174 Units: The Story of a Pharmacy F-Up

Once upon a time, there was a woman whose large employer violated reasonable accommodation laws, which had a severely negative impact on her health. So, she left the large employer for a much smaller one. It wasn’t perfect, but it was much better.

Then, after just a year, another large company came along and ate the smaller company. The woman was not encouraged by her first interactions with the large company, and she dreaded the change of health insurance – the second time in two years.

As it turns out, the woman was right to be afraid. When she went to her endocrinologist for the first time under the new plan, she knew she would need all new prescriptions. But when her doctor, who worked for a very large hospital system, tried to find the mail-order pharmacy – the cheapest option – she could find neither hide nor hair of the company listed on the woman’s prescription card. So, the woman left the doctor’s office with a stack of paper prescriptions. She wasn’t too worried. She still had a little more than a bottle of insulin left (~ 3-4 weeks’ worth).

As soon as she could, the woman called the number on her prescription card. When she asked the customer service rep to help her figure out the name of the company in charge of the mail order pharmacy, the rep asked for all the numbers on the card before replying, “That’s strange. I’ve never had our phone number come up in place of a company’s phone number.” The rep couldn’t help. The woman began to get frustrated, and a little bit anxious as she counted in her head how much insulin she had left.

The woman shook off her anxiety. In a few days, she had an appointment with her primary care doctor, who worked for another very large hospital system. Surely his office would be able to find it. But again, the name of the company on the card could not be found.


So, the woman again left frustrated. This time, she had a prescription that needed to be filled right away, so she went to her usual pharmacy (not a preferred pharmacy), and they said that they had dealt with the company before, and they gave her the phone number her doctor should call. When she called her endocrinologist back, she discovered that they could look up the company by phone number. As it turned out, the real name of the mail order pharmacy was Alliance Rx Walgreens, which never appeared on the prescription card.

Hooray! The prescriptions were submitted the next day. Which was a relief because the woman was down to about 600 units (10 days). In 27 years, she couldn’t recall ever being so low on insulin before getting a refill.

Just to be sure everything was moving forward, the woman called the company a couple of days later, on Sunday. She explained to the rep that she was extremely low on insulin. The rep assured her that though there was a hold-up pending approval on one of the prescriptions, everything was in order for the insulin, and that it would go out on Monday, to arrive on Tuesday. The woman wouldn’t be completely at ease until she got the lifesaving drug, but this definitely helped.

On Tuesday, the woman waited anxiously for the notification from her apartment building that she had a package. It came around 2:00, and she ignored the repeated automated calls from the company. But when the woman got home, she discovered that it wasn’t the insulin.

When she finally had time to listen to the company’s messages, they said that there was a problem with the order.

She called back.

This rep told her that, despite making it abundantly clear that she was dangerously low on insulin, they had bundled the order together with the prescription that was waiting for doctor approval. The company had been too cheap to sever the order on their own and pay for two separate packages. The woman was livid. She was very proud of her calm, but clipped tone of voice when she laid out for this rep exactly what the company was going to do now.

Finally, after five weeks (since she first saw her endocrinologist), the company sent the insulin. She was careful to pay much more attention to the notifications this time. And, as expected the box arrived after she came home from work on Thursday. With one little hitch. The company had neglected to put her street address on the box. If the USPS deliverywoman hadn’t known that her building was the only one in the zip code with a south building and a north building in the address, the box of insulin would have languished at the post office, with the woman none the wiser.

It would have been a disaster – at the moment the insulin was delivered, she only had 174 units left.