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Express Scripts

Joe of Avon OH (11/08/08)
This drug insurance company denied payment for Caduet....telling my pharamasist that I must take the generic. I will keep this long story short. I tried the substitute.....and the side effects continued to be awful. I had been on Caduet for 4 years without adverse side effects. Then.....when my doctor told Epress scripts about that problem....they agreed to s second teir medication.... which was the very medication I had switched from.....to Caduet for the same reason.

I am going to file a formal appeal under ERISA.....because this is the LAW that governs most group medical. All of us who have this problem should become acquainted with this law.....it is a terrible law and one that both administrations ( republican and democrats) promised to deal with after the election. In any event...there are obligations imposed on the health provider to give more detailed information as to the Plan.....the Plan Documents....including recorded conversations with the patient.....the name and address and person ( by name ) who is the plan administrator....etc etc. It may not produce anything....but a lot of mail.....but I guarantee you it will drive them more crazy than their unilateral decisions, disrespectful decisions drive us. Anyone who wants to talk more about this can call me....if they wish. I have had personal experience with ERISA....in our local , sixth circuit, Federal Court...as I work for a small town attorney who is NOT looking for business.....by the way, not at all or whatsoever. There is a chink in ERISAs armour...including not following the very law they use to protect themselves. and.....the breech of feduciary duty. It is tough to get to.....but sometimes persistance pays off.

As to just my circumstances.....it is my doctor who has had to deal with a very stubborn company....and the company does not want to pay her for her services. My wife has suggested we go ahead and pay for the preferred drug......well I would.....except at this time Express Scripts does not seem to be in the mood to give credit for the difference between their recommended drug and the better drug. Thats what this whole insurance thing is about.....reasonable compromise. Apples to apples money would be great. the difference is about 10.00. So go figure. As to the medical consequences?....i do not wish to share all of that today....but it is very sharable....very.

Dorotha of Santee, CA November 6, 2008

Dorotha of Santee CA (11/06/08)
As of Nov 6th I received an e-mail from Express Scripts breifly explaining what I as the Client/Patient is now required to do to have my prescriptions filled. I MUST SEND EXPRESS SCRIPTS THE NEW PRESCRIPTIONS FORMS WHICH I HAVE WITH ME and if there is still missing information EXPRESS SCRIPT will CALL MY DOCTOR, I will have to wait another 3-5 business days ONCE EXPRESS SCRIPTS receive the new prescription (deliver by the USA Mail service AFTER THE PROCESSING BEGINS TO BE SHIPPED, THEN IT WILL TAKE UP TO 12-15 DAYS TO BE RECEIVED.

At 12;05 pm (calif time) I placed a call to my Medical Insurance Co HEALTH NET, playing punch the number in order to speak with a real person, got Karen C/S tried to explained the problem I am having with Express Scripts, of course she stated I must contact Express Scripts because her records indicates my prescriptions were ordered on 10-10-08 which is too soon to refill again.

I asked how can that be if (1) I had to call my own doctor for an emergency refill) which was done on10-14-08 and Karen states that she will make an attempt to contact Express Scripts Pharmacy and get this problem resolved. So NO HELP EVEN FROM MY HEALTH CARE PROVIDER----HEALTHNET

OUT OF ALL MY REGULAR MEDICATIONS AND AT LOSS AS TO WHAT TO DO NEXT

Jo of Chicago, IL November 1, 2008

Jo of Chicago IL (11/01/08)
I had a large basal cell tumor (6 round) removed from my scalp last year...since then I've been on Ambien CR 12.5 (sleeping medication). I toss and turn in my sleep and now with 1/3 of my scalp missing (there has been a skin graft from my thigh to replace it)...there is no cushion or fat layer or hair on my head...when I turn my head in my sleep...the hardness of my skull hitting the pillow wakes me up. I have been on the medication for over one year (MD prescribes).

My mail-order pharmacy called me and told me they won't fill this med anymore as they have a generic and called my MD and told him he'd have to prescribe that. It was that or nothing. The substitute drug is Zolpidem...and the strongest strength is 10 mg...it doesn't have the long activing feature as Ambien CR 12.5. It doesn't work...it'll put you to sleep for about three hours and that's it. I thought the FDA rules for substituting a generic drug have to be apples-to- apples...the dosage isn't the same, the efficacy isn't the same, it's doesn't have this two-layer feature of keeping you asleep.

I have had non-restorative sleep for weeks (with their substitute medication)...I'm in the midst of an appeal and am helpless in fighting them. But I just don't get it...of course I understand the saving for pharmacy companies in getting away from brand names - but this substitute med is just not the same. I'm an RN by trade and am responsible in my work for quick and accurate decision making...which I feel is compromised due to Express Scripts now filling the medication Ambien CR 12.5) as my MD prescribed. Is there anything I can do?

Again, I wrote my appeal letter and their answer to me was to have my MD appeal for me. WHY? My MD isn't taking the medication I am. He prescribed it to begin with...I'm so confused and aggravated with drug companies...and just wonder as a consumer if there is anything I can do?

As stated above...my cognitive abilities are compromised...I'm getting three-four hours of sleep instead of the 7 hours I was with Ambien CR 12.5 (the dosage of the substitute medication isn't the same, nor is the long acting feature). I could make mistakes as an RN, I'm not as alert, sharp, I'm tired and not quick thinking...all essential needs of my job as an RN.

Jack of Hillsboro, OR October 17, 2008

Jack of Hillsboro OR (10/17/08)
no service. phone , fax, us mail, or e-mail all the same result : never heard of you. wait 48 hours, same result: nothing done. My doctor's office faxed twice, letter to their vice president and their president: no reply, as yet.

I am waiting and running out of meds.

Vickie of Eastpointe, MI October 11, 2008

Vickie of Eastpointe MI (10/11/08)
Never put your credit card on file with Express Scripts. They will charge anything they want to when they want to.

I am like most of you. They are slowly weining me off the non-generic brand prescriptions and putting me on all generic drugs. There is one thing you do not want to do. Do not let them take over working with your doctor on what is best for you on prescriptions. The bottom line was they tried getting me to sign this agreement to have them to work with my doctor to tell him what I should be on. Taking over my doctor duties. Why have a doctor then? Right?

They tried that with my health insurance too! The health advocate wanted me to sign an agreement that I would follow what they suggest for so many months. My question is what if I do not follow their suggestions? What if they suggest I have a lap band surgery and my doctor says I am not fit to have any surgery. What is the insurance going to do then? Drop me from their plan because I am not participating and working with them.

A friend of mine has a similar problem like that except it's her doctor that is reporting to her insurance company. He reports to her insurance company that she refuses to take the prescription because it upsets her stomach to much. Her insurance tells her that if she does not follow her doctors orders she will be dropped from the insurance. So she goes to him for a while and finds a new doctor.

Express Scripts lastest pain for me was that I was waiting for a shipment to arrive so I went online to check the status. I found out that my Wellburint XL 300 mg was 377.66. Now last time I ordered it was 160.00. The time before that it was 80.00. This was all in this year. I immediately call Express Scripts and told them that they should of call me or my husband. That we can not afford it and we were sending it back. Why didn't they call us? They then said that the doctor did not write DAW. Well, he did too! He writes on carbin paper. She says well he did not!

You know how it continued. Then she said have your doctor call this number. I then hung upand of course it was 5:30 pm and the office was closed. So I waited until Thursday the next day. Called the doctor. The rep calls Express Scripts and calls me and tells me to call a certain number and for me to send the package back with a new scrip. Okay! so I call the number they say the Rep did not call! Oh boy! Do I have to go through this again. Which I did. Hung up and called the Prior Approval Number and asked did my doctor call you. No they repiled. I start complaing ask to speak to a Supervisor and she passes me back to one regular Express Scripts people. I explain my whole story over thinking it's a Supervisor and then she tells me she not and I exploded. I ask for again for a Supervisor and I get this man who I don't remember his man. We start talking and I tell him that I can't pay this amount and I did not open the package we'll be shipping this back. He told me he can not recieve it. I said why? I did not open it! He replied it's the law! I said ........ and hung up.

Called the credit card company and they can not do anything until 15 days after the order was cancelled. I went to a notary of public on Friday to have them see the bag that it was not opened and I signed a document that I typed up stating that it was never opened. It should be recieved by Express Scripts by Tuesday. I wonder what they are going to do?

Hildajill of Brooklyn, NY October 4, 2008

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