Recently, a state appellate court issued a very interesting and important opinion in a pharmacy error case discussing a pharmacist’s duty to inform a prescribing physician when a patient attempts to fill a prescription that required pre-authorization from the patient’s insurance company. Ultimately, the court held that pharmacies have a limited duty to notify both the patient as well as the prescribing physician each time a patient attempts to fill a prescription requiring pre-authorization.
The Facts of the Case
When the plaintiff was 18 years old, she suffered her first seizure. She was taken to the hospital and given a dose of Topamax, an antiepileptic medication. After discharge, the plaintiff saw a neurologist who recommended she continue taking Topamax and wrote her a prescription.
The plaintiff filled the prescription without incident until her 19th birthday. However, when she went to fill the prescription after turning 19, the pharmacist informed her that her insurance company required pre-authorization for Topamax prescriptions for patients over 18 years of age. The pharmacist told the plaintiff that they would follow up with her physician in order to obtain the required pre-authorization. Although not required to do so by law, the pharmacy routinely sent a fax to prescribing physicians offices when a patient tried to fill a medication that required a pre-authorization.