Rx forms causing confusion in triplicate, say pharmacists

Drug Store News, Feb 6, 1989

Rx forms causing confusion in triplicate, say pharmacists

NEW YORK -- New York pharmacists complaining about triplicate prescription forms for benzodiazepines aren't really concerned about the extra paperwork. What bothers them more is turning patients away when prescriptions are written on improper prescription forms.

The state has added benzodiazepines to the list of drugs which must be prescribed using triplicate forms, but some doctors are still either unaware of the new law or are ignoring it.

"Doctors are not on the service end of prescribing," said Don Arthur, president of Owl Drug Stores, which operates eight pharmacies. "They don't have the need to keep up with this information. We didn't think the legislation would go through, since the state kept staying the ruling. We certainly aren't ready for it since it's an inconvenience to our customers.

"We are the ones who have to see the patients and turn them away when the prescription is not written on the correct form," he said.

Elderly patients, who make up a large percentage of sleeping pill users at Owl, are upset when they have to go back to their doctors, according to Arthur.

Arthur said that the triplicate form allows for a 30-day supply with no refill -- a requirement he sees as unreasonable for patients who are elderly and unable to visit their doctors once a month.

Prescriptions filled before the new rule took effect can stil be refilled to the maximum of five times.

"Doctors are already overloaded," Arthur said. "The new legislation will make it worse since patients will have to see their doctors more often."

Maurice Mallin, president of Ogden Center, an 8-store chain in the Bronx, said that the triplicate forms have posed a problem for his business as well. "Some doctors just aren't prepared. Some of my pharmacists are complaining that it's become a problem," he said.

Other pharmacies have had few problems with the forms. Kenneth Gerber, director of professional services at Peterson Drug, a 16-store chain based in Oakfield, said that he has heard of only one case in which a Peterson pharmacist had to send a patient back to the doctor.

Thriftway Drugs, a Brooklyn-based 13-store chain, avoided problems by contacting heavy prescribers in the area before the law took effect.

"We contacted the physicians before Jan. 1 and told them that without the proper form, we could not dispense and could only dispense a 5-day supply in the case of emergency phone prescriptions. We also don't consider sleeping pills emergency drugs," said a pharmacist for the chain.

Other pharmacists are still concerned about the amount of paperwork the new legislation will create. Mallin is concerned that the new regulation creates paperwork for pharmacists that must be filed by the 15th of the month. "How much paperwork can we do for the government?" said Mallin. Pharmacists will be fined $100 if they are late filing their copies of the triplicate forms."

Arthur of Owl is worried that physicians may substitute other drugs for benzodiazepines. "I'm concerned that doctors may be substituting Buspar, a new anxiety medication, which has a slightly different mechanism of action and is not generically equivalent," said Arthur. "One physician said he would substitute barbiturates."

Most pharmacists agree that if the new regulation cuts down on drug abuse, it's a good rule. Arthur still sees problems. "Sure they've identified there's a problem. But to penalize the elderly population, who it affects most, is unfortunate."