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

Annabelle

Annabelle, a retired cosmetician and widow, had been diagnosed with Philadelphia chromosome-positive + chronic myeloid leukemia. Her community oncologist tried her out on 180mg of a particular medication, and Annabelle’s response was highly positive. Her blood work showed immediate improvement, and she showed no significant side effects.

The doctor wrote out a prescription for the medication, which according to Annabelle’s PBM had to come from their mandated mail order specialty pharmacy. As the medicine does not come in pills of 180 mg, the prescription clearly stated: one 100 mg tablet and one 80 mg tablet. Nevertheless, over the following months, each time Annabelle had her prescription renewed, she was given either 100 mg or 80 mg – never both. This meant that she was not only taking the wrong dosage, but also her dosage was changing each month, according to the whim of the pharmacy and whoever happened to be filling her prescription.

The PBM specialty pharmacy refused to take the necessary measures to ensure that Annabelle received the proper dosage.

Annabelle did not do well with the incorrect dosing; her laboratory results showed dangerous levels in her blood work, again.

Despite the clinic’s repeated attempts to get the PBM to deliver the right medication, the PBM specialty pharmacy refused to take the necessary measures to ensure that Annabelle received the proper dosage. When the doctor tried to have the script filled in the in-house pharmacy at his clinic, it was denied. Meanwhile, Annabelle continues to be improperly dosed, impacting her opportunity for remission.


This story exemplifies the constant dangers patients are in at the hands of incompetent, faceless PBM pharmacy workers. Removed several times from the patients they are meant to serve, their inattention to crucial detail is not what we should expect from a company in the business of caring for patient lives.