By Kayla Yup | Photographs by Andrew Spear for WSJ
Constance Nicastro-Bowman lost hope that her father's medications would ever arrive.
Ralph Nicastro, 78 years old, takes 12 prescription drugs a day for conditions including diabetes, high blood pressure and depression. He and his daughter waited over two months this year for CarelonRx Pharmacy, a digital pharmacy, to send refills. They didn't come.
CarelonRx did, however, deliver a diabetes drug called Farxiga that Nicastro-Bowman hadn't ordered. It billed her $84 and said it wouldn't release her father's medications until she paid. She did. His refills still didn't come. Instead, CarelonRx sent a diabetes medication her father no longer took.
"That's when I got really upset," she said.
Elevance Health, the nation's second-largest health insurer by market share, opened its new digital pharmacy, CarelonRx Pharmacy, in January. It said it would help patients order prescriptions to their homes in a few clicks. Customers could track shipments and contact a pharmacist at any time, Elevance said.
Since January, customers have logged hundreds of negative reviews and complaints against CarelonRx. Some reported spending hours on the phone tracking down medications long after they needed them. Others said CarelonRx sent them the wrong medications entirely.
Elevance said it has improved its technology to fill prescriptions promptly and cut call-center wait times. "We sincerely apologize for the inconvenience and strain this has caused some home delivery customers," Elevance said.
Digital bust
Online pharmacies and other consumer-health startups boomed during the pandemic. Venture funding in digital-health startups surged to $29 billion in 2021 from $14 billion a year earlier, according to Rock Health, an advisory and venture fund.
But the digital revolution hasn't arrived, and some companies haven't delivered the convenience they promised. The share of adults who reported using telemedicine decreased from 37% in 2021 to 30% in 2022, the National Center for Health Statistics found. Funding for digital-health startups dropped to $11 billion last year.
Pear Therapeutics, the first company to win Food and Drug Administration approval for a software-based prescription treatment, filed for bankruptcy in April 2023. Babylon Health, a digital-health startup once valued at $2 billion, went bankrupt in August 2023. And Health IQ, an AI-powered insurance company, went bankrupt a couple of weeks later.
"What's happening now is a bit of a retrenching," said Megan Zweig, president of Rock Health Advisory, the digital-health strategy arm of Rock Health.
Elevance wanted in on the digital wave. It said CarelonRx Pharmacy would help people keep on top of their prescriptions and lower costs. The platform was a bid to compete with retail pharmacies and the growing number of online competitors.
Paul Marchetti, who was then president of CarelonRx, said in January that he expected the percentage of Elevance customers getting refills by mail to more than triple over the next few years. He said CarelonRx might even require customers to order some prescriptions by mail.
Marchetti's LinkedIn posts have been inundated with comments from upset customers. He left CarelonRx this spring.
Left waiting
Donnie Walton, a 51-year-old loan officer from Troy, Tenn., relies on two medications to help his heart pump enough blood to his body. He first called CarelonRx Pharmacy to fill his prescriptions on Jan. 24.
A representative pledged to call his doctor to verify his prescriptions. His doctor didn't receive a request. Walton spent hours calling CarelonRx Pharmacy every few days. One representative gave him an order number, and the next told him the order didn't exist.
CarelonRx's website says that first-time orders should reach a patient's home in two weeks and that refills should take three to five days. Walton received his order 46 days after he placed it.
Eventually, his doctor called in an emergency prescription to a local pharmacy. Walton posted on X about his ordeal, he said, to make a record of it: "Because who knows, I mean, what if I'd have died?"
Wrong drugs
Nicastro-Bowman had gotten her father's medications from Elevance's previous mail-order pharmacy, CarelonRx Mail, since last year. When she tried to order refills on Jan. 1, his prescriptions didn't appear on the website. Elevance had shifted records to CarelonRx Pharmacy's platform, but for Nicastro, the transfer failed.
She and her sister spent more than 200 hours calling CarelonRx trying to order their father's refills. Representatives said they would file complaints and promised to follow up. They didn't. The website said the order was processing, but nothing arrived. Nicastro-Bowman only reached a pharmacist by calling the line for doctors instead of customers.
In late January, her father's refills were still missing. That is when CarelonRx errantly sent a diabetes medication called Actos to Nicastro's home in Dublin, Ohio. The drug lowers the level of sugar in one's blood. He was taken off it in June 2023 after his blood-sugar levels dropped so low that he fell into a diabetic coma.
"It was insanely frustrating and an extremely dangerous situation," Nicastro-Bowman said. Nicastro relies on his daughters to manage his care because he is deaf and has aphasia, a condition that impairs his ability to use language.
In March, Nicastro-Bowman switched her father to a Medicare plan managed by Humana. Its mail-order pharmacy has filled his prescriptions without a hitch.
"We cut our losses and just said we're done," she said.
Write to Kayla Yup at kayla.yup@wsj.com
(END) Dow Jones Newswires
July 04, 2024 05:30 ET (09:30 GMT)
Copyright (c) 2024 Dow Jones & Company, Inc.
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