CVS Caremark: Inconvenient Prescription Refills

In today’s digital age, almost anything can be ordered online and delivered to your front door. We don’t even have to step outside to get everything we need — why not get medication delivered as well? It’s tempting to think that only the sick and elderly have to worry about prescription drugs, but this leaves out a large part of the population: women who go to the pharmacy each month to pick up their birth control prescription.


Every month, I would trek down to my local pharmacy, hand the pharmacist behind the counter my insurance card, and go sit down in a chair among screaming children and exasperated parents, waiting for my name to be called. Although the pharmacy had its own shortcomings, I didn’t mind going there to pick up my prescription because I could decide for myself when a trip there was most convenient. That was, until August of this year, when I was told that I could no longer pick up my pills at the pharmacy.


Shocked, I tried to explain that I had been picking up my prescriptions at that very pharmacy for about a year, and that my gynecologist had prescribed enough refills. I left the pharmacy with no pills in hand, but with the advice that I should call my insurance company about their new policy. After calling Aetna and speaking with a representative, I was told that because I was taking a “maintenance medication,” I was required to use the CVS Caremark® Mail Service Pharmacy, an Aetna partner service that mails your prescription to you. The problem for college students is that we have two different addresses, creating the challenge of keeping one’s current address updated on the website or by phone.


I gave up trying to reason with Aetna, and went to the pharmacy the next day and paid $30 out of pocket for the pills. I had one pill left in my previous pack, was leaving for college in a few days, and I had other priorities on my plate, such as packing. $30 may not seem like a lot of money to everyone, but $30 every month adds up, even for the financially stable.


Aetna’s definition of maintenance medicines is a medication taken everyday for “conditions that are considered chronic or long-term.”1 This definition does not seem very inclusive of college-aged women who are trying not to get pregnant. Birth control is taken every day, but it is not taken for a “condition,” unless being a female of reproductive age is considered a medical abnormality. At the very least, this policy should be elective so that it is more inclusive of people who would prefer to use the pharmacy. For college students and others for whom mail order is inconvenient, what choices are they left? Should they stop taking the medication? Switch health insurance companies? Pay out of pocket indefinitely? None of these options is a good solution for most patients.


Luckily for me, my “maintenance medicine” was just birth control pills. This mail order policy was the last straw for me, and I made the decision to stop taking the medication. But I would be in a different, more difficult position if I were taking maintenance medicine for a serious condition, as I’m sure many other college students are. Health insurance companies, when planning policy changes, need to consider how their decisions inadvertently affect patients. Although the majority of patients may be of a certain demographic, minority patients and outliers, such as college students who regularly switch between residences, do exist. Insurers cannot assume that one policy fits all.

References:

  1. CVS Caremark® Maintenance Drug List: CVS Caremark. (2019, June 5). Retrieved November 20, 2019, from https://www.caremark.com/portal/asset/CVS_Caremark_Maint_DrugList.pdf

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