Express Scripts drops coverage of 1,000 drug ingredients

WASHINGTON (KTRK) -- Most pharmacies carry thousands of medications. But sometimes you need one made just for you.

"Cream for arthritic joint in my thumb and they just didn't have anything over the counter that would do that," explained Houstonian Tom Seiler.

Seiler and many other Americans use compounded medications. Most of them aren't very complicated. For example, turning pills into liquid for those who can't swallow. Or creating pills with lower dosages than come over the counter.

"We get a lot of patients out of Texas Children's Hospital and they are heart patients," explained Steven King, the Pharmacy Manager at HEB on Buffalo Speedway. "They have to have very low doses of standard drugs, which are not available in the market."

But Express Scripts, the country's largest pharmacy benefit manager, will no longer cover most compounds. The company, which covers prescriptions for 90 million Americans, calls some compounded medications "exorbitantly overpriced" and blames pharmacies for it.

Bottom line, pharmacies, drug manufacturors, and Express Scripts can't get along. And you'll now have to pay for it.

Without insurance, some compounded medications cost around $500.

"The ones that we do are mostly for children and mostly for drugs that are not available on the market," King said. "So why is that a luxury? If it's not available anywhere else, it's a necessity, in my opinion."

"For those patients who might be impacted, we'll be communicating with them over the coming weeks and months to ensure a smooth transition to a more cost-effective option. Again, for those patients whose physician requires them to have a compound and who need access to it, we'll work with them and their physician to do so. However, most people should be able to easily switch," said Brian Henry, Express Scripts' VP of Corporate Communications.

For more information, visit Express Scripts' website.