What happens if Walgreens decides to not fill your script? What can you do? Can they deny your prescription if you are med seeking? How do they know? read on …
An internal document has been obtained that the nation’s largest drug store chain has been trying to keep secret. It reveals why Walgreens is now turning away some customers and refusing to fill their prescriptions. “We were told patients are not supposed to know we’re using [this],” said pharmacy technician Marianne Ryan. “But I don’t think it should be some big secret. This form had to be filled out by the pharmacist, so I think patients should know what’s on it.” Ryan is talking about what Walgreens calls its Good Faith Dispensing policy checklist.
The controversial checklist – and the policy behind it — first came to light earlier this year after it was reported that many Walgreens customers are facing problems when trying to get prescription refills for pain medication. Walgreens patrons across the nation told Eyewitness News their prescriptions were being delayed or denied because of a new pharmacy policy, but Walgreens would not tell them what the policy is. The pharmacy chain declined to provide a copy of its GFD Policy, explaining it is for “internal use only.” But after investigations quickly spread across the Internet and more patients began speaking out, Ryan decided to leak the checklist to Eyewitness News to help educate consumers. A separate source provided a copy of the full GFD Policy. “I don’t think [Walgreens] will be happy about it, but when patients are denied prescriptions, they should know why,” Ryan said. “And this is why.”
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Confidential checklist exposed
Walgreens’ one-page checklist must be used by its pharmacy staff each time a customer presents a prescription for a powerful narcotic. Oxycodone, Methadone, Hydromorphone (Dilaudid), Morphine, Fentanyl and Opana are included on the list of Walgreens’ “target drugs” because they are all highly-addictive controlled substances that government regulators have placed in a high-risk category for prescription drug abuse.
According to the GFD checklist: a pharmacist is required to complete four mandatory steps before filling a prescription for one of the GFD Policy target drugs:
- Check Walgreens’ national Itercom Plus computer system to confirm the prescription has not been previously denied by another Walgreens pharmacy
- Review a customer’s personal prescription drug history maintained by a state Prescription Drug Monitoring Program (PDMP). In Indiana, the state tracks all residents’ opioid prescriptions using an online PDMP system called INSPECT.
- Photocopy a valid government photo ID for the individual(s) dropping off and picking up each prescription
- Answer a series of seven questions about the prescription, patient and prescribing doctor to look for “red flags” of possible prescription drug abuse
The additional seven questions include:
- Whether the patient has previously received the same medication from Walgreens (new prescription or new patient is a red flag)
- Whether the prescription is written for the same medication and from the same doctor as the previous fill (new doctor is possible red flag)
- Whether the patient and doctor listed on the prescription are within close geographical proximity to the drug store (far distances that cannot be explained are a red flag)
- Whether the prescription is being filled on time (attempt to fill early is a red flag)
- Whether the patient is paying for the prescription using insurance (cash is a red flag)
- Whether the quantity of pills prescribed is considered excessive (more than 120 pills is a red flag if paying by insurance; more than 60 pills is a red flag if paying cash)
- Whether the patient has been taking the same medication and dosage for a long time (more than 6 months is a red flag)
- Prescription is written within the prescriber’s scope of practice
- The therapeutic regimen is within the standard of care
- Expected length of treatment
- Date of last physical and pain assessment
- Use of alternative/lesser prescription medications for pain control
- Coordination with other clinicians involved in patient care
“He said, ‘We suggest you take it to CVS. At this point, we’re just feeding an addiction.’ He was very loud and it was right in the open when he basically called me an addict. At that point, I was just so upset I left,” said the customer, who requested anonymity to protect her family’s safety. “I’ve been going to the same Walgreens for eight years. All I wanted was the same medication from the same doctor for the same medical condition, and they refused with no warning. It’s very upsetting to be treated this way,” she added.
Industry observers say Walgreen’s decision to change its policy regarding the distribution of pain pills was borne out of necessity. The company introduced its Good Faith Dispensing Policy and GFD checklist earlier this year as it was embroiled in a massive investigation by the US Department of Justice and US Drug Enforcement Administration. Federal agents targeted six Walgreens drug stores and a Walgreens distribution center in Florida, where they caught the company repeatedly filling bogus prescriptions for pain pills.
“These retail pharmacies filled the prescriptions for addictive prescription narcotics despite obvious red flags that clearly indicated the prescriptions were illegitimate, and the drugs were likely to be diverted for street use,” said U.S. Attorney Wilfredo Ferrer, culminating a year-long investigation by the US Drug Enforcement Agency. Walgreens agreed to pay an $80 million fine for those violations, and as part of its settlement, the company promised to improve its policies and procedures to help reduce prescription drug abuse involving addictive pain narcotics. That’s when Walgreens rolled out its GFD checklist and told its employees to implement it – quietly. “Managers made it clear … we don’t want the patients to be made aware this what we’re doing,” Ryan told 13 Investigates. “They never really explained why. I just figured we had to do it to give Walgreens cover because of what happened in Florida.”