Everytime she tried to speak to a new PBM representative, a woman was passed off to a new person who refused to listen.
About a year ago, Darlene was diagnosed with multiple myeloma and prescribed a particular medication. Single and living alone, Darlene decided she would continue to work full-time while being treated for the disease.
The first hurdle Darlene met was getting her 21-day supply of medication filled by the mail-order pharmacy mandated by the PBM. The pharmacy called her while she was in a meeting at work and insisted that she listen to the mandatory recital of the “Patient Understanding.” They promised it would take no longer than five minutes, yet forty-five minutes later, having been transferred to four different representatives as part of the process, Darlene finally hung up the phone.
While confused and upset, Darlene also felt relieved that the PBM ordeal was over, and all she had to do now was to wait for the medication to arrive. She could not have been more wrong. Although Darlene had made it very clear that she arrives home every day from work at 4:30 p.m., two days later Darlene arrived home to find a note on her door that UPS had tried to deliver her medicine at 2 p.m. She spent the rest of the day trying to locate the medicine.
As time went on, Darlene’s situation only worsened, becoming more and more time-consuming for this elderly woman who was already contending with a fatal cancer.
After a great deal of effort, Darlene managed to schedule future deliveries of her medication for Saturdays before 1 p.m. Darlene is hard of hearing, so that Saturday, she sat in her front room from 8 a.m. to 1 p.m., afraid to even go to the bathroom lest she miss the knock on the door. At 2 p.m., she opened her front door and found a note from the UPS driver that he had attempted to make the delivery but found no one at home. Again, she had to chase down the package and finally ended up retrieving her drugs from a drop center twenty-five miles away from home.
As time went on, Darlene’s situation only worsened, becoming more and more time-consuming for this elderly woman who was already contending with a fatal cancer. Each time she attempted to speak to a PBM representative to resolve the issue, she was passed to a new person who refused to listen to what Darlene had to say, but rather droned on repetitively that Darlene must “follow procedures” or she would not receive her medication.
Not every cancer patient has a vast network of family and friends who are there to assist them in their time of need. Often the elderly, or those living alone without close friends nearby, are forced to handle everything by themselves. While a physician-managed pharmacy would be able to adjust to such a patient’s needs and assist them in easily accessing their medication, PBM mail-order pharmacies are not set up to handle the requirements of individuals. Patients must comply with their procedures and regulations, regardless of the personal cost.