"Patients should be told of any substitution before being made to pay for it," he said. "You should only have to pay what you agree to pay."
Jim Thornton, a health economist at Eastern Michigan University, said patients should be included in any decisions involving their treatment.
"I believe doctors should be required to consult patients before giving a pharmacy permission to make these sorts of drug substitutions," he said. "Pharmacies should be required to inform patients about drug substitutions so they have the option to seek out alternatives."
Christine Cramer, a CVS Caremark spokeswoman, declined to comment when I asked what rights patients should have in situations like Segal's.
But she said that, in response to my bringing Segal's dissatisfaction to the company's attention, "we are providing a credit for the difference in the co-pay." In other words, she'll be charged what she would have paid for her intended drug order.
That's nice, but it overlooks the fact that CVS did nothing when the customer herself brought up the matter. It was only after the prospect of bad publicity arose that the company was moved to act fairly.
Moreover, CVS' response doesn't address the potentially thousands of other customers who also may find themselves paying more for a substitute med they never requested or approved.
If Segal's complaint merited action, doesn't every other person in her position similarly deserve a credited refund? You'd think so.
Speaking of which, Adele Curcuruto, 55, told me that CVS refilled a prescription for her thyroid medicine recently even though she'd watched her doctor cancel the prescription online.
The Burbank resident called CVS to complain and was told that she had to cancel her automatic refill order separately. The company said she couldn't return the unwanted pills.
This is, of course, silly. If CVS' computers could receive word from Curcuruto's doctor about the canceled prescription, those computers should have no difficulty canceling all related services. It seems absurd to require patients to jump through such hoops themselves.
CVS' Cramer said that in response to my bringing this to the company's attention, Curcuruto will be allowed to return the drug refill for a full refund.
Deja vu all over again.