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Caremark RX Inc

Caremark Rx • Changing Prescriptions • Delivery Problems • Refusing to Fill Prescriptions • Shorting Prescriptions --- News • Caremark Settles Drug-Switching Charges • CVS, Caremark Rx Agree to Merge • CVS In Merger Talks With Caremark • Feds Side With Whistleblower In Caremark Case • Pharmacy Benefit Managers Scrutinized • Class Action Filed

Caremark Rx is one of the big three pharmacy benefit managers, companies that supposedly save consumers and, not least of all, their insurers big bucks on prescriptions. But these savings, if indeed they exist, all too often come out of the consumer's hide, as the complaints in this section demonstrate.

Thomas of Malverne, NY January 22, 2009

Thomas of Malverne NY (01/22/09)
I've been on Hyzaar 50/12.5mg for my blood pressure for several years. I USED to pay 40 for a 90 day supply, since there was no generic. There is still no GENERIC but the same prescription is now 177.12 for the same 90 day supply. My PCP put me on Micardis 40/12.5 tablets @ 43.61 and I have had nothing but problems with this substitution. How can a medication go up 137.12 for a 3 month supply if there is no generic available and the alternative is making me ill? All the other big medical plans still charge 40 for this same Rx. What gives?

costing me 548 more a year for medication that has NO GENERIC available. Alternative is causing me many physical problems, dizziness, numbness, lethargy etc.

Martha of Rustburg, VA January 15, 2009

Martha of Rustburg VA (01/15/09)
My husband was diagnoised with MS 1 year ago, he is still employed but finding it difficult to stay awake on his job, his neuro. prescribed Provigil/200mg. and said that this drug has been used by MS patients with good results, the drug is very expensive and needless to say Caremark would not approve the prescription, reason being that it was not a drug used expressly for MS.I am outraged, we pay very high premiums , and have for years, and now we need help and ..nothing!

My husband stands the risk of being fired from his job that he has worked at since 1968.We can not afford the cost of the drug that he needs.

Christy of Brandon, MS January 7, 2009

Christy of Brandon MS (01/07/09)
I renewed several prescriptions via the internet on 12-22-08. After waiting nearly 2 weeks, I never received my medication. I researched the matter and found a tracking number that only revealed billing information received. From past history of tracking numbers, I believe this means UPS was notified of a shipment, but they have not physically received the package. No other information was available.

On January the 5th, I contacted your customer service and after a 45 minute conversation including the representative being in contact with the pharmacy, I was assured the prescriptions would be resent out overnight for me to receive them on Wednesday, January the 7th. Even though I was already out of one of my medications, and was presently experiencing withdrawal symptoms, I agreed that would be fine.

On Tuesday, January the 6th at 6:58 pm central time, I received an email stating there was a problem with my order. I wonder how there could be a problem since the order was processed nearly 2 weeks ago. The simple solution was to reprint the original labels, fill the prescriptions, and ship the package. I contacted customer service immediately and learned the pharmacy closed at 8:00 pm eastern time.

Not only did they not send my prescriptions for me to receive them on Wednesday, they waited until after hours before they contacted me with this information. The hold up was the pharmacist for some unknown reason chose to fill my prescriptions again, and some of those prescriptions did not have refills. The original prescriptions were not delivered to me the patient, so there is no need for a new refill. In addition did they intend to charge me for both? If not, then they must believe I didnt receive the original medications. If they do, then they must have made 2 separate claims to my insurance benefits. How did they explain in the over ride for the second transaction?

The patient did not receive original medication I am sure. Well then either way, they believe the patient did not receive the medication, so an additional refill was not necessary. I have now been without my medication for 4 days, with no delivery in sight. I have been experiencing withdrawal symptoms for 3 days. It is affecting my job and my home life.

Steven of Marshfield, VT January 6, 2009

Steven of Marshfield VT (01/06/09)
Briefly, on 12/18/08 I called Caremark to expedite needed perscriptions. i was told the fastest way was for them to call my physician. I provided information. Their system shows confirmation of order on 12/19/08. On/about 12/23/08, I received an automated call that my order was delayed. I called and thought I clarified the confusion.

On 12/30/08, I had not received my order so i called again. Still NO ORDER and I was told they have 10 days to fill - according to whom? i was also told they would expediate as I was running out of medication. on 01/02/09 I received an automated call that the order would be sent, but I had to confirm. At 6 P.M. est, there was no one to speak with, so i left a message.

On 01/03/09, antoher automated message that I had to confirm before they would ship. i called again and confirmed. On another matter, I called on 01/04/09 to cancel a perscription becasue I now needed to have it filled locally as I was running out. By now, I had already run out of another med. I checked again on the order and was told it would be expedited and sen FEDX at no cost on 01/05/09.

On 10/06/09 i received yet another automated message that the order shipped and I would receive in 5 - 7 days. What happened to overnight? I called AGAIn and had to speak to 3 people (supervisors) before anyone could tell me the stats. in the meantime, I had run out of 2 medications. it is very difficult to actually have personal, courteous interaction with Caremark.

I am unsure of physical damage as I have been out of two medications that are required daily. It is too soon to tell. Finaclially, their failure to fill promptly meant that I went into a new caledar year and immediately incurred a potential 1,800 expense. I had to cancel that order. Plus, i spent at least 2 hours of work time since i had to resolve immediately.

Susan of Yukon, OK December 29, 2008

Susan of Yukon OK (12/29/08)
I have been taking Wellbutrin XL for about 4 years. It's a medical necessity. About a year and half ago, the drug coverage was switched to Caremark. They covered my Wellbutrin just fine. When the generic version became available, I gladly switched to that to save money. Unfortunately I had a bad reaction to that and had to go back to the name brand version. The doctor also wanted to try a higher dose but in the past I couldn't handle one pill with a higher dose. So, he prescribed 2 pills daily. I filled that but after a few days, I felt that I couldn't handle that and stopped. When I went to refill the prescription for just a 30 day supply all hell broke loose. Caremark decided that they weren't going to refill it because I was only allowed 365 pills for a lifetime. My pharmacist could not believe it. She said she had NEVER heard of such a thing. Neither had I.

Caremark had made a decision, out of the blue, that I was taking the Wellbutrin for smoking cessation! I have never smoked in my life. They have access to my MIB and they can see what the Wellbutrin was prescribed for. So the battle begins. I call them and ask what we need to do to get this corrected. After MUCH time on the phone, they said that my doctor needs to call the Doctor Call Prior Authorization Line and tell them I'm taking the drug as a medical necessity. My doctor did that promptly. I called a week later to verify, and after an hour on the phone, it was decided that now the doctor need to FAX, not call, three things in: 1. Medical necessity but NOT for smoke cessation. 2. Show any past history for why I'm taking Wellbutrin. 3. For medical reasons I cannot take generic version. My doctor faxed in this information.

Within the week I called to see if everything had been received and if we can get this cleared up. After some discussion and review, I was told that there was no information about me other than I had used up my 365 day supply! They had nothing in their notes about any of this! They suggested that I try a different number on my card. I said no way. I want to talk to the highest member of management that I can talk to right now. They sent me to a Sr. Team Supervisor. After going over the whole story with him again, he was going to try and dismiss me with the premise that the 365 day deal was in the contract and that's all that could be done. I told him that this better be settled and today because I will not let it rest. They did say that the doctor would need to fax the same information in again with Urgent written on it and they could work toward a 24-48 turnaround time. The Prior Authorization group is the problem here. They are being as difficult as they can be and I really don't know why. They are denying any help to me even though the premiums are being paid.

I'm extremely grateful that I have been blessed with prescription drug coverage. However, for some reason, even though we're paying for it, we're not being authorized to have it covered.

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