On 7 Aug 2009, I received an email from Medco's Senior Manager of Public Affairs, Jennifer Luddy, reacting to my blog post titled "Medco Thyroid Scandal: Thyroid Patients Demand Answers Regarding Misleading Thyroid Drug Shortage Notices." Here are a few relevant excerpts from Ms. Luddy's email:
Medco was notified by the manufacturers that there is a national shortage and these products are unavailable to Medco. There is no timeline established by the manufacturers that guarantees when we will receive a supply of these products. This shortage is well-documented and other organizations, including the American Society of Health-System Pharmacists (www.ashp.org), are also warning patients and doctors.
...Please understand that Medco is not favoring levothyroxine treatments over desiccated thyroid drugs. We mention levothyroxine treatments in our communication simply because we have ample supply of levothyroxine and the guidelines from the American Academy of Clinical Endocrinologists recommend levothyroxine for the treatment of hypothyroidism.
Unfortunately, Medco is still not forthcoming in their response to thyroid patients. Prior to Medco releasing their "Thyroid Drug Shortage" notification to doctors, RLC did not notify Medco of any shortage of natural desiccated thyroid. Medco issued their alert without investigating availability of natural desiccated thyroid drugs.
As for the shortage being "well-documented," Ms. Luddy points to the American Society of Health-System Pharmacists as documenting the shortage. This group, however, is warning patients and doctors of a shortage of Armour Thyroid, NOT Nature-Throid.
Even the ASHP's own notice regarding thyroid drug shortages indicates that Nature-Throid is available, except in the 3-grain size.
I responded to Ms. Luddy, indicating that I appreciated her email response, but it did not address the specific questions I outlined in my letter of August, 6, 2009 to David Snow and Kenneth Klepper.
Unfortunately, there is good reason for concern regarding Medco. In the past five years alone, the company has paid almost $200 million to settle various charges of fraud involving "drug-switching" practices, and switching prescriptions to favor particular medications for their own financial benefit.
Medco's notice regarding thyroid drug shortages, therefore, raises familiar concerns among patients about Medco's motivations, and what is truly in the best interest for thyroid patients around the nation.
If it is indeed not the case that Medco is favoring levothyroxine treatments over desiccated thyroid drugs, then I have again asked Medco to openly answer, in a forthcoming manner, the specific questions I outlined in my original letter, rather than bypass them entirely, as their response has done.
So, again, Medco, thyroid patients are waiting for answers to the following questions:
- Why is Medco unable to obtain Nature-Throid, when other pharmacies are able to obtain it, and the company itself has indicated that supplies of all dosages (except 3 grain) are available for immediate shipment to distributors?
- Why is Medco disseminating incorrect information to doctors, suggesting that there is a nationwide shortage of natural desiccated thyroid drugs, when the shortage is only in the Armour Thyroid brand?
- Why does Medco appear to be attempting to deliberately mislead doctors by saying that natural desiccated thyroid does not have U.S. Food and Drug Administration (FDA) approval, when the company should be well-aware that like many older drugs, natural desiccated thyroid does not require FDA approval, given its grandfathered status and 100 year history of safe use?
- Why is Medco making predictions and speculating about FDA activities when the FDA itself has not discussed any intent to regulate natural desiccated thyroid drugs?
- Why is Medco trying to link Forest Labs reformulation and backorder difficulties with Medco's unfounded speculations regarding the FDA plans for natural desiccated thyroid, when no such link is established, and the FDA has no such plans?
- Why is Medco saying that no natural desiccated thyroid is available, when Nature-Throid has availability of all but the 3 grain size, and is considered an equivalent to Armour Thyroid for patients taking natural desiccated thyroid by doctors who prescribe natural desiccated thyroid?
- Why is Medco recommending that doctors who have specifically prescribed natural desiccated thyroid for their patients switch those thyroid patients to levothyroxine?
Photos: clipart.com
Medco’s response is simply a lie. They have ample supply of levo because no one wants it.
Thanks for putting the pressure on Medco and exposing their prior misdeeds. My insurance uses Medco for prescriptions but since Nature-throid is so inexpensive I’m able to use my local pharmacy and still get some coverage. I strongly suspect there is pressure from Big Pharma at play here. Let’s hold their feet to the fire!
Mary,
Thank you for your courage and composure to expose this fraud and to stand up for yourself and all thyroid patients. What you are doing, so few people have the backbone to handle without crumbling under the pressure that Medco and others no doubt put to you. God bless you for your efforts!
My pharmacy informed me last month that my Armour prescription was on “back order” and they did not know when it would be available. Thankfully, I knew from your website that there were alternatives available. I was able to call my doctor and switched to Westhyroid, which also reduced my copayment from $50 to $10.
I am sure we will have a long wait for a legitimate reply. Medco seems rank up there with Medtronic when it comes to be honest. Or, should I say, as low…
My insurance coverage is through CVS/Caremark and I was told on Wednesday they could not fill my order of 1/2 grain Nature-throid. I called RLC directly and they confirmed they are out of that size indefinitely with no anticipated restock date. So the powers that want dessicated thyroid off the market are making progress. I would guess that would be any pharmaceutical that makes levothyroxine (T4) or liothyronine (T3). *sigh*
Barb – my Walgreens told me the same thing. But then when pressed found out that the 1/4 grain Nature-throid is available (it had to be ordered, but was available). It took several phone calls but my doctor was able to call in a script for 1/4 grain 2x/day. Hang in there and be creative!
My doctor was able to get Nature-throid for me from Medco and it has shipped out. I think the key is that doctors need to write out the prescription for it and if Medco comes back to them, they need to stand firm that synthroid, etc. is NOT an option.
I have to tell you…I wrote a letter vis email through their website about this issue and the response I got was so bizare. It was if they had never read it at all. It was all canned responses. I wrote back and told them that…the 2nd response wasn’t much better.
Supposedly the Nature-throid has shipped. : )
Karen : )
Karen, thanks so much for leaving your comment! I have been on the phone with Medco for TWO WEEKS. They claimed that they had no Armour and no Nature-throid and no Westhroid. I have been panicking, because I finally feel good after getting my PCP to prescribe Armour last fall. I got some Armour from my local pharm, and they say they can’t get it either. Because of your comment, I will ask my doctor to specifically request Nature-throid, and send the request to Medco and see what happens. Thanks for giving me an option for what to do next. And thanks, Mary, for standing up for all of us!
THANK YOU SO MUCH FOR TAKING MEDCO TO TASK. THEY HAVE PLAYED THIS GAME IN THE PAST AND HAVE SADLY WON MANY TIMES BUT NOT THIS TIME. KEEP UP THE GOOD WORK.
The chickens have come to roost for Medco. If you are a trial atty or if you know one please forward these comments and the other over 90 comments related to this post. Medco must be investigated for their willful misconduct. Medco prouldy boasts that their mission is to switch to generics so they can generate profits. They have even bought out the state boards so the AG’s must investigate.
For DOREEN, WHY would your copay be $50 for Armour???
I don’t have insurance and I only pay @ $23 for THREE months!! PLEASE check on that!!
It feels that Medco has even control of the pharmacy boards because people on Medco’s Board of Directors belong to the exec committee on state boards… Medco’s stock closed higher today despite all that is going on.
Medco just called me in response to my request to refill my Armour perscription (.5 grains 3X daily). I was informed that Armour (all strengths) was on long term backorder. When I asked about a NatureThroid substitution I was told that Medco could not provide me with any natural thyroid product. However, the representative said that Medco would cover these products obtained through my local pharmacy. Further, I asked whether I would be charged the higher retail pharmacy rate and she said, “no.” This is frustrating, but I will try to obtain NatureThroid at my local pharmacy tomorrow.
I just got off the phone with Medco. I had to call call them because there is still an issue getting my Armour prescription filled. The representative got a pharmacist on the phone to inform me that “The FDA is requiring all manufacturers of desiccated thyroid drugs to get their products certified. Until such certification if obtained desiccated thyroid based treatments will be unavailable.”
On top of this bad news, they charged me for some Levoxyl I did not order, or want
I placed numerous phone calls today and here is what I’ve been told:
* Medco could not fill my Rx for either Armour or Naturethroid. They have an indefinite backorder due to a nationwide shortage of porcine-derived desiccated thyroid. And that I should ask my doctor if a synthetic thyroid medication, such as levothyroxine is right for me. What!???
I was also told by a Medco pharmacist that I should look at the FDA website for information regarding natural thyroid.
* All I found on the FDA website was a page titled, “Thyroid Medications: Q & A with Mary Parks, M.D. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107377.htm which made no mention at all about natural thyroid being a viable alternative to the synthetic thyroid that was being promoted. My search of the FDA’s website turned up only this link. Wow!
* Forest (the manufacturers of Armour) did not know when they would be able to ship out any of their product due to a lack of supply of porcine desiccated thyroid which is provided by the one and only national source, American Laboratories, Inc.
* If you look at American Laboratories, Inc.’s website, http://www.americanlaboratories.com/ under “Products”, “Thyroid”, you will see that you are unable to see the details of the product specifications for their thyroid products as you are able for their other products. ??? Something’s up there ???
* I placed a call to American Laboratories, Inc. as well as sent an inquiry via email, and have gotten no response from them as of the end of today.
I’m thinking an attorney of some sort would be helpful at this point.
I, like many of you who have posted here, have a medical necessity for natural thyroid supplementation, and have been taking Armour thyroid for a few years now. None of the above mentioned sources has even mentioned what might be wrong with a natural thyroid supplement such as Armour. Really, I would like to know the full truth behind this seemingly mysterious evolution of a set of circumstances which leaves us with no source of natural thyroid. Help! JO
It is clear to me now that Armour is not the brand I should be using. Sadly, there is no source of natural, pharmaceutical grade thyroid available at all. With no distribution date in sight…
I too have been a victim of Medco and this atrocious armour thyroid scandal. Bottom line is that it’s most likely not profitable for Medco to offer Armour and potentially for the manufacturer to make it. One point I had not seen brought up is whether the swine flu had anything to do with this. Has anyone heard of pigs being killed off in order to not spread the disease? * DEAR MANUFACTURER, GOVERNMENT, ETC.: PLEASE NOTE THAT SWINE FLU IS NOT TRANSFERRED THROUGH ARMOUR. Kindly continue to make armour, an Rx that has benefitted and not harmed its users for years. (Attorney?)
I talked to the people at RLC 2 weeks ago and they told me that they WILL NOT give any Nature-Throid or Westthroid to Medco until they retract the statement they made which lied about RLC no longer having desiccated thyroid (before they really DIDN’T have natural desiccated thyroid). so those of us who have the awful misfortune of Medco being our pharmacy, we’re going to be out of luck anyhow, even when desiccated thyroid becomes available again, unless we buy it from another source.
An ex medco employee is preparing to interview with several national news programs. After you see this, you will understand why medco cannot get their story straight. I am talking about video, audio and just how bad this company is. Trust me on this, you won’t believe your eyes in regard to how Ohio medco sites operate and how the NJ leadership turns a blind eye!
Thanks for the great info and posts.
How can I find out what the ex medco employee said during the interview with several national news programs? I’m interested. Also, I would like to know how the “NJ leadership turns a blind eye”–I’m here in NJ and want to ask them, in person, what they are up to. It’s time to organize.
PS: Are we on Twitter yet? We need to be!
According to the most recent article on this website, the FDA claims that natural desiccated thyroid products is not approved, Armour or otherwise, considers them not to be GRASE *or* Grandfathered. Looks like natural desiccated thyroid medication is on the way out! =/