23 January 2011

Two Conversations from Last Thursday

Conversation #1: with my NP after school

NP: I was extremely shocked at your progesterone results for this month.  A 2.2?  That shouldn't have happened.

Me: Yeah, that was not at all what I thought would happen.  Of course, I didn't expect to start my cycle 5 days early, either.

NP: Let's skip the fasting insulin test since your progesterone was so low.  We can go ahead and start you on Metformin and increase your Femara.  Now, Metformin isn't usually prescribed for fertility-related issues.

Me: Isn't it typically used for insulin resistance in diabetic patients?

NP: [obviously surprised at my response] Why, yes, that's right!  It was discovered that one of the possible side effects could be ovulation.  You'll have to build a tolerance to it, starting at 500mg a day until you can get up to the recommended 2000mg.  Keep some Pepto handy, just in case.

Me: That, and my handy-dandy Sea-Bands for if I get nauseated.

NP: Can we see you next Friday for an ultrasound to check your follicle development?

Me: I'll be there as soon as the car rider line is clear from our school's parking lot.

NP: Great!  Let me call in that scrip for you.  See you next Friday!

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Conversation #2: with a super nice pharmacy technician at Kroger...

Me: I'm here to pick up.  Name's Wynne.

Tech: Ummmm, we have it scheduled to be ready at 7:00pm, but I can bump it to 6:00.  Can you give us half an hour?

Me:  That's fine.  I'll do a little shopping.

Half an hour and four grocery bags later…

Tech: We have it ready, but this says it'll cost $158 dollars.  Did your insurance change since you last filled with us?

Me: [wide-eyed over the rather large number] No, nothing's changed.

Tech: Is there a deductible you have to meet first? [she's double-checking everything on her computer screen for me to make sure she hasn't missed something]

Me: No deductible.  I just have copay on prescriptions.  Is the Metformin really that expensive?

Tech: It's the Femara, actually.  It's showing up at $150 by itself.

Me: Holy crap!  It was only $40 the last time. [kicking myself at how I complained before about it being so expensive compared to the $9 the Clomid cost me the previous two months--was I just going to have to suck it up this time?]

Tech: Well, your doc prescribed 3 months worth.  If it was only a month's worth before, then the cost would go up.

Me: Wait, wait, wait...I'm confused.  On the phone, they said to take it for 5 days this month only, not for the next three.  Could there be a mistake?

Tech: Hold on a sec…I think I just figured it out. [walks over to talk to one of the pharmacists…returns with a confirmation]  They prescribed 15 pills, which would normally be a 3-month supply if a woman was to take only 5 pills a month.  That is, one per day for the 5 days early in her cycle.  Since it sounds like they upped your dosage from last month, it was run through our system as a 3-month supply of 15 pills, not a 1-month supply of 15 pills.

Me: That makes way more sense.

Tech: So if we enter it in as a 1-month supply, that should change everything.  Give me a few minutes to print a new label and ring it up again.  This should take care of the hefty bill!

I stand off to one side so I can get out of the way of other patrons.  My phone keeps me entertained for the entire 3 minutes it takes her to fix the glitch.  She glances up at me while she's entering information to her computer, thinking I'm using the phone to keep an eye on the time.

Tech: It'll just be another minute.  I'm sorry to keep you waiting.

Me: Seriously, you're fine.  My husband works in a pharmacy.  I'm not about to be the angry patron out to ruin your night, especially when you're going out of your way to help me.

Tech: So you have heard stories about life behind the counter…

Me: Oh yes…

Tech: OK, it's ready!  That'll be $58.  That doesn't sound quite so scary, huh?

Me: Thanks for taking care of everything!

It's a little blurry, but the prescription print-out boasts a $281.89 savings through my insurance company.  I'll take it!


1 comment:

A. Hab. said...

1. I LOVE pharmacists. Seriously. And coming from a family of pharmacists and other medical folks, I might be a bit biased...but I truly feel like pharmacists in particular are really looking out for the patients' interests. When I was on Seasonique (that BC that gives you four periods a year), my insurance didn't cover it. So, every three months, I had to answer the same question: "This is coming to $150. Is that okay?" Even though I knew to expect that question, I always appreciated that they asked me before charging my card. I think if I said that it wasn't okay that they would have tried to work something out...maybe talk to my doc or something. I don't know because I never took them up on the subtle offer.

2. Your pharmacist is so wonderful to have worked so hard to figure out where that humongo number was coming from. We should all be so lucky to have an advocate for us! And, let us all take a note from your playbook: advocate for yourself--if the cost seems too high or abnormal, speak up!

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