Dallas, Texas
Not resolved

Two problems with Walgreens, which have been passed along as of August 25, 2008 to Greg Abbot, Texas Attorney General, of which I've been assured an investigation will take place due to, in the AG staffer's words, "an alarming increase in similar complaints since the beginning of the year."

First complaint is Walgreens Health Initiatives practice of denying all Prior Authorizations on prescriptions that do not explicitly meet FDA usage recommendations. Ie, Adderall for those suffering from Chronic Fatigue Syndrome, certain fentanyl pain medications for those diagnosed with chronic neuromuscular pain and who have shown tolerance to more traditional opiates. According to the AG's staffer, WHI is one of the smaller PBMs, but has the highest number of rejected Prior Authorizations.

In other words, Walgreens' cubicle doctors are practicing medicine on patients they've never examined.

Second complaint is Walgreens practice of ungodly markups on their pharmacy products. Example: 5 mg Diazepam (generic valium) is purchased in lots of 1000 pills for a wholesale cost of less than $15. Cash price for 30 pills exceeds $30. That is a markup from a cost of 1.5 cents to $1 per pill. There are hundreds and hundreds of such similar examples.

This is why Walgreens will fill all scripts with generics over brand without telling the patient--Walgreens gross profit SKYROCKETS with generics due to markups in some cases of over 2000%.

This is wrong. Just wrong. I look forward to both the AG's investigation as well as the joint investigation by Dallas Morning News and Houston Chronicle.

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1. Here's a good reason why a PBM (which is not an insurance company) would deny a prior authorization for a medication given for an off-label use: since the FDA hasn't approved it for that use yet, there is little to no data on its safety when used in that manner. You want it? You pay for it.

2. Not only do most pharmacies fill generically, but they're given the right to do so by state law (in all 50 states). Unless your doctor specifies brand name medically necessary (in his or her own handwriting), you'll more than likely be receiving a generic substitute which has been approved by the FDA as pharmacologically identical to the brand name medication.

3. Your numbers for the mark-ups on prescription drugs seem a bit off. Even so, I doubt you complain about the mark-up of fountain drinks.


1. How did you get all this information about how their purchases take place.

2. Most of the pharmacies today give you generic over brand name, it is much cheaper.

I have worked at pharmacy as TECH and we use to do same, because customers can't afford it. so what is wrong in that.