Fed up with pharmacy service

Does anyone have issues with poor service from their pharmacy? I do.

I was put onto new basal and bolus insulins about 4 weeks ago to try to reduce the amount I was having to take to control BG levels. Previously on Lantus Solostar and Humilin S, now on Toujeo and Fiasp. Neither are any better than the previous ones and the pack of Fiasp pens only lasts 10 days.

I live in a country area and the only pharmacy I can reach is a small local one but their supplies are erratic. Last week, I almost ran out of Fiasp, but the carrier arrived just in time and I had enough left in the pen for my last dose. I ordered more right away but today, I have run out and the carrier didn't come with the next supply (which should have been ordered by the pharmacy as soon as the previous pack was delivered, but clearly wasn't). Now I have only half a dose left of the Fiasp to take before my evening meal. It will be nowhere near enough, even though I am low carbing.

I do have a couple of phials of Humilin S left - old stock but I suppose it will be OK. But I'm getting very fed up at the poor performance of the pharmacy. They also seem to be running out of other medical supplies as well, which may reach crisis point later this week, if they don't restock. The assistant did apologise - not her fault, of course. But that doesn't help.

In Response said:

Thankfully, my local pharmacy is wonderful. That said, there have been times when they struggle to get supplies.
Therefore, I ensure I have sufficient backup in case there is a shortage of supplies due to manufacturing issues, transportation issues, weather, Brexit, ...

I recommend
- asking your doctor to increase the size of your prescription. If a box of pens only lasts 10 days, ask the prescription to be increased to at least two boxes and explain why.
- changing from prefilled pens to cartridges and get TWO (one to use and one backup) reusable pens for EACH of your insulins. The cartridges will take up much less space in your fridge, there is less waste and the reusable pens are much more robust.

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Yes, I will ask the GP to increase the number of pens in the prescription. Unfortunately, neither of the 2 new insulins are available in any other form. In fact, they warn against any other kind of injection (in case of overdose, apparently).

Since I am new to the current insulin, I am still working out how much I need on a daily basis. I did work out that one pen lasts me 2 days so requested a prescription to be available in good time, but everything seems to be slow at present. On top of that, one pen doesn't last as long as I thought because I am having to up the dose. My response to that has to be, go even lower carb than before. Not what my Diabetes nurse wants me to do, but my GP, on the other hand says that if it works - do it. It doesn't help when supplies are not ordered by the pharmacy in time and deliveries don't arrive when expected. Saw yesterday when I went in for my prescription, that pharmacy shelves are pretty empty, so other meds are either not ordered, or are in short supply to small local pharmacies - not the first time that has happened.

I'll just have to take whatever action I can to stop this happening again (as close to zero carbs as possible and try to get extra prescribed). Just a bit fed up with it all.

kaylz91 said:

I was on an order repeat as and when needed and usually got it within 3 days of ordering

My health centre pharmacist wants me to try a serial prescription in which I'll get 2 months worth of things every 2 months, I'll collect the 2nd one just before Christmas and then call the chemist to see about cancelling it as it just isn't going to work

Are you on other diabetes meds as well as the insulin?
xx

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Just been put back onto 2 x 500 daily Metformin after being taken off of it for a couple of surgical procedures. Other medical issues are probably having an effect as well as the change of insulin, so getting dosing right is proving a bit difficult. I've dug out some older (still in date until January) Humilin S to use until the Fiasp arrives, so it will be a bit of a hit and miss affair until then. BG already sliding up higher than I want this evening - probably stress.

sleepster said:

I'm sorry to hear you're having problems @Annb. I used to use Boots, and between them and the doctors I would have to put in a prescription request at least 10 days before I was going to run out of something, they seemed to have a problem with losing prescriptions too and would swear blind that they'd never received it from the doctors or that the items had already been collected. I have since moved house (and doctors) and at the beginning of lockdown had a local independent pharmacy that delivers recommended to me. Between them and the doctors I can request my prescription items (in the early hours of the morning) and usually have the items delivered later that day, if there's a delay it's usually at the doctors, they will only prescribe 28 days-worth of medication but don't like to authorise and send the prescription until those 28 days are up, but that's a story for another day!

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Your story sounds much like my brother, who lives in the south of England. His medication keeps him alive and even so, he has had trouble with getting supplies, problems with both doctors and Boots.

I have been told in the past that our small pharmacy loses out to the larger chains when stocks become difficult to obtain. I don't really blame them - except when they forget, or don't get around to, ordering in time. Why their shelves are so thinly stocked right now must have a reason. This pharmacy used to have problems under previous ownership but has, within the last year, been sold to people who do not live here and only have a manager/pharmacist on our island and I wonder if they really appreciate the problems this little pharmacist faces.

lessci said:

Could you change to one of the online pharmacies that deliver, or are you still on manual prescriptions?

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I'm on manual prescription.

For a month's supply, I would need to have 3 packs of 5 prescribed. Sounds as though my pharmacist might find that a problem. Today I've used some old, but still in date Humilin S, but just now my BG is up to 14.8 (on a few strawberries and some cream for breakfast). Probably should use a higher dose. The Fiasp still hasn't arrived at the pharmacy. Tried phoning GP and diabetes clinic yesterday afternoon, when it was apparent there would be no delivery yesterday, at 4.10 pm. Nobody was answering. No point phoning yet today - I've decided to use the Humilin and maybe asking them to prescribe something different - it's not as if the Fiasp is very much good anyway. Better than the Humilin but no good if it can't be supplied.

DCUKMod said:

Ann, if your pharmacist knows a client requires x amount of meds and uses their services, in my view, it is their role to facilitate that, not some random amount.

Of course there will be glitches arise from time to time, but for regular, baseline amounts, he should be preparing himself to meet your needs. He is providing a service to you, and is being paid to do so. It's not up to you to solve his problems.

In your shoes I would be doing the following:

- having a conversation with my GP to ensure he/she understands what you need and how his/her prescribing rationale is failing you.
- asking him/her for a one-off larger amount on prescription, to allow you to hold a very modest amount for such glitches
- asking him/her to contact the pharmacy to ensure the pharmacy/pharmacist understands your requirements
- for the short term, I would be ordering my supplies to ensure I had some leeway each time I ordered to father facilitate glitches.

Each time a pharmacy dispenses a prescription they charge a fee for that. Incurring that fee every two weeks is bonkers.

I know you haven't been on this new insulin very long, and you are only just beginning to understand the amounts you are realistically going to need, so I wonder if that is compounding matters.

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I'm still not sure that Fiasp is the right insulin for me - a matter of trial and error really. I realise that the pharmacy may have difficulty keeping on top of my needs. I'll give it another while, once Fiasp comes in, to see if I can get BG at a reasonable level. The situation clearly is being compounded by this change over to a different brand - Humilin was also a problem for them - again obtaining supplies when they ordered them.

Once I see where this is all going, I'll talk to my GP. He will probably refer me back to the diabetes clinic, but that'll be OK.