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CVS Caremark Formulary Change Freezes Out Apixaban

CDreamer profile image
15 Replies

This will only affect people in the US but I found this article very troubling when anyone other than clinicians can dictate which medication you may have access to. Obviously the clinicians are also troubled from the tone of the article.

Has anyone on the forum been affected?

medscape.com/viewarticle/96...

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CDreamer profile image
CDreamer
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15 Replies
mav7 profile image
mav7

Thx for posting that important info !

Hopefully, those affected can receive Eliquis from another source thru their healthcare plan.

Finvola profile image
Finvola

Thanks for this CD. Any system driven by finance will always put the real needs behind the worship of profit. I hope our US friends can find workarounds for this - and we in the UK shouldn't be too complacent that 'it couldn't happen here'. Money doesn't talk - it swears.

CDreamer profile image
CDreamer in reply to Finvola

Certainly a possibility.

bayonnejoe1 profile image
bayonnejoe1

I'm a retired teacher in West Virginia. I was told just today by a friend who is still actively employed as a teacher that he is being forced to choose between rivaroxaban (Xarelto) and warfarin (Coumadin).

I have Medicare Advantage with Humana. It's the the option offered retirees by the WV Retired Teacher's System. As such, it may be governed by Medicare rules as far as drug formularies are concerned. Not sure about that, but I do know I continue to have my Eliquis covered.

Xarelto has had some disturbing recent reports regards increased bleeding, so my friend is not happy at all about this. W/o insurance a month supply of Eliquis easily runs several hundred dollars. Right now I pay about $30 a month with Humana.

CDreamer profile image
CDreamer in reply to bayonnejoe1

That sounds very concerning. It seems the clinicians are objecting to these policies and it constantly amazes me about how money dictates just how the US system operates.

I know that many in the US hate the idea of socialised medicine but then I read so many of this type of strategy and it’s beyond me how NOT having some sort of socialised Health Service which at least co-ordinates systems and to some extent standardises who gets what would be helpful.

I think we in the UK need also to be vigilant as the US Big Pharma are desperate to get into the UK market as the NHS is one of, if not THE largest, single Pharmaceuticals market.

KMRobbo profile image
KMRobbo in reply to CDreamer

You better watch closely what Sajid Javid is doing. The Conservatives clearly want more private companies in the NHS.

Cookie24 profile image
Cookie24 in reply to bayonnejoe1

I am in the U.S. and retired from state government. I have Medicare and a Medicare PDP supplement in retirement. It appears from the article that only commercial drug plans are dropping Eliquis. This exclusion may only apply to active government workers who are not yet Medicare eligible. Nevertheless, I stocked up on Eliquis prior to January 1.

mrdarcy1 profile image
mrdarcy1

Thank god for the NHS!!

Auriculaire profile image
Auriculaire

When I had my TIA and was finally resigned to taking an anticoagulant my doctor said I could choose between Rivaroxaban and Apixaban ( I had already tried Pradaxa but could not put up with the digestive side effects). He said there wasn't much in it beside the once or twice a day dosing and then remarked darkly that with Xarelto "I don't like the company". Bayer has now merged with Monsanto and wields enormous financial clout. One wonders if that influences the outcome in this type of decision.

astle profile image
astle

Luckily we have a company managing our health insurances here in US. We changed our prescription provider for this very reason. Thanks for sharing article,

bayonnejoe1 profile image
bayonnejoe1

Someone mentioned Americans don't want 'socialized' medicine. The irony is we Americans actually have a hodgepodge of social programs that provide health care. Medicaid, medicare, Affordable Care Act, employer provided insurance, last resort ER access . . . what we have, speaking very broadly, is a political football and an uninformed populace that has no idea what 'socialized medicine' actually is, and the degree to which it already exists here. And, on the other hand, as my daughter, an expat in Ireland, points out, most folks she knows, carry private insurance to supplement their universal government health care. What I conclude is we all have a lot in common, and many have blended health plans on both sides of the pond. All in all, there's a lot to be legitimately dissatisfied everywhere.

CDreamer profile image
CDreamer in reply to bayonnejoe1

Agreed. It was me that mentioned US not liking ‘socialised medicine’ and I agree it’s a political football.

Married to an Irishman Domicile who worked in US whilst living in Spain whilst my domicile was UK, resident in UK believe me I’ve experience of them all!

Best service - No 1 Spain followed by South Africa when I needed attention whilst visiting followed by UK.

UK has NHS but those who can afford it often also have Private Health Insurance - problem is that Private Insurance here doesn’t cover you for chronic conditions. Thankfully though the cost of private health here is a fraction of costs in the UK.

As you say there are cons in every system.

bayonnejoe1 profile image
bayonnejoe1 in reply to CDreamer

My daughter lived for an extended time in Spain and also said their national health service was top notch. She is very disappointed in what goes for nation health service in Ireland. Health care across the EU seems to be nearly as variable as state to state in the US. To be sure: a political football.

lovetogarden profile image
lovetogarden

If I’m interpreting the various news articles correctly, this only applies to people who have their health insurance plan through the CVS Health arm of the company (which of course is still important!) It shouldn’t mean that the CVS drug selling arms won’t fill a prescription for it, if you have another health plan. I do hope I’m interpreting things correctly.

(To digress a bit…. CVS has at least 3 different prescription filling divisions and they rarely seem to know what the other is doing. A local CVS pharmacy recently auto-filled a script I didn’t need. It was easier to pay the $5 than argue. And on top of that, one of their mail-order divisions repeatedly called and texted that the very same prescription was overdue to be filled. )

CDreamer profile image
CDreamer in reply to lovetogarden

😱

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