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PostPosted: Tue Jan 11, 2011 12:22 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
I'm very disappointed.

for a variety of reasons we decided to switch to the twinject. Since the pharmacist doesn't keep them in stock we did have to wait a few days, which was fine. But here are the list of things I'm upset about.

1. I wanted one twin pack and one single twinject. The twinpack was unavailable, so I had to order three singles. Two singles costs more then one twin pack.

2. Twinjects website says they are covered by all provincial drug plans. My policy covers some stuff at 90% and some at 50%. The twinject was only covered at 50%. Pharmacist called and was told this is because the provincial plan does not cover it. :scratchy

3. They expire in 10 months. :verymad

So I phoned them. Got transferred. got transferred again...this time got voice mail. Nobody has called me back. It's been a few days now.

I feel ripped off. I hoped if their website is accurate they could help me deal with the insurance company. if not, then correct the website.

They feel 10 months is acceptable. When I'm paying (and have to pay more because the twin pack is unavailable) it is not acceptable.

And no call back......

I guess when these expire I'll go back to the epi-pen.

_________________
self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Tue Jan 11, 2011 12:39 pm 
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Joined: Fri Oct 10, 2008 9:40 pm
Posts: 2034
Location: ottawa
Very unfortunate. Going by what you have said above that is NOT good customer service!!!

_________________
DD 12 yrs -no allergies
4 yr old DS - asthma/eczema Anaphylactic to Peanuts, all tree nuts, sesame , all pea/lentil legumes, gelatin.
Allergic to trees, grass,ragweed, feathers, dander, mold and dust.
Outgrew eggs, fish, shellfish


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PostPosted: Tue Jan 11, 2011 12:53 pm 
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Joined: Mon Jul 05, 2010 11:37 am
Posts: 1523
Location: Alberta
I agree. The money this is involving is crazy.

Michele

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Myself - Seasonal, cats
dd-asthma (trigger - flu) anaphylactic to eggs, severe allergies to bugspray and penicilin,pulmicort
ds-Seasonal, cats and OAS
dh-allergy cats, bugspray and guava, outgrew egg allergy


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PostPosted: Tue Jan 11, 2011 2:28 pm 
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Site Admin

Joined: Mon Feb 07, 2005 6:39 pm
Posts: 2928
Location: Toronto
That's not good CS on their part, I've had better experience.

FYI, though, expiry is a drugstore shelving/ordering issue.
Can happen with any drug. I now always ask about the expiry before buying either pen.

If I don't like the dates, on to the next drugstore. G

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Allergic to soy, peanut, shellfish, penicillin


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PostPosted: Tue Jan 11, 2011 2:46 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
The expirey date was not because of the pharmacy. He had none in stock and had to order them in for me...would have been the same at any pharmacy. and, when I did call twinject, one of the people I spoke with did say ten months is acceptable. I think she said 10 - 15 months.

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Tue Jan 11, 2011 11:57 pm 
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Joined: Wed Aug 10, 2005 11:21 am
Posts: 684
Location: Cobourg, ON
With our health coverage, we had to pay more at the drugstore for the twinject which I wasn't happy about but then we discovered that we had to submit a further drug claim form to our health provider to receive the full amount back. Could this be the case with your coverage?

_________________
11 year old daughter -- lives with life-threatening allergies to milk, eggs and peanuts; seasonal allergies (birch, maple, ragweed); pet allergies; asthma; and eczema
9 year old son - no allergies


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PostPosted: Wed Jan 12, 2011 10:06 am 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
So far, they are saying it's only covered at 50%.

was it only the first time you had to do it that way? Probably it was not in your carriers system the first time, but after that you shouldn't have to wait for the refund.

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Wed Jan 12, 2011 3:04 pm 
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Site Admin

Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6429
Location: Ottawa
Quote:
Ontario Drug Benefit : Allergy Products

What ?
Certain mixtures used to treat severe allergy symptoms and given by injection under a physician's guidance, are available to people who are eligible for drug coverage under the Ontario Drug Benefit (ODB) Program.

Coverage does not include
The ODB program's coverage of allergy products does not include antihistamines or mixtures used to diagnose specific allergies.

How ?
The ODB program will pay for covered allergy products only if your physician prescribes the product and completes a special form, on your behalf, for coverage. You must also be eligible for drug coverage under the ODB program.

Cost
Cost-sharing will not apply to allergy products. The ODB program will continue to cover 100% of the cost of these preparations.
http://www.health.gov.on.ca/english/public/pub/drugs/allergy.html

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Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Jan 12, 2011 11:42 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
Autoinjectors are not used nder a physicians guidance. so that quote won't help me.

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Thu Jan 13, 2011 7:58 am 
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Site Admin

Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6429
Location: Ottawa
Hmmm

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Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Tue Mar 01, 2011 11:53 pm 
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Joined: Sun Nov 30, 2008 11:00 am
Posts: 1115
We wanted to get the twinject but the pharmacist had to phone the Allergist since it was a change from the EpiPen. Our Allergist would not let us use the Epi-pen prescription for a twinject because the Allergist tested them and was not satisfied - said there were multiple failures. The next time we see the Allergist in person I will ask for more details!

Even without details, that is enough info for us not to use the twinject. This is a pediatric allergist who has many patients with epipens.

_________________
me: allergic to crustaceans plus environmental
teenager: allergic to hazelnuts, some other foods and environmental


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PostPosted: Wed Mar 09, 2011 12:40 am 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
Well, twinJect wouldn't call me back....so I went searching myself. dealings with company administrator and some guy at the insurance company.

i've been trying to contact someone from the government....today, after getting e-mails returned as undeliverable :confused I managed to get a person. A real live government employee. :rofl I explained that I wanted to find out if a particular prescription was covered under the Ontario formulary.....she told me to call a pharmacy. :dungetit

The pharmacist checked and said it is not covered unless you get a letter from the doctor.....must be in advance.

So, went back to the government web site. Apparently twin-ject is covered under The Exceptional Access program.

Quote:
To apply through EAP, the patient’s physician must submit a request documenting complete and relevant medical information to the ministry, providing the clinical rationale for requesting the unlisted drug and reasons why covered benefits are not suitable. All requests are reviewed according to the guidelines and criteria established by the CED and include a thorough assessment of the patient’s specific case and clinical circumstances, as provided by the physician, as well as the scientific evidence available.


So, I'm out $140. i don't know if the insurance company would cover it with that note or not....but since twinject misleads on their website and then wouldn't help me.......I'm just waving the white flag. I will NOT request a letter explaining why this is preferable to a covered script.

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Wed Mar 09, 2011 8:02 am 
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Site Admin

Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6429
Location: Ottawa
So Epipens are covered but not Twinject, unless you give the government your complete medical history etc (which is private)?!? :freak

This creates a monopoly for King Pharmaceuticals
Oh, this needs to be changed! :swing

Quote:
The Ombudsman investigates complaints about services provided by the government of Ontario and its organizations. He also conducts systemic investigations on important issues about government services, which can affect large numbers of people. Under the Ombudsman Act, individuals as well as government officials and staff working in government organizations are required to co-operate with the Ombudsman and provide information during an investigation.

http://www.ombudsman.on.ca/en/what-we-do.aspx

_________________
Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Mar 09, 2011 9:25 am 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
not your complete history. just why this specific medication is required instead of the alternative which is covered (and usually the cheaper med is the one covered).

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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PostPosted: Thu Mar 10, 2011 12:16 pm 
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Joined: Mon Sep 05, 2005 12:53 am
Posts: 373
Location: Alberta
OK, I might be able to help here.

First off - regarding the special request to the Ontario benefits ... this is a common thing for many medications considered to be a "me-too" drug (a drug that doesn't offer any real benefit over existing medications that are covered and offer no cost benefit). It's a way of trying to discourage pharmaceutical companies from putting drugs out there for no other reason that to get a piece of the pie, so to speak. Here in Alberta, we have to remind physicians to fill out these forms every day, for things like Plavix (only allowed in certain populations, but potentially life-saving for those who have had strokes and MI's), Alzheimer's medications, and arthritis meds.

So honestly, if you asked your doctor's office to send in that form, it will not be a big deal. There are standard forms available, and they don't have to give a complete medical history - the doctor just has to list a reason why he feels the Epipen isn't appropriate in your case - the need for a back-up dose due to allergy severity might be all he/she needs to say.

Secondly, if the acceptance goes through quickly, the billing can be reversed at the pharmacy. We do this ALL THE TIME for patients. Almost every shift, I get a message back for a senior's meds that their special auth has run out, and the doctor needs to re-apply. I send a quick fax off to the doc, give the patient a 10-days supply at no charge, then we re-attempt the billing to the government plan until it goes through.

So while all this may sound like a hassle, it's every-day life at a doctor's office and a pharmacy.

As for the dating... my ds was switched to a Twinject, and I spent months waiting for stock to come in with better expiries (we were getting no better than 6 months dating last year)... and it never happened. I'm a pharmacist , and I can order directly from the suppliers, and even I can't get a decent expiry on a Twinject! So really, pharmacies hands are pretty much tied when it comes to giving you priority dating. We get what we get. Shopping around might help, but there are fewer and fewer drug wholesalers these days, so pretty much every pharmacy suffers from the same problem.

That being said, epinephrine injections are Schedule 2 (at least in our province), which means a pharmacist can prescribe. So I asked my colleague to switch my ds back to an Epipen (I can't prescribe for my own family), and now we have at least 1 year expiry.

So bottom line if it were me .... I would get the forms filled out by the doctor, and see if the pharmacy could re-bill it when approval comes through. If not, you could try asking the pharmacy to change it to the Epipen. In the asthma world, choice of inhaler boils down to patient acceptance, and the same is said of auto-injectors. I chose to go back to the Epipen because of the expiry dates, but also because the school freaks out a little about Twinjects - they are not as confident using those, and much prefer an Epipen. I have not told our allergist that we have switched back, but next appointment I probably will (we've been bumped to every 2 years now). As long as we have 2 on hand, it's no different than having a Twinject. Just a little more expensive up front, but with longer expiry dates :wink: - so maybe less expensive in the long run?


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