Random Text Fun

Do you ever get a random text from someone who is texting the wrong number... but instead of texting back “Hey wrong number,” you go ahead and keep the conversation going as long as possible?

I did, recently. I couldn't help myself. The potential for comedy was just too enticing. Sadly, it didn't last long, but it still ended up funny.

It was quiet on my side for a little while... maybe 30 minutes or so... then finally I received a response:

Sadly, my trolling for some of the real wedding pictures was left unanswered.

When you're a pharmacist and you get beat down, every single day by patients, physicians, and the company you work for, you seek out these outrageous moments to decompress. 

Hopefully my little bit of fun made you laugh.

What is a FORMULARY?

In the United States, a formulary is the list of medications available to someone enrolled in a specific drug insurance program.

Usually a "tiered" system is in place as an incentive for patients to select lower-cost medications. Under a three tier system (the most common), first tier has the least expensive generic drugs and the lowest co-pay. As the medication cost increases, it is listed in a higher tier and thus has a higher co-pay. Usually the third tier has most brand-name medications and the highest co-pay.

The formularies are in place to help insurance manage drug costs imposed on the insurance policy. If the drug is not on the formulary, it usually requires a "prior authorization" -- meaning the insurance company wants to talk to the prescriber to see if there is a lower-cost alternative for the patient. Formularies vary from plan to plan and insurance to insurance. Co-pays vary as well.

Your pharmacy has no control over your insurance, your formulary, or your co-pay. As a courtesy we bill the insurance electronically in your behalf. Within seconds we receive information on if your claim was paid and the amount of your co-pay. Sometimes we get a reject saying "prior authorization" required or the medication your insurance will pay for.

You can always find out if a medication is on your formulary by calling your drug insurance company or looking on their website. Your pharmacist has no way of knowing what is on your formulary without a valid prescription to adjudicate.