Patient Horror Stories

PBMs have very real and negative impacts on patients with cancer and our entire health care system. Read for yourself just how horrific PBMs are in the following collection of real stories. While these stories are real, we changed personal details to protect the privacy of patients.

It took five calls just to get in touch with a case worker, who ultimately knew nothing about this patient’s case.

Due to clerical error and the absence of anyone to take responsibility, the patient had already gone 10 days off of her regimen, something which never should have happened.

This PBM tried to steal business and intimidate community pharmacists—despite the patients wishes.

When a kindergarten teacher’s insurance changed PBMs, she saw weeks of delays on her proven course of treatment.

She watched her health deteriorate for almost two months while PBMs consistently denied her doctor’s request for a new life-saving medication.

When bureaucracy leads to patients falling through the cracks, a young boy finds himself in danger of bleeding to death.

An oncologist’s expertise was undermined when a PBM insisted they knew which drug was better for a brain cancer patient.

After repeating her story from one PBM representative to the next, she finally received her medication just before running out.

A father with two young children missed his chance at a full recovery–all because his PBM-mandated specialty pharmacy couldn’t fill his prescription.

With no other option, a father of two was dangerously forced to wait for his life-saving medication after the PBM-mandated pharmacy sent the wrong dosage directions.

PBM carelessness and incompetence delayed a woman’s care by 19 days, landing her in the hospital and hospice.

Incorrect dosing by a PBM specialty pharmacy caused this widow’s prognosis to worsen, impacting her opportunity for remission.

He kept getting the runaround, being told one thing by a representative, only to have that information contradicted the next moment by someone else.

A cancer patient’s life was put at risk when unnecessary bureaucracy delayed oral chemotherapy.

Even with a life or death prognosis, his PBM specialty pharmacy chose profit over patient care.

While the PBM bureaucracy failed to remedy the situation, his cancer went untreated and continued to spread.

Had she been any less vigilant, her health may have been been compromised.

The PBM specialty pharmacy could in no way help her situation, nor could they refer her anywhere for more information; they were completely useless.

Another eleven days passed—nearly one month from the initial prescription—and he continued to wait, though his cancer did not.

Every time she tried to speak to a new PBM representative, a woman was passed off to a new person who refused to listen.

Even with his care team’s support, this patient still experienced weeks of delays due to a lack of communication by a PBM-mandated pharmacy.

Already fighting for her life, one mistake at the hands of the PBM nearly killed her.

Instead of receiving her prescription within 48 hours, this patient waited nearly two months because of a PBM specialty pharmacy.

PBM delays and runarounds caused this patient’s cancer to go untreated for nearly two weeks, leaving him vulnerable to a number of infections and diseases.

In addition to fighting for her life, a patient fought with a careless, mandated pharmacy month-over-month on delays and technical errors.

The day she was scheduled to receive her treatment—her PBM called to ask for additional authorization due to the medications cost, a detail they failed to mention when the prescription was first filed—causing a three week delay in treatment.

After multiple delays and ruined medications, this community oncology clinic began documenting numerous cases of PBM Abuses.

Unnecessary treatment denials put this patient’s safety at risk and undermined his doctor’s expertise.

Clearing out their inbox, the PBM was filling prescriptions and sending prior authorization notices for patients who had passed away.

As the doctor waited on hold with the insurance company to figure out why a patient’s potentially life-saving medication was denied—the family called to say their loving husband, father, and grandfather had passed away.

Unauthorized changes to prescriptions by the pharmacy consistently puts patients’ care in danger.

$12,000 worth of medication had to be taken into the clinic and destroyed—all because the PBM sent the wrong dosage.

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.

A PBM insisted a clinic transfer a patient’s prescription to a specialty pharmacy, but not under the patient or doctor’s orders.

When a clinic staffer finally made it through the busy signals, the PBM told her they would’t discuss the prescription because she wasn’t on the “preferred” contact list for the patient.

A $4,000 co-pay forced this prostate cancer patient to admit defeat and not receive a treatment that could have extended his life.

While her prescription sat on the fax machine at the PBM-mandated pharmacy for five days, a cancer patient’s life-threatening condition worsened.

Too careless to pick up the phone, PBMs made her suffer six weeks without medication while the same drugs sat on her doctor’s in-house pharmacy shelf.

Two weeks and four pharmacies later, a patient was finally able to receive his medication.

After weeks of delays, a young husband’s life-saving drug finally arrived, only after he could no longer swallow and shortly thereafter died.