Dear Patient Care Advocates,
I’m not asking for much – just the Humira that my doctor ordered for my rheumatoid arthritis. For six weeks,you have explained to me that a doctor’s letter of medical necessity was missing, or that I was refilling the prescription too soon. Or that there was some kind of unknown problem and they would look into it. And for several weeks it was simply pending insurance approval. How can this take so long?
This is a new prescription so it’s impossible to refill it too soon. And my doctor did send the required letter. In fact, two different Patient Care Advocates have confirmed the receipt of that letter over the last three weeks. Why are you not seeing that on your screen?
On four separate occasions, a representative confirmed that all problems were resolved and we scheduled the Humira for delivery. A rush was placed on the prescription and it was scheduled for overnight delivery. On four separate occasions, it did not arrive. Can you explain what is happening?
I have called my doctor’s office, the very nice representatives at the Humira Protection Plan, Blue Cross, CVS Caremark, and Accredo/Express Scripts. And still I have no medicine.
It’s difficult to place the blame directly on each of the 30 Patient Care Advocates with whom I’ve had conversations. They can only read the information on the screen in front of them. Even supervisors seem unable to unlock the mysteries of their flawed software programs and processes. I’ve received so much conflicting information that I find it ridiculous at this point. (Or I would if I were not experiencing severe symptoms of R.A.) I’ve documented every phone call and results because after so much misinformation, it was impossible to make sense of it. Even with the notes, it’s still impossible to make sense of it.
My suggestion to Express Scripts and Accredo? Please take a good look at how your system works. It’s flawed and is causing people with chronic illnesses to go without the medication they need to go to work – and enjoy life.
And you, the Patient Care Advocates, can help by questioning the process. When a patient tells you that he or she has been out of medication for six weeks because your company has not released it for shipment, what are you thinking? If this was your child or a parent who had to go without medicine for a damaging autoimmune disease would you not be more persistent?
Hoping that the next time you tell me the shipment is scheduled it actually arrives.
A Person with Rheumatoid Disease
Note: Please feel free to pass this letter on to others. This is not an isolated problem. Perhaps you know someone whose medication has been delayed by misinformation and system errors.