The following letter has been published with approval by the author. Per the author’s request, names of the Patient and Prialt Representative have been removed to preserve anonymity.

January 2, 2013

Dear William,

When the Prialt Rep came to visit me last December, she informed me that I had to leave your company and use Navigator and Bioscript, to fill Prialt. She told me that once I filled out the paperwork it would be done on a scheduled basis and that was it. She neglected to inform me that I did have to write out a new script for each refill. This new company was represented to me that this recurring script refill was not needed. Also they were supposed to notify me ahead of each refill. This notification was not done to my knowledge.

Today was a refill day for one of my pump patients. No medications were sent.  This resulted in a crisis mode that could have jeopardized my patient’s health. It adversely affected my patient (and her plans to travel the next day), my office staff and the surgery center staff where we refill these pumps. We contacted Navigator ““ the company that was supposed to take care of these items. They informed us that there were no automatic refills, that we do need to send a script for every fill, and that they might be able to send it overnight. This result was unacceptable and put my patient’s health at risk.

I contacted the Prialt Rep again and she informed me that maybe your company [Hartley Medical] had some remaining Prialt and, in this type of emergency, Hartley might be able to refill it and send it. When I contacted you, I was informed that you had no problem doing this fill and that Hartley could continue to service this patient. We called at 9:30 AM to arrange the refill and it was received at our surgery center by 12:30 PM ““ 3 hours later. The patient had her pump filled at 3:00 that afternoon and was able to catch her scheduled flight to Houston the following day. Thank you.

I have subsequently learned that in December the requirement to use “Navigator” was dropped. At no time, including during this issue, had the Prialt Rep informed me of this change. I always felt I was being strong-armed into changing from Hartley to them. This resulted in loosing the relationship that I had built with Hartley and yourself, moved the filling pharmacy to the East coast, and caused some serious problems that had the potential to adversely affect my patient’s health. Needless to say, I was extremely dissatisfied with the demands made on me by this Prialt Rep and Navigator/Bioscript. They created a mess and real risk to my patient along with all the staff I had to involve with solving this problem.

Thanks for your support on behalf of my patient and me.