At the end of March, my PCP wrote two prescription refills for Semglee and Humalog. While she has written me prescriptions in the past, she often sends them to CVS for a 30-day supply rather than Express Scripts for a 90-day supply. During my appointment, I asked if she could write each prescription for a 90-day supply through Express Scripts, which she did without any issue.
Unfortunately, when I received my prescriptions a few days later, I noticed that Express Scripts only sent me one box of each insulin rather than two. After checking my prescriptions online, I noticed that the Semglee prescription was for 63 days and the Humalog prescription was for 50 days. As a result, Express Scripts only sent me one box each, but charged me the full copay for a 90-day supply.
Thinking that my PCP may have calculated the amount needed for a 90-day supply incorrectly, I called Express Scripts to verify what happened. After explaining that I thought my doctor wrote the prescription incorrectly, a pharmacist verified that I had the correct amount for 50/63 days, but couldn't answer why I was charged the full copay. At this point, I assumed my PCP made a mistake and I would have my endocrinologist write a new prescription at the end of April.
Last Friday, I met with my endocrinologist and she wrote two prescription refills for Semglee and Humalog. After explaining what happened with my last two prescriptions, she checked the prescriptions from my PCP and noted that everything looked correct. However, just to be sure, she deleted the prescriptions from the portal, wrote two new prescriptions, and double checked that each prescription was for a 90-day supply.
Fast forward to today, I received my prescription for Humalog. Upon opening the box, I noticed that Express Scripts only sent me one box. After checking my prescription online, I noticed that once again the day supply was for 50 days. Same amount as before and the exact amount I need for 50 days. At this point, I realized that neither my PCP and endocrinologist calculated the wrong amount, but Express Scripts was changing the prescriptions.
I immediately called Express Scripts and asked why they changed the day supply for my prescriptions. After talking to a pharmacist, they confirmed that my doctor wrote the prescription for the correct number of pens, but since each box only has five pens and they can't open a box, they decreased the day supply to match the number of days that one box of insulin will cover while still charging me the full copay for a 90-day supply.
Understanding that they can't open/send me a partial box, I explained that in the past, Express Scripts would always round up rather than down. Unfortunately, Express Scripts couldn't look up any of my past orders because all orders prior to March 2026 have mysteriously disappeared from my Order History. However, despite showing no orders prior to March 2026, I did find several order confirmation emails dating back to at least the beginning of 2025, but the pharmacist told me that even with an order number, she wouldn't be able to check since no orders were displaying on their end.
Out of curiosity, has this happened to anyone else? The pharmacist did say that I can ask my doctor to write the prescription for 30 mL, or two boxes, but wouldn't answer if their policy has recently changed because she couldn't look at my order history to see how my doctors have written the prescriptions in the past.
While my doctors could have written the prescription wrong, it's frustrating that Express Scripts automatically lowered the day supply of a 90-day prescription without contacting me first. Even more frustrating is the fact that my insurance covers two boxes without any issue, which leads me to think this is purely about profit because they could have easily contacted my doctor to update the prescription to cover two boxes.
TL;DR: Prior to March 2026, Express Scripts always rounded up for a 90-day supply and sent me two boxes of insulin. However, for the last two orders, Express Scripts has changed the prescription day supply to cover exactly one box of insulin while still charging me the full copay for a 90-day supply.