Express Scripts’ Passive Mail Order Mandate

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.

4 Responses to “Express Scripts’ Passive Mail Order Mandate”

  1. 1 Mike Steinbrink November 8, 2010 at 7:33 pm

    This is one of the lowest ways to create business I have looked at. Not even the phone companies can swithch your services without asking you first, so why can the PBM’s? I work in cancer care, and my patients may only need the meds for three to six months. Why should they be forced to use mail order for anti-emetics and other meds that are only used during treatment if that treatment extends more than 3 months?
    This is nothing but a low handed attempt by the PBM’s to put all community pharmacists out of business so that they can charge what they want and mandate the care they want to give without anyone telling them otherwise.
    Express Scripts management should be ashamed or themselves for putting a dollar or two of profit above patient care and access.

  2. 2 American April 12, 2011 at 8:05 pm

    I just got caught up in this “mandate” and as a consumer, I don’t like it. I have spoken to our HR department at work and during the next open enrollment period, I will be dropping Caremark as the provider. Since I have been caught up in this mandate, I have purchased my medications at full expense. Being forced to use the mail order system without any opt-out options is almost as crazy as Obamacare. I will NEVER buy from mail order and I will NEVER purchase Obamacare.

  3. 3 Gary February 1, 2012 at 10:57 pm

    This number 877-331-3252 is a automated number and is no help.

  4. 4 Pam December 5, 2012 at 6:28 pm

    DO NOT ever use EXPRESS SCRIPT mail order program. I am forced at work to use Mail Order Pharmacy for any over 30 day supply prescription. It takes them more than 2.5 weeks to fill a cough syrup with codeline (what they identify as control substance due to codeline in it). EXPRESS SCRIPTS require doctor office to CALL verbally to verify prescription order even if prescription is sent directly from Palo Alto Medical Foundation doctors office. Once the 2.5 weeks pass & medication ship out, the package is SO INSUFFICIENTLY package that half of GLASS BOTTLES containing medication shattered when arrived at patiient’s home. To save SHIPPING expense, EXPRESS SCRIPT mail your prescription to US Post Office only, and then US Post Office will deliver medication to you (free service). After almost 4 weeks after seeing the doctor, I still had not received my doctors FULL prescription of cough syrup. When you call in to complain, those customer service rep will only authorize 5-day supply to tie you over. IT IS A NIGHTMARE. I never wish this experience on anyone else especially when you are sick and need to medication to get well.

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