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Express Scripts is eliminating coverage for a brand name drug I’m taking and forcing me to take generic. I know for sure the brand name one is working well. My doctor already submitted a pre-approval for me to continue taking the brand name but got denied. I asked the doctor to resubmit an appeal and am waiting to hear back. In case Express Scripts denies coverage for my brand name drug again, I am strongly opposed to using generic because my doctor and I do not have confidence in this particular generic since it is way too new on the market and the track history is not proven yet. We are afraid I will develop resistance to the Brand name drug by the time I realized the generic sucks and we have to switch back.
Is there a way to get Accenture to give us another pharmacy coverage option? I would then try to select the option that did cover my brand name. Otherwise this is a sad reason I would want to leave the firm for another one just for better insurance plans.
Two suggestions -
1. I've had brand exceptions made several times with CVS. always been approved, but normally they want to know that you've had a reaction to the generic, not something hypothetical. I know that probably doesn't help you, though. I used to deal with ExpressScripts - they were horrific.
2. see if there is any sort of pharmacy discount card from the drug manufacturer. these sometimes go by copay assistance cards. when generics become available, the brand sometimes issues these plans.
Most of the insurances are pretty similar. Weigh in Accenture’s generous 401k match and Employee share purchase program and vesting time (which is immediate) into consideration before considering offers.
Most Pharmacy Management programs are administered by the pharmacy companies but the Employer (ACN) is the one that chooses to participate in it. You will have to try the generic for a month and then if it does not work an exception for the name brand will be approved, but you have to at least try the generic. Remember most generics have the exact same active ingredients, so maybe give the generic a try and see what happens. Think positively, it could work for you and you will have a little more money in your wallet.