (easier than the stress of following through on filing the complaints and easier than going through any hearings, etc, as complaints are processed). I think you can "win" this in the least stressful manner.

If all else fails, you may fall back upon filing complaints.

Just my 2 cents.

WC

It's not the pharmacy , Denials like this are on your medical insurance...

Hope it gets sorted out quick

It does sound like an insurer's response. How does the pharmacy have your diagnosis?

If it is the insurer, your pdoc can write an appeal. The appeals are usually ruled upon quickly.


WC

how does the pharmacy know your diagnosis?

I have never heard of this in my life. they can warn you all they want but they are not the doctor and have to fill the script. like that is insane

unless like Christina said it must be insurance

it's so wierd it's approved for MDD and schizophrenia but not bipolar. that does not make sense

---response. Speak to the lead pharmacist. Have your doctor call them.