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540,000 Patients Lose Compounded Prescription Coverage says Patients and Physicians for Rx Access
Date:8/14/2014

hat fail to tell them their compounded prescription coverage is ending, instead describing the cutoff as a "clarification" of coverage. Those letters mention nothing of the mid-September cutoff date. Both versions of the letter instruct patients to replace their customized prescriptions with mass-produced, FDA-approved medicines, but warn that Express Scripts may not cover the new medications either.

In presentations regarding these benefit cuts, Express Scripts executives have told other audiences that the company's goal is to save hundreds of millions of dollars annually by ending coverage of essentially all compounded medicines before the end of 2014. When talking to patients, however, Express Scripts attempts to conceal its financial motives with misleading statements, McEniry said.

"By arbitrarily eliminating an entire class of medications, Express Scripts is unfairly limiting physician and patient options," McEniry noted. "Express Scripts is placing the physician in the impossible position of either prescribing a medication that the patient needs but can't afford, or prescribing a less effective treatment because it may be covered by the patient's insurance. Express Scripts is effectively hijacking the physician-patient relationship."

Linda Sauer of Dwight, Ill., one of the 540,000 patients affected by the Express Scripts decision, said she is taking her story to social media to tell others what the company is doing. Sauer has several painful and debilitating conditions that are treated with customized prescription medications.

"Express Scripts is denying me access to medicines that work better than the mass-produced drugs I've tried," Sauer said. "It's not fair to suddenly refuse to pay for medications that patients have relied upon for years in some cases, just to pad the company's bottom line. Express Scripts' decision will cost me hundreds of dollars per month, and I'm just
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SOURCE Patients and Physicians for Rx Access
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