Compounded Drugs Are "Medically Necessary"

Pharmacy benefit managers, or PBMs, are companies that process prescriptions for insurance companies and corporations, and use their size to negotiate low prices with drug makers and pharmacies. Several PBMs are dramatically decreasing their coverage for some bulk ingredients of compounded drugs, arguing that compounded medications “[have no] additional clinical value” over FDA-approved drugs. They argue that compounding is not “medically necessary.”

Drug purchasing managers for insurance companies have no right overriding the medical decisions of physicians. And attacking compounded medications simply gives more of a monopoly to FDA-approved drugs.

Tell the major PBMs that they have no authority to countermand a doctor’s healthcare directive with their own assessment of what is “medically necessary.” Show them how important compounding is to families like yours.

Please personalize your message if you have the time!

Recipients

  • CVS Caremark
  • Optum Rx
  • Catamaran Rx
  • Express Scripts

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Dear [Decision Maker],

Sincerely,
[Your Name]
[Your Address]
[City, State ZIP]