Dear Employer –
Recently, Express Scripts sent out a letter launching their new comprehensive compounding
management strategy. With this new strategy, Express Scripts will target 1000 ingredients in
compounds and if a prescription comes through with any of these ingredients, the compound will not be
covered. This strategy will affect all patients in employer plans, for which Express Scripts is the
pharmacy benefits manager. Express Scripts is including EVERY employer plan in the program: therefore
employers must opt out to be excluded from the program.
Express Scripts plans to roll out its compounding management program in three phases:
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Phase 1 – Early adopters switch date is July 15, 2014 without patient pre-notification
Phase 2 – Patients notification on July 15 with a 60-day pre-notification and switch on
September 15, 2014
Phase 3 – Union groups and large employers switch date is January 1, 2015
Express Scripts is attempting to deprive me of a medication that my doctor, after careful examination,
has determined to be the most effective and appropriate therapy for me.
I am asking you to keep in mind that a significant number of people have unique health needs that offthe-shelf, one-size-fits-all prescription medication cannot meet. These include elderly, children, and
those whom manufactured drug products are not available in the appropriate strength, dosage form, or
composition. For them and for me, customized medications are the only way to better health and those
valuable preparations are available only by compounding.
To opt-out, please contact your employer plan representative and include the following statement in
writing;
“Please do not enroll my members in Express Scripts’ Compound Management program at this time.”
Time is of the essence!
Thank you for your immediate attention to this matter.