Complaint Review: MEDCO , Medco Health Solutions - Pine Brook, New Jersey Internet
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- MEDCO , Medco Health Solutions P.O.Box 2015 Internet U.S.A.
- Phone: 866-386-3797
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- Category: Health Insurance
MEDCO ,Medco Health Solutions Are ALL Generic drugs therapeutically equal ? Medco plays doctor Pine Brook, New Jersey Internet
*UPDATE EX-employee responds: A few options
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My wife is on a medication for which the BRAND was found to be more therapeutically effective than the generic version.Our health plan supplied the brand,at a higher co-pay than the generic,but we accepted that. Last month,the co-pay for the brand was a certain price, but when I ordered a refill,this time the co-pay was more the three times the previous amount.
When I checked to see if there was an error, I found that the Brand was no longer on the "preferred" list. This means we are economically forced to accept the generic,by any manufacturer chosen by the pharmacy (usually by the lowest cost price currently available),with possibly unreliable therapeutic effect.Who is the guarantor that ALL generics are therapeutically effective ? Not the FDA, who recalls drugs long after the "bad" ones are on the market.
Why are MBA's dictating what doctors can order and pharmacists dispense,and how does the consumer know that AWP is the REAL cost basis for the health plan charge ? Who is out there to protect our interests ?
MB
Scarsdale, New York
U.S.A.
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#1 UPDATE EX-employee responds
A few options
AUTHOR: Joy - (U.S.A.)
SUBMITTED: Saturday, June 19, 2010
Yes, MBA's suggest the changes, but a panel of doctors and pharmacists have to agree that any changes they make are medically sound.
That being said, each plan has different rules. Contact your customer service rep to see if having the doctor write "Brand Necessary" on the prescription would bring it back to the preferred level. If not, ask for the appeals process. That will take some time back and forth, but you could possibly get it back to the preferred level that way as well. Another option is, if you found a particular generic brand that worked for her, have your doctor write a prescription for the medication and specify the manufacturer you want, along with "DAW" (dispense as written) At that point, they have to obtain that generic for you.
Hope this helps.
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