By MATTHEW HOLT
Today we’re going to have fun with show and tell. I’m going to show you how a little corner of American health care is making my life as a consumer worse and more expensive – hopefully someone can tell me why.
The cast members are: me, my MD, the (sort of) independent pharmacy that delivers, Alto, and my insurer Blue Shield of California and its PBM CVS Caremark, which also owns a mail order pharmacy.
The brief backstory: For some years my doctor has been concerned about my high cholesterol and prescribed me a generic statin called Rosuvastatin Calcium. My cholesterol has improved on this medication, but my MD recommended increasing the dose from 20mg to 40mg a few months ago.
Until recently, my statins were free, but the price later increased to $23 a month. When transitioning to Blue Shield of California, the cost at Alto was $28.
Now, let’s fast forward to when my 90-day supply was delivered, but shockingly it was only for 30 days. I inquired with Alto and they blamed Blue Shield. It seems Blue Shield wants me to move my 90-day order to their mail-order service.
Considering my options, GoodRx offers a 90-day supply for $18 cash, but I prefer Alto’s convenient delivery service.
After encountering issues with Blue Shield’s customer service, I discovered that they want me to use CVS Caremark for my statin prescription, which would significantly increase my annual cost. It seems Blue Shield wants to keep the profit by switching my pharmacy.
In trying to navigate the Blue Shield and CVS Caremark websites, I encountered frustrating technical difficulties, causing unnecessary delays. Blue Shield claims I can get a 90-day supply via mail order, but the CVS Caremark site does not offer this option.
Through the drug pricing tool on the Blue Shield site, I learned that the price for the statin through CVS Mail order is $19 for a 30-day supply. However, obtaining a 90-day supply seems to be a challenge.
It appears that Blue Shield and CVS Caremark are pushing me to switch pharmacies for a maintenance drug that benefits them financially, potentially complicating the process of obtaining my medication.
