Had she been any less vigilant, her health may have been been compromised.
Maria was a colon cancer patient prescribed several rounds of chemotherapy. For her first round of treatment, all went smoothly; she was permitted to fill the drug prescription right there at her clinic’s physician-run pharmacy. However, for the second round of treatment, her insurance company mandated that she use one of the large, well-known PBM specialty pharmacies.
Had Maria been any less vigilant, her health could have been severely compromised by such sloppy drug administration.
The problems began when the specialty pharmacy delivered Maria’s medicine late, which delayed the beginning of her second treatment round. The following month, things worsened. Maria had suffered profound side effects from the medication, causing her oncologist to lower the dose for her third round of treatment. When Maria called the pharmacy, however, they said they had no record of the new prescription on file — though it had been sent and received.
Confusingly, shortly after the call, the PBM pharmacy called Maria back and said the medicine was about to be shipped. Upon her inquiry, the pharmacy informed her of the dosage; it was the same dosage and instructions as the previous two rounds, which had caused the intolerable side effects. Maria proceeded to spend the next several hours on the phone with the pharmacy to correct the situation. In addition, her physician’s office called and spent time clarifying the matter with them. Had Maria been any less vigilant, her health could have been severely compromised by such sloppy drug administration.
With PBM specialty pharmacies being run completely separately from the point of care and physicians, patients must be extremely vigilant at all times to ensure they receive the correct medication. For cancer patients who are already dealing with a life-threatening disease and a range of debilitating side effects of the toxic medications they are on, this additional burden can be very costly — and for some, simply not feasible.