Kickbacks?

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Not sure if this is the right place for this post, but none of the existing forums jumped out as being any more logical.

Does anybody know if HRT clinics get kickbacks from pharmacies that they fill patient prescriptions from? My reason for asking is that I've tried to get my clinic (Defy) to let me fill my Test Cyp prescriptions locally. I can get 10ml of 200mg/ml Test Cyp from my local CVS pharmacy for $40.00 (as of today - I know prices change) - a far cry from the $130.00 Defy charges. That would also eliminate the $12 shipping charge and one-to-two week delivery wait.

I've checked with my local pharmacies (Walmart, Costco, CVS, Walgreens) and all of them indicated there would be no problem having a prescription called in from out of state for Test Cyp. Only the Walmart pharmacist inquired as to what the prescription was for - he said opioids and pain killers might raise oversight eyebrows and closer scrutiny, but Test Cyp would not be an issue.

However, when I asked about having my prescription called in to my local pharmacy, I got an emphatic "No, that's illegal". When I pointed out that I'd already checked locally and was assured it was fine, I was told it was a Florida law that prevented them from calling in prescriptions from out of state.

I was very skeptical of that, as many people winter in warmer climates (ie, Arizona, Florida, etc) and some summer in cooler climates (ie, Colorado, Minnesota, etc), but still need their prescriptions re-filled by their home physicians. I checked with the Florida Attorney General's office and, after getting transferred about 200 times and spending well over an hour in total on hold, finally was told it was perfectly acceptable to call in most medications, including HRT compounds, to an out-of-state pharmacy. The person I spoke with echoed the sentiment that strong narcotics would draw some serious attention - that may or may not mean they're forbidden, but nothing was explicit said and I didn't care about those drugs anyway.

I've checked with three other online HRT clinics and all indicated they would not call in prescriptions locally. When pressed, they all said it was "...policy..." - none would provide any kind of reason when pressed.

The only explanation I can come up with for caring where a prescription is filled is kickbacks. There's simply no reason to think pharmaceuticals filled by a local licensed pharmacist/pharmacy are inferior to what Empower or Hallandale (or any other) would provide. I can see a clinic not wanting their patients using Test (or any other compound) from purchased over the web from a black market producer, but that's not an issue if the script is called in to pharmacy.

Any comments on this? Has anybody had luck, or tried, getting their clinic to let them fill scripts at the pharmacy of their choice?

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Defy Medical TRT clinic doctor
One of the costs of doing business with a typical TRT clinic is having to buy most of you meds from them. I don't like the term "kickbacks" as that has a negative connotation, but do the clinics mark up the price of the meds as a source of revenue? Yes they do. If this isn't something you're willing to accept then you will need to find a strictly fee for services doctor that will write you a prescription. I went to such a physician once, he charged 4-5 times what my current clinic charges for consultations, but he would write me a script to take to my local pharmacy. Overall cost was about the same.
 
Testosterone is a controlled substance scheduled 3. Ask them to fill anything locally that is not controlled and they will do it for you. Any doctor ordering testosterone for every patient that they have would throw a red flag don't you think. There is something different with compounded. I don't know the details. If you want to fill your testosterone locally go see an endocrinologist or get your primary to write you a prescription. This how the game is played so get used to it or don't play.
 
Not sure if this is the right place for this post, but none of the existing forums jumped out as being any more logical.

Does anybody know if HRT clinics get kickbacks from pharmacies that they fill patient prescriptions from? My reason for asking is that I've tried to get my clinic (Defy) to let me fill my Test Cyp prescriptions locally. I can get 10ml of 200mg/ml Test Cyp from my local CVS pharmacy for $40.00 (as of today - I know prices change) - a far cry from the $130.00 Defy charges. That would also eliminate the $12 shipping charge and one-to-two week delivery wait.

I've checked with my local pharmacies (Walmart, Costco, CVS, Walgreens) and all of them indicated there would be no problem having a prescription called in from out of state for Test Cyp. Only the Walmart pharmacist inquired as to what the prescription was for - he said opioids and pain killers might raise oversight eyebrows and closer scrutiny, but Test Cyp would not be an issue.

However, when I asked about having my prescription called in to my local pharmacy, I got an emphatic "No, that's illegal". When I pointed out that I'd already checked locally and was assured it was fine, I was told it was a Florida law that prevented them from calling in prescriptions from out of state.

I was very skeptical of that, as many people winter in warmer climates (ie, Arizona, Florida, etc) and some summer in cooler climates (ie, Colorado, Minnesota, etc), but still need their prescriptions re-filled by their home physicians. I checked with the Florida Attorney General's office and, after getting transferred about 200 times and spending well over an hour in total on hold, finally was told it was perfectly acceptable to call in most medications, including HRT compounds, to an out-of-state pharmacy. The person I spoke with echoed the sentiment that strong narcotics would draw some serious attention - that may or may not mean they're forbidden, but nothing was explicit said and I didn't care about those drugs anyway.

I've checked with three other online HRT clinics and all indicated they would not call in prescriptions locally. When pressed, they all said it was "...policy..." - none would provide any kind of reason when pressed.

The only explanation I can come up with for caring where a prescription is filled is kickbacks. There's simply no reason to think pharmaceuticals filled by a local licensed pharmacist/pharmacy are inferior to what Empower or Hallandale (or any other) would provide. I can see a clinic not wanting their patients using Test (or any other compound) from purchased over the web from a black market producer, but that's not an issue if the script is called in to pharmacy.

Any comments on this? Has anybody had luck, or tried, getting their clinic to let them fill scripts at the pharmacy of their choice?

View attachment 13073
 
100% 'kickbacks'. i am not condemning this. you need to look at market prices in general for TRT clinic. one local clinic here wanted me to come in person for every shot. one had to wonder why, they came with explanations like 'cause people had too high levels of T' - is BS - but they took insurance. I live in 2 states 70/30 so this is not an option. even for locals - go in once a week (or more) - is painful.
they probably don't want the overhead of dealing with all kind of pharmacies either, although in the day of electronic RX - prob not much of an issue. it takes about 10seconds for my general doc to send me an RX anywhere.
the question is why so few docs want to deal with TRT and think it is the devil, or have no clue what they doing and think 100mg/2x month is enough.
 
It may be illegal for Defy to write a script for T out-of-state. IDK. For a fee, I have had Defy write other scripts for local pharmacies here. Even with the fee, I still saved a bunch.

One question I have is, my FNP will write T scripts for me for local pharmacies. Is that acceptable with Defy? Must I get it through them? If I can, that would help me save even more.
 
It may be illegal for Defy to write a script for T out-of-state. IDK. For a fee, I have had Defy write other scripts for local pharmacies here. Even with the fee, I still saved a bunch.

One question I have is, my FNP will write T scripts for me for local pharmacies. Is that acceptable with Defy? Must I get it through them? If I can, that would help me save even more.
Like I said in my post, I already checked that. It's not.
 
I used to belong to a TRT clinic and they would not write a script for testosterone even for a local pharmacy. I had to use there compound pharmacy was $115.00 with shipping at that time. I found a PCP who prescribes it to me now and I pay $43.00 with GoodRx. No problems. Plus I save the annual fee that I was being charged. When I need a refill I just go on my portal and request a refill they send it to Rite Aid.
My PCP runs most of the same blood panels that my TRT docter runs. And if I ask him to run a certain one he will.
 
Like I said in my post, I already checked that. It's not.
Well it is that, because they WILL write an RX for local pharmacy for t if you're in the state of Florida. They won't do it out of state. They will call in any (except HCG to California and the other weirdo states) regular meds to a local pharmacy, even stuff that the compounding pharmacies sell. They likely do not want to deal with the feds in regards to a schedule 3 substance being prescribed across state lines. That is the same reason they don't call HCG into California, California considers it a controlled substance.

For $30 they called in t, sildenadil, tadalafil, and anastrozole to have on hand. I used goodrx coupon.
 
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Let's not beat around the bush, clinics do make money (kickbacks) and if they didn't they probably wouldn't be in business.
If by kickbacks you mean they sell a product that a compounding pharmacy offers. How else would they stay in business if they could only prescribe in one state by calling into a local pharmacy?

At least Defy gives the option
 
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