eli5 – Doctor writes me a Rx for “prenatal vitamins” and checks box for may sub generic – how does pharmacist choose which vitamins to give?

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There’s many different brands of Rx prenatal vitamins, both name brand and generic. How does the pharmacist know which one to fill based on such a vague Rx? Eeny, meeny, miny, moe?

This is what happened several years ago and I mailed the Rx to my mail order pharmacy and was mailed generic prenatal vitamins. No questions asked of me. I’m curious how they were chosen. I wasn’t informed enough at the time to compare ingredients or even know that there were several options. If there’s a better sub to ask this question please let me know. Thanks!

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Anonymous 0 Comments

Former retail pharmacist here. Doctors do this because insurances do not cover all prenatals so they trust us to decide what’s best according to the patients’ formulary. How do we know this? Literally by experience from dealing with so many types of insurances daily. For example, where I’m from, our state insurance is called CALOPTIMA, I know that they will cover A, B, or C and as long as one of these genetics contain all the vitamins the brand name has, I will select the one we have in stock. Other patients have regular insurance and say if their insurance covers A, B, C, D, and E, then I would dispense whichever has the cheapest copay because their efficacy is comparable. If a pharmacist is not as experienced, when a claim is rejected by the insurance, they usually tell you which one is covered in the rejection so the pharmacist will change the med, annotate it on the Rx, and run it through again for it to be covered by the insurance. Most of the pharmacists I’ve worked with are great at what they do so you can trust them to select the right medication for you. I’m in oncology now and although my work is a little more rewarding, I do miss patient interactions and being able to help people (within my scope of practice) when they can’t go see their doctors or if their problems are minor medical problems that we can help with!

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