Dealing with modern pharmacy chains

[Scrapr]

Kaiser so far has been wonderful. We do mail order, they contact us prior to refills due, click a button on the reminder message, and it's ordered! 3 months at a time, it is nice.

I am so thankful for Kaiser. I don't know if I could navigate the "real" world. With pre authorizations, doctors moving in/out of networks., etc I just ordered an ongoing prescription Saturday. It was filled Sunday afternoon & in the mail.I was in for an annual check up & asked about an RSV shot. Doctor got it done in about 5 minutes.

 

[scrabbler1]

After I was diagnosed with Type 2 Diabetes in July, 2015, I had to start taking various prescription drugs. My IC at the time allowed me to use a local pharmacy for the first refill, but after that I had to switch to Express Scripts. ES was terrible, often not mailing me my drugs on time, sometimes allowing me to pick up emergency scripts at a local pharmacy. They and the prescribing doctor always pointed fingers at each other, one saying they faxed the script and the other saying they never got it.

When it came time to renew my ACA plan for 2016, I happily switched ICs to one which allowed me to use my local pharmacy, a CVS next to the supermarket I shop at all the time.

Over the years, the number of scripts grew so I am in the store often. Some of the more experienced staffers recognize me when they see me, given that I am often in the store on weekdays at around the same time. The staffers have been good at straightening out problems I have had with the CVS website, for example. Sometimes, I go there to get a last-minute script refilled, then go into the supermarket to do some food shopping, then return to the CVS to pick up the drugs 15 minutes later.

But not all CVS stores are this good. My ladyfriend uses a different but nearby CVS to get drugs which ES doesn't provide and has had lots of trouble with both pharmacies, worse than my times with ES and, oddly, bad times with her local CVS. Her ES problems don't surprise me, but her CVS ones do.

 

[target2019]

It might just be me, but it seems to have become harder and harder to vote with my feet. Capitalism does well only if there's true competition. When the government has a hand in things, competition is often lost. In the realm of pharmacies, you're going to be forced to use "in network" pharmacies or have your insurance company not pay. Government writes these rules and then the big business of insurance and the big business of pharmacies collude to shut off options. I'm sure "new business model" pharmacies, like Amazon are glad CVS and Walgreens pharmacies suck. There would be no reason to complain if the current situation was working, but with chain pharmacies, it seems to be a race to the bottom, from a service perspective.

I've got to go...I need to figure out which in-network pharmacy has the least worst customer experience.

I learned a lesson or two about the winds about 40 years ago (mid 80's) when I was self-employed and working for big businesses. When the winds change with tax law, for instance, it's best to "Go with the flow..."

If big business works with politicans to make it harder for you to even be in small business, there's no stopping it.

We are in the age of big-getting-bigger. The complexity behind business process, gov't/insurance rules and everything else is out of my reach now.

I have CVS, Rite-Aid and Walmart pharmacy customer experience. There are many stories in the Naked City.

 

[jim584672]

CVS hounds you for refills, no matter how many times you tell them no. Also always a wait and a line. Walmart is better.

 

[frayne]

Does anyone else see a trend here? A small business, like a pharmacy or a doctor's office, that has a stable set of employees, good customer service gets bought up by a conglomerate (or the conglomerate opens a nearby outlet). This new entity is driven by the corporate overlords to increase efficiency at the expense of customer experience. Customers have to deal with ineffective online tools, as do the employees. Everyone is a slave of "the system"; it "won't let me" is the usual refrain. The employees come and go, probably trying to find a less horrific workload. Meanwhile customers can't talk to anyone; phoning "the local outlet" goes to India first (who must get paid more for keeping you on the line the maximum number of minutes before actually doing nothing and forwarding you to a REAL real person). And get off my lawn.

Nail, head. I have an Aetna Medicare Advantage insurance plan that comes with ExpressScripts/CVS. Between trying to find in-network health providers or dealing with ExpressScripts over some stupid muscle relaxer they won't cover is enough to drive a sane person insane and a healthy person into bad health. I'm a fairly astute almost 73 year old and I have no idea how an older or less astute sick person can deal with this thing we call health care. Just so frustrating at about every level.

 

[Venturer]

CVS hounds you for refills, no matter how many times you tell them no. Also always a wait and a line. Walmart is better.

-----Not always!
My daughter had to use Walgreen for years, then her employer switched ins.co. and she now has to use Wal mart and regrets it every time she has to sit and wait for her prescription to be filled. She loved her Walgreen, so there again the staff has a lot to do with it. We use our local Kroger and have had great service here as well as having to get an emergency fill while on vacation in Missouri. We just called our local Kroger and they set up for us to pick it up where we were camping at the local afilliate.

 

[sengsational]

-. We just called our local Kroger and they set up for us to pick it up where we were camping at the local afilliate.

That is one benefit of the national chains. If you had a responsive doctor's office, they could call it into a pharmacy where you were traveling, but the national chains can let you pick up anywhere without involving the doc.

 

[frayne]

I think I would faint if I ever called a pharmacy, doctor or health insurance carrier and an actual person answered the call as opposed to some automated response with a menu of a dozen different options that drills down into three more levels of options, followed by a ten to twenty minute wait listening to bad elevator music before you can actually talk to someone that has a foreign accent that you can't understand fifty percent of the time.

 

[Car-Guy]

We have used many and here's how I'd grade them based on personal experience and w/o going into the details.


Express Scripts = F- (Slow shipments, poor customer services)
Walgreens = D (Lines can be long, poor customer services, staff doesn't care)
Walmart = C- (Lines can be long, but staff seems to be better)
CVS = C (Better in all aspects than Walgreens and Walmart)
Local Mom and Pop = A- They are always busy but seldom any lines. Prescriptions are ready when I walk in 90+% of the time. And filled in 5 mins if I need to wait. Pharmacist(s) know us by name.

 

[target2019]

Local Mom and Pop is not a selection I can find in my plan. But I do remember those days.


We went to Walmart with my daughter (7 months preggers) at the end of November 2023. The experience was entertaining, but potentially dangerous. Three or four people behind the counter. Somehow, a bigger fellow had managed to keep all CS occupied, just as my daughter went to the injection window. He wanted a pill or two until his current prescription renewed in a day or two. Why did the Rx run out? Well he doesn't know exactly, but thinks a few pills rolled around and were lost in the car. He repeated himself over and over, and I lost track of time after 20-30 minutes.

Eventually my daughter got her RSV shot. It was not covered by her insurance, they insisted. She had proof that it was covered. But she needed to get this done, as we had travellers coming in, in a few weeks. It took quite a bit of time before someone took her into the private area for a shot.

I stood near the door, and a younger, bearded man entered the store. and walked by me. His wife was further behind, still outside the store. He shouted at the two young women who were greeters working the exit doors. He insisted they say back, "Merry Christmas." I think they did not understand his language, as they did not turn around or respond to him at all. He continued walking further, yelling expletives, until his wife caught up. She loudly agreed with him about this and that, and they entered into the depths of Walmart to entertain more shoppers.

OTH, I logged into CVS Caremark, clicked a button or two, and my prescriptions were home-delivered by USPS or UPS or FedEx.

Free entertainment, or home delivery? I am torn.

 

[MarieIG]

Our local family pharmacy is long gone. We have a CVS and DH's plan uses Express Scripts. Express Scripts has improved its service - as far as DH's deliveries - from amazingly, unbelievably bad to poor.

I have a harder to fill prescription, and that particular pharmacy uses a vendor, with whom I refuse to contract. (No, I am not agreeing to pay your attorneys' fees if you decide to sue me, thank you very much.)

 

[braumeister]

Express Scripts has improved its service from amazingly, unbelievably bad to poor.

Very surprised to hear that. We've been using ExpressScripts for decades and never had anything but good luck with them. Two or three times there was an issue, but in each case one phone call to them cleared it up immediately.

Recently started using their subsidiary, Accredo, for a specialty drug, and they have been great as well.

 

[MarieIG]

Very surprised to hear that. We've been using ExpressScripts for decades and never had anything but good luck with them. Two or three times there was an issue, but in each case one phone call to them cleared it up immediately.

Recently started using their subsidiary, Accredo, for a specialty drug, and they have been great as well.

DH's experience was very reminiscent to what was described by Scrabbler1, supra. There is much less of that now but it was awful and there were times when the doctor has to call into the local pharmacy to get DH his blood pressure and diabetes medication as he had run out and the delivery had not come.

 

[Gotadimple]

Nail, head. I have an Aetna Medicare Advantage insurance plan that comes with ExpressScripts/CVS. Between trying to find in-network health providers or dealing with ExpressScripts over some stupid muscle relaxer they won't cover is enough to drive a sane person insane and a healthy person into bad health. I'm a fairly astute almost 73 year old and I have no idea how an older or less astute sick person can deal with this thing we call health care. Just so frustrating at about every level.

I have this same insurance. CVS owns Aetna and so they prefer you use them exclusively. ExpressScripts are owned by Cigna. But! they are not the only pharmacy in Aetna's medicare advantage network. CMS doesn't allow that.

There should be other preferred pharmacies local to you where you can get better service. I use the pharmacy in my local Safeway store and have great experiences with them. You may be stuck with ExpressScripts if it is providing you with a specialty drug.

Call Aetna's Customer Service (or go online) and they will search their pharmacy database for you and get you other pharmacies that are near to you.

 

[target2019]

We had ExpressScripts ten years ago or longer. It was the beginning of the mail order Rx craze. They did ok, but I suspect things go up and down for them as with other companies investing heavily into systems, and getting yanked around by insurance companies and regulations. So timing of our encounters is something.

 

[bjorn2bwild]

Very surprised to hear that. We've been using ExpressScripts for decades and never had anything but good luck with them. Two or three times there was an issue, but in each case one phone call to them cleared it up immediately.

Recently started using their subsidiary, Accredo, for a specialty drug, and they have been great as well.

The only glitch I had with Express Scripts was when their system could not reconcile a prescription for Flovent where one 120 puff inhaler @ 2 puffs/day = 60 day supply, i.e. - they charged 2x the normal price to fit the 90 day protocol.
When I spoke to the in-house pharmacist, the only solution she could offer was to get my PCP to change the script to 4 puffs/day and they would send 3 inhalers for the price of two.
My overly pedantic doctor would not budge as this was not his recommended treatment, never mind that I could be trusted to make the adjustment and use as I have been for the past 15 years.

 

[Koolau]

It's called "greed" and when we get TOO greedy we all suffer poor service in order to pay the shareholders. Healthcare for profit is immoral.

Play their game. Buy the stock. You too can be greedy for fun and profit.

 

[Koolau]

All this talk of various good/bad/ugly pharmacies reminds me that much of the issue is the particular local pharmacy (store) you use. By this I mean that even with (for instance) CVS, there are huge differences store to store.



We have found a CVS that is "acceptable" to us. It's not perfect but the people are nice and they do seem to try to do a good j*b. Where they fall down is in their robot calls. The robot may call and say you have a script ready, but upon arriving, they do not have enough on hand to fill that script. I can deal with that as long as I'm not short on the medicine (and I never am.) YMMV

 

[Koolau]

Try Safeway pharmacy in the Bay Area. My local store has great pharmacy employees, very conscientious and helpful. No long lines and reasonable hours.

ETA: I, too, miss the old Longs Drugs...

Heh, heh, all our "Longs" drugs are really CVS but they still go by the old name "Longs." So there is a bit of a mix of standard CVS brand products and all the extra stuff that Longs has always handled. It w*rks out reasonably well for us.

 

[Calico]

It appears I may be in the minority when it comes to CVS, but I have to say I love my local CVS pharmacy. They are well-staffed, polite, efficient, organized, and have an excellent "reminder" system whereby they text me when it's time to renew a script; then when they are working on filling the script; then when it is ready. They have never once let me down - the scripts are always ready right on time.

Until 2018 I very rarely took any Rx medications - maybe once every couple of years.

Starting in 2018, I began taking all kinds of meds for one year (and continued one med for five years). They never had a shortage of any med, and I never had difficulty getting scripts filled.

Maybe I just got lucky in choosing this CVS 4 miles from my house. As it happens, they are one of the "preferred" pharmacies under my Part D plan, but even if they weren't, I would probably choose to use them (if needed) in future, due to their stellar track record so far.

Even during the pandemic, when they were very overworked and stressed, they remained helpful and cheerful and took the time to answer any questions I had. I have been getting all my "senior" vaccinations there for several years; their pharmacists give the vaccinations and the whole operation is a well-oiled machine.

The website for the pharmacy works perfectly too.

I just wanted to shout out the hard working folks at my CVS, because it seems they might be the exception to the norm.

 

[TickTock]

I have a friend who has various health issues and need certain meds to survive. And he's had issues with getting those meds in a timely manner. He told me, "If they interfere with me getting my meds on time again, I will charge them with attempted murder!". And if (I hope not) it happens again that he does that. And wins.

 

[Koolau]

I have a friend who has various health issues and need certain meds to survive. And he's had issues with getting those meds in a timely manner. He told me, "If they interfere with me getting my meds on time again, I will charge them with attempted murder!". And if (I hope not) it happens again that he does that. And wins.

I suspect such issues would be considered civil and not criminal. If there is any reasonable chance of death due to a shortage of meds, it might be a good idea to w*rk with the doctor to find a way to stock pile some meds to head off any shortages. It's doable, though the doctor would likely have to be willing to "fudge" the script a bit (For instance, write the script for a larger amount than actually needed per dose in order to build a reserve.) Trust between doctor and patient would be key here. But, considering the alternative (possibly death) I'm guessing a doctor would play along. Alternately, a doctor might keep "spare" meds on hand for just such possible shortages. Where there is a will, etc. etc. YMMV

 

[target2019]

My latest interaction for a prescription from CVS Caremark mail order. No calls or interaction with a human by me.

Feb 20 13:39 Contact Dr. office through portal. Request Rx.
Feb 21 12:21 CVS Caremark email notifies that Rx received
Feb 22 17:37 CVS Caremark email notifies shipping and tracking
Feb 23 07:35 USPS email notifies of pending delivery today

All together that's 3 days for turnaround.

If I had requested delivery through the local pharmacy, it would have been about 24 hours. But I'm not a fan of bricks and mortar. We only go there when absolutely necessary.