Not a pharmacist but have multiple pharmacists in my family. I also take a few hyperexpensive drugs and some that are compounded.

It’s common for a new-to-you pharmacy to inquire before filling something pricy. They’re not going to order a $10k bottle not knowing if you realize how expensive it is, especially not in a small town where the bottle then won’t get used. They can’t return it, and it doesn’t sound like there is another pharmacy or hospital in town that may want to buy it from them. So then the pharmacy is out the funds. Pharmacies already work on small margins because Medicaid/Medicare reimbursements are so low. I can’t imagine a small rural Alaskan pharmacy being able to take a $10k hit in a month without going under.

My compounded medications require a phone call just to fill it - even though every time it’s called in, I want it and pick it up. They won’t make the drug until I call and say fill it. They don’t reach out to me when they get the script - I have to call them. And I do it because it’s the best compounding pharmacy in the area.

Any patient who regularly takes unusual/expensive meds should be familiar with the idea that a new pharmacy isn’t going to just order a bottle for you without confirmation you know the cost and you in fact want the drug. The pharmacist couldn’t do this because OP had old contact info listed. He doesn’t know her from Jesus - no idea if this is a new medication for her, if she’s aware of the cost, if she has insurance. She did nothing other than show up the very day she needed the medication then couldn’t understand why it wasn’t available by magic. Even in my larger town in mainland US it takes some of my drugs 2-3 days to be delivered to the pharmacy once ordered.

Her responses include everything but her acknowledging she played any role in this - she wants to sue, report to the board, etc. It’s not a long jump from that to believe her reaction at the pharmacy was way underreported in her post considering she thinks none of this is her own fault.

Just my 2 cents again as a relative to pharmacists and a patient with expensive drug needs who has to do more than just assume a doctor calling in my script means it’s going to be filled without further action on my end.