On Annoyances with Mail Order Pharmacies

Last evening, I posted a few tweets about a problem with getting one of my prescriptions via mail order through Express Scripts:

The longer story, which doesn’t fit in a few tweets is complex: I ordered a three month supply of my Freestyle Libre 14 day sensors through Express Scripts on the 11th of December, with a message from them showing they’re reaching out to my doc for a write-up of a 90 day run. I had just taken on a refill a couple days prior, and wasn’t scheduled to swap sensors until the 14th of December. That gave me a bit over 16 days to have new sensors in hand, which is plenty of time under typical circumstances.

Two days later (Friday the 13th, no less), in the evening, I get an email from Express Scripts letting me know they’re waiting on my doctor’s office to send over the updated scrip for a 90 day fill. I send a portal message the next morning to my office, and mention that it’s possible that the refill request went to my previous practitioner, who had left the office in the prior month. That way, they should be able to find that and migrate it over. I specifically named the sensor as the requested item for refill in that message.

~ 12 Days of Sensor Time Remain ~

Monday, 16 December hits, and the office acknowledges that they got the message and sent things along to Express Scripts for my sensors.

Tuesday, 17 December lands, and I get a message: “We shipped your order on December 17, 2019.” for a medication starting with F. Express Scripts, of course, obscures the name of the medicine in email by default. I have two prescriptions that begin with an F, and the other one had been filled a month prior, not due for refill for two months. I’m calm and not worried — this package has a UPS tracking number, and should deliver by Christmas. I think nothing of it and don’t log in to the Express Scripts portal.

Wednesday, 18 December sticks its head over the fence. “We’re working on your order,” another email from Express Scripts reads. Wait, what? is my reaction, knowing my refill dates for my other maintenance meds are a week out — I had already received that message. So I log in to their site, and my blood starts to boil.

Somehow, there’s a refill on the 13th of December for the Freestyle Libre READER. The SENSOR KIT has an order date of the 18th of December. I had no emails suggesting they were actually filling the reader, which I really do not need — I have two of them, before this shipment. One is my phone, the other is an actual reader.

Keeping in mind that I check my email in the evening after work, usually, it’s late and I write off my attempt to scream at someone until the next morning.

~ 9 Days of Sensor Time Remain ~

Unusually, I check my email that morning as I wake up, and there’s a rather mollifying message there: “We shipped your order on December 19, 2019.” for a Medication starting with: F*****. I check the app, and it’s the sensors actual this time. I’m still miffed, but there’s still a good chance I’ll get them on time — it’s another UPS shipment. So I’ll check the tracking number in a couple of days, give logistics time to move the package.

~ 6 Days of Sensor Time Remain ~

It’s a lazy Sunday, and I check my email. I find myself pulling the tracking number for UPS out of the email, and growing irritated. The estimated arrival date of this package? 31 December 2019. That’s three days past my sensor swap day. That’s LATE. I bite my tongue, however, because a mote of logic shows up: “Hey. It’s a couple of days until Christmas. It is possible that the package is moving right now, and has not been scanned in transit because of a glut of packages.”

That is what it looked like when I looked at the tracking data, so I decide I’ll wait for the 26th, just in case that’s exactly what’s happened.

~ 63 HOURS of Sensor Time Remain ~

Thursday morning, I check that damn tracking number. No updates, still 31st of December. Now I’m Angry++. I try to call Express Scripts while I’m walking to work. Their IVR is infuriating, and eventually asks me if I’d like a call back as the wait is seven minutes. I select yes — this would give me a chance to finish walking and get out of the sounds of traffic.

Express Scripts is, bluntly, fucking stupid at this point. Their callback system calls from a phone number of ALL ZEROES. How do I know this? My cellular carrier blocked the call as potential spam, showing a number of ALL ZEROES.

Great. Now I have to call back and murder my way through their IVR. I’ll have to do this in a couple of hours… and I do. At this point, I’m voice gating through their system, taking advantage of a few tricks I had discovered and get a human in record time.

This human just hems and haws about — I’m frustrated, but doing a remarkable job of not taking it out on them. This person is just a cog in the great and terrible machine, and isn’t the root of my ire. However, three minutes into the conversation, they earned a prunable branch status by virtue of NOT GETTING THE POINT.

So I cut to the quick on it: Look. I ordered this well in advance. Your company goofed up. My sensor wears out in two days. Your delivery lands several days after that. Can I just go to my local pharmacy and get this thing filled so I’m not out?

This human finally gets it, says yes, get a one-off scrip and have a local pharmacy fill it. They then pork about a bit more, and ask a stupid question. “Can I transfer you to a pharmacist so we can ask what happens if you don’t get your refill in time?”

I’m angry actual at this point, and stop drawing all punches. I can tell you what happens if I don’t get my sensors in thirty seconds. I come out of pocket at about eighty cents a pop to test my blood glucose with strips I have to buy out of my own money. Express Scripts does NOT COVER the cost of the testing strips that are compatible with my glucometer, and as an insulin user, I have to test. And testing three times a day is the average for me on finger sticks. That’s about $2.40 a day in strips alone for every day I have to wait. At this point, you’ve given me the information I need, and I need to get that ball rolling. This is all I need; thank you for your time, good day.

I drop that call, and call my doctor’s office, tell them what’s going on and get them to fax over a fill to my local FredMeyer Pharmacy, figuring that if anyone would have them in stock within the next 24 hours, it would indeed be them. Plus, with their longer hour availability, I would have a chance to get in to the pharmacy and pick this up before it’s too late.

I call FredMeyer that evening and ask if they got the order, and when I could pick it up, and the poor tech had to tell me that insurance is denying the fill.

If you see a smouldering pylon off to the east, that’s the Express Scripts office. They’ve goofed me up on this. They told me to have my office send this over because the mail order isn’t going to arrive on time, I said.

Don’t worry, fam, I gotchu. That’s the short version of what I got back. “Hey, don’t worry. We’re going to call them now to get an override. Can we call you back?”

I get a call back eight minutes later, and was told to swing by in an hour.

I do so, and the tech apologized — they didn’t have two sensors in stock, so I’d need to come back the next day. They offered to text me when the sensors arrive, saying they unpack their pharmaceuticals mid-day. Sure, I’ll take a text, but won’t be in until about 17:30, 18:00 or so.

I’m completely okay with this, because I have a hard arrival time on the board, and it’s a number before sensor depletion time. Thank you, thank you, I’ll come back tomorrow. Buy some groceries, go home, and rest.

Oh, and that reader I didn’t order had arrived.

~ 29 Hours of Sensor Time Remain ~

Friday evening. I hadn’t received a text, but I’m dead set on going to the pharmacy anyway, and if I have to camp out in the pharmacy area until the next morning, at least there’s food and a bathroom, and some furniture. But I was not planning on leaving without sensors, even if I had to ask the cash price and buy one right then.

Different pharmacy tech, and I ask for my prescription. “You don’t have any prescriptions.”

Nope. That wasn’t what I wanted to hear. Nuh-uh. Re-evaluate. Are you certain, I ask her. I was here yesterday, and was told that a pair of Freestyle Libre Sensors were ordered and should’ve arrived on today’s truck. Express Scripts screwed up a mail order, and I have 28, 29 hours left on the one I’m wearing. I really need them.

A screenshot from Freestyle's LibreLink app
At the bottom, the system is counting down in HOURS to replacement time.

She checks, and does see the scrip as well as sensors in stock, but also reports that Express Scripts is blocking the fill because of the mail order. I went through this yesterday, and Express Scripts was called for an override to be authorized. Now I’m about to start panicking.

At that point, I’m visibly distressed, feeling like I’m being punished for doing the thing my insurance has mandated, and I just want to cry.

The tech was very comforting. “Hey, don’t panic. Have a seat — we’re going to call them again to get this fixed. We’ll get this taken care of.”

So I sit. And I tweet a bit of acid about Express Scripts, with a very overt thanks to my local FredMeyer Pharmacy.

And ten minutes elapse… with the tech calling me up. They’ve got the refill. There are TWO sensors. I’ll TAKE IT. I thank her and the pharmacist profusely, and take delivery of two units. I now have a backup in case of emergency that I can rotate into the cycle, and I have one for my sensor day.

I’ve never had such an ordeal in getting a prescription, and no-one should ever have to do that much chasing and fighting to get something that they’ve been prescribed.

Express Scripts should feel shame for making this such an arduous task, as well as being rather environmentally unfriendly. Medicines that need refrigeration, as well as equipment that contains lithium-chemistry based batteries should not be REQUIRED to be mailed to the home. I should be allowed to walk into a pharmacy of my own choice and get a three month fill of these. Don’t mandate that I have to use a specific national chain that begins with a W for three month fills — no-one’s paying for my Lyft to get there and back when I have to go late in the evening or on a weekend.

Instead, I have to take delivery of a big styrofoam crate with ice packs inside for two different medicines quarterly, and no, they won’t synchronize the prescriptions to send them all together.

Tell you what, Express Scripts: Honor a prescription for an electric bicycle of my choosing, or pay for medical transportation and I’ll show you cost savings: Every time I can go pick up my own prescriptions in 90 day runs, you don’t spend money on shipping, packaging for shipping, carbon sequestration (because I know big companies like to do that to look carbon neutral), logistics to pack meds, and all that.

By making sure I actually have access to my medicine, it lowers the chance of negative impact to my health.

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