Caremark - Changing Prescriptions

I have had to be on some pretty expensive and potent medications for Reflex Sympathetic Dystrophy, a very painful condition. The doctor wrote me a prescription with one refill for a pain med. They, although the prescription is due to reach me by 09/04/2004, state because of the amount of the pills the doctor has prescribed, they will not refill it for another month. They stated she is giving me too many doses. This is always for a 3-month supply and she prescribes 540 pills.

They told me today that at this rate that means I would be taking 10 pills a day which disqualifies the script. They said that two pharmacists did the numbers and this is what they came up with, stating that I should have at least a month's supply left yet. If it's a three-months supply and it is written for 540 at an average of 30 days a month, this comes to 6 pills a day, which is just what the doctor had ordered.

I have had them refuse to fill prescriptions and return them to me. They call the doctor continuously and harrass her about the medications she has me on. It seems to me that when a person has a disease that is barely controlled by any meds, this company automatically takes it upon themselves as to whether they will will the prescription or not. Meanwhile I suffer.

They noted that I had gotten a prescription filled at a pharmacy other than them, I told them I had no choice as that was when they denied my meds and sent all my prescriptions back to me. I am forced to use this Caremark mail order due to my husband's insurance plan. At this point I am stuck ... I cannot get a prescription at a pharmacy as they deny it stating any chronic long-term medications MUST be filled by them. I could get the medications if I wanted to pay full price, but I am totally disabled and do not have the money to do so. I haven't worked in over two years.

In talking to them today I told them that they were taking away the very thing that keeps me at least within a tolerable pain level. I told them that a life lived like this is not worth living. It has been two months since I have even left the house due to the pain, left leg being totally numb and paraysis of my foot. I have a constant, aching, burning pain. I average maybe four hours of sleep a night and that is broken sleep. I can't stand anything to touch my left leg or foot, it is a painful sensation and causes my leg to spasm.

The pharmacy cares little about this. They make the ultimate dicision as to whether I will get my medication or not, even though the doctor goes to bat for me. I at this point feel as if I no longer have any option except to suffer the pain ... and what kind of life is that? Even with medication I don't have a good quality of life.

One giant, rich company calls the shots as to whether I will be a bit eased of pain or not. It all lies in Caremark's hands and there is noting I can do about it. Once again the little man loses. I only know that I can't and won't tolerate this pain much longer. I won't tolerate being made to feel like an addict. I have been an upstanding RN for many years, I don't even so much as drink. Now I am reduced to this.

I take Celebrex 2 times a day for arthritis. The last prescription I mailed in was for a three months supply (180 pills). I received 120 pills. A letter accompanying the medication explaining that my doctor's office had been contacted by Caremark and they had agreed to change my drug therapy so that my new therapy was to take one capsule twice daily as needed. Because it said as needed they only sent 120 pills.

The doctor had originally written 1 capsule twice daily. I called 1-800-224-1193 and talked to the pharmacist. He said if this was incorrect to call my doctor's office and have them call this same number. Caremark would then send me the remaining 60 pills free of charge within 7 to 10 days. I called the doctor's office. They called this number and were told to call a different number. At that number they were told they could not change the Rx back because it had already been mailed and they did not keep records of old prescriptions.

The nurse said, well let's just go ahead and call in another prescription so that it is right in the future. They said they were sorry but could not do this because they had just filled my prescription. They told her I could contact Caremark again if I had any more concerns. She relayed this to me sounding rather frustrated and saying this didn't really make sense to her. I called this same number for 2 days leaving messages and waiting for answers -- receiving no returned phone calls.

I paid $50.00 for 180 capsules and received on 120 capsules for the same price.

I have had a problem with Caremark for at least 5 years. I take a few high priced medications that they continually would try to change every time I needed a refill. They would call the doctor's secretary and get them to ok a change in the actual drug to another less expensive drug, the dose, the refill amounts, the actual number of pills they would send. They make the secretary or the doctor feel like their is no option but to change the medication. I have called my doctors and their secretaries and complained to them but there is always someone new or a reason why Caremark gets away with this.

Over the years, I have called SBC Connect, and SBC who is our company providing the insurance coverage. There is a tidy little game going on that they all blame the other two parties, and pass the buck and get nothing accomplished for the consumer. I was told to write "daw" on my prescriptions and then they could not change them. Then the new game was they were not sending generic, even thought I wrote on the order form to send generic if possible. So now instead of paying a $20 co pay, I am charged $95 on one, $53 on another and $186 on another. Then when I told them I don't want the non-generic drug, they tell me they can't return the medication, and I just have to pay the full price.

I have been without several of my medications for weeks while trying to figure out this problem. One is a circulation medication I have been without for months while I wait to get this problem fixed. My health is definitely affected by my continued problems with Caremark. My doctors are constantly aggravated with Caremark because of being hounded by them to change my prescriptions to something that costs SBC and Caremark less. My business is suffering from time lost by its owner working on Caremark Issues instead of business.

I am retired from Allstate and pay dearly for a medical prescription plan administered by Caremark, Inc. Recently, without informing me, Caremark reduced my prescription refills for Celebrex from 90 to 60 pills. I did not notice this change, nor was I informed, until this change until my last refill in January, of 2004. I called Caremark and suggested that they must have made a mistake because for over a year, I had been taking one pill per day and my prescription was for a 90 days supply and that's what I was paying for.

Caremark's response was, "Oh no, we talked to your doctor and the doctor agreed that you should be taking the medication on an "as-needed basis" rather than on a one-pill-per-day basis. I suggested if that was the case, they had some obligation to inform me of the change. They said, "No, that's your doctor's responsibility. We have no legal obligation to tell you." I then checked with my doctor who advised me that on two different occasions, Caremark attempted to get her to change my prescription, and on both occasions, she declined to make the change. She so advised Caremark by faxes dated September 30 and October 1, 2003.

I then wrote to Caremark and told them about my findings. I also told them that they owed me additional pills or money. A woman named Sheila called me on February 13, and in my absence told my wife that because it would be too difficult for me to reach her, she would call me back on February 16. Today, February 20, I still had not received a call back and so I called and attempted to reach Sheila. Caremark didn't know who Sheila was but advised me that my doctor had changed my prescription in January of 2004, not last Fall. I told the lady, I didn't believe her. Her response was, "Well you can choose who you believe." She then gave me a number to call for a higher level discussion.

Isn't that wonderful treatment to a man who worked for them for over 28 years? If that's being in "Good Hands," I wonder who poked holes in their hands.

I have had to use Caremark as my employer's PBM for about ten years now. There have seldom been extended periods of time without any problems. Caremark has a serious problem with notifying participants of changes, order status, etc. Most recently, effective with the 2003 benefit year, Caremark instituted a Formulary Listing with a tiered co-pay structure. The 2003 Formulary Listing contained no HIV medications. Anyone requiring HIV meds had to pay $80.00 per three-month mail order supply. The standard co-pay for meds on the Formulary was $40.00.

I could not find a lawyer to pursue the issue and Caremark/SBC did nothing but point the finger at each other. It was even stated there was no "standard of treatment" which was the reason for their exclusion. Effective October 2003, HIV meds were on the Formulary. There was no prior notification that this would occur. I placed my last order for 2003 at the end of September. As of this date, Caremark is still saying that I owe them for past prescriptions.

I have been mistreated many times. They have a promise that they will not change the prescription if doctor signs it "dispense as written." They say they will notify the doctor and consult if medication is changed. They have changed my prescriptions medication and the amount without contacting my doctor. They have mislabeled my medication and taken 5 weeks before I received my medication and have told me that the mail took a week and half before it reached them.

I take my prescriptions to the post office because of the fear of someone stealing it out of my mailbox. They sent me medicine that had made me throw up blood, because of my ulcers. After being notified by phone, doctor's signing prescription dispense as written and again on the forms we send in, it has a place for drug allergies and health conditions. On this form that I sent off for my 540 pills of Vicodin, I wrote that "I could not tolerate the generic brand of Vicodin that they sent me in June, because they made me throw up blood after 2 weeks of use." However that I could handle the Watson brand, Loratabs and brand name vicodin. I also put that I was allergic to aspirin and that I have bleeding ulcers. I put what the doctor told me.

He also told me to call before I mailed the prescription in. He also wrote me a prescription of 60 Loratabs to take to my local pharmacy to get filled until I get my mail-in order, which I refilled again on Aug 28th. But I had to call Caremark first to notify them about my stomach problems.

My Loratabs ran out on Sept. 8th and I received my mail-in order on Sept. 15th. But when I opened the package, Caremark had sent me the generic Vicodin brand again, the brand that made me throw up blood after being notified what they had done to me. I called them the same day and they said they would have it taken care of by Wednesday.

They sent FedEx to come to my house to get the generic vicodin Tuesday at approx. 3:30pm. Wednesday came and no medicine so I called them and they said they could not send them until they get the generic Vicodin. I checked the tracking number from the shipping ticket from FedEx on the internet before I called them and it said the medicine arrived at their dock at 7:30 am Wed. so I told them it was there and they said they would check and call me back. They call back 30 to 45 minutes stating that the new prescription had not arrived from the doctor's office because FedEx didn't pick it up Tuesday. But they made sure to come by my house to get the medicine Tuesday.

I told them I was not paying for it and hung up. I call them back 15 minutes later and told them to put it on my MasterCard because I needed the medicine because I was in great pain and been out since Sept the 8th, she said they would ship it right out. It is now Sunday and the Caremark website states that the order is still being processed.

I have sent several emails telling them about the pain that I am in. They have not offered calling a local pharmacy for me to pick up some medicine to last me until my order comes. Also other times they have approved for me to go to my doctor to get another prescription written due to their slowness. But I have to set up an appointment, drive out of town and pay the doctor money. Where are they saving me money?

I am in chronic pain and been on disability since Jan 2001. Had neck surgery last August and need another again on my neck. I have had ten surgeries to my left median nerve, where the nerve was severed when a stick went through my left wrist and the last doctor that operated informed me that the nerve was damaged so bad that I would have severe pain for the rest of my life.

I think that something needs to be done to Caremark before they hurt someone else, not just me.