Donna Thorp to Molly Janczyk: One retiree's experience with Caremark

Donna Thorp to Molly Janczyk, February 10, 2007
Subject: Phyllis' letter to Caremark

TO: Donna Thorp-Concerned Ohio Retired Teachers (CORE)
FROM: Phyllis Newton-Ohio Retired Teacher
RE: Caremark-company that manages STRS prescription drug program
DATE: February 5, 2007

I received a 90 day supply prescription drug refill of Prednisone (Img) which I noticed was manufactured by Jubilant P (an India company) instead of ones manufactured by Roxane (these I have been using for several years). I contacted Caremark on Dec. 12, 2006 and was informed by a pharmacist that STRS had decided, due to cost concerns, that this was the drug to be dispensed and that quality control was assured.

On Dec. 13, 2006 I began to take the pills and on Dec. 14, 2006 I began to experience extreme nausea (24/7) but I continued to take the pills until Dec. 19,2006. I then contacted my rheumatologist and obtained a prescription for Prednisone (1 mg) manufactured by Roxane from my local pharmacy and no longer experienced nausea.

On Dec. 26, 2006 I wrote to Caremark regarding my problem and returned all remaining pills (a count of several hundred). In an accompanying letter I asked Caremark to contact me regarding my inability to use Prednisone (1 mg) supplied by Jubilant P. I also sent a copy of this letter to STRS.

I received a letter from a STRS health care representative, dated January 5, 2007, in which she stated that she had contacted Caremark and they were asked "to research my issue and respond expediently to my concerns". Also spoke with this representative around Jan. 17, 2007.

After not hearing from Caremark in a time period of approximately 3 weeks, I contacted Caremark again and was told that they had no record of my letter and no record of receiving the hundreds of unused pills. I sent them another copy of the letter around Jan. 17, 2007.

Still not hearing from Caremark I contacted them again on Jan. 29, 2007 and was told there was no record of any communication or of pills received from me. A pharmacy technician informed me that Roxane no longer manufactured Prednisone (1 mg) and that Jubilant pills were the only ones available. She also told me that someone from Caremark would call me regarding my returning the unused pills.

To date I have not heard from Caremark I am extremely concerned as to the location of these pills. I also told this individual that I believed I should be reimbursed for this medication. On the same day (1.17.07) I contacted my local pharmacist who informed me that as of that date he was still receiving Prednisone (1 mg) from Roxane and that his experience was that Caremark believes "you do things their way or hit the highway". A person who works for another one of my doctors said that "Caremark is the worst company with which to work".

On Jan. 29, 2007 I talked with the STRS health care representative. She called me back on Jan. 31, 2007 and explained to me that her manager told her to inform me that since Prednisone (1 mg) is still available from Caremark that no exceptions can be made implying that if I wanted to use the pill from Roxane that does not make me ill that I would need to use my local pharmacy. Since Prednisone (1 mg) is a fairly inexpensive medication there is not a lot of difference in obtaining this drug from Caremark or my local pharmacy.

My concern is that STRS will not approve my receiving a 90 day supply of a drug that I can take which makes me spend more money, however small, at my local pharmacy. What if this was an expensive medication and a retiree developed a reaction to the medication? Would the position of STRS be the same?

I do not believe that this is how our prescription drug plan is supposed to work. We are supposed to be saving money, not spending more. I do want to say that the STRS health care representative and everyone I spoke with at Caremark (with the exception of the Dec. 12 pharmacist) were very courteous and responsive to my concerns. Management seems to be the problem. This entire episode leaves me with 2 great concerns:
...1. Caremark showing a lack of concern to my problem by not responding to my letters, phone calls and my deep concern regarding the status of the pills I returned to them.
...2. The refusal of STRS to help me obtain my medication at a lower cost to me (even how small this cost is).