Cancer patients denied medication by pharmacy, over ruling physician.
“But that insurance didn’t ensure Smith would get the drugs she needed when facing CVS Specialty Pharmacy– the pharmacy their insurance required them to use. Cancer drugs prescribed by Smith’s oncologist were denied because they didn’t follow the standard protocol sequence of medications that Smith’s pharmacy benefit manager, CVS Caremark, had in their guidelines.”
“That means pharmacy benefit managers have the authority to trump a doctor’s medical judgment without seeing patients or knowing their full medical history, and without accountability for the consequences of what happens to sick people.”