Kacie's Story - Cancer Patients Experience Delays and Interruptions In Treatment Due to Forced Mail-order Pharmacy
Imagine, a patient just diagnosed with cancer and the physician informs them that chemotherapy will be needed. Taking chemotherapy comes with many risks. The medication can be toxic to the patient’s body and destroy healthy cells, hair loss may be inevitable, there is an increased risk of infections, and the battle will most likely be difficult emotionally, physically, and financially. Although chemotherapy may not be a promise to a cure, the patient decides to embrace and fight cancer.
Patients Didn't Know They Would Also Have to Fight The Mail-order Pharmacy Just to Receive Their Medications
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Upon the physician writing the script, the patient goes to their trusted local or hospital pharmacy to fill the prescription. As the pharmacist tries to run the script through the insurance, the pharmacist who the patient has built a relationship for years looks saddened as they inform the patient, “I’m sorry, this will only be covered by mail-order.” At this point, there is a feeling of emptiness in the patient's stomach as there are many others who have had devastating experiences with mail-order pharmacy. Left without any other options, the feeling of a new fear and anxiousness sets in as the patient can only hope that they will not become another mail-order pharmacy casualty.
In Kacie’s experience, the nightmare came true. Less than 3 months after releasing this video and publicly announcing her fears of her medications not arriving in time, her life-saving cancer medications are delayed.
Sadly, she is not alone in her experience. Although the patient does everything they can to win their battle and ensure their treatments are not interrupted, the PBMs delay medications and interrupt treatments. In the past, patients were able to safely pick up their medications at the location of their trusted pharmacy, without the concerns of delays, interruptions in treatment, thefts, improper storage during shipping, or of medications being delivered to the wrong address.
Several cancer patients, including children, have experienced needless interruptions in the middle of their battle with cancer. The chemotherapy medications they needed were available in their local pharmacies or hospital pharmacy, but the pharmacy benefits manager selfishly demanded that they use only the mail-order pharmacy for coverage.
As Kacie points out, many are told that they must use mail-order because it’s cheaper. As PBMs, Optum RX, Express Scripts, and CVS Caremark, force patients to their owned mail-order pharmacy, the costs of many medications are actually being inflated.
Today, an article released by the Columbus Post Dispatch stated, “ The PBMs also essentially set the price paid by taxpayers, via managed-care organizations hired by the state to administer the Medicaid program.
"But when it comes to specialty drugs, there’s a catch: PBMs often guide purchases to pharmacies run by the PBMs’ parent company."
The article goes on to share the price hikes as PBMs force us to their mail-order or retail pharmacies,
"• The markup for 100 mg of leukemia chemotherapy drug Imantinib Mesylate jumped $274 a prescription, increasing from 491% to 572% of the federal average price.
• A script for 1 mg of Entecavir showed an increased mark-up of $552, growing from 284% to 1,394%."
The article ends with a clear statement of what is happening, “You have the price of a drug going down, and the amount charged to the state increase."
Patients are not consistently forced to mail-order for life-saving medications because it’s cheaper or safer. PBMs can set low copay and still price gouge behind the curtain when they reimburse their owned pharmacies. PBMs who have merged with insurers have secured positions as the wealthiest billion-dollar corporations in our nation.
We don’t have to allow for our pharmaceutical care to rapidly decline. Please help us win safe access to medications for all patients.
Thank you to our supporters and to Kacie for sharing your story. We hope the best for you and your family.
Speak to your legislators. Share the petition.
Share your story: loretta@uniteforsafemedications.com https://www.change.org/p/stop-forcing-mail-order-pharmacy/u/25047222