Her family and friends called every specialty pharmacy in the county to find a pharmacy to fill the prescription, but the medication had already been filled by the initial specialty pharmacy— the one that had said they were out of stock.
Diana, a patient with metastatic breast cancer living in Ventura County, California, needed to refill her oral medication. On a Thursday, the clinic staff called in to the PBM specialty pharmacy to refill it on her behalf. The specialty pharmacy representative promised to expedite the process and overnight the medication, at no additional cost. On Monday morning, the staff member walked into her office to find several faxes, e-mails and voicemails from Diana’s family, friends and assisted living staff.
Apparently, they had received a phone call from the specialty pharmacy on late Friday afternoon, saying that the drug was out of stock in their pharmacy, and suggesting that she call around to local pharmacies to try and find some. Over the weekend, Diana’s family and friends called every pharmacy in the county, before starting on those in Los Angeles and Santa Barbara, all with no success.
The new specialty pharmacy called her to say that they were unable to fill the prescription for at least another month, as it had already been filled by the initial specialty pharmacy— the one that had said they were out of stock.
Hearing the news, the clinic staff immediately contacted the drug manufacturer, who gave her the name of another specialty pharmacy to try. She faxed over the prescription, and then followed up over the next few days, each time being told that the script was being processed. Near the end of the week, the new specialty pharmacy called her to say that they were unable to fill the prescription for at least another month, as it had already been filled by the initial specialty pharmacy— the one that had said they were out of stock.
The staff member now called back the first specialty pharmacy, asking that they reverse their claim; however, they reported that the medication had already been shipped out via UPS. Tracking it down, the staff member discovered that indeed the medication was on the truck, ready for delivery.
The cost in hours wasted per patient, per medicine, multiplied by the millions of people living with cancer today in the US, is astronomical. This is in addition to the high toll that the resultant stress takes on patients and their caregivers, as they race through bureaucratic hoops and set off on what often prove to be wild goose chases.