1. Can you explain the process for patients and for caregivers – from sign-up to delivery of medications?
Patients or caregivers who want to get their medications packaged by Freedom Pharmacy simply need to call the pharmacy and request the service. Pharmacy staff can then send out some forms to be completed and contact the patients prescribing physicians to obtain new orders. The pharmacist will consult with the patient to ensure that the medications they consume/self-administer are packaged by the “time of day” the patient is used to taking the medications. Once the prescriptions are prepared Freedom Pharmacy will contact the patient/caregiver to arrange the first delivery.
2. What is the cost of this service? If there are different price levels, how is the price determined? What methods of payment do you have and how often?
At this time there is no additional fee for 28 day supplies of the Medicine-On-Time service at Freedom Pharmacy. The only payments due are for copayments on the prescriptions and OTC items that are dispensed. If you need medication packaged every 14 days there is a $10 monthly fee & if weekly a $30 monthly fee.
3. How far in advance can meds be sorted and dispensed?
Freedom Pharmacy works on your prescriptions in advance of “dispensing” the medications to the patients -However, most prescription drug plans and/or other prescription insurance dictate how soon a patient can pick up their refills from the pharmacy each month. Typically if your prescriptions are delivered the delivery date will be a day or two before your current medications will run out. If we mail the medications we generally send them out about a week early to ensure they arrive before the current medications run out.
3a. Can patients get several months’ supply – let’s say 3 months at a time?
We typically dispense bubble packed medications in a 7, 14 or 28 day supply. Longer day’s supplies can be provided for vacations or other reasons at the discretion of the PDP/prescription insurance company. Most insurance companies will only allow a 30 day supply to be filled each month since Medicine-On-Time is not a “mail order” product/service. They may allow a longer days supply with a prior authorization on a case-by-case basis.
3b. How are refills handled – especially at the beginning in order to get all meds synced?
The pharmacist can “partial fill” some of the medications until they are all due on the same date of the month. After the medications are “cycled up”, refills each month will become due at the same time.
3c. How does syncing affect drug coverage by health insurance?
In most cases, the pharmacy will contact the prescription drug plan/insurance company and explain they are assisting the patient with medication adherence, and they are needing to “cycle up” the patient’s medications. The PDP/insurance company typically allows/authorizes the pharmacy to partial fill a medication in order to get all the medications due on the same date. Once medications are due on the same date, the pharmacy can package the patient’s routine oral medications.
4. How soon can a patient start getting meds once he/she signs up?
Depending on the number of medications needing to sync-up, it typically takes no longer than three days to one month for a patient to get their complete routine oral drug regimen in Medicine-On-Time from their pharmacy. If the pharmacy currently services the patient, it could be immediate.
5. How do you handle meds that require a "hard copy" paper prescription?
Most offices can now also send these prescriptions electronically which is acceptable in place of a hard-copy and much more convenient. Prescribers that cannot, may instead fax the med order to the pharmacy then mail the prescription to the pharmacy after faxing it to minimize patient inconvenience. However, the pharmacy will not be able to “dispense” the medication to the patient without the hard copy of the prescription.
This is law.
6. How do you handle bulk medications (liquids, creams, inhalers, patches, birth control)?
These types of medications are dispensed from Freedom Pharmacy as they are with any typical pharmacy. Liquids, patches, creams, eye drops, and injectable medications cannot be packaged in Medicine-On-Time. These will be labeled & dispensed with standard pharmacy prescription labels.
7. How do you handle over-the-counter (OTC) meds?
If a patient takes OTC’s on a routine basis (i.e. one baby aspirin each morning), the Prescriber can write an order for the OTC medication, and the pharmacy can also package the OTC in the multi-dose cup with the other prescription medications.
8. How do you handle changes that occur mid-cycle?
For additions of new medications or increases in dose the pharmacy will typically send out a supplemental pack to be taken in addition to the pack the patient already has on hand. For discontinuations, or decreases in dose the patient +/or caregivers will need to remove the affected medication from the current pack until the next scheduled pack. The pharmacy is prohibited by law from taking back medications to be repackaged except in the case of a facility where the medications are kept with nursing staff.
9. Can MOT arrange for home delivery or do meds need to be picked up at the pharmacy?
Freedom Pharmacy offers home delivery in the greater Burlington area. We also deliver medications throughout the state of Vermont & New Hampshire via courier service or the United States Postal Service.
10. What kind of response has MOT received from patients and caregivers?
Caregivers who spend hours each week filling “weekly plastic pill sorter boxes” LOVE Medicine-On-Time because now they can spend quality time with their loved one instead of filling up the pill boxes. Consumers who receive their medications in the Medicine-On-Time color-coded calendar cards like it for the “simplicity and convenience” – medications are pre-sorted expertly by their pharmacy for “time of day” self-administrations. Caregivers and patients, alike, feel that it is much easier than juggling multiple pill bottles each month, because you can “visually see” if a dose cup has been opened and medications consumed from the dose cup. Each dose cup identifies the patient’s name, the date, the day of the week, the time of day the meds are to be consumed, and the contents/name of meds in each individual dose cup.
11. Do patients need to let their doctors know that they will be using MOT? Do doctors need to do anything in particular while using MOT?
It is not necessary to let one’s doctor know, but it is helpful to the Prescriber for his/her education, so he can be assured that his patient is striving for medication adherence. Doctors do not need to do anything additional if their patient gets their monthly routine oral meds packaged in Medicine-On-Time by their pharmacy provider.
Freedom Pharmacy strives to work closely with your doctor to provide the best level of service possible. Only with close cooperation between prescriber and pharmacy will you get the full benefit of the Medicine-On-Time bubble packs.
12a. In the rare event that an error is made, who is responsible?
This is a difficult question to answer. Different factors could play into this. Patients who know/have been told to discontinue a medication need to relay this information to their pharmacy provider so that they do not re-fill the medications the next month.
The Medicine-On-Time packaging process requires three points of checking the prescriptions – 1) at the time the pharmacy technicians are placing the pills into the dose cups; 2) prior to “cold sealing” the pills inside the dose cups with the pharmacy label; 3) the pharmacist checks it again prior to the medications being dispensed.
The medications are also checked by the patient and/or caregiver when they pick up the medications from the pharmacy and/or as they are getting ready to take their dose.
12b. Does anyone check the bundling of the meds for accuracy? (As a family caregiver, I check all prescriptions for accuracy when I pick up the meds!) See above
13. What else would you like to tell us about MOT?
The Medicine-On-Time color-coded calendar card system was used as “the compliance packaging component” in a South Carolina Medicaid Demonstration study – conducted by the University of South Carolina, Arnold School of Public Health. The study found that “by coordinating the medications with the pharmacists, prescribers, patients and/or caregivers - and giving the patient an easy compliance package - especially prepared for the patient & dispensed by their personal pharmacy - we can reduce one’s chances of a skilled nursing facility admission by 69%.