A couple of weeks ago, I got a refill for Barb at the local independent we patronize… It is a longtime available generic and the copay was $60.00 and they paid the pharmacy $16.72. I thought that purchasing generics was suppose to save everyone money…
We have Silver Scripts – which is part of CVS Health – and the PBM is also part of CVS Health (Caremark). I went to their website ( https://www.silverscript.com/ ) and found out that the independent that we patronize was NO LONGER A PREFERRED PHARMACY and if had it filled at a “preferred pharmacy” it would have been $32.xx. So I went thru into the website and found out who is a preferred pharmacy is… and guess what the only preferred pharmacies in the county (approx 80,000 population) was TWO CVS STORES… which are about 3 blocks apart (one is a former Target) and located on one of the most congested roads in town and 8+ miles from our house. – we live in a rural area – and the pharmacy we patronize is only about 2 miles away and will deliver, if I can drive over there. Barb only drives in emergencies any more.
I searched further and found out that out of three adjacent COUNTIES.. there are only TWO INDEPENDENT PHARMACIES that are preferred pharmacies in the Silver Scripts network. None in the country that we live in.
I filed a grievance with Medicare, feeling that we were being discriminated against and being financially fined, because we did not wish to patronize part of the CVS Health pharmacy chain.
CVS Health seems to be in the news a lot lately, especially in the overcharging of patients Lawmakers, Pharmacists Meet with CVS over Regulation of Pharmacy Benefit Managers
CVS Hit with Class Action Lawsuits from HIV Patients
And here is lawsuit that was finalized this week by a former CVS Pharmacist winning a age discrimination lawsuit against the chain… that took SIX YEARS because CVS kept appealing.
Today I got a call from a person who said that he was the CVS person who dealt with Medicare complaints.
Barb started using the first company Community Care Rx Part D back in 2006, when Part D’s first came on the scene.. and that company has changed hands several times over the years with CVS Health being the final owner.
This person’s only suggestion to resolve the issue was to either patronize a CVS pharmacy and he stated that he had been handling a lot of complaints from pts. Apparently CVS dramatically reduced their “preferred pharmacy network” the first of the year.
OR … just look for ANOTHER PART D PROVIDER that the particular pharmacy we patronize was a preferred pharmacy. Barb has a couple of meds that are being covered as exception to their formulary because she as been on them for 10-20 yrs.. and just because I found another Part D provider does not mean that those medications would be covered.
If this employee is properly reflecting CVS’ philosophy … apparently that philosophy is “our way or the highway”
It would appear that CVS Health is in the process of creating their own monopoly in as many markets as possible, and according to those issues on the above hyperlinks… their bottom line .. is all that really matters to them.
Filed under: General Problems
[…] connie on Maybe you should find another company ! […]
I think we all saw this coming or at least should have! PBMs and CVS have grown much to big and powerful! Between them and the anti opiod government agencies we’re totally screwed. I’ve lost hope.
I noticed our pharmacy bill (from a locally-owned independent pharmacy in which my entire family, along with me, my husband and son, have used since 1990) was about twice as much. We have Cigna, which uses the PBM known as OptumRX. I’m going to talk to the pharmacy to see if this – your situation – is what is going on here. I hate these PBMs and the power they hold. We live in a small town of about 13,000 (along with a few thousand who live in the more rural areas outside of town). We have one major business which employs a great deal of our town (this is where my husband is employed), so I’ll be very surprised if our pharmacy is no longer “preferred,” as our pharmacy is one of the main pharmacies that locals use. (We have one Fred’s, one Walgreens, and one Walmart as our “chain” pharmacies. The few others are independents).