Specialty pharmacy blues

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celebrate life
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Date Joined Dec 2014
Total Posts : 2066
   Posted 2/8/2017 2:14 AM (GMT -6)   
This year I made what I hope to be a good switch in insurance companies to get my eye Dr visits covered since I'm being monitored for potential glaucoma.
I've been on biologics for awhile now, and have had to make switches with the specialty pharmacies that supply the biologics before. And sure enough, the new insurance uses a different one. For some reason making the switch for biologic is always the biggest pain. So I started the process right after I made my last order for Enbril a month ago. Called the new insurance to get the name and number of pharmacy. Called current pharmacy to tell them I'm leaving. Called the Dr office to give them a heads up and the name and number of new pharmacy. Called the new pharmacy and gave them all pertinent info. including my copay assist info. Of course every call included a a phone tree and then elevator musak and then a lot of talking to a computer before you get a person...but I was patient and talked to real people and told them to make notes. I followed up and left messages everywhere last week and then again yesterday. Was told that they were waiting for authorizations. Called the Dr office and have them the pharmacy fax number for authorization form. Then I called again today and was told the prescription ended up in the wrong distribution center and they have to get it sent (by courier, mail WHAT????) Aren't we in the tech age where anything can be scanned, faxed, emailed, etc?? I am supposed to inject Friday and it looks like it's once again not going to het here on time. I'm venting cause I've been here before and I just don't know how this keeps happening. Has this been anyone else's experience with specialty pharmacies?
BTW, while I'm ranting, I hate the Styrofoam boxes they send it in that can't be recycled too. I could build a Styrofoam house with all the boxes I've collected over the years.
Beth eyes

Alice22
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Date Joined Jul 2015
Total Posts : 595
   Posted 2/8/2017 10:01 PM (GMT -6)   
I have been through hell with CVS Specialty pharmacy. It would take too long to write about all the problems I've had over the last two years with them. I think they must have poor management, poor staff training and pay minimum or very low wages because there are way too many problems with simply ordering my medication. The last time I went to get my infusion of remicade it hadn't even arrived, and the shipment was "expedited"! And that was after several phone calls that began three weeks before the infusion date. Thankfully, now the infusion center is ordering my medicine and I don't have to deal with CVS anymore. It was a major headache. It's no wonder the company isn't doing well. I feel for you. If you could get the name of a supervisor that can help you when there is a problem I think that's your best bet. There's usually at least one person in a supervisory role that knows what they're doing and is willing to help. You aren't the problem - it's them!!
Diagnosed with ulcerative colitis in 2005 and rheumatoid arthritis in 1998. On Remicade since 2005 for both diseases. For UC tried sulfasalazine, Lialda, colazal and others which made me ill. Started 50 mg. Imuran July 2015. Use peppermint oil capsules and Bentyl which help during a flare and with IBS symptoms.

Caregiver for mother with Alzheimer's Disease (for Alz. forum)

celebrate life
Veteran Member


Date Joined Dec 2014
Total Posts : 2066
   Posted 2/8/2017 11:26 PM (GMT -6)   
LOL Alice! I didn't even give the name of specialty pharmacy and you nailed it. What irks me is that we have no choice which one to use. The insurance picks. I've dealt with four different ones over the years and Acreedo has been the best to deal with so far. The customer service people are super nice, but they can't seem to make "expedited" expediate! Tomorrow I'll ask for a supervisor unless it's going in the mail first thing in the morning. Thanks for the tip.
Beth

Alice22
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Date Joined Jul 2015
Total Posts : 595
   Posted 2/9/2017 8:22 AM (GMT -6)   
Beth,

That bothered me too that there was no choice. Maybe if we all complained to the insurance company they would give us a better specialty pharmacy. But while you're stuck with CVS for now, trying asking for LaToya on the "escalation line." After multiple problems I got passed on to her and she told me to ask for her when it was time to order my medicine. I hope that helps. Good luck!

Alice
Diagnosed with ulcerative colitis in 2005 and rheumatoid arthritis in 1998. On Remicade since 2005 for both diseases. For UC tried sulfasalazine, Lialda, colazal and others which made me ill. Started 50 mg. Imuran July 2015. Use peppermint oil capsules and Bentyl which help during a flare and with IBS symptoms.

Caregiver for mother with Alzheimer's Disease (for Alz. forum)

celebrate life
Veteran Member


Date Joined Dec 2014
Total Posts : 2066
   Posted 2/9/2017 10:17 AM (GMT -6)   
Hurray! They say it's on its way today! Thanks Alice Good info for future reference.
Beth

Don_D
Veteran Member


Date Joined May 2013
Total Posts : 548
   Posted 2/12/2017 12:29 AM (GMT -6)   
Glad to hear it all worked out and even in time for your next dose smile I have not used the CVS specialty RX, In all these years I have only used 2 one that I can not remember the name of but was a real PITA to deal with and now Walgreens.

Walgreens has been really great with insurance changes which I just went through at the beginning of the year. Their customer service really impressed me and they did most all of the leg work for me. Getting my RX re-submitted and approved under my new plan.

You made a good decision getting it all sorted out directly after your change, that way they have ample time.
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