A RESOLUTION to Why was my approved prescription denied-Part IV

From (Name withheld to protect privacy) to John Curry; March 9, 2007
Subject: Just a follow-up

John,

I do need to clear up a few things for all who may be reading. Before I retired, I tried many drug combinations to help me with the Narcolepsy symptoms. And, the drugs do treat the symptoms, but there is no drug that will help the problem. It is forever, and with the drugs I can live a "normal" life. It could be compared to being a diabetic; insulin will help the symptom but not cure the problem.

I know all about the side effects of these narcotics, I have never abused them or used them inappropriately. I just hate it when any reference is made about the improper use of medications. Remember I have used the same two drugs for 5 years. I also would not spend a penny that was not necessary for these medicines. My doctor usually has given me samples of medicines to try before I fill a prescription.

Before retiring, I had two different complete sleep studies done. Each test takes two days in a sleep facility, and at times they were grueling. My first test was done in Dublin and the second one in Huntington, WV. I also spent 5 days with the neurological department at OSU. Sleep study tests rule out what person does not have, and then the tests indicate what sleep problems a person has. It is too complicated to write any more about the tests. Not only have I been diagnosed with Narcolepsy but obstructive sleep apnea, restless legs, and cataplexy. My retirement system did not pay for any of these. I'm not complaining about the disease; it could be something worse. I just wanted my medication. I haven't decided if I'm offended about some of the comments made to explain why my drug was denied.

But, the good news ...someone has fixed by problem. Maybe it was Brenda Foster at STRS. Caremark called me this A.M. to tell me that my medication has been approved. This rep was extremely nice and was eager to help. She told me that this had really "gone up." I thought she meant the price of Provigil, but she really meant at Caremark. She had talked to my doctor earlier, and the drug is to be sent as soon as Caremark receives the prescription... which I sent on Tuesday. It will come express mail at their expense. I asked if my doctor had caused any of this mess, and she said no.

I also received a prescription for a 10 day supply of my other medication. When I went to pick it up it was $50. I had them to check to see if it was mine, YES, was it the generic I asked for, NO, the pharmacy was out and none to be had until next week. I asked for my prescription back...that was too much since I did pay $30 for 270 pills from Caremark. The Caremark rep offered to override the Brand cost for me at the local pharmacy, but I didn't want that...I took it to 2 other pharmacies until I could get the generic...which costs $10. Remember I told you I live in southeastern Ohio, and I am a proud Appalachian.

I am appreciative of your help, Brenda Foster's at STRS, and Stephanie Watson's at Caremark.

Another short piece of info...I never heard anything from Medical Mutual about the need for further testing that my doctor did not prescribe for me.

(Name withheld to protect privacy)