Walgreens may leave insurance network

Ed Marlowe
Staff writer

 Effective Jan. 1, 2012, faculty and staff under the University’s healthcare plan must pay half of the cost of prescriptions bought at Walgreens of Murray.

The date marks the end to the three-year contract signed between Walgreen Co. and pharmacy benefits manager (PBM) Express Scripts Inc., and contract negotiations have stalled over the last few months.

The current University healthcare plan, provided by Anthem Blue Cross & Blue Shield, falls under the pharmaceutical network of Express Scripts Inc. and will no longer be covered by Walgreens come the start of the new year.

In June, Walgreen Co. officials said the company would discontinue its relationship with Express Scripts Inc. over contractual differences, as Express Scripts wanted to cut payments to what pharmacy managers consider unacceptably low levels and desired too much control over other terms of the contract.

Express Scripts Inc. filed suit against Walgreen Co. in September 2011, citing breach of contract issues between the two companies.

In the lawsuit, Express Scripts said Walgreens was trying to get Express Scripts members to switch to new plans to keep their business, something not allowed in the original contract.

On Oct. 16, a federal judge in Illinois denied preliminary injunctive relief of the lawsuit between Walgreen Co. and Express Scripts Inc., further removing the possibility of negotiations continuing between the two companies.

Tom Hoffacker, director of human resources, discussed the drawbacks of the changes and how they affect faculty and staff who partake in the University healthcare policy.

“Our employees will not be able to go to Walgreens as an in-network drug provider,” Hoffacker said. “They’ll essentially be paying close to retail should they continue to receive prescriptions from Walgreens (after the deadline).”

Since Walgreens will no longer be part of the in-network provisions of Anthem, Hoffacker said prescriptions could be transferred to other local pharmacies at the discretion of the customer in order to continue to receive maximized healthcare benefits.

An undisclosed source knowledgeable of Walgreens of Murray said the local store was not only concerned of losing the business of the University, but also of the local schools, Briggs & Stratton and other local companies that use Anthem and other healthcare providers under Express Scripts.

Walgreen Co., the largest pharmacy chain in the U.S. with almost 8,000 stores nationwide, said it receives $5.3 billion annually from Express Scripts.

Express Scripts said it gives Walgreens access to about 60 million people through Anthem, Empire and UniCare.

It is still possible an agreement can be reached between Walgreens and Express Scripts before the contract terminates. Should ties be mended and a contract signed before the current one expires, those carrying Anthem would remain unaffected by the lawsuit and carriers would be informed of the decision by both Walgreens and Anthem.

Hoffacker said he has heard nothing about a final decision regarding the business partnership and remains hopeful the issues can be resolved.

“I hope it isn’t happening,” he said. “Until both companies say ‘this is not happening,’ we can hope it works out.”

 

Q: How do you find other network pharmacies?

A: Contact Anthem for assistance in identifying names and locations of convenient, nearby pharmacies
or utilize the online ‘Find A Pharmacy’ tool at www.anthem.com.

 Q: How do you transfer prescriptions to another pharmacy?

A: Take the prescription bottle to your new pharmacy, and they will contact your old pharmacy OR call your new pharmacy and ask them to contact your old pharmacy OR ask your doctor to call your new pharmacy with prescription information.

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