Not Fun and Games

Sometimes, as much as we’d like to, it’s hard to temper the hard truth with diplomacy.

I’ve been trying to calm down ever since I received a letter from my prescription provider, Express Scripts. I’ve been trying to choose my words carefully, trying to understand the other side of the equation, trying to consider how this makes me or the plan I’m a part of better.

Let me tell you, that’s a tall order.

The letter states that I can no longer take part in the automatic refill program through Express Scripts unless I move from the Novolog I’ve been using for a long time, and which works best for me, over to Humalog. In other words, if I have a prescription for insulin, I can get my prescription renewed every 90 days. But only if I use the insulin on their formulary list, which is Humalog.

Now, you might be thinking, this can’t be non-medical switching… you can still get the Novolog, right? First world problems! Stop yer bellyaching!

They’re making it harder and harder for me to still get the drug that works best with my diabetes.

I’ve got nothing against Humalog. It just doesn’t work as well for me. So already, I’m paying three times as much (through my plan) to get the Novolog every 90 days. I’ve been doing this ever since the “preferred drug” on the formulary was switched from Novolog to Humalog.

Additionally, I stayed with Novolog in spite of underhanded dealings where reps from Express Scripts shoved prescriptions in front of my endocrinologist, telling her I asked to switch to Humalog, which is a big fat stinking lie.

Now they’re trying to put roadblocks in my way again.

There’s not a medical reason for this. They’re simply doing it because they want to. Because they really want me to start using Humalog. And they’re trying anything they can to get me to switch.

Non-medical switching, in one form or another, is standard operating procedure for pharmacy benefit managers like Express Scripts. Instead of making it easier to get the drug that helps keep me alive, or at least not making it more difficult, they’re actually paying people money to come up with new ways to keep me from getting it. In subtle and not-so-subtle ways.

This is just another example.

So, my choices, after taking the time to, you know, do my best at managing a 24 hour, 7 day a week condition, are:

1. Spend more time calling and complaining, trying to get Express Scripts to change their minds, as if they were an actual organism with an actual mind

2. Spend more time asking for a refill every 90 days, even though it wouldn’t cost Express Scripts one dime or one minute extra to keep doing things the way they’ve done them. For years.

3. Make the switch to Humalog and get the automatic refill every 90 days

I will likely go with #2, though doing so makes me very unhappy. But hey… happiness or unhappiness are not part of the equation when it comes to pharmacy benefit managers. For Express Scripts, there’s only one part of the equation that counts. And I think everyone knows what part that is.

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Comments

  • Ivan  On March 13, 2019 at 12:07 pm

    There is no fun and games with type1 diabetes.

    Liked by 1 person

  • Rick Phillips  On March 13, 2019 at 8:58 pm

    PBM’s suck. I cant say that enough. I hate to ruin our day by the bill in Indiana never got a hearing. Not surprising it was filed by the minority party as much as anything as a prank. Fun and not games indeed.

    Liked by 1 person

  • Rick Phillips  On March 13, 2019 at 9:00 pm

    Oh sorry Indiana H.B.1307

    Liked by 1 person

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