April 18, 2024

Bucks Blog: When an Automated Drug System Is Mute on Cost

1:02 p.m. Updated / To provide additional information about obtaining cost information from Express Scripts by phone.

A reader, James Turnage, wrote to report his dismay with the automated prescription ordering system operated by Express Scripts, the pharmacy benefits provider he is required to use by his employer.

Mr. Turnage, who lives in northwest Washington, takes some maintenance medication and orders his drugs from Express Scripts using its telephone system. The system, he said, requests his authorization to charge the prescription to a credit card kept on file. But what irks him, he said, is that the system doesn’t tell him the amount that will be charged to his card before he gives the approval.

“I have never, at any other vendor, been asked to approve a credit card charge without being provided the cost being authorized,” he said.

He was further dismayed recently, when the system filled a three-month supply of a brand-name drug for about $150, even though the drug was to go off patent and become available as a much less expensive generic.

Mr. Turnage ended up contacting Brian Henry, a vice president at Express Scripts and a company spokesman. As a result, Mr. Turnage said, the company credited him for two months of the brand-name drug — for which he is grateful.

But the voice authorization system hasn’t changed, despite several follow-up phone calls, Mr. Turnage said.

Mr. Henry, in an e-mail about Mr. Turnage’s situation, said that after he was first contacted by Mr. Turnage, he had the company’s “escalation team” look into the inquiry. That led to a “courtesy credit” for the brand-name drug. The company also contacted Mr. Turnage’s doctor to get a new prescription for the generic version of the medication, and changed it to generic for the next refill.

But as to Mr. Turnage’s concern about the credit card authorization system, Mr. Henry noted that the complexity of prescription drug plans make it difficult for the specific charge to be relayed by the voice system.

“Express Scripts has thousands of clients with many different member/employee co-pay structures and plan designs,” he said in the e-mail. “A voice-activated system could never capture all the differences to provide an accurate cost to a person as it relates to their specific plan.”

Mr. Henry clarified that members using the automated system can opt to speak to a human representative, who can provide cost information and can also advise about potentially less expensive options, like generic drugs.

Members also can find out the amount of their co-payment for their drug prior to ordering and providing credit card information in “two easy ways”:

Members can go to the Express Scripts member Web site to see what their co-payment is under their prescription drug plan. They can also see comparison costs for buying the drug at retail or a mail-order pharmacy.

Members can also use the Express Scripts mobile app, which can be downloaded to their smartphone, to use the same pricing features available on the Web site. With the app, consumers can look up the drug when it’s being prescribed by the doctor to see if there are lower cost alternatives.

“The bottom line is that Express Scripts helps drive down the cost of prescription drugs and we provide members many ways to find out what they will pay before they do so,” Mr. Henry said.

Mr. Turnage said he has to accept that the voice system will not be changing, but he thinks the company’s excuse is a “cop out.” He said he has tried to limit the number of online accounts he uses because of the need to maintain various passwords, So, he said, he would prefer not to have to do that to check co-payment amounts.

Do you order prescription drugs by telephone? Does the system make clear what your cost will be?

Article source: http://bucks.blogs.nytimes.com/2012/11/01/when-an-automated-drug-system-is-mute-on-cost/?partner=rss&emc=rss