My complaint:
My physician called in pain medication to my CVS on Feb 8th. I received notice in the CVS app that it was on hold due to being out of stock and to contact the pharmacist in 2 days if not filled. I called the pharmacy on Feb12th and was rudly explained that it is not in stock and has to be ordered. I went to the pharmacy on Feb 13th and asked if there was an approximate date the medication would be in stock. Again, I was greeted with a very rude and became hostile response stating that CVS will never stock that medication.
I called the CVS number on the back of my card and after over an hour and being escalated to Senior Team I was told I could get it through the mail order system and I could receive it overnight once it was processed which would take about 24 hours. It took time to get script switched. It was then pending in my CareMark app and when I called they again that it was not on back order and I will receive it once processed. On Feb 19th I was charged for the medication however I still did not receive the medication. I called again and was sent to Senior Team again how told me it is in stock and I will receive the medication. I did not recieve the medication.
I called to try and put in a complaint about Senior Team providing me the wrong information 3 times. Senior Level team came on the phone again and said there is not someone else to complain to and she would help. She said there is no hydrocodone ER 100mg to be in stock till earlies of April. Their were three other medications CVS wrote me stating I need to try prior to appealing my prior authorization for Nucynta 100mg. Two were also not in stock. The Senior Team found Tramadol ER 100mg in my area the prescription get sent. When I looked up the medication interaction prior to picking up the mediation, I found out it as a HIGH risk interaction with Wellbutrin which I take for Anxiety/Depression. I started on Feb 8th trying to get medication off a list of what I need to take prior to getting the medication that will actually work for my condition. I am now 16 days with NO pain medication. The current script written because CVS said I could take that as an alternative has a HIGH risk interaction. I now have NO choices. 16 days of NO medication and NO alternatives available.
I asked Senior Level team today if an override on the denial can be done now since it is now documented that there are no alternatives and was told no I have to go through the entire appeal process. I will have to go back to my doctor that will take up to 2 weeks depending on availability, then his staff has to write an appeal, the CVS has 72 hours to respond for an urgent appeal. This will place me at minimum, if I can see the doctor on Monday, 6 more days of NO pain medication thus totallying 22 days. I do not have a photo for proof but CVS customer service line has logged all my calls.
All calls should have a note written although some of the employees did not fulfil their responsibility. There are sufficient notes written to show the extent I have gone through while in pain to be able to get pain medication prescribed.
Suggested solution:
Provide an override to my denial of Nucynta 100mg due to no other alternative able to be stocked by CVS, other local pharmacies, and the mail order system. If CVS cannot provide the alternative to the medication then CVS needs to override the denial and provide the medication-even if it is a partial override to provide a weeks worth of medication while an appeal process is completed.
