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Prescription Refills
Posted by Misspink on 08/04/2009
I have been receiving my birth control pills for 2 years now through a home delivery service at first the company that Cigna used was Medco and just a matter of a few months ago they switched to Express Scripts. I sent in a request last week for a refill of my prescription and yesterday in the mail was a 3pk supple of a generic drug called Tri-Lo-Sprintec and not my Ortho-Tri-Cyclen-Lo.

I immediately call Express Scripts and informed them that, I was to receive my Orth-Tri-Cyclen-Lo and not this generic brand. They informed me, that because my prescription does not state "DO NOT SUBSTITUTE" that is why they sent me the generic drug instead of the brand name one. I was too, too, upset!!!! To top it off I then asked well can my doctor write a new prescription stating that I am to only receive the brand name( Ortho-Tri-Cyclen- LO) and the representative told me NO!!!, then I said well what the hell am I suppose to do with these generic pills, because I am not using them, can I send them back and she told me because they already sent me the generic drugs, by law my doctor cannot write another prescription and I would have to keep the generic pills.

By this time I was too pissed off, this non- informed representative then told me that I CAN get the brand name pills through my local pharmacy, fine!!! I them called my doctor's office and left them a message asking them to write me a new prescription. Well, today I call the pharmacy to see what my co-pay would be when I go to my local pharmacy to get it refilled and boy did I get mad again!!! This representative tells me that because CIGNA my insurance company has it set where I cannot get the prescription refilled locally, I can only receive the Ortho-Tri-Cyclen-Lo through home delivery service.

So, I asked why is that? She stated that if I go to my local pharmacy then I would have to pay 100% of the cost and if I go through the home delivery service then the cost of the medication is cheaper. I then said so, what do I have to do to get my damn pills. I was told to get the new prescription from doctor and have them fax it over and then I will receive the pills in the mail. Well, I go do that today and still there was more drama!! With Medco, I use to fax over the prescription with no problem. Express Scripts the new pharmacy says that only the doctor office can fax over the prescription.

I call my doctor office and tell them that they have to fax it and they say that they need the request form, that comes with the pills in order to fax it. So, I'm thinking fine, then I look ar the request form and see that it has the generic drug listed and not the brand name. I call the express scripts company and ask them if they can fax over to me a new form with the correct medication listed and they tell me NO!!!! To make a long story and bit shorter, I had to mail the damn prescription to express scripts!!!

For those that use Express Scripts if you have a particular brand name drug that you have been on for awhile and you like it and do not wish to be change to another drug for instance a generic drug. Make sure that your doctor has on your prescription "DO NOT SUBSTITUTE" because if not when a generic drug becomes available for your medication they will send you the generic drug without giving you an option!!! I think it is only right that I should have been sent a letter stating that a generic drug is now available for my birth control pills and upon my next refill I will be sent the generic drug instead of the brand name if I do not provide them with a prescription specifying for me to use the brand name only.

That is all they should have done and I would not have been so surprised when I received them. Express Scripts need to take my advise and write the above letter that I suggested to them, and they need to give patients the option of choosing whether or not they wish to have the brand name or the generic name. I feel like because my prescription says for me to receive Ortho-Tri-Cyclen-Lo, then that is what I should have received, regardless of whether or not it states "DO NOT SUBSTITUTE". Both CIGNA and Express Scripts SUCK!!!!!!
     
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Posted by goduke on 2009-08-04:
The script has to state DAW or Do Not Substitute or they are allowed, under the plan designed agreed to by the company through whom you get your benefits, to sub the generic.

You really ought to talk to a doc or pharmacist about generics. I'm not sure you have all of the facts.
Posted by BokiBean on 2009-08-04:
I know! My sis does it and SWEARS that generic pills in general do not work on her. I think its just silly, but that's just the way she is.
Posted by goduke on 2009-08-04:
And you know the cats at GlaxoSmithKline do a happy dance every time someone says that....

I myself have generics for all the maintenance drugs I take. Work like a champ (or so the doc tells me).
Posted by Principissa on 2009-08-04:
My doctor just switched me from generics to brand name only because of my allergies, and let me tell you I'm livid about it. My prescription for birth control just went up from 5 bucks to 25. Expensive. I only wish I could substitute.
Posted by goduke on 2009-08-04:
See...you have a really good reason and have talked to your doc, which makes absolute sense. The co-pay jump can be a killer.
Posted by Principissa on 2009-08-04:
Duke it damn near gave me a heart attack! I had to get some ear drops and nasal spray for my sinus infection and spent 50 bucks! So wasn't prepared for that. But my doctor doesn't want to take the risk with me anymore. She thinks that certain generics have a filler I'm allergic to and it's causing really bad reactions. If I could take generics I would, they work just the same as brands and I save a ton of money.
Posted by goduke on 2009-08-04:
Sometimes you can find a generic manufacturer who will disclose and guarantee the fillers they use, and the pharmacy will order it. But it's a lot of leg work.

Doc gave me a non-preferred brand one time when I wasn't paying attention to the formulary. Cost $80. We found an alternative.
Posted by Principissa on 2009-08-04:
I wonder. I did a lot of research on the drugs prescribed for me and surprisingly a lot of the fillers in generic pills are sulfate based. Scary right? Even OTC medications (generic) have sulfate based fillers in them.
Posted by PepperElf on 2009-08-04:
Yes. Your doctor **HAS** to state "dispense as written" on the 'script

otherwise they can legally substitute a generic medication.


Mom has that trouble sometimes. Whenever her doctor writes a script she has to remind him to put "DAW" on it before she gets it filled.

If she doesn't notice it... she'll go back and have him change it.


the reason why is because, some of the meds she's on have very bad generics that don't work as well (or react badly) with her. plus her insurance covers getting brand names better than it does the generics anyway
Posted by Suusan B. on 2009-08-04:
Misspink: You can rant and rave all you want but the days of getting a branded prescription because that is what you want are over. For all the details of your prescription plan go to mycigna.com. Most insurance companies have a stipulation that prescriptions will be filled with generics when available and in some cases, your doctor has to provide information to substantiate why you have to have the branded one and it can't be "becaue she wants it". On top of that, once a generic is available the price of the branded goes sky high.
Posted by Eloise on 2009-08-05:
There was a news program (sorry can't remember which one, but it was a major network). That did a big story on the differences between name brand and generic. I've personally never noticed a difference, but they showed that many people do.
Posted by misspink on 2009-08-05:
Suusan B: I do intend on ranting and raving. Isn't that what part of this website is for?

Skelly39: didn't I already post what? Tcomplained about Cigna and I wrote a complaint about the home delivery pharmacy service.
Posted by PepperElf on 2009-08-05:
but there's a difference between complaining
and understanding the rules on scripts.

and although you dislike it the script - by law - has to have "DAW" or "dispense as written" on it or they will give you the generic.

i am sorry you had to learn this the hard way.
Posted by misspink on 2009-08-05:
PepperElf: I didn't learn anything the hard way. I will still receive the brand name scripts. So the topic of generic and brand name medication about my particular situation is done. Now, I know and on top of that I still have the option of getting the brand I prefer.
Posted by Anonymous on 2009-08-05:
MissP, have you confirmed with the insurance company that you have that right? Or do you mean you will just pay full price and get the one you want?
Posted by misspink on 2009-08-08:
KenPopcorn: I was told by my insurance company if I choose to get the pills refilled at my local pharmacy, it would cost me more, therfore by me getting them refilled through the home delivery serice it would be cheaper. I can still receive the brand name birth control pills at the same price I have always been paying. Nothing has changed.
Posted by Jen on 2012-12-05:
According to my doctor, generic medications can make a difference. The active ingredients have to be the same but the other ingredients can make a big difference as to how the medication gets into your system and your body receives it. Express Scripts put me on a generic for migraines and it now takes much longer for me to get any relief. I noticed a difference immediately. It was not a placebo effect because I didn't think there would be any difference because I believed the active ingredients was the thing that mattered. Wrong. So, getting generic medications instead of the name brand can/does make a difference according to a real medical professional!
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A Deceptive Mail Order Service for Prescriptions
Posted by Simmertime on 12/03/2010
BENSALEM, PENNSYLVANIA -- EMAIL TO ANTHEM:

Unfortunately your prescription vendor is Express-Scripts, which is a dishonest service that takes advantage of the customer. My recent experience using their mail order service was a disaster, both service and financial wise.

The service took 30 days to establish. First, they denied receiving by mail the five 90-day prescriptions, then I received a letter with the prescriptions enclosed saying that I did not have an account. Next, after three phone calls, they delayed filling the prescriptions and wanted to talk with the doctor's office. Finally, they sent out five prescriptions. However, one prescription was for a name brand Toprol XL instead of the generic Metoprol0l. Instead of a $20 charge they billed me $150 for the brand name. I did not OK the brand name being sent.

As of today, Express-Scripts is denying fault and refusing to adjust my bill lower to the correct co-pay. I think that Anthem needs to get involved and straighten-out their vendor of drugs. None of this is my fault, especially since their person called the doctor to verify the prescription information.

Thanks in advance for managing your relationship with poor vendors and assisting me in dealing with one.
     
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Posted by fast327 on 2010-12-03:
Getting prescriptions by mail is, in intself, a risky business. The post office is in no hurry to get your prescriptions to you in a timely manner. Losses, delays, wrong delivery, abound in the mail delivery system. Just say NO!
Posted by raven2010 on 2010-12-03:
fast327, you may not be aware that MANY benefits programs now require people to get their maintenance meds thru the mail.

This means anything you take on a daily basis has to be obtained and renewed via the mail, with the occasional exception fro "emergencies"

Just saying no is simply not an option for many folks unless they can afford to pay full price
Posted by Alain on 2010-12-03:
A good point, Raven. I was fortunate in that my maintenance medicines are available at my pharmacy for the same or less than the price charged by Express Scripts (possibly because my insurer is based in the same city). So I no longer use Express Scripts since, as Fast mentioned, mail can be unreliable.
Posted by trmn8r on 2010-12-03:
fast327-> We used Medco for my mom's prescriptions for 3 years. It was flawless, and they had a good system for handling generic/brand issues such as those the OP faced.

I had Medco stock for a year and did well. I should have kept it. It had a rough ride this summer, but so did many stocks. I'd use Medco in a heartbeat if I needed something for my heartbeat.
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A Company That Cars Nothing About Their People
Posted by Caring for the people on 11/06/2007
FLORIDA -- Make sure that when you sign up for Insurance benefit that you deal with companies that hire the right companies for you as far as prescription are concern some Insurance companies have contracts with pharmaceutical companies that do not allow you to get your medications where you want they have a contract with them and when they switch they don't even let you know till it is too late. This is bad business ethics and we should not have to take it especially when your dealing with medications that are costing the people thousands of dollars they have this thing now that they are saying it is specialty medications and have to be order by them but when you look into it it is one in the same I was getting my medication at a local pharmacy for years never had a problem no since Express script took over they are unprofessional they hire people that know nothing of the medical field and as a consumer I feel we should ask for the managers and supervisors credentials stating they do have medical background to deal with patients like myself .

I have cancer and I need my medication on time always I have had this company misplace my orders or not order them at all I have spoken with indivdules that have no knowledge of medical background and I'm not speaking of the people that order I'm speaking about supervisors themselves that have been transfer to me as well as managers. This company is interested only in one thing and that is capital not the patients well being yes I'm certain it is a well establish company but at who's expense. We are the consumer and if you are a patient just like me that needs your medication to survive than if not now when will you take a stance. These pharmaceutical companies and Insurance companies are making a killing and are properly number one but how did they get there by using us to benefit themselves.

THINK ABOUT IT. Make a difference complaint if you have had this problem with this company. Or whatever company that is getting away with cheating you. This company delivers to many people they are not even in the same state I'm in so I have to wait to get my deliveries from Florida when I can go down the street and pick up my own on time.
     
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Posted by Anonymous on 2007-11-06:
What? I couldn't even get through the first paragraph without getting lost.

You had a local place then went to another and they wouldn't let you get your medication? I have no idea what you are talking about here.
Posted by Anonymous on 2007-11-06:
Express Script is you get your stuff by mail. Like GothicSmurf2 even knowing what I know of Express Script this post lost me.
Posted by Anonymous on 2007-11-06:
Alright. So, who is your insurance company?
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