Home » Autoimmune Disease » An Open Letter to Express Scripts and Accredo

An Open Letter to Express Scripts and Accredo


Dear Patient Care Advocates,

Since the first week in November, I have placed 30 calls (and still counting) to your Customer Service Department.

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.

Sincerely,

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. 

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5 thoughts on “An Open Letter to Express Scripts and Accredo

  1. Pingback: My Life is Not a TV Commercial | Geeks and Goats

  2. I am also waiting on my Humira prescription to be filled. Two separate Dr. approvals…one for the Humira itself and one for the quantity…DONE. The representatives I speak to have no idea what the problem is, only that it is “processing” or in the “authorization” dept. BOO BOO BOO!!

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    • Amy,
      Sorry to hear you’re having such a difficult time having Humira approved.

      Even after my prescription was approved at the increased quantity (1 x week), I had trouble renewing it. After many phone calls, I was informed that the daily dose was over the amount the insurance company would approve.

      This was after they approved the initial dose! After almost two weeks and many discussions with doctors, insurance company, and online pharmacy the medication arrived. I have concerns that next month when I want a refill it will be the same battle.

      Could the “daily dose” be what’s holding up your Humira?

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  3. Each day that goes by with an unfilled prescription is a $ savings for accredo and express-scripts they purposely delay prescriptions and refills to save money. Contact your states insurance commissioner. Actively pursue an answer and do not think they are working on the prescription until it is in your hands. When you hang up the phone they have already said it will be a week until you call them again and guess what it is another week you will lose in time. Prescription override letters, letters of medical necessity, alternate generic medicine trials until you work your way up to the medicine that works. All cost you two to three weeks of time. $’s saved by your insurance company and accredo and express scripts. Squeaky wheel.

    Liked by 1 person

    • Although this problem is now resolved and I am no longer on this medication, these are good thoughts for next time. Hoping there won’t be a next time. But it’s likely this is not the last time any of us need to fight for medications that help us function every day.

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