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After spending 3 weeks dealing with changes to how to obtain a prescription refill for a medication I have been on for over 6 months do to benefit rule changes we finally had the prior authorization correct and the new prescription correct to get the medication as a 90 day supply only through the PBM or their designated two pharmacies who don't have stock on the drug. I then found that the prescription which had been scheduled for deliver was on hold pending a drug interaction review. I got no notice of this however they constantly text me on all other prescriptions and status. Called in and they cant tell me what the issue is other than they need to Dr office to respond. No medications have changed for me for over 9 months. MY options are to spend over a $1,000 for a 30 day supply I can get locally or continue to jump through arbitrary hoops that are being thrown up to delay this fulfillment. This should be illegal and its definitely not ethical. My Dr. Office is not inclined to continue working this as they don't get reimbursed unless I come in for an appointment. So in 6 weeks I may be able to resolve this when the next available appointment can be.
Claimed loss: I will have to titrate back onto this drug if I am off it long enough and I am out again....
Desired outcome: Receive my Prescription in a timely manner and know all requirements to get it fulfilled in one session.
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Convey your point or worry directly to Express Scripts make sure to emphasize the aspects of the hold which concern the delay and communication issues. Inform them that this problem interferes with your ability to have the necessary medication. At the same time, involve your insurance provider so that the such incidents will not happen again, also make sure they address these stock problems in their appointed chemists. If that fails, make a complaint to the insurance department of your state or to a relevant consumer protection body to complain about this described immoral delay.