Another perspective on mail-order pharmacies

By - Last modified: October 11, 2012 at 8:50 AM

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It's American Pharmacists Month, and they're celebrating by deploring what they term “mail order pharmacy waste.”

Heather Stauffer

That is, the National Community Pharmacists Association has put together an 89-page PDF, of which 87 pages are photos of mail-ordered pharmaceuticals presented to physical pharmacies participating in the Dispose My Meds program.

Comments accompany some of the photos. Here's one:

"Just over $17,000 worth of meds from Medco Mail order. I hate to see what this person's company paid for these meds and what it did to his company's health premiums. Mail order facilities can shout from the rooftops about compliance all they want but just because you mail a person his/her meds, that doesn't mean they are taking them."

As arguments go, the PDF is heavy on emotional appeal and short on specifics. To effectively assess how much of a problem there really is, I'd want to know a lot more about each situation. The mere fact that there are glitches doesn't mean a system should be scrapped.

Also, frankly, there's the issue of motivation: I doubt anyone reading this will have a hard time figuring out why brick-and-mortar pharmacists might dislike mail-order ones.

However, there's more to the argument than just the photos. The Pennsylvania Pharmacists Association has issued some news releases making these points:

• Pharmacy benefit managers "are currently entirely unregulated in Pennsylvania."

• PBMs operate between insurance companies and pharmacies, a position of power that allows them to control "which pharmacies a patient can use, copay differentials, what pharmacies are paid, which drugs can be utilized and how many pills they can dispense."

• PBMs can do things like restricting community pharmacies to dispensing 30-day supplies while allowing mail-order pharmacies (which the PBMs may own) to offer 90-day supplies.

Ergo, PPA says, PBMs should be regulated.

I've heard the "mail-order pharmacies can get you your (legal) drugs cheaper" spiel a couple of times, and I have no reason to believe it's not true. But now it strikes me that providing drugs cheaper is not necessarily the same as reducing the overall cost of drugs.

What do you think?

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According to a Kaiser Family Foundation report issued earlier this year, the cost of prescription drugs is only 10 percent of total health expenditures but "has received considerable attention because of its rapid growth (114% from 2000 to 2010)."

Heather Stauffer covers Lancaster County, nonprofits and health care. You can reach her at 717-285-4237, 717-236-4300, ext. 289, or heathers@centralpennbusiness.com. Follow her on Twitter, @StaufferCPBJ.

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