For the second time since Express Scripts began blocking coverage of hundreds of ingredients used to make compounded medicines, several compounding pharmacies have filed a lawsuit accusing the pharmacy benefits manager of using illegal tactics.
In the latest instance, a half-dozen compounding pharmacies have charged Express Scripts with violating antitrust laws and is attempting to force them out of business. And they allege that other pharmacy benefits managers are conspiring to do the same thing, although none are named as defendants.
Express Scripts has taken “a series of unreasonable restrictions and rules that would make it impossible for [the compounding pharmacies] to fill prescriptions” for patients “and obtain reimbursements that would cover their costs,” according to the lawsuit, which was filed in federal court in St. Louis. The company and the other benefits managers “employed tactics designed to ensure that the compounding pharmacy industry … cannot survive.”
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I was just told by Express Scripts today that the compond medication mix I need, for nerve pain and slower healing after surgery, is not covered under my plan.
Claiming 1 of the ingredients, is not covered in that “form”.
Have my dr. File an appeal, after reading this, I have little hope. Too expensive to pay out of pocket.
I’m disappointed in the people in power, people like me suffer.