By John Norton
Several publications have run what appears to be a mail order pharmacy advertisement, masquerading as a news story, entitled “A Pharmacy in Your Mailbox,” It lists five reasons why patients should use mail order pharmacies to fill prescriptions for maintenance medications – 90-day supplies of drugs for chronic conditions such as diabetes, hypertension, high cholesterol, etc. But as many consumers and health plans have discovered, mail order is not for everyone.
Let’s see what an authentic news report about mail order has to say. Drug Benefit News reports that “Although many PBMs and employee benefits consultants say plan sponsors should promote mail order both for convenience and potential savings, not all plan sponsors agree. The University of Michigan (UM) does not promote mail order for its employees, says Keith Bruhnsen, assistant director of the university’s benefits office and manager of its prescription drug plan.”
“‘UM began offering mail-order pharmacy [fulfillment] in 2003,’” Bruhnsen says. But despite using three different mail-order vendors, “our experience has been less than satisfactory. In our last customer satisfaction survey, mail order scored significantly lower than retail pharmacy services.”
“The problems with mail pharmacy have been mostly inadequate communication with members on the status of their orders; handling any exceptions (like larger supplies for travel); and delays due to prior authorizations, refill too soon, etc., he explains.”
If consumers care about great service and personalized care, there is no better place for consumers to have their prescriptions filled than at neighborhood independent pharmacies. A new pharmacy survey finds that 94 percent of consumers who shopped at independent drugstores were highly satisfied with their experience.
Some health plans encourage their beneficiaries to at least try mail order by picking up one of the three co-payments that patients owe for 90-day supplies of medications. Other health plans have taken away their members’ choice, basically mandating that consumers use only mail order for maintenance drugs. A study published in the Journal of the American Pharmacists Association finds that, among those consumers who have been forced to fill their prescriptions at mail order instead of local pharmacies, over two-thirds return to community pharmacies once those restrictions are lifted.
Saving money on maintenance medications is extremely important and the best way to achieve significant savings is through the appropriate use of generics. In 2009, the average cost of generic drugs was only a fourth of brand drugs – $35.22 for generic vs. $137.90 for a brand. Eighty percent of all drugs dispensed in 2010 were generics, and over the next couple of years some of the most highly utilized brand drugs will become available as generics.
Those consumers who are attracted to the reduced co-payments of mail order should know that during 2010, the average generic co-pay difference between mail and retail shrunk to just $3.61. That’s about 11 cents per day for 90-day supply. Patients have to sign up for mail. It doesn’t happen automatically. Many patients hate the associated paperwork because it’s time consuming and may not be worth the effort.
Mail is a tough sell to most consumers, but generics, where appropriate for the patient, offer a more effective cost savings strategy without some of the pitfalls associated with mail.