SPECIALTY PHARMACY FEEDBACK FORM

Use this form to provide feedback to your specialty pharmacy about what it is doing well or how it could improve. The Pulmonary Hypertension Association (PHA) receives a copy of your comments and shares them with our contact at your specialty pharmacy.

 This form is not for emergencies or case management. While the information provided through this form will be available to your specialty pharmacy, we encourage you to contact the patient support line at your specialty pharmacy about urgent issues. Because of the high volume of submissions, you might not receive an individual response from their specialty pharmacy.

You can also contact these specialty pharmacies by phone:

  • Accredo/CuraScript/ExpressScripts: 866-FightPH (866-344-4874)
  • AllianceRx Walgreens Prime: 800-445-3674
  • Cigna Tel-Drug: 855-326-7463
  • CVS/Caremark: 877-242-2738
  • Humana Specialty Pharmacy: 855-478-8405
  • OptumRx: 855-856-0536
Have you or your patient used a different pharmacy in the last 12 months for this drug? *

About how long have you been taking a PH medication delivered by a specialty pharmacy (include any specialty pharmacy that has delivered to you)?

Feedback Topics

Positive Feedback

My pharmacy did well in the following areas

Negative Feedback

Refill process
Billing
Call time
Medication delay and delivery concerns
Customer service skills
Are you currently experiencing a missed dose or are you at risk of missing your next dose of medication?

This form is not for emergencies or case management. Patients are encouraged to contact their specialty pharmacies in instances of missed doses.

Please share any other information about your experience with this topic, including any other organizations you have contacted for assistance and whether or not you have dealt with this topic before.

By checking this box, you give permission for the information provided in this form to be made available to the Advisory Board and your specialty pharmacy. If provided, your name and contact info will be used to assist you in resolving your issue.

Yes, I give permission.
Thank you for submitting your comments to the PHA-CVC Specialty Pharmacy Advisory Board. The comment will join a database of information to help the Advisory Board better understand PH patients’ interactions with their specialty pharmacies. If you shared your name and contact information, your specialty pharmacy may contact you directly to resolve your concern. If you do not choose to share contact information, your anonymous comment will still be reviewed and considered by the Advisory Board. If you have any questions, please contact us at Insurance@PHAssociation.org.
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