A Walgreen's pharmacy in another state is a defendant in a wrongful-death lawsuit filed by a teenager's survivors after the 19-year-old died when the pharmacy denied her prescription to fill a seizure medication.
The state high court gave a green light to the survivors' petition to sue the nationwide pharmacy even though Walgreens maintains there was no legal obligation for the pharmacist to contact the woman's physician to obtain pre-authorization documentation.
At the heart of the litigation is a central question — whether the pharmacy has an obligation to help patients verify whether their insurance will cover their prescriptions.
The woman was epileptic and was prescribed the anticonvulsant Topamax to manage life-threatening seizures. Her insurance company covered her medication. Until nine years ago, her family members never had any problems picking up refills at a local Walgreen's.
Once the young woman turned 19, her insurer required her physician to pre-authorize the medicine in order for it to continue to be covered. Walgreen's informed her family about the new requirement and told them that without insurance, her medicine would cost $399.99, which was unaffordable.
Walgreens offered to fax the doctor's office for the required pre-authorization form — a routine practice, according to court documents. Yet, after five subsequent trips back to Walgreen's, the family members were still denied the pre-authorization necessary to refill the woman's medication.
Caught between a rock and a hard place, the family called the doctor's office repeatedly to resolve the matter.
Expert testimony indicated that the common practice of pharmacies contacting doctors' offices is "typical of the industry," according to the court decision. Her physician maintained they were "never notified by pharmacists or family members about the need for prior authorization in this case."
The woman succumbed to the last of three seizures that she suffered as a result of being denied her medication. She died in October of 2009.
Other defendants in the case are the prescribing physician and his practice.
It can seem impossible to take on one of the nation's leading pharmacy chains, but if you lost a beloved family member due to a denial of a covered medication, you may be able to prevail in court.
Source: CNN, "Family can sue Walgreens over woman's death after insurance denial, court says," Jen Christensen, June 08, 2018