What does the prescription need to say to get the Certified Generic for Concerta

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This topic contains 3 replies, has 4 voices, and was last updated by  Pump2Duncan 1 year, 6 months ago.

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  • #71285

    goaliemom22
    Participant

    The doctor wrote the prescription for Methplyphenidate ER 27 with no substitutions thinking that would solve the problem, but it did not and the prescription was filled with the new generic by Trigen which we tried last month and it was a disaster. Since he doesn’t know how to write the prescription I need to figure it out so that we don’t run into this next month. I feel awful because my son was doing great on the Actavis and the Trigen did nothing for him – he went from doing really well to barely holding it together his teacher said recently. The pharmacy is telling me that we’re out of luck for this month because they can’t take it back and the insurance won’t cover it again.

  • #71340

    donsense
    Participant

    It appears that the pharmacy filled the script contrary to the instructions of the doctor. Depending on regulations in your jurisdiction this could be considered their mistake and they should supply you with the corrected version. Please note i am not a lawyer but a business man.
    If i were a pharmacist To my customers, I would replace remaining supply for the additional cost or some portion.because i would expect you not shop in my store again. From a patients point of view Concerta original is much more expensive and the original prescription also required an advertising form (convenient) orange and Black cardboard fold over with rip off portion. This manufacturers “no substitution” form allowed the druggist to dispense the drug with substantially reduced copay and co insurance cost to you that was paid by the manufacturer. That made the cost equal to or less than the generic version.
    Did the Pharmacist choose to fill with generic low cost rather than give you the choice of going back to the docs office for form or paying the much higher cost more than $100+ a month.

  • #71529

    ADHDmomma
    Keymaster

    What did the pharmacy say about substituting a generic when the prescription said not to? Was the prescription written for Concerta, no substitutions, or for Methylphenidate ER, no substitutions? A script for Methylphenidate ER is a prescription for the generic.

    When CVS once filled my son’s with one of the generics that the FDA had revoked the equivalency status on, I called them and complained and they told me to bring it back and they would back it out of the insurance and refund it. Then the doctor wrote the prescription for Concerta, “brand-name medically necessary” so the insurance would cover the brand name Concerta. I’ve heard of docs writing it for Concerta with the addition of “brand name or Actavis-manufactured generic only.” A lot of it has to do with what you’re insurance will cover. My insurance will only cover brand Concerta now since the prior generics were obviously not equivalent.

    I would go back to the pharmacy and demand a refund and return on the insurance if it was written for brand and no substitutions and they filled generic.

    Penny
    ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

  • #71571

    Pump2Duncan
    Participant

    I had actually asked my doctor about writing my son’s prescription for Methylphenidate 27mg ER because on my insurance prescription list that drug was listed as one of the few ADHD Tier 1 drugs. And I thought it was the same as Concerta. The doctor said no. He said “ER” and “CR” are old or different drug delivery mechanisms and are NOT the same as Concerta’s delivery mechanism, hence why the insurance company has tiered it so differently. Methylphenidate 27mg ER and Concerta are listed on my son’s formulary list as two completely different drugs – not equivalent to each other. Concerta 27 mg Generic name is Methylphenidate HCL Tab SA OSM 27mg. The “OSM” being the delivery mechanism.

    To ensure my son gets Concerta, he will only write the prescription for Concerta. The pharmacy fills the prescription with the generic that has the “ALZA” printed on it. We go to Walgreens. Unfortunately for me, the insurance company has tiered both the authorized-generic Concerta and the brand name Concerta as Tier 3 prescriptions. UGH!!

    I would go back to the pharmacy and seek a refund and in the future ask the doctor to write the prescription for Concerta. At least from my understanding, Methylphenidate 27mg ER is a completely different delivery system from Concerta and that prescription will not get you Concerta or its authorized generic.

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