Mail-order pharmacy system delays meds for some patients

http://www.dispatch.com/news/20180603/mail-order-pharmacy-system-delays-meds-for-some-patients

Imagine the terror of being diagnosed with cancer.

Your doctor writes a prescription that you pray will save your life. You go to the hospital or oncology clinic’s in-house pharmacy. The medicine is right there on the shelf, but you’re told the only way your insurance will cover your medication, which might cost $10,000 or more per month, is if you get it through the mail.

So, you go home empty-handed and wait. If you’re lucky, the medicine will arrive in just a couple of days. But it could be up to a month before delivery of the drugs.

Uncounted numbers of Ohio cancer patients don’t have to imagine this dilemma. They have experienced it because health insurers and the pharmacy benefit managers hired by insurers dictate it.

They require that prescriptions be filled at mail-order pharmacies. These are often owned by the pharmacy benefit managers rather than allowing patients to get the drugs immediately by going down the hall at the James Cancer Hospital at Ohio State University, Cleveland Clinic, Mount Carmel Health System or Nationwide Children’s Hospital.

“Rather than filling a prescription I have on the shelf, I have to tell the patient they have to go home and wait for a phone call from the pharmacy and arrange having this medicine sent to you,” said Christine Pfaff, pharmacist for the Zangmeister Center, a Columbus cancer-treatment facility. “I can’t give it to you today. Your insurance won’t allow it.”

Health-care providers say the goal is to start treatment as soon as possible, because delays can be detrimental to their patients’ health.

“New diagnosis, with medications as good as we have today, speed to therapy is important. Even a few days can make a difference,” said Curt Passafume, vice president of pharmacy services for Ohio Health.

Filed under: General Problems