Is a new wave of patients unwittingly “signing up” for Express Scripts mail order? The giant pharmacy benefit manager (PBM) is reportedly expanding a program in which patients are enrolled into mail order unless they call the PBM to affirmatively opt out.
Under this “passive” mail order plan, patients must contact Express Scripts before the third refill and voice their preference in order to continue patronizing their local pharmacy as usual.
The program came to light earlier this summer. As Alabama pharmacist Norman Davis put it in a letter to his U.S. Senator: “EXPRESS SCRIPTS has enticed their sponsors to pre-enroll their employees into mail-order employing passive acceptance whereby in order to continue the trust relationship with the pharmacist of their own choosing, they have to physically take action themselves to dis-enroll from something that they never enrolled in. This is insanity.”
Since then, more community pharmacists and their patients are encountering the stealth program. To opt out, patients must be proactive and call Express Scripts at 877-331-3252.
It’s unclear which health plan sponsors have implemented these plans. While some patients may receive letters from the PBM alerting them to the change, community pharmacists may want to warn their patients who have Express Scripts’ coverage.