This is a Sponsored post written by me on behalf of Walgreens. All opinions are 100% mine.
Express Scripts is used by many health care insurance companies including my own. A few years ago I was informed by my local grocery store pharmacy that I could no longer get my “maintenance” meds through them. I was shocked. It turns out that the letters I’d been ignoring from Express Scripts were not an offer to have my meds mailed to me, but a mandatory change in the way I get my meds. Quite frankly, this irritated me.
Since only one of my drugs is considered a maintenance drug, they expected me to still visit my pharmacy monthly to get the rest of my drugs. This means maintaining a separate set of prescriptions online with them. I just didn’t understand the purpose since my co-pay would stay the same and I would be inconvenienced. And that’s why I ignored the mail. I thought I had the choice; it turns out I didn’t.
For three months I continued to purchase my drugs at my local pharmacy until the day they said my insurance would no longer cover my prescription with them. Still not willing to deal with online and in-person pharmacies every month, I thought to ask my pharmacist how much my prescription would be if I paid out of pocket. The answer? Five dollars as they’d match another national pharmacy’s price who sold it for that amount. I was shocked. I’d been paying $25 co-pay for years! So I kept my prescription with my local pharmacist and no longer run it through my insurance company and I bypass Express Scripts and the benefit? I’m saving $240 a year out-of-pocket on that one prescription. So tell me again how Express Scripts was going to save me money?
I’ve used meds-by-mail before and loved it, so my issue isn’t the process. My complaint is being forced in to it, paying more to be a part of the program than the cost at my own local pharmacy, and needing to still obtain some of my meds locally.
Now it turns out they’ve done something similar, this time with Walgreens. As of 1/1/2012, Walgreens is no longer part of the Express Scripts provider network and that includes all of the Duane Reade pharmacies in NYC as well. Now patients will have to find new in-network stores which may or may not be convenient for them. To make it more confusing, not everyone is affected. Only some insurance plans are impacted. To find out if you are, take a look at the back of your prescription insurance card – if it has Express Scripts’ name there, you may be affected. If you’re not sure, check with your local Walgreens to be certain.
So you’d think that patients would benefit from the change, why else would they put their subscribers through this. Sadly, that’s not the case. Patients may not find any benefits in their wallets either and in fact, some may see an increase in their out-of-pocket expense because Walgreens offered competitive 90-day refill prices. Walgreens offered to keep their rates flat; instead, Express Scripts asked them to take below the average industry cost for those medications.
So why did Express Scripts not take them up on the 90-day refill promotion? Because they run their own mail-order med program that is in direct competition – remember the one I mentioned before that they tried to force me into? Same one.
So who is Express Scripts? They are a middleman working between the local pharmacies and the health plans that pay for the meds plus they have their own pharmacy. While most businesses are working on lowering overall health care costs and keeping prices flat, they’re increasing profits. Why do I care? Because it’s like UPS vs USPS. USPS has to deliver to every person in the US no matter how remote they are. UPS is more profitable because they can pick and choose their routes and only take the most profitable ones, or they can charge more in the form of a surcharge if they want to take on a route that’s a little further out.
Now that sounds great for the consumer in that rates are cheaper. But what happens is that USPS isn’t profitable because they HAVE to provide service to everyone. They can’t compete and they are in financial trouble. That’s how I see this fight. Express Scripts gets the easy money, doesn’t have to provide hours of coverage that are convenient for customers, doesn’t have to provide walk-in assistance when someone has a question about an over-the-counter drug, and doesn’t have to interact and work with the customer. And that’s why I object to this whole scenario and why I won’t participate in it.
So what can you do? Walgreens’ is working to minimize the disruption to its customers by offering special discounts on annual memberships in its Prescription Savings Club. More than 8,000 generic and brand name meds are available, some with 3-month supplies for less than $1 a week. Regular membership is $20 annually for an individual or $35 per family. During the special promotion, memberships are $5 for an individual or $10 for a family.
I guess in the end we need to look out for ourselves. Do what I did. Ask about the costs and then make your own decision. It’s just frustrating that we’re put in this position. I’m sure our employers never meant for it to be this difficult.
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Photo Credit: © Robert Byron | Dreamstime.com
- Walgreen pushes to keep Express Scripts clients (seattletimes.nwsource.com)
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