ExpressScripts @%$#!

[CardsFan]

Just venting.

ExpressScripts handles my retiree drug plan. I have been on benazepril htcz for blood pressure for several years, and get the 90 supply via mail and have it on autofill.

In late Oct. I get an email saying it is currently out of stock, and I should contact a local pharmacy if I need an immediate refill. Since I had accumulated a full extra 90 supply, no problem. I call and am told it should be in stock by Nov. 19.

Sent a secure message last Friday to check. Get return message yesterday that I should call. Called today and they have no idea if/when they will have it in stock. It has been out of stock since July (around when I got my last refill). So sorry. Then they say you should talk to your doctor about getting a different drug.

Ummm, NO. I will call my doctor tomorrow and have the script transferred to a local pharmacy, at which I will pay $6 more for the 90 supply. I can't find anything on line about a shortage of this drug, so I suspect they are just trying to negotiate a lower price with the supplier, and tough luck for the insured.

End of rant.

[dtbach]

I have Express Scripts also and have had to wait for some prescriptions. Still waiting for some epey pens for bee sting allergies. Good thing I live up North and don't need it for a few months.

[Jerry1]

I don’t blame you. The insurance industry does not appreciate how difficult it is for some to change medications. I’m off all meds now but when I was on some a few different times, it was amazing how I was one of the 1 in thousands who experienced certain side effects. So, when I found one that worked, I was not going to change for any amount of money that I could have afforded. I feel terrible for those without the means to either argue effectively on their behalf or pay the difference.

In one dr office I’ve been to, there is a sign that says something like your insurance is a contract between you and your insurance company. We will do what we can to work with them but payment is your responsibility. I look at it a little different. My healthcare is a “contract” between me and my healthcare provider. We’ll work together to seek payment for services, but I will not turn over medical decisions to my insurance company. Of course we all have our financial breaking point, but until then . . .

[Red Badger]

Sorry for your troubles, but I'm coming from the other side of the fence. In my mega corp days/high deductible days, we paid through the nose for meds. DW has a host of genetic ailments, and takes ~10 meds per day.

When TriCare (and express scripts) kicked in at age 60, it was like a lodestone lifted from our shoulders.

I do hope your issue is solved promptly and without incurring unwarranted cost.

[CardsFan]

Quote:

Originally Posted by Red Badger Sorry for your troubles, but I'm coming from the other side of the fence. In my mega corp days/high deductible days, we paid through the nose for meds. DW has a host of genetic ailments, and takes ~10 meds per day. When TriCare (and express scripts) kicked in at age 60, it was like a lodestone lifted from our shoulders. I do hope your issue is solved promptly and without incurring unwarranted cost.

Actually, up until now, I have been fairly pleased with ExpressScripts. The extra 6 bucks is not the issue. It is the way this was handled. " sorry, we are out, go talk a local pharmacy or to your doctor". Since there is NOT a widespread shortage, the only reason they are out is either a lack of planning, or a deliberate shortage to make me change my prescription

[Chuckanut]

https://www.nytimes.com/2018/07/16/h...valsartan.html

https://medicalxpress.com/news/2018-...dications.html

Quote:

Two more Chinese drugmakers have announced that a blood-pressure medication they exported to Taiwan contained a potentially cancer-causing impurity, a month after the same problem at another Chinese manufacturer prompted a global recall.

My understanding is that the company involved has provided contaminated ingrediants for two BP drugs. This may be causing a shortage as people scramble for alternatives. Just a thought.

[CardsFan]

Quote:

Originally Posted by Chuckanut https://www.nytimes.com/2018/07/16/h...valsartan.html https://medicalxpress.com/news/2018-...dications.html My understanding is that the company involved has provided contaminated ingrediants for two BP drugs. This may be causing a shortage as people scramble for alternatives. Just a thought.

I have seen these reports. While my meds are not the list, a very real possibility it is causing disruption. BUT, no indication from ExpressScripts that this is the issue. My problem is with how they reacted. They spend a lot of effort convincing you to "save money" by getting mail delivery, and then when they have a problem delivering they say "not my problem, check with someone else".

[Huston55]

Quote:

Originally Posted by Red Badger When TriCare (and express scripts) kicked in at age 60, it was like a lodestone lifted from our shoulders.

^^^THIS.

Currently covered by TriCare (Express-Scripts for drugs) and comparatively, it’s at least as good as any other employer provided benefit pharmacy in terms of service, and WAY BETTER in terms of cost.

I admit that I do share the frustration of med shortages, prior authorizations, or appeals when required. But, overall, I am very please with our Tricare Express-Scripts coverage.

[Car-Guy]

On my best day and in the nicest terms I could come up with, I'd be permanently banned from this site if I told you how I felt about Express Scripts "as well as" their specialty pharmacy Accredo. For reasons pretty much beyond my control, I'm stuck with them for the next 3 years.

[mamadogmamacat]

I'm stuck with express scripts in my retiree medical plan, as i was also stuck with them while working. Most of the time mail order works well. Never had a supply issue, yet, like the OP describes. I did get a Dr ordered change due to the Chinese source contamination. But that was handled smoothly. Only annoyance was I had to call to get the new med on auto delivery, as the old one was already for yrs. That was minor.

My beef with them is the arbitrariness, from my point of view at least, of their approval process. Very little in the way of meds for knee pain, including injections, is allowed. So, I'm forced to get "samples" of voltaren gel for example from my orthopedist routinely. Actually cheaper for me this way, but a hassle nonetheless.

[Another Reader]

This is good information for people trying to pick a Part D drug plan. If I have problems with Aetna, I will know NOT to sign up with Express Scripts next year.

[braumeister]

I've been with ExpressScripts for a couple of decades without any real problems.

A couple of times there have been small difficulties, but I've found their phone support to be excellent.

[Winemaker]

My problem with Express Scripts is they have sent refills to me too far in advance. I currently have well over 200+ days of 2 BP meds.

[CardsFan]

Quote:

Originally Posted by Winemaker My problem with Express Scripts is they have sent refills to me too far in advance. I currently have well over 200+ days of 2 BP meds.

OP here.

This is actually what has made my issue a minor aggravation and not a major emergency. I currently have about a 90 day extra supply.

[Car-Guy]

So "one" of my problems with Express Scripts is their policy on BP meds. I've been taking BP meds for better than 10 years now. I found early on that only the band named drug works for me. I tried several of the generics 10 years ago and they didn't work for me. FYI, it takes a while to figure that out. Anyway, in the past year Express Scrips said they would no longer pay for the brand name BP drug "unless" I tried the "lower cost" generics and the doctor signed "something" saying they would not work for me. I explained I went through that 10 years ago but that wasn't good enough for them. THEY called my doctor without my knowledge or approval and got him to write a new script for a generic. I refused to take it or pay for it. After numerous calls to the doctor and Express Scripts I finally had them transfer my remaining brand name refills to a local pharmacy and I paid full retail out of my pocket for it.

Sounds to me like Express Scripts is telling the doctors what to prescribe for some specific conditions. Isn't that like practicing medicine? Anyway, I dropped the doctor and will drop Express Scrips in 3 years when I can.

[MRG]

Quote:

Originally Posted by Car-Guy So "one" of my problems with Express Scripts is their policy on BP meds. I've been taking BP meds for better than 10 years now. I found early on that only the band named drug works for me. I tried several of the generics 10 years ago and they didn't work for me. FYI, it takes a while to figure that out. Anyway, in the past year Express Scrips said they would no longer pay for the brand name BP drug "unless" I tried the "lower cost" generics and the doctor signed "something" saying they would not work for me. I explained I went through that 10 years ago but that wasn't good enough for them. THEY called my doctor without my knowledge or approval and got him to write a new script for a generic. I refused to take it or pay for it. After numerous calls to the doctor and Express Scripts I finally had them transfer my remaining brand name refills to a local pharmacy and I paid full retail out of my pocket for it. Sounds to me like Express Scripts is telling the doctors what to prescribe for some specific conditions. Isn't that like practicing medicine? Anyway, I dropped the doctor and will drop Express Scrips in 3 years when I can.

Step therapy. I was put on that in order to get a script for Flowmax. First they gave me an alpha blocker that is similar. It was great for BP, why my blood pressure was 60/40 when I was taking that crap. Couldn't figure out why I kept falling.

From now on, I'll decide if I'm going to take the medication or just tell them what was wrong.

[Car-Guy]

Quote:

Originally Posted by MRG Step therapy. I was put on that in order to get a script for Flowmax. First they gave me an alpha blocker that is similar. It was great for BP, why my blood pressure was 60/40 when I was taking that crap. Couldn't figure out why I kept falling. From now on, I'll decide if I'm going to take the medication or just tell them what was wrong.

I'm not particularly thrilled with a doctor "trying" stuff out on me after he's examined me and run all sorts of tests. I'll be %$&# if I'm going to let some ya-hoo at a on-line pharmacy that knows nothing about me and that's only concern is cost to second guess my doctor. Sooner or later, these insurance companies are going to go too far and the government will give them a well deserved swift kick in the ......!

[MRG]

Quote:

Originally Posted by Car-Guy I'm not particularly thrilled with a doctor "trying" stuff out on me after he's examined me and run all sorts of tests. I'll be %$&# if I'm going to let some ya-hoo at a on-line pharmacy that knows nothing about me and that's only concern is cost to second guess my doctor. Sooner or later, these insurance companies are going to go too far and the government will give them a well deserved swift kick in the ......!

The frustration I had was no one took ownership of the issue. I should not have been prescribed an alpha blocker, I'm on a beta blocker and it's no surprise my BP cratered!

My docs office blamed the insurance company, script had my docs name on it. The insurance company blamed the doctor for following their instructions. At least the pharmacy warned me I might be dizzy.

I used to not read side effects thinking I'd imagine what I read. Never again. If that happens again I'll get the script and throw it away.

[jim584672]

I used to have Medco which I think became Express Scripts. Mail order pain in the neck. They wanted a payment but couldn't tell me the exact amount. So it was back and forth with the money. It is like they wanted to make it hard on purpose.

[scrabbler1]

I had a terrible time with ExpressScripts back in late 2015 after I was first diagnosed with Type 2 Diabetes.


I was allowed to get my initial script with a local pharmacy. But after that, if I wanted to keep the insurance coverage for the drug, I had to go through ExpressScripts for subsequent refills. This was a nightmare. First, the drugs often arrived barely in time, if at all. Second, I was always being told that they needed further authorization from my doctor, triggering a very annoying runaround. I would call my doctor and the staff would tell me they faxed a copy of an authorization to them, something they do routinely for many patients. But then the ExpressScripts people would tell me they never saw it, even though I verified the fax number. This would go back and forth for several days as my current supply dwindled to nearly empty. One time, ExpressScripts authorized a 7-day emergency supply from my local pharmacy to hold me over until the new supply arrived (it did).


When the ACA's open enrollment period began that November, I couldn't wait to change insurance companies, to one which didn't require ExpressScripts to retain coverage for my drugs. I can now use my local pharmacy, although I have been having an issue for 2019 regarding "Step Therapy" or an extra layer of prior authorization to keep receiving my main drug. I have been describing my growing ordeal with that in the lengthy "2019 ACA Increases" thread I began earlier this year.