I am a patient who has Atrial Fib and occasionally needs to have a procedure done called an ablation to my heart. It requires that I go on Eliquis prior to the procedure and then one month post procedure. My Cardiologist gave me some samples to start using that day (Monday 11/4/24) and then I just had them send a script to my local Walgreens for a 30 day supply.
My normal copay would have been $38.00 but because I only needed a 30 day supply they state that I have to pay $43.00 because I went through my retail pharmacy. And remember, I needed to start the medication that day.
I contacted Customer Service as to why but basically that was a waste of my time. If I had asked the MD to give me a 90 day supply (which I would have wasted) my copay would have been the $38.00. Also, was told that Express Scripts could not have done anything for me if I had need the medication that day (which I did).
So where does this leave a patient? Express Scripts would rather see me waste a very costly medication? Why can't a patient, a doctor or even a local retail pharmacy use their common sense to not have a patient pay more for a medication or even worse, have to throw away medication that will be wasted because of Express Scripts ridiculous rules?
Claimed loss: Common Sense of Pharmacy
Desired outcome: I would appreciate an answer and would like to see this silly 60/90 day or else rule be eliminated.
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