"������ � ���� ���� ������ ���� ��� ������ ��� ���� ��� ���� � �������� �-����-��� ������� ������� ��� ��� �������� �� �� ������ ���� ���?"
After this child was left without insulin, this pharmacist made a point. Patients cannot wait days for medications to arrive by mail. The pharmacy benefit manager should be required to cover any prescriptions at a local pharmacy when patients are without medications. Please know that insulin freezing during shipping puts a patient's life at risk. Many mothers including myself do not want to risk the shipping of medications. It's unsafe due to temperatures and delays not being regulated.
Here is the story:
"Imagine telling your son they won't need to take insulin in their pump for the next couple of days as the insurance requires them to get it through the mail after it's filled twice at a local independent pharmacy.
11/14 child receives vaccine through a Skippack Pharmacy clinic/family likely hears about our local independent pharmacy for the first time
3/21 family transfers all scripts for the family to our pharmacy for customized care
5/8 insurance rejection pops up for son, "Refills are not covered” for his insulin
We call the insurance company to see how we can get an emergency override so the child does not run out of insulin in the process of it being transferred, filled, and mailed from the mail order facility.
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That was not acceptable to us so we spent about an hour and a half on the phone calling back and chatting with mom to come up with a solution and came up with a temporary fix to get her child insulin as we nor she were going to let him be without it.
The part we did not tell Mom is that on these insulins we have been filling for her son, we have been losing money on every fill as the insurance does not reimburse us even the cost of the drug.
It's a tough battle out there but these battles teach you to be even stronger and more resilient for your patients.
If they thought we were too weak to reopen when CVS pinned a nail in the coffin for the old Skippack Pharmacy 4 years ago, they were wrong.
If they thought forcing patients to use a chain or mail order after 2 fills would cut us out of the picture, they were wrong again.
We might not have the money to be as powerful but we have a voice and will continue to share our patient stories until change happens.
It won't happen overnight, it won't happen easily, but we'll keep fighting for patients like him who we refuse to let suffer because of a broken system."
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Many of these locally owned independent pharmacies are closing due to the abusive practices of pharmacy benefit managers.
This week there was a hearing about pharmacy benefit managers (PBMs) and their roles in drug prices. Optum RX, CVS Caremark, and Express Scripts are PBMs that have merged with mail order pharmacies and insurance companies. They use their power to not only distort drug prices by charging patients over 10X more than the cash price of a medication but they also force patients to their own mail order pharmacies. They oversee the reimbursements to their competitors and often make more money as a middleman overseeing a transaction than the pharmacy filling the prescriptions.
The nightmare stories that have been shared on this petition are not rare.
It's wonderful that members of Congress from all political parties are realizing the role that PBMs play in drug prices, but we dream of the day that access issues are also discussed. PBMs are destroying America's safe access to medications.
Please keep sharing the petition.
Patient choice of pharmacy will save lives.
Thank you for your support,
Loretta Boesing, Patient Advocate