Understanding the VA Formulary

[rpowell01]

I have a copy of the VA Formulary of all their medications.

 

If a medication is not on the list does this mean they won't prescribe it? I've been on Oxycodone 5mg every 6 hours for 2 years now.  I feel my body has become tolerant to the medication that its not even helping me anymore so what I have to do is take 2 5mg Oxycodone TWICE a day. I don't go over the 4 unless the pain is above a level of 10 and some of you know what I mean about the pain level being over a 10. On my last refill of Oxycodone my VA PCP changed it from every 6 hours to every 4 hours as needed but left the quantity at 120. He said if I was able to wean down to two a day, which I did for two weeks, he felt he could prescribe for me like this. But that still puts me in a catch 22 because he told me in a Secured Message that on days where my pain levels are high to go ahead and take it every 4 hours. HUH? But I still have to take it every 6 hours in order to stay within the quantity limit for the month.

 

Anyway my question to him was if he could give me a trial run of Tramadol Extended Release which comes in the form of 100mg, 200mg and 300 mg tablets. Its really made for us who has been on Opiates long term because the Tramadol HCL immediate release will not even touch the pain. He comes back and tells me that the Tramadol Extended Release is not in the VA Formulary. So, does this mean they cannot even prescribe it whatsoever? Or does the formulary mean these are the common medications that doesn't need a special approval?

 

Last, many of you who have chronic pain is there anybody that take small doses of Abilify as in 2mg or 5mg for your Chronic Pain? Read this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184588/

I gave this to both my VA Mental Health MD who submitted it along with a prescription of it to the VA Pharmacy and the Pharmacist DENIED me this medication.  I then submitted this article to my VA PCP through secure messaging and he said he wasn't going to "go over somebody head" but he said he would submit it to my Pain Management Neurologist. I just don't get it, I submitted EVIDENCE, FOUR different case studies that proves Abilify helps people with chronic pain when other meds won't help anymore. We all know that even with these mental health medications they have an end of life period where they will quit working for you. Even over the counter meds like Tylenol. If you take them every day they will eventually quit working. ALL meds are like this to include alcohol. Anyway my question about this is who do I go to about them denying me Abilify as a trial run to file a complaint to at least have it over turned? Patient Advocates Office?

 

I am wanting to come off the Oxycodone as its end of life has now affected me. Yes the VA could increase the dosage to 10mgs or add morphine extended release but they won't now because of the DEA crap that is going on. They are grouping every single veteran who is in fact suffering with chronic pain with those who are abusing it. This pisses me off and I truly believe the VA medical needs to be shut down and we are given a special medicare card so we can see outside doctors. JMHO.

 

I am willing to try anything except entering to any Chronic Pain Rehab Program for 3 weeks. I just cannot do that.

[Vync]

I think the VA medical system should not be shut down, but do believe they should cover our treatment costs from the provider we choose. I read online that Trump wants to remove the monopoly the VA has over locking in veterans to their substandard treatment system by allowing them to go to any doctor who takes medicare, show their veterans ID, and get treated. This plan alone is 100% better than the (lack of) Choice Card program. Here's a link to his plan: https://www.donaldjtrump.com/positions/veterans-administration-reforms.

The VA prefers to take the cheaper route first. I have taken tramadol before and it made me feel funky, not to mention I developed an allergy to it after taking it for a while. It is a good alternative to the regular opiates, but the risk of abuse can be a problem which is why the FDA placed restrictions on it. It stinks that our bodies develop a resistance to pain meds. I don't blame you for wanting to take another route. Perhaps if you can get something non-narcotic that addresses the pain, then you can only take the opiates during flare ups.

Have you tried seeing a chiropractor? I went to one before and it felt like an assembly line. I recently found a non-VA doc who genuinely cares about their patients. Some of the visits are painful and I am more sore for a short period, yet I have noticed a more long term reduction in the intensity of the pain level compared to just taking opiates alone and getting temporary relief for a few hours at a time. If your VA does not offer that kind of treatment, perhaps you can take the (lack of) Choice Card route and try it.

[rpowell01]

Well it doesn't matter now. My private PCP prescribed it to me but I don't have $300 as part of the share cost with medicare. I cannot believe these companies are allowed to charge this much for medications. Screw that, nothing is worth $300 a month!!!!

[Vync]

Wow, that's robbery!

Consider the programs with reduced or no co-pays from the pharmaceutical manufacturer if you can't get it from the VA. They base it on annual income, but I am not sure if they count VA disability payments towards that.

[rpowell01]

Vync there are no programs for us who has medicare. I researched today and even called CVS and talked with a Pharmacist. I don't understand why these companies think because we have medicare we are good to go. But luckily my mother, a precious woman, Is going to lend me the $376.71 so I can get a one month prescription of Abilify. I will just pay her back on income tax return. 

I downloaded my VA Records and read over the VA Pharms denial. There was no reason given except her saying this crap:

VA POLICY ON NON-FORMULARY DRUGS:

1) According to VA policy, medications prescribed by the VA clinician will be CHOSEN by the VA clinician, using the VA formulary for all prescriptions unless the VA formulary agents are contraindicated due to allergy, drug interaction, previous therapeutic failure, or other valid justification for utilizing N/F agent.

 

2) If the patient prefers N/F medications despite availability of equivalent formulary alternatives, the VA provider may write a prescription for N/F agent for the patient to fill at his OWN expense at a private pharmacy (per VA policy).

So I guess the VA Pharmacist didn't read the policy on medications that must be given for service connected issues? BTW there are NO EQUIVALENT formulary alternatives to Abilify. NONE. Research Abilify and you will see there are no other medication alternatives to it.

Here is what I am going to do. If the Abilify works then I am going to file a complaint with Patient Advocates Office to get the VA Pharm to approve this medication. If they still deny me then I am filing TWO complaints with both Congressman here in Florida. If they want to play STUPID and HARD BALL then I say "lets play".

How can they deny medications to veterans that already tried things such as:

amitriptyline, nortriptyline

duloxetine 60mg/day
gabapentin 3600mg/day
hydrocodone/apap., morphine sr, oxycodone/apap, oxycodone, tramadol & venlafaxine sa 150mg/day

 

and none of them worked? A person can only try so many medications before their body becomes TOXIC. If you don't believe me ask the veterans who are now in the "Six Feet Under Club" and their spouses just testified in the past 2 years on capital hill about the VA and their medication crap.

 

If this medication works I promise I will respond to everybody on here so others can at least try Abilify and hopefully group together to get the VA to get the generic form of Abilify on the VA's Formulary worksheet. But I can promise you I will take this all the way to Capital Hill if I have to because I am sick of the VA just handing out certain mental health medications like its candy. Please, please understand these medications can cause toxicity in our bodies and they can and will send you to the ER. From January - May of this year, 2015, I went to the Emergency Room at least 10 times with rapid heart rates and high blood pressure. In the end it was found that the Amitriptyline was causing severe dehydration and making my Obstructed Sleep Apnea worse. So what does the VA do they give me Ambien that even made my life worse. They hand out Ambien like candy to many veterans. Ambien messed up my sleep big time because it made my OSA severe, so severe I stayed fatigued and tired and I slept and slept and slept. If I am willing to be a guinea pig to see if the Abilify works in place of these opioids please do not hestitate to protest to your VA PCPs or mental health staff on getting them to protest to the VA Pharmacy about getting this on the Formulary list.

 

Edited November 11, 2015 by rpowell01

[Espalda]

Thank you Vync for the link to Donald Trump's platform for VA reform -it was very refreshing.

I am new to this Website.