Friday, March 29, 2024

Building a reserve supply of prescription medications

 

Yesterday I said, when speaking about a Canadian forecast for foreseeable problems over the next few years:


For several years I've seen to it that my wife and I have a six-month supply of every long-term prescription medication we take.  I'm now doubling that, to a year's supply, and adding to it a selection of antibiotics that we've used in the past for common conditions and that we might need again.  I think I'd be irresponsible not to do so when the health care system can't guarantee their availability.


In a comment to that article, reader coyoteken48 asked:


One question though, where do you get the stockpile of prescription drugs?


This article will try to answer that question, as far as US residents are concerned.

First off, there are legal ways to accumulate such a stockpile, and there are illegal ways, in terms of US law.  I am not, repeat, NOT advocating that my readers break the law.  It would be irresponsible for me to do that, and it would make me an accessory before the fact to any crime any reader might choose to commit in that regard.  Therefore, if anyone decides to skirt the edges of the law in dealing with this . . . you're on your own.  Don't blame me.

That said, let's look at a couple of legal solutions.  The simplest (although it takes quite a long time) is to refill your prescriptions on the very first day that your health insurance will agree to pay for them.  Typically, the insurer will pay for a refill between 7 and 10 days before the old prescription runs out.  You can then stash the last few pills of the old prescription, and begin using the new one.  Over time, as you do this, your reserve supply grows - but, as I say, it's a very slow way to achieve that.  Mark on your calendar the day on which you obtained a refill of every prescription, and then ask the pharmacy for the date on which your insurer will cover the next refill.  Mark that on the calendar too, and the day before, call the pharmacy and arrange to pick up the refill on that date.  It's not difficult.

There's a faster, easier and more convenient way, if you can afford it.  You have to ask your healthcare provider to give you one or more additional prescription(s) for your medication(s), in quantities sufficient to build up your stash.  Many of them will not do this, for reasons that doubtless seem good to them:  but others are OK with it, provided you explain not only what you want, but why you want it.  Our health care provider was more than willing to help, particularly because many of their patients had experienced delays in getting their hands on critical medication(s) thanks to supply chain and other issues.  We were able to get extra prescriptions for an extra 90-day supply of our medications, which we filled, and then got another prescription and filled it in the same way.  It took about a year, but doing it that way provided the reserve supplies we needed, and did so legally.

Next, to fill those prescriptions, pay cash - don't charge them to your medical insurance.  The latter may consider it fraudulent for you to build up your reserve supply of medications at their expense, because they budget to pay only for an ongoing supply on a regular basis, not a reserve supply.  Also, your regular pharmacy may or may not be willing to fill extra prescriptions, even if you're paying cash, because they don't want to get crossways with your health insurance if the matter ever becomes public knowledge.  We chose to use a different pharmacy for our cash purchases, and paid in cash - not by credit card - to avoid any complications that might ensue.  Since we had a legal, legitimate prescription on every occasion, there were no problems.  (You'll have to ask your health care provider to phone through the extra prescriptions to the alternate source, not your primary pharmacy, but there are normally no problems with that if you have an understanding doctor or nurse practitioner.)

(Rotate your reserve supply of medication to use the oldest pills first, and reserve the newest ones for your stash.  However, don't be put off by expiration dates on a prescription bottle.  Many medications remain effective for a very long time..  For example, I'm using a pain medication pill right now that was prescribed for me in 2007!  The container was stored in a box and forgotten for many years, and I recently rediscovered it.  It still works well, and is effective at treating my condition.  I'm not complaining!  If you're in any doubt about the safety of using older medications, check with your health care provider or pharmacist;  but the practice is widespread, even official.)

Those are the legal options.  If you can follow them, I highly recommend doing so.  However, there are those whose health care providers won't cooperate, or who have other difficulties in getting what they need.  There are other options for them - but they involve breaking US law.  As I said above, I do NOT recommend these measures;  I'm just telling you about them for information's sake.

One approach, no longer generally available, used to be to purchase pharmaceutical-grade medications from suppliers of veterinary medicines.  However, it's illegal to sell animal medications for human use;  and there's also the problem that many agri-businesses have misused antibiotics, dosing animal herds with vast quantities of them and thereby encouraging the spread of antibiotic-resistant strains of various illnesses or infections.  The authorities have therefore made it very difficult to obtain such medications online or by mail.  I understand some people have friends who are farmers or ranchers, with prescriptions for their businesses, and get some medications from them;  but again, this is illegal, and could result in big trouble for both seller and purchaser.  I don't recommend it.

It's illegal for individuals to import their own scheduled (i.e. regulated) medication into the USA.  That doesn't stop literally hundreds of thousands of people doing it by visiting Mexico, across our southern border, as day tourists.  Many Mexican towns, particularly those with heavy tourist traffic, have pharmacies that are only too happy to take visitors' money and supply them with what they need, with or without a prescription, often at prices far cheaper than those charged in the USA.  Entire busloads of "pharmacy tourists" cross the border in places like San Diego, California, every day, and US customs officials often turn a blind eye to what they're carrying when they return.  It's official tolerance for something they couldn't stop even if they tried, because too many people are doing it.  Businesses in Mexico even advertise to Americans for their custom.

A slower and more complicated route, if you can't cross the border easily, is to order from pharmacies in other countries.  Some Canadian and Indian pharmacies are well-known for their willingness to assist US customers, and there are other countries doing the same thing.  Many will not ask for a prescription from their customers.  There are risks involved in ordering from a Third World pharmacy;  one can't be sure of the quality or purity of the medications involved, which can be actively dangerous to your health.  On the other hand, there are pharmacies who derive most of their business from such orders, and who take great care to "keep the customer satisfied", because if they don't, they'll go out of business.  Customers who take care to patronize only the latter, and who check references with other customers online, have generally had good experiences.  Read this article for a good summary of what's involved.    (During the height of the COVID-19 epidemic, thanks to often misguided and ill-informed official restrictions, medications such as Ivermectin and Hydroxychloroquine were often only available to US consumers through such sellers.  That introduced many new customers to such pharmacies, who've done a roaring trade with them ever since.)

As to which international pharmacy to choose, do your own search, something like this example.  You'll find plenty of results online.  I obviously can't recommend any particular provider, partly for legal reasons (because I can't and don't advocate breaking the law), partly because I never recommend any supplier I haven't used myself and therefore have reason to trust.  I understand there are forums online (here's one example) that discuss such pharmacies and their merits or flaws.  Some Web sites also recommend certain providers in their responses to reader questions (for example, here or here.)

Bear in mind that if US Customs detects medication being imported from foreign countries, they may confiscate it;  and, if they're not in a forgiving mood, they may investigate further and prosecute the person importing it.  I understand this happens very seldom, but that doesn't mean it never happens.  Caveat emptor.

Well, there you are.  Ways and means to build up a reserve supply of essential medications.  Let me close by saying again that you should not break the law, and I'm not recommending that you do so.  Don't blame me if you choose to disregard that!

Peter


13 comments:

Bob M said...

As soemeone whose health requires a bunch of Rx meds, I have yet to find a provider who is willing to prescribe more than a 90 day supply-and that drops to 30 for contrlled drugs.

But it is not just providers- health insurers often dictate how much a pharmacy can dispense.

Anonymous said...

Why do you permit government to dictate what medicines you may possess and take? It only is able to do this because you obey it. Why do you obey it? Only 2% have been obeying the recent Illinois gun registration law, and there have been no reports of negative consequences.

Beans said...

To Bob M. The Fed Gov, thanks to Obama, only allows 30 days for controlled drugs, with only a 2 day (28 days in) lead allowed, but a lot of pain management doctors won't write for that 2 day lead time.

As to the whole drugs thingy. Big tip to keep you out of Federal Jail. That is... Only have the max number of pills in the bottle as is shown on the outside of the bottle. Only. Especially with controlled drugs. You will catch a federal level felony for having 31 Oxycodones in a bottle labeled for 30.

And don't put controlled drugs in an unlabeled bottle or container. If the police or the feds are after you, especially. That means every time you use a pill box or pill minder, you run the risk of serious felony charges.

Especially when travelling. Use your newest bottle, but move what you aren't going to use in last month's bottle that stays at home. That way you have the new pill bottle with all the drug info on it and if or when the police search your stuff, you won't get jammed up.

And once they find a controlled substance in an unlabeled container or loose in the car or in too much for the bottle, they have you and will rip your car/apartment/house/luggage/clothing apart with glee and much happiness on their part. (While ignoring the 3 Mexican Cartel members who are leaving a trail of blood and drugs behind them as they saunter by the police/feds that are shaking you down.)

I know it's stupid. But it's the Fed Gov. Who treat prescription meds as bad as guns. Or worse.

Aesop said...

'zackly.

Being "in the biz", I can ask co-workers to write me an Rx for meds (provided no scheduled narcotics are included).
I took those to a completely different chain, pled no insurance, and paid full cash price, until I had a year's reserve.

I now rotate those with the ones insurance pays for, and so I always have and additional 12-15 months' supply on hand.

Any problem you can't solve in 15 months is a Zombie Apocalypse.

Price out of pocket was maybe $80-$100.
Small price for a years' worth of peace of mind.

I may push for a second year this year.

As long as you aren't asking for controlled narcotics, and you're not defrauding your insurance by trying to double-dip, it isn't that hard to find a willing professional with Rx-writing privileges who'll go along with your plan, provided they know you well enough to know you won't blow it up in their face and bring DEA heat backon them.
More than a few have remarked, "Hey, that's a great idea; why didn't *I* think of doing that?" too.

Now you've got a like-minded individual, with advanced medical training, who may be open to other sensible suggestions. Maybe even a solid medical resource. Think like a recruiter, not a scammer, and this is easier than you think.

The Old Sarge said...

"You can then stash the last few pills of the old prescription, and begin using the new one."

Bzzzzzzzt...! Wrong. Always use up the oldest first (FIFO). Then start using the newer stuff.

boron said...

I hate to be "the contrary one" (heh!), but
all chemical compounds/drugs/medications have, not an expiration date per se, but a time at which the efficacy may drop and the chemical changes may even produce a small amount of something that may not do you any good.
If you're intent on building up a supply of needed meds, please consider vacuum sealing and keeping the supply in a very cold environment: this is not true for all meds (tresiba is a good example) which require cool, but not cold storage; please check the PDR.

Ultimate Ordnance said...

In some cases, there may be "over-the-counter" equivalents. I take 40mg Nexium daily. When the insurance would only pay for generic, which doesn't work for me, I bought the 20mg real Nexium from Amazon and took a double dose. I can buy as much of that as I want to.
Also, be diligent about refilling prescriptions for "as-needed" drugs. I take Imitrex for occasional migraine. The standard is 9 pills per month. I refill it as soon as it is possible, even if I have only used 3 that month.

Harbinger62 said...

This became evident to me after the Hurricane Katrina debacle in New Orleans. Patients that I treated up in Oklahoma at Camp Gruber had spent a week in the Super Bowl and then another week or more on busses in Dallas and finally got to Oklahoma after being out of their blood pressure and diabetic medicines for two to three weeks. Many of them admitted that they had just barely ran out of their medicines as the hurricane was about to hit and so they had no reserve medicines to take with them when they had to bug out to the Super Bowl and the other travels.

I advise patients all the time to fill their prescriptions a few days early and build up a reserve and also for non-scheduled drugs and glad to write a second paper prescription for them to take to a different pharmacy chain and fill on their own with cash. The difficulty sometimes comes up in regard to medicines that have to be stored in the refrigerator and are non negotiable such as insulin for insulin dependent diabetics like my daughter. We do have a year-ish of insulin available rotated to keep inside the expiration dates and oldest used first. And I have a generator to run the fridge to keep the insulin good, but that generator won't keep the refrigerator cold for a year if the zombie apocalypse does come. I don't store that much extra fuel. I do have paper copies of Banton and bests 1923 article about how to isolate insulin from animal pancreas. But it has been a long time since I've been in a chemistry lab and don't have a lot of confidence in really being able to do all of it.

Do what you can, and keep your imagination going looking for solutions to problems and solutions to potential problems.

Anonymous said...

Beyond medications I have been asking folks from other parts of the world about internet based medical help. One couldn't do surgery on the kitchen table. But there are many minor issues that could be answered via a chat room and perhaps in a cost effective manner

coyoteken48 said...

Thanks much. I'll start as you indicated and follow through as needed. ---ken

tweell said...

Check out Jase Medical - jasemedical.com
They do prepper kits with antibiotics and ivermectin, plus can get you a limited number of common prescriptions. Fill out a questionnaire, chat with an affiliated pharmacist, and pay. They aren't cheap, but who is nowadays?

They're US based, so if you're worried about ordering from oversea pharmacies, give them a try. No, I'm not getting a kickback or even a discount, just a satisfied customer.

Anonymous said...

Monty Python's Judean People's Front Crack Suicide Squad is comedy because it's a political strategy that obviously doesn't work. Meekly obeying laws which ban logistics for your medicine, is likewise a political strategy that obviously doesn't work. You could have voted for Ron Paul for president, but you didn't. It's like that joke where God sends two boats and a helicopter, but the voter still drowns.

Anonymous said...

I gained my reserve supply by spending unanticipated three month in a nursing home on IV antibiotics as plan B to an amputation. My mail order pharmacy sent my usual home while I was supplied by the nursing home! I make sure to rotate stocks.