Comments on: Extra Rx Meds for Disaster Preparedness

By: Haiti Quake-Psychological Care Needed - PsychiatryTalk

Haiti Quake-Psychological Care Needed - PsychiatryTalk — Wed, 27 Jan 2010 08:59:52 +0000

[...] and mostly other non- psychiatric medications which people need and did not have . (See my previous blog on this subject) Psychiatrists may also participate in the delivery of general medical care or even [...]

By: Tim Murphy

Tim Murphy — Sat, 09 Jan 2010 04:37:06 +0000

My worry is that many if not most patients would use the extra month’s RX to delay coming in for f/u, or simply because they forgot to pick up a routine refill and is was more convenient – or cheaper – to use their emergency supply. ( Thanks for your comment. Interesting point. However do you find that pts who get 90 day supply and are suppose to come for monthly or weekly visits delay their appointment?
If doctor felt patient couldn’t be trusted for whatever reason , it could be discussed in treatment and the medication rx not issued if doctor were concerned- mb )

By: Leslie Gise

Leslie Gise — Fri, 18 Dec 2009 21:13:34 +0000

In the public sector we routinely write double prescriptions with no refills for people who are travelling for more than one month. Doctors could do that for people who want to have an extra month supply of medication. If the dose is out of the usual range, I usually tell the pharmacist whey I am doing it and they accept it. This idea came from them anyway. Creative sociopathy as Ken Minkoff would say.

By: Barbara Cox

Barbara Cox — Fri, 18 Dec 2009 18:49:49 +0000

Just like the supermarkets, rotation of meds might best be handled by simply staying ahead by a month, that is, always use the bottle that was “on hold” last month as the “in use” bottle this month. This way the meds are always quite fresh and you don’t worry about keeping tabs on the expiration dates of the reserve meds. Also there is less likelihood of someone having a med change and forgetting to change the stockpile.
The insurance will certainly be the sticking point but also the potential for huge wastage of meds, pollution of water sources, etc. I wonder what percentage of prescriptions are maintained long term, or at least long term enough to make this financially feasible and how long that would be, I can’t see supporting payment for meds or dosages that have been in place less than a year, since the disaster might not happen for 5 years or more and a 90 day supply is great if you just got it, but not helpful if you are almost out when the quake hits.
I wonder if it would make more sense to have some sort of mobile emergency pharmacy that can go to a disaster, maybe a big truck with a fleet of smaller trucks to travel about in the disaster area and coordinate with any existing local pharmacies. Then have people register their scripts with a central computer as they get them so there is a list of current meds safely stashed somewhere else altogether. At the time of the disaster it might take a few days but if you had only a week’s supply, it would give “pharmacy central” a week to check the list and fill by the mobile pharm. or by mail if you still have a way to get mail. Since this could be done at several sites by computer far from the disaster area hopefully many hands could make light work. This would obviate the problem of medication changes and insurance would be much happier to give out an extra week’s worth, in fact, I expect they already do that much.

By: David Milstein MD

David Milstein MD — Fri, 18 Dec 2009 18:27:47 +0000

Dear Dr. Blumenfield,

Thank you for alerting us to this issue. My own insurance plan will allow a refill only when I have no more than a 10 day supply of a medication on hand.

David M. Milstein, MD

By: Peter Gold

Peter Gold — Fri, 18 Dec 2009 18:16:17 +0000

This certainly is a real problem. Good luck with the politicians and the insurance industry.

P.S. Can you get medicare to pressure the insurance indsustry?