In less than a month, more than 150 pharmacists, doctors, nurses, patients, patient advocacy organizations, and other advocates have banded together to form a coalition named Patients and Physicians for Rx Access. The coalition was formed to stop or reverse unprecedented cuts in prescription coverage by pharmacy benefit managers and some insurance plans. The cuts will directly impact millions of patients who rely on compounded medicines to address an array of medical conditions that are not satisfied by commercially available medications. This loss of coverage will force patients to pay out-of-pocket the full cost of their custom-formulated medications. Due to the financial burden placed on these patients, many will be forced to forego a compounded medication altogether, thus forcing physicians to prescribe less effective treatments.
Companies with plans to eliminate or severely restrict compounded medication coverage include Express Scripts, United Healthcare/Optum Rx, CVS/Caremark, Catamaran, Harvard Pilgrim and some Blue Cross Blue Shield plans. Express Scripts, the country’s largest PBM, will end compounded medication coverage for 750,000 to 1 million patients.
“Pharmacy benefit managers are hijacking the sacred doctor-patient relationship in order to increase profits. These unprecedented actions are being carried out with little or no notice to patients and without any regard for patient wellbeing,” said Jay McEniry, executive director for Patients and Physicians for Rx Access. “We simply can’t sit back and allow insurance companies to dictate physician decisions regarding the best course of treatment for their patients. We must act now.”
Patients and Physicians for Rx Access is working tirelessly to educate and empower individuals and organizations nationwide with information they can use to stop PBMs from making intended coverage cuts. The Coalition website, found at www.saverxaccess.org, serves as a hub where patients, pharmacists, and other advocates may learn about the issue and take action to protect patient access to compounded medications. Supporters of this effort may get involved in the following ways:
· Join Patients and Physicians for Rx Access
· Ask impacted customers to share their story
· Sign-up for updates on this issue
· Email Patients and Physicians for Rx Access to request a free educational toolkit, or download the toolkit from the website:
- Educational posters that you may hang in your pharmacy
- Content for your pharmacy website
- An Rx Stuffer to include with prescriptions you fill
- Flyers and fact sheets for educating others
- Scripts for pharmacists and support staff to use when presented with questions regarding prescription benefit cuts
About Patients and Physicians for Rx Access
Patients and Physicians for Rx Access is a coalition consisting of individual patients, patient advocacy groups, pharmacists, physicians, pharmacies and healthcare organizations focused on raising awareness about compounded prescription access. The coalition formed to protect patients from the immediate threat from a growing number of pharmacy benefit management firms and insurers who are working quietly to deny coverage for the vast majority of compounded medicines.