"Not on Formulary" are the ugliest words I've ever heard.
Lorelei has received chemo for many months at the Integris Cancer Institute of Oklahoma (ICIO.) Before each infusion of ABVD she would receive a miracle nausea drug called Emend. Emend is a long acting nausea medication usually given to her via IV before the chemo infusion begins. All of these treatments occurred at ICIO which offers chemo to patients on an outpatient basis. Since Emend is a long acting drug it is perfect for treating day patients who will go home and continue to battle nausea. Emend works so well that Lorelei never once got sick for the six months she took chemo.
But this new chemo regimen (RICE chemotherapy) needed to be administered to her as an inpatient. In RICE chemo she would actually receive as many hours of infusion in three days as she had during the entire six months of outpatient ABVD chemo.
This is where I messed up; I mistakenly assumed that because Dr. Geister was the same doctor overseeing both types of chemo and that each was to be given at an Integris location, Emend would be given. But I was wrong. Apparently, Emend is "Not on Formulary" at Baptist Hospital. So there was absolutely no way Lorelei could get it. I even offered to drive over to ICIO and buy it and bring it over to Baptist but that was not allowed. We settled on getting a prescription from Geister for the pill form of Emend. We hurriedly filled it at CVS and brought that up to Baptist. But it was too late. She threw up the pill immediately. Lorelei threw up her stomach acids for twenty four hours.
If I ever meet the person who made the financial decision for Emend NOT to be on formulary at Baptist I might be unable not to commit a crime. This person should have to hold the emesis bag in front of a vomiting child for 24 hours. And they should know that their decision is not just about money, it's a human being who is affected. Plus, the most stupid thing of it all is that Lorelei had to stay an extra day in the hospital and be given five other medications intravenously just to keep her hydrated and get her nausea under control. I can't imagine that an extra day in the hospital wasn't more expensive than one miraculous dose of Emend.
Needless to say, we won't be going back to Integris Baptist. Lorelei's next round of RICE chemo will be given to her at OU Medical Center. Emend is on formulary there.
Posted on Fri, August 10, 2012
by Andrea Decker