Mail Order is Not for Everyone

Survey after survey has confirmed that the overwhelming majority of patients prefer to obtain their medications from a local pharmacy. The PBM-owned mail service pharmacies are aware of this preference, so, they "hard sell" pharmacy benefit plans on prohibiting the use of community pharmacies. They even go so far as to slightly reduce the co-payment to incent the use of their out-of-state pharmacies. Additionally, the PBMs promise significant savings that are never guaranteed and are seldom delivered. (For more on this, see Mail Order False Economies.)

For the overwhelming majority of patients, mail service pharmacies are out-of-state operations. These are not traditional pharmacies. They look more like a factory with multiple machine-operated assembly lines that fill orders across 2-3 work shifts. If you have a concern, problem or question, you can send an email or call a 1-800 number to speak with an out-of state corporate pharmacist or technician. In most cases, you'll get a different corporate pharmacist or technician each time you call.

All factories make mistakes—that's why there are recalls for automobiles and other products. But unlike auto recalls, patients cannot bring medications that have already been shipped back to the factory.

There are other significant problems with reliance on mail service pharmacies. Patients that have been forced to purchase their medications from out-of-state pharmacies have reported delays in receiving their medications, temperature-sensitive drugs being left outside, drugs lost in transit, medication switching and even the wrong drug being shipped. This has caused patients to be unable to take medications that are vital to their health and well-being.

Moreover, patients taking multiple prescriptions that are filled through the mail are at high risk for non-adherence (not taking medications as directed by their doctors). Taking the medicine as directed by your doctor is the key point of drug therapy. A recent study shows that mandatory mail appears to cause some patients to discontinue therapy prematurely, particularly those without previous mail service pharmacy experience. Non-adherent patients can find themselves in the emergency room, doctor offices or hospital more often than patients taking their medications as directed by their doctors. This is a major issue because $290 billion is the estimated annual cost of non-adherence to the U.S. health system.