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CVS Pharmacy / CVS Caremark / rip off drug prices

1 United States Review updated:
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I have two questions for you. The first- I currently purchase 2 prescriptions each month. Before I meet my deductible I pay $4.04 for one and $4.83 for the other. As soon as I meet my deductible it goes up to $10.00 per prescription. I have called both my local CVS pharmacy and Blue Cross. I was told by CVS that they had gone to the 90 day refills and that is why I was charged the $10.00 since I was not getting 90 days worth which makes no sense because in January it went back down to the four dollar amounts. Blue Cross says that it is paying the amount that CVS submits. My question to you is why are the amounts changing. It has nothing to do with what prescription plan I am under. It seems that you are billing Blue Cross extra once I reach my deductible which is not right. I should be paying the same amount as before I reach my deductible as after.

The second issue is for a prescription for Clebetasol Prop .05% foam. As you can see from my records I paid $195.17. When I returned home I called 3 other pharmacies one of them another CVS to see what they would charge for this. Imagine my surprise when I found out that (and these are retail prices) all were lower than the CVS that I use. One almost half. I also learned from the other CVS that the price quoted of $175.99 would be less once she determined what type of insurance that I had. I cannot understand why there would be a $25.00 difference in 2 stores in the same area. Walgreens was $134.99 and Midtown Pharmacy was $89.93. Quite a difference. I wrote this letter to CVS in RI over a month ago with a request that they respond in a timely manner. As of this date I have heard nothing from them. I had this problem about 10 years ago with their pharmacy and quit using them. I tried again and this is what happens. I can unequivocally state that I will never ever use them again.

Me
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Comments

  • Ra
      16th of Feb, 2010
    0 Votes

    I personally know of this issue about the copay prices. My aunt had the same issue on her medications. And from working in the pharmacy I called them about it. Basically what it comes done to is a software issue. The pharmacy does not "send a bill price" to the insurance. The prices that the pharmacy gets paid by the insurance company based on the contract they sign.
    [It is something like AWP - ? % + a dispensing fee]. So the cash price has nothing to do with the billing issue. The pharmacy submits the information to your insurance carrier [Drug NDC, quantity of meds, days supply, doctor's ID...]. And the insurance company sends back if the prescription is covered and your price that you pay. This is where the problem is. If you have not met your deductible, your insurance sends back the price based on the contract price [awp - ?% + fee]. Once you meet your deductible, the insurance is set up to send back copay amounts.

    Your insurance is not paying anything so they just send back the copay amount. [The $4 you where paying is the most they are willing to pay for the med] I seen this happen a lot with blue cross [Mainly with Medco that handles the pharmacy benefits.] Without knowing the meds that are in question. I have seen sometimes it is better to pay cash for them then use the insurance on some. The pharmacy has no way to override a copay amount that the insurance sends us back.

    As for the second issue We have had prices cost more then $20 for the same medication in the same store. The manufacture has a set AWP price for their drug and they do vary by the manufacture. When ordering drugs for our pharmacy I see our costs and I have seen the same medications with $40 price differences. So the price can have a difference. The one with a $100 difference, I would make sure that they looked up the correct form. And with the Clobetasol foam, I make sure that the pharmacy for a lot less gave you the price for the correct form. That has a cream ointment, gel, solution.. forms.

    I worked as a tech in a chain pharmacy for about 10 years, before I left and opened a pharmacy that I own.

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