If you're like many patients, your employer has received a letter from their Pharmacy Benefit Manager (PBM), stating that they would no longer cover compounded prescriptions. Express Scripts (ESI) launched a program "Compound Management Solution," that would exclude coverage to the majority of compounded prescriptions, and began contacting its clients through sales force calls and a national webcast in June 2014. ESI's "solution" to a growing number of claims for compounded preparations is simple: they won't pay for them.
So what do you do if the compounded medications upon which you depend are no longer covered?
1. Determine if your Prescription Coverage is Affected
Meet with your Human Resources contact, and review your benefits information. Ask for your Summary of Benefits and Coverage so that you know exactly what your coverage entails.
2. Talk to your Benefits Manager about the Value of Compounded Meds
Let your Benefits Manager know how important personalized prescriptions are for you and your family. If possible, meet in person with the personnel responsible for making these decisions, and acknowledge that you understand cost-cutting measures are important for the company; but, that the omission of compounded meds would affect your well-being and that of your family's.
Even if you don’t now rely on compounded medicines, you or someone you know might need to in the future.
3. Share your Story
Don't keep pharmacy compounding a secret. Let the world know how important and necessary customized medications are for your health. Visit our website Partnership for Personalized Prescriptions, and provide us with your testimony. Also visit Patients and Physicians for Rx Access.
4. Join P3!
Join Partnership for Personalized Prescriptions and become a part of a 150,000-strong advocacy society that believes in the value of pharmacy compounding, and wants to preserve continued patient access.