Your Pharmacy Benefit Program: Fill & Download for Free

Welcome to evidence based medicine. Your pharmacy benefit company has a computer program that reviewed the specific drugs you use and the frequency dosage and may have cross referenced it against the diagnostic codes used by your doctor. The algorithm suggests less expensive alternatives or weaning you into a different regimen.Since an algorithm can’ talk and the pharmacist is a learned intermediary,he calls your doctor.Your doctor may agree or not but this is his fight. You risk being labeled drug seeking if you are the moving party.Bottom line: call your doctor.

With your doctor’s OK, most pharmacies will readily fill a prescription for 3 months. If you are looking to travel longer than that, you have a few options:Ask your doctor to prescribe you a larger amount of pills. However, depending on which countries you are visiting, there is a chance that customs or police officers will discover the large pill cache in your bags and assume you are trafficking. You would want to have a letter from the doctor in hand describing your medical needs, but this may not get you very far in some instances.Ask your doctor or pharmacy about the possibility of getting your prescription filled in a foreign country. You would also want to contact your insurance company to find out if this would be covered or reimbursable. Otherwise you may have to pay out of pocket.If your pharmacy benefit manager has a mail-order refill program, find out if they will send refills to a foreign address. If so, you can have refills waiting for you when you arrive at one of your destinations.Good luck.

There are far better treatments for Hepatitis C than there were 5, 10, or 15 years ago. If you live in the US, and have private medical insurance, your plan may or may not cover your treatments fully. However, most of the current medications are listed on the Tier 4 formulary as part of the pharmacy benefits program.If you have public insurance — MediCal in California, Medicaid everywhere else, you will need referrals to a liver or infectious disease specialist, most likely. And, there Nurse Practitioners, Physicians Assistant, or social worker will go to battle for you to get the public insurer to pay for your treatment. If you have any history of abuse of or misuse of alcohol, illegal substances, or even mis-use of prescription opioids, they will find you for payment of your care.Of note, clinically, some 15–20% of patients antibody positive for HCV will clear the virus on their own. That still leaves 80% who will not. The word “hepatitis,” means inflammation of the liver. Heavy alcohol use exacerbates HCV. HIV further complicates HCV’s management, but both can be treated. Hepatitis C is far more infectious than HIV.There are some great resources on-line for persons with HCV or advocating for family and friends with HCV. Some of these are listed on either the Home | AASLD web site, or the Infectious Diseases Society of America web site. I am a member of both of these professional organizations. Since I noted you are in the Pacific Northwest, you might also check out the Caring Ambassadors resources; they are based in Portland, OR, but do national work and a lot of clinical support work with OHSU in Portland and with UW in Seattle. They are also a non-profit — and disclosure I chaired their board of directors for 2.5 years and was a board member for 5 years. See: Hepatitis C | HepC Challenge