Formulary activated

     In May of this year, I was notified of new changes to my Prescription Plan, as per the new contract.  The letter says there will be changes to what we will be paying, as well as the addition of "step therapy."  All of this language was foreign  to me, though I pretty much knew the "changes" meant I would be paying more. We were invited to ask questions to help us understand, but  I let the matter rest  until it arose in real time.  The letter explained that the 3-Tiers allows us to make informed choices and encourages values when choosing prescriptions.  The Step-Therapy encourages judicious and appropriate use of medications.  Sounds as if it's for the good of the subscribers, but of course, it's just a way to cheapen the benefits.
   When I was discharged from the hospital last  Thursday, I was given scripts for 2 medications: Percoset and Celebrex.  The Rite Aid pharmacist said she could not fill the Celebrex Rx until she contacted the prescribing physician.  This drug needs "Prior Authorization."   The reason is to  protect the patients because these drugs have clinical value for only a narrowly defined population, they have potentially serious side effects if used inappropriately and have high potential for misuse or abuse due to consumer advertising or a general lack of understanding on how to use the drug most safely and effectively.  Take that, Celebrex!  Prior authorization "helps assure that the  clinical situation of the patient, including the underlying condition, is appropriate for the use of that particular drug."   "The process involves a  review by our pharmacy management clinical team."   All this to protect us. 
    Today, Monday July 14, I received a call from Ortho NY.  She said that the "process of review" typically takes a week or more, and that I would be off the Celebrex by then, so she kindly offered to send me some sample packets.  They'll be put in the mail Tuesday morning. 
It's so reassuring to know that we're being saved from Big Pharma by Big Insurance Co.  I hope Celebrex was not critical to my healing.  And now I know what that letter meant, and I didn't have to ask a single question.