Omnicare faxed a form to my wife's doctor changing from Razadyne to Aricept

Have done a little research on Omnicare.

In 2007, Omnicare asked the Arizona State Pharmacy Board for "enable long term care facilities to
establish formularies specific to each individual facility and physician". Under questioning Omnicare admitted they were really asking for the authorization to make therapeutic substitutions. Per minutes, Arizona does not allow Long Term Care facilities to establish formularies. It was also noted "that the statutes only allow therapeutic substitution by hospitals and
institutions and he does not believe that long term care facilities fall under this category."

From what little I have seen, Omnicare is acting as if there was a formulary in place. At the top of the fax in large caps is: "THERAPEUTIC INTERCHANGE REQUEST / PHYSICIAN ORDER".

Text includes:

Dear Dr X

Please approve the interchange request below.

.... If you have questions please contact the Omnicare Clinical Intervention Center at 1-800-...

Also:

_ (check here if) REQUEST DENIED REASON: ___________ INITIALS: _________

===> The request was faxed to the doctor without notification to the responsible party.
===> Residents and family were not informed that such requests would be made.
===> Years ago, my wife was on Aricept and had GI problems. Nobody asked if she had prior problems with Aricept before making the recommendation.

Looks like after being denied the right to develop formularies, Omnicare is operating as if they have one.

Please help me clarify this issue.

Thanks

Omnicare sent me a booklet and "Patient Information Sheet" stating that no medications will be supplied to the care facility until they have the completed forms and financial obligation guarantee. heh. If you are asking if it is legal for Omnicare to change prescriptions per their formulary, nope it isn't. Only a doctor can prescribe and make medication changes. If a change was made, get the nurses notes to see if the doctor made the change (after a visit and check-up)

Update -- The Pharmacy Board has agreed to investigate.

Bottom line --

Omnicare recommended a change change from a treatment that is working to one that may or may not work for this patient.

Also, stopping, and later restarting these medications can result in a loss of effectiveness that cannot be regained. Restart must be at a lower dose, and a drug free period may be required to clear adverse side effects.

If the change is made, evaluation of effectiveness should be made at 6 and 12 month intervals. Omnicare is not likely to volunteer for payment of these fees.