Posted by: notdeaddinosaur | August 7, 2008

The Latest Craziness

Old man in atrial fibrillation orders his Coumadin from a mail-order pharmacy benefit manager. (I tried to send him to Walmart, or even Tar-jay, where they have even better deals, but he doesn’t drive.) His INRs, measured monthly, range between 2.4 and 2.6 (ie, perfect.) Early last month we faxed refills for the Coumadin and his ToprolXL to the mail-order PBM, per his request. For some unknown reason, they ship his ToprolXL but not the Coumadin.

He called us. We faxed it again two weeks later. We also called in a thirty-day supply to his local pharmacy to hold him until it arrived.

Today he calls again: still no Coumadin in the mail. So we call the PBM. Four departments and six idiots later, we hear this about his prescribed dosage of 3 mg/day, except for 4.5 mg on Sundays:

That’s considered high for his age.

See the gouges in the desktop from my saurian claws of outrage as I reply through clenched teeth:

His INRs are therapeutic and monitored regularly.

Aren’t you proud of me for sucking back the words, “You ignorant fucktard!”


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