Insulin Rant

I am steaming from both ears$@$!

I’m at Costco to pick up a Toujeo prescription. I have two prescriptions for it on file with them. They used the newest prescription first and that’s out of refills. The older prescription is now out of date by about a week.

Ok. I’m angry at their incompetence, but I tell them that’s ok, I’ll just write a prescription myself. I have done this several times previously with no problem.

The fill in pharmacist proceeds to tell me that she can’t accept my prescription for insulin because it is out of my scope of practice as a dentist! I should say that I have a six year history of writing and filling prescriptions with this Costco pharmacy.

I’m angry now. I tell the pharmacist that I’ve been taking insulin for 45 years, I’m a doctor, I probably know more about diabetes and treating it than 90% of gp’s who she accepts the same prescription from. She tells me she doesn’t care how much I know, it’s still out of my scope!!

When the hell is the Damn FDA going to make accommodation for those diabetics who have taken the time to learn how to take care of themselves, have achieved homeostasis, and need a drug so they can continue to live?

/rant off


Especially infuriating because a slightly different formulation of insulin is available over the counter without a prescription.

1 Like

Since when is the pharmacist (or more than likely a pharmacy tech) able to regulate the scope of practice of a licensed prescriber? Is that really within their scope?

1 Like

Each state has rules. The pharmacist cannot regulate, only apply.

This was a pharmacist. About as old as my oldest grandchild.

The state laws allow a pharmacist to determine if a prescription is within the scope of the prescriber’s practice. It is at the judgement of the pharmacist. She was within her legal rights to refuse my license for an insulin prescription. But within her power of reason she was a moron.

So it’s just solely their judgement? That logic can be taken to any degree can’t it? It’s not really in the scope of practice of a general practitioner to prescribe andidepressants is it? What about a surgeon prescribing benzos? They do it all the time… to prevent post op muscle spasms… hope we don’t end up with a pharmacist like her around here…

Lol but this was insulin… not exactly a high abuse potential, although they may have realized that you are an addict

Sorry you had such a runaround…

1 Like

Here in Texas, as in California, as a dentist I am licensed to prescribe any legal drug. It is at the pharmacist’s discretion if the drug is within my scope of practice.

That is what was so frustrating. Considering it was for myself, and that I had a prescription for it from an endocrinologist that was a week out of date due to their fault, and that it is a drug which I am fully accustomed to taking, I would call her discretion to refuse me was flawed.

1 Like

Well as a dentist who probably has several thousand patients, what would stop you from refusing to write scripts to Costco pharmacy? And including that in a complaint…

My professional ethics would not allow me to involve a patient in a personal conflict I had with another provider (or pharmacist).


I’d also argue it’s also potentially endangering you. From what I understand, in some states they have laws stating that you can get insulin as a T1D at any pharmacy (without a prescription if you run out), precisely because so many people have run out of their insulin and fallen into DKA because they couldn’t get their insulin soon enough.


I have had a pharmacist refuse to fill my insulin prescription when I was out of insulin once. It was not a pretty scene, and I did get my prescription honored and filled.

Thankfully the incident today was only a matter of inconvenience so I did not persist or make a scene.


This is extremely frustrating. I’m sorry you had this experience @docslotnick! And it brings up the question that we wrestle with a lot with our practitioners (or pharmacists). When to push or make a scene and when to let things go. It’s a tightrope I find difficult to walk well. Pushing back against what we know is an injustice even if it isn’t a dire situation versus riding it out and taking one for the D team for the sake of achieving what we want in a slower fashion than we want it. Frustrating,…this dependence on others.


It’s also frustrating for me professionally. I am licensed to write a prescription, only to have a twit pharmacist refuse to fill it due to their flawed logic.


Yes! Doubly frustrating for you!

UPDATE: Yesterday the lead pharmacist at Costco called to apologize to me and to let me know my Toujeo prescription was ready and waiting for me to pick up.

He told me that the weekend pharmacist was a new graduate, and that she needed some time to develop better judgement.


Could not love this more! This is tremendous! And all without making a scene! Bravo!

1 Like