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HCW-00003 Fialkowski, Kelly

Submission Number: 00003
Received:2/5/2015 11:04:44 PM
Commenter: KellyFialkowski

Agency: Federal Trade Commission
Initiative:FTC, DOJ to Host Second Public Workshop on Examining U.S. Health Care Competition; Project No. P13-1207
Attachments: No Attachments
Submission Text
We wanted to express our concern over the lack of options when it comes to mail order/specialty pharmacies. My husband and I have suffered repeated problems with mail order prescriptions filled by ExpressScripts. The prescription with the most egregious errors has been a life-important heart medication, that if not received on time and at the correct dosage will result in a trip to the Emergency Room. We have our insurance through my husband's employer (a large banking company) and unfortunately no insurance plan they offer allows us to avoid having to use ExpressScripts for longterm prescriptions. We looked and would have picked any insurer that allowed us to avoid ExpressScripts. But unfortunately there is not an option currently. We can fill our first 3 scripts at our local pharmacy (which has never made a mistake and is very convenient with courteous employees), but after the 2nd refill our insurance requires mail ordering through ExpressScripts. And we wait for a mistake - whether it's a billing mistake or misreading the dosage or not mailing the medication soon enough resulting in an emergency 7 day refill from our local pharmacy - 80% of the time there is some sort of mistake. (And we are sincerely not exaggerating.) We have lost hours of time on the phone trying to work mistakes through the dysfunctional machine that is ExpressScripts. We often have to be transferred several times for someone remotely helpful, and have even had to wait by the phone for a direct call back to us (usually a full 24 hours later). They have no direct phone numbers to give to patients, so we must wait for them to call us, there is no option for us to call a specific person at a time convenient for us. (Even after we are told we must speak with a specific person, no direct phone number is provided.) It seems there is a lack of accountability. Additionally, the company is too large for how ineffectively it is being run. There are just too many mistakes. We wonder if more options on the patients' end would require ExpressScripts to provide better service or risk losing business. We would absolutely not use this company if we had another choice. We are required by our insurer. It puts the patient in such a hard place - there is no where to go, and nothing to do - except wait for the next mistake and pray it is one that can be ironed out quickly. We implore you to do whatever you can to encourage competition in the healthcare industry. We feel it will do much to inspire the best care and service for patients, while resulting in the best use of money spent as well. Sincerely, The Fialkowski Family
Updated April 7, 2016